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Disease and Defense: Unit 2 > Major Cancers in Adults > Flashcards

Major Cancers in Adults Flashcards

1
Q

Small cell lung cancers are associated with what syndrome?

A

Paraneoplastic syndrome

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2
Q

A patient presents with Cushings syndrome, hypercalcemia and gynecomastia. This patient is 40 years old and has a 25 pack year smoking habit. What would be on your DDX?

A

Small cell lung cancer with paraneoplastic syndrom

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3
Q

A patient comes in with acites, back pain, and unexpected painless jaundice. She is 66 years of age and has been drinking since she was 15 and smoked a pack a day since she was 16 years old.. What should be on your differential diagnosis?

A

Pancreatic cancer

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4
Q

Where would you likely find metastases if the primary cancer started in the pancreas?

A 
Lung 
Liver
Perigastric
Peri-aortic
Omental lymph nodes
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5
Q

What is a whipple procedure?

A

Removal of a large part of the pancreas, common bile duct, gall bladder, and duodenum

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6
Q

Name one situation in which invasion of the basement membrane does not precede metastasis.

A

When the cancer is directly sheeding into and seeding body cavities e.g. Ovarian carcinoma

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7
Q 
Benign or Malignant?
Never invades or metastasizes
Can be encapsulated
Can overproduce proteins that are harmful 
And have a uniform appearance
A

Benign tumors

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8
Q

Give two examples in which a benign tumor can be dangerous.

A
  1. If growing inside a confined space

2. If overproducing proteins that are harmful e.g. Insulin which can lead to hypoglycemia

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9
Q

What is the strongest predictor of prognosis?

A

Stage

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10
Q

Define stage.

A

The extent of tumor spread at the time of diagnosis

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11
Q

What is the TNM classification system?

A

Tumor- size
N- Lymph Node envolved
M- Metastases

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12
Q

Describe “T” in the TNM classification system.

A

1-4 scale on tumor size
4- Biggest and with the most involvement
Tis- Tumor is “in situ” and still confined to the epithelium

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13
Q

Describe “N” in the TNM classification system.

A

Lymph Node involvement.
No= No involvement
N1-4 Increasing degrees of lymph node involvement

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14
Q

Describe “M” in the TNM classification system

A

Presence of metastasis
Mo= no evidence of distant metastasis
M1= evidence of distant metastasis

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15
Q

Define grade

A

Refers to the state of differrentiation of the tumor cells seen in histological section

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16
Q

What does low grade mean?

A

The cells are well differentiated and exhibit features of normal cells

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17
Q

What does high grade mean?

A

The cells do not resemble “normal” epithelial cells. They are usually pleomorphic, anaplastic, and the nuclear:cytoplasmic ration is high. Usually mitotic figures may be seen

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18
Q

What are some signs and symptoms of cancer?

A

Extreme weight loss, loss of appetite, fatigue, infection

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19
Q

Name some symptoms of lung cancer.

A

Present with coughing, difficulty breathing, secondary pneumonia, chest pain, persistent hoarseness, facial swelling, weight loss.

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20
Q

What two lung cancers are strongly linked to cigarette smoke?

A

Squamous and small cell

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21
Q

Where do most squamous cell carcinomas occur in the lung?

A

Centrally. Because they arise from areas of squamous metaplasia and dysplasia in the major brances of the bronchial tree where pseudostratified columnar is replaced with squamous epithilium

22
Q

Name some characteristics of squamous cell carcinoma

A
  • Quite large
  • Necrotic and hemorrhagic near the center of the lesion
  • Moderately well differentiated. Stain for keratin
  • Form Keratin pearls
23
Q

How do lung cancers usually spread?

A

Through the lymphatics or blood supply

24
Q

Which of the four lung cancers has the best prognosis?

A

Adenocarcinoma

25
Q

Adenocarcinomas are found most often in what patient population?

A

Women

Non-smokers

26
Q

Where do andenocarcinomas form?

A

Either centrally or in the periphery
In areas of previous scarring
Cells grow out of the alveolar septae

27
Q

Unlike squamous cell carcinomas, which stain positive for keratin, adenocarcinomas stain positive for….

A

mucin

28
Q

What mutations are commonly found in squamous cell carcinomas?

Adenocarcinoma?

A

P53 mutations and loss of Rb, inactivation of p16

K-Ras

29
Q

What are large cell carcinomas?

A

An undifferentiated, high grade lung cancer in which the anaplastic appearing cancer cells may not produce either keratin or mucin

30
Q

This cancer can arise anywhere in the lung. It is NOT treated surgically, has no glandular or squamous differentiation, and cells are small and dark staining that form clusters.

What is this cancer?
What does it stain positive for?

A

Small cell lung cancer

neuroendocrine markers

31
Q

Describe colorectal cancer.

A

Well differentiated cancer arising from the innermost, mucosal layer of the bowel. They form from pre-existing adenomatous polyps

32
Q

How do colorectal carcinomas spread?

A

Hematogenous or lymphogenous

33
Q

What are the two major types of neoplastic colonic polyps?

A
  1. Tubular adenoma

2. Villous adenoma

34
Q

When would you start to worry about a polyp developing cancer cells?

A

When it is over 3cm

35
Q

What are the general symptoms of colorectal cancer?

A 
Abdominal pain
Blood in the feces
Anemia
Jaundice
Cachexia
36
Q

What colorectal tumors can grow to a larger size, ones that develop in the right or left colon?

A

Right colon cause the feces is more fluid

37
Q

What symptoms would present to a patient with a left colorectal tumor?

A

Constipation
Change in stool caliber
Obstruction
Apple core lesion

38
Q

Where do colorectal cancer cells usually metastasize?

A

Liver

39
Q

What is early vs. late treatment of colorectal cancer look like

A

Early- Hemi- or total colectomy

Late- chemotherapy with 5-fluouracil

40
Q

Name some risk factors of colorectal cancer

A 
Age
family Hx
alcohol consumption
obesity 
diet rich in animal fats
inflammatory bowel disease
41
Q

Name three inherited risks of developing colorectal cancer.

A
  1. Familial adenomatous polyposis (FAP)
  2. Hereditary nonpolyposis colorectal cancer- loss of mismatch DNA repain
  3. Loss of mutY base excision DNA repair enzymes
42
Q

What is the most common cause of cancer in men?

A

Prostate carcinoma

43
Q

Would prostate carcinoma cause problems with urine voiding?

A

Not usually. That is more common with benign prostatic hypertrophy.

44
Q

What is benign prostatic hypertrophy?

A

Enlarge central peri urethral region region

45
Q

What are the two risk factors for prostatic carcinoma?

A

Age

African American

46
Q

How would you diagnose prostate carcinoma?

A

Ultrasound or elevated PSA beyond patients normal baseline

47
Q

How does prostate carcinoma progress?

A

Starts with protstatic intraepithelial neoplasm (PIN) then progresses with loss of tumor suppression genees (PTEN and glutathione transferase)

48
Q

Name three biological behaviors of prostate cancer.

A
  1. Quiescent disease
  2. Can track up the nerves
  3. Can be an aggressive disease that is fatal
49
Q

What is the treatment for prostate carcinoma?

A

Prostatectomy with or without radiation therapy

Or. Antiandrogen therapy

50
Q

What is a common metastatic site for prostate cancer?

A

Bone

Disease and Defense: Unit 2 (12 decks)

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