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MHD 1 > L8 Neoplasia III > Flashcards

L8 Neoplasia III Flashcards

1
Q

Tumors begin as monoclonal; what happens next?

A

Sub-clones arise from the descendants of the original transformed cell by multiple mutations; these cells have specific evasive functions.

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2
Q

___ agents inflict genetic damage.

A

Carcinogenic

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3
Q

What are three types of carcinogenic agents?

A
  1. Chemicals
  2. Radiant energy
  3. Microbial agents
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4
Q

What is the difference between direct acting and indirect acting chemical carcinogens?

A

Direct acting require no metabolic conversion; indirect acting require metabolic conversion

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5
Q

Carcinogenicity may be augmented by promoters - what are these?

A

Non-tumorigenic compounds which facilitate the induction of cell proliferation in the initiation-promotion sequence

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6
Q

Given the toxin, name the organ affected and the resultant cancer: vinyl chloride

A

Liver; angiosarcoma

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7
Q

Given the toxin, name the organ affected and the resultant cancer: nitrosamine (smoked foods)

A

Stomach; gastric cancer

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8
Q

Given the toxin, name the organ affected and the resultant cancer: asbestos

A

Lung; mesothelioma, bronchogenic carcinoma

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9
Q

Given the toxin, name the organ affected and the resultant cancer: arsenic

A

Skin; squamous cell carcinoma

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10
Q

Given the toxin, name the organ affected and the resultant cancer: napthalene (analine) dyes

A

Bladder; urothelial carcinoma

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11
Q

Given the toxin, name the organ affected and the resultant cancer: aflatoxin B

A

Liver; hepatocellular carcinoma

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12
Q

What are some sources of radiation carcinogenesis?

A
  1. Sunlight (UV)
  2. X-rays
  3. Nuclear fusion/ionizing radiation
  4. Fission by-products
  5. Radionucleotides
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13
Q

How does ionizing radiation act as a carcinogen?

A

Chromosome breakage, translocations, point mutations, all leading to genetic damage

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14
Q

What type of cancer is associated with ionizing radiation?

A

Papillary carcinoma of the thyroid

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15
Q

How does UV light act as a carcinogen?

A

Damages DNA by forming pyrimidine dimers

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16
Q

What type of cancer is associated with UV light?

A

Skin, squamous cell, basal cell, and melanoma

17
Q

True or false - radiation initiation is reversible due to its long latent period.

A

False - it is irreversible despite a long latent period

18
Q

What is the defect in xeroderma pigmentosum?

A

Defect in nucleotide excision repair pathway; increased disposition to skin cancer

19
Q

What is a type of RNA virus that can cause cancer, and what type?

A

Human T-cell lymphotropic virus (HTLV-1) –> T cell leukemia/lymphoma

20
Q

What are 3 types of DNA viruses that can cause cancer, and what type?

A
  1. HPV –> benign warts, cervical cancer
  2. Epstein Barr Virus (EBV) –> Burkitt lymphoma, nasopharyngeal carcinoma
  3. Hepatitis B/C –> hepatocellualr carcinoma
21
Q

What is a type of bacteria that can cause cancer, and what type?

A

Helicobacter pylori –> gastric adenocarcinoma, MALT lymphoma

22
Q

What are the 4 major anti-tumor effector mechanisms?

A
  1. Cytotoxic T lymphocytes
  2. NK cells
  3. Macrophages
  4. Humoral mechanisms
23
Q

___ patients are at an increased risk for cancer development.

A

Immunosuppressed

24
Q

What are several ways cancers can evade the immune system?

A
  1. Eliminate strongly immunogenic sub-clones.
  2. Fail to express HLA class I, escape cytotoxic attack
  3. Suppress host immune response by secreting TGF-beta, expressing FasL, and activating tRegs.
25
Q

What are some effects of the tumor on the host?

A
  1. Compress structures
  2. Ulcerate through surfaces
  3. Affect hormone production
  4. Cancer cachexia
26
Q

What are symptom complexes that cannot be readily explained by local or distance spread?

A

Paraneoplastic syndromes

27
Q

What is grading of a tumor?

A

An attempt to estimate the aggressiveness of the tumor based on cytologic differentiation

28
Q

What 4 aspects are considered when grading a tumor?

A
  1. Degree of cellular differentiation
  2. Degree of cellular pleomorphism
  3. Degree of loss of normal architecture
  4. Mitotic index
29
Q

How are tumors staged according to size?

A 
CIS (carcinoma in situ) - confined to epithelium
T1 - through basement membrane
T2 - into muscle
T3 - into fat
T4 - out of tissue
30
Q

How are tumors staged according to the extent of spread to lymph nodes?

A

N0
N1
N2
N3

31
Q

How are tumors staged according to metastasis?

A

M0 - none

M1 - metastasis

32
Q

Which is of greater clinical value - staging or grading?

A

Staging

33
Q

What are two major tumor associated markers?

A
  1. Alpha-fetoprotein (AFP)

2. Carcinoembryonic antigen (CEA)

34
Q

What cancers are associated with AFP?

A

Liver carcinomas, tumor of yolk sac remnants, gonadal tumors

35
Q

What cancers are associated with CEA?

A

Colon, pancreas, lung, stomach, breast

36
Q

Tumor associated markers are most useful for what?

A

Detecting recurrence of disease

MHD 1 (58 decks)

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