Lec 01 Basic Neoplasia Flashcards
According to Galen, the excess of this humor causes cancer.
A. blood B. phlegm C. yellow bile D. black bile E. saliva
D. black bile
blood = inflammation phlegm = pneumonia yellow bile = jaundice black bile = cancer saliva not part of the 4 humors
ID: First tumor classification made by Andreas Vesalius.
immovable vs movable
T/F: William Halsted’s radical mastectomy patients had the same survival rates compared to patients who declined surgery.
T.
- too much tissues removed
- led to chronic pain and edema
- metastases not removed
Enumerate the 6 hallmarks of malignancy according to Hanahan and Weinberg (2000).
self-sufficiency in growth signals insensitivity to anti-growth signals evading apoptosis limitless replicative potential sustained angiogenesis tissue invasion and metastasis
Genes that keep the integrity of the genome mainly include
A. oncogenes
B. tumor suppressor genes
C. DNA repair genes
D. apoptosis-related genes
C. DNA repair genes
True of oncogenes EXCEPT
A. promote cell proliferation
B. recessive
C. highly conserved and always turned off
D. may be overridden by tumor suppressor genes
E. NOTA
B.
Oncogenes are DOMINANT.
Activation of proto-oncogenes occur during
A. hepatitis B. wound-healing C. embryonic stage D. A&B only E. AOTA
E. AOTA
Proto-oncogenes are activated whenever there is a need for proliferation.
RAS belongs to what category of oncogenes
A. growth factors B. growth factor receptors C. signal transducers D. transcriptional activators E. cell cycle regulators
C. signal transducers
Point mutation that leads to production of stop codon
A. missense mutation B. nonsense mutation C. silent mutation D. frameshift deletion E. frameshift insertion
B. nonsense mutation
Instead of glycine, what amino acid is produced in codon 12 of bladder CA with HRAS mutation?
A. valine B. lysine C. leucine D. glycine E. serine
A. valine
CGC to CTC
ID: This mutation in lung CA is indicative of poor prognosis.
KRAS
A deletion frameshift mutation moves the reading frame to the:
A. left B. right C. no change D. either A or B E. down
A. left
deletion - left
insertion - right
Which of the following results in a longer mRNA strand?
A. incomplete removal of an intron B. incomplete removal of an exon C. complete removal of an intron D. complete removal of an exon E. AOTA
A. incomplete removal of intron
Introns should be COMPLETELY removed.
You DON’T remove exons.
ID: In the absence of p53, frayed ends of two different chromosomes may join together especially when the telomeres are already eroded. This pathway is called:
non-homologous end junctions (NHEJ) pathway
ID: The BCR-ABL fusion gene is also known as:
Philadelphia chromosome
ID: The BCR-ABL fusion gene is inhibited by what targeted therapy molecule?
imatinib mesylate
HER2 in breast cancer is a form of
A. translocation mutation B. splice mutation C. amplification mutation D. point mutation E. recombination mutation
C. amplification mutation
multiple copies of HER2 gene > overexpression of receptors > highly sensitive > poor prognosis
ID: What enzyme coverts viral RNA to viral DNA inside the cell?
reverse transcriptase
Which is TRUE about tumor suppressor genes?
A. recessive and highly conserved B. mutation probability is 1:1M C. always kept on D. A&B only E. AOTA
E. AOTA
T/F: Mutated oncogenes + normal tumor suppressor genes will not be malignant.
T
TSGs overrides oncogenes.
Which is not a regulator of the cell cycle?
A. APC B. TP53 C. RB D. CDKN2A E. NOTA
A. APC
APC is an inhibitor of WNT signalling.
True of Knudson’s two-hit hypothesis EXCEPT:
A. wild type tumor suppressor genes needs two hits
B. loss of heterozygosity leads to malignancy
C. inherited TSG mutations needs two hits
D. 2nd hit may be from deletion
E. NOTA
C.
When you have an inherited mutated TSG, you only need ONE other hit.
ID: Phenomenon wherein deactivation of just 1 copy of a TSG allele (1 hit only) will lead to expression of malignancy.
haploinsufficiency
It means that 2 normal TSG alleles are needed for proper functioning.
NF2 gene product which mediates contact inhibition.
A. TGF-B B. neurofibromin C. merlin D. E-cadherin E. NOTA
C. merlin
Neurofibromin is a product of NF1.
E-cadherin also mediates contact inhibition but is not a product of NF2.
Activates epithelial-mesenchymal transition in late stage tumors.
A. TGF-B B. neurofibromin C. merlin D. E-cadherin E. NOTA
A. TGF-B
Which of the following is NOT involved in DNA repair?
A. MSH2 B. PMS2 C. BRCA1 D. KIT E. NOTA
D. KIT
KIT is an oncogene.
ID: These are tandem repeats of one to six nucleotides that arise from inefficient repair and replication resulting in increased mutations of oncogenes and TSGs.
microsatellite instability
T/F: DNA repair genes are also governed by the two-hit hypothesis.
T
Guardian of the genome:
A. p21 B. p53 C. RB D. RAS E. NOTA
B. p53
Most common genetic alterations found in human cancer.
A. p21 B. p53 C. RB D. RAS E. NOTA
B. p53
To facilitate repair, p53 associate itself with what protein?
A. p21 B. p53 C. RB D. RAS E. BCL2
A. p21
p21 = repair
BCL2 family = apoptosis
Which is anti-apoptotic?
A. BCL2 B. BAX C. BAD D. BAK E. BID
A. BCL2
BAX, BAK, BAD, BID are pro-apoptotic
ID: These effector proteins denature the interior of the cell and are the final executioner of apoptosis.
caspases
ID: Overexpression of BCL2 is found in:
follicular lymphoma / B-cell lymphoma
ID: Number of times a normal human cell will divide until cell division stops.
Hayflick limit
ID: Ribonucleotide protein which preserves the integrity of telomeres.
telomerase
Which is the most potent inducer of angiogenesis in a tumor?
A. lack of nutrients
B. hypoxia
C. space
D. hypoglycemia
B. hypoxia
If tumors are highly vascularized, then why can it also hamper chemotherapy?
Vessela are not well-developed. They are thin-walled, friable, and leaky.
ID: Dual effect of neovascularization.
(1) perfusion (oxygen + nutrients)
(2) secretion of growth factors
ID: Inhibitor of VEGF.
bevacizumab
ID: Side effects of anti-angiogenic agents.
hypertension, proteinuria, delayed would healing
ID: These are normal cells that provide support and maintenance of functional tumor vasculature.
pericytes
ID: Most important hallmark of malignancy.
invasion and metastasis
ID: What two process define invasion and metastasis? These may occur even before clinically detectable disease.
loss of E-cadherin
elaboration of proteases
Which is NOT a consequence of epithelial-mesenchymal transition?
A. loss of adherens junction B. increased motility C. resistance to apoptosis D. expression of degrading enzymes E. NOTA
E. NOTA
ID: Three main features of invasion.
(1) cell adhesion to basement membrane
(2) local proteolysis of membrane
(3) movement of tumor cell outside basement membrane
Method of spread of choriocarcinoma.
A. contiguous B. lymphatic C. hematologic D. nervous E. NOTA
C. hematologic
Hematologic route is the most malignant.
This type of invasion is characterized by morphologic plasticity of cells.
A. mesenchymal B. collective invasion C. amoeboid D. class struggle E. espionage
C. amoeboid
What are the two ENABLING characteristic hallmarks of cancer?
A. genomic instability
B. tumor-promoting inflammation
C. evading immune destruction
D. reprogramming energy metabolism
Select 2 answers.
A. & B.
C. & D. are emerging hallmarks.
ID: Process by which tumor cells prefer glycolysis even in the presence of oxygen.
aerobic glycolysis
ID: Why do tumor cells favor aerobic glycolysis?
(1) The nutrient supply is not secure (due to poorly formed vessels).
(2) Produce metabolites for other synthetic pathways.
This effect occurs in glucose-dependent cells that secrete lactate.
A. Warburg effect B. Hamburg effect C. Salzburg effect D. Nurburg effect E. Cheesybaconburg effect
A. Warburg effect
ID: Reason for the development of the ability to evade immune detection and destruction.
natural selection
Highly immunogenic tumor cells are killed out leaving weakly immunogenic cells that can evade the immune system.
T/F: Tumor cells secrete immunosuppressive factors.
T
ID: Number 1 cause of death and treatment failure.
metastasis
T/F: Well-differentiated tumors tend to be more aggressive.
F
Well diff tumors tend to spread by direct means and are slow growing.
ID: This type of adhesion occur between tumor cells and blood cells, particularly platelets.
heterotypic adhesion
Enumerate (4) conditions that must be fulfilled before metastasis.
self-renewal
evasion of apoptosis
overcome hypoxia
evade immune system
ID: This hypothesis states that increased genetic instability leads to more mutations and production of new subclones in the tumor that have increased malignant capacity.
Nowell’s hypothesis
ID: A mutation that is present in all clones of the tumor.
driver mutation
The first event in the pathogenesis of polyposis colon cancer.
A. loss of APC
B. KRAS mutation
C. 18q mutation
D. loss of p53
A. loss of APC
True of somatic mutations:
A. inheritable B. take more time to manifest C. less common than germline mutations D. NOTA E. AOTA
B. take more time
Somatic are NON-HERITABLE and MORE COMMON than germline.
Hereditary cancers involving tumor suppressor genes are inherited in what manner?
A. autosomal dominant
B. autosomal recessive
C. Y-linked
D. X-linked
A. autosomal dominant
The INHERITANCE is dominant.
The PATHOGENESIS / EXPRESSION is recessive.
Hereditary cancers involving DNA repair genes are inherited in what manner?
A. autosomal dominant
B. autosomal recessive
C. Y-linked
D. X-linked
B. autosomal recessive
First person to discover association between environmental carcinogen and malignancy.
A. Bernardo Ramazzini
B. John Hill
C. John Snow
D. Percival Pott
D. Percivall Pott
True of initiation in carcinogenesis EXCEPT.
A. rapid B. reversible C. genotoxic D. requires at least one round of cell division E. NOTA
B.
The initiation is IRREVERSIBLE.
ID: 3 properties of promotion phase of carcinogenesis.
reversible
dose-dependent
time-dependent
ID: Most notorious carcinogen.
tobacco
The carcinogenic effects of alcohol and tobacco is:
A. additive B. subtractive C. synergistic D. no effect E. AOTA
C. synergistic
alcohol - 3x
smoking - 3x
alcohol + smoking - 35-40x
ID: Only bacteria implicated in malignancy.
Helicobacter pylori
