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NBDE PART 1 MICRO/PATH > Micro/Path Neoplams > Flashcards

Micro/Path Neoplams Flashcards

1
Q

most deadly form of skin cancer (most deaths from skin disease)

A

melanoma

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2
Q

the development of melanoma is related to

A

sun exposure

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3
Q

Melanoma has 2 growth stages: radial (initial) and vertical (later phase) which phase has metastatic potential

A

vertical. = tumor invades (vertically) downward (vs initial radial where it moves horizontally)

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4
Q

in radial phase = horizontal spread of melanoma in epidermis, tumor cells lack the capacity to

A

metastasize. (think R - radial comes before V = vertical) and also makes sense that at first they haven’t metastasized

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5
Q

superficial spreading melanoma is the most __ type of melanoma. ___ phase predominates

A

common. radial phase predominates = large flat irregularly pigmented lesion

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6
Q

nodular melanoma is the most __ type of melanoma,__ phase predominates

A

aggressive.

vertical growth phases = poorest prognosis

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7
Q

lentigo maligna melanoma occurs on ___skin. __- phase predominates. most often develops from pre existing lentigo maligna called

A

sun exposed, radial growth phase, Hutchinson freckle

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8
Q

Acral- lentiginous melanoma is the __ form of melanoma

A

least common. arise from pigmented lesions on the palm, sole or under the nail.

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9
Q

pheochromocytomas are neoplasms made of __ cells

A

pheochromocytomas = chromaffin cells = synthesize catecholamines ( epinephrine (adrenaline), norepinephrine (noradrenaline) and rarely dopamine made from tyrosine)

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10
Q

pheochromocytomas cause surgically correctable hypo/hypertention

A

hypertention (think catecholamines = epinephrine = SNS)

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11
Q

pheochromocytomas rule of 10:

  1. 10% of pheochromocytomas are ___
  2. 10% of sporadic adrenal pheochromocytomas are __
  3. 10% of adrenal pheochromocytomas are biologicaly ___
  4. 10% of adrenal pheochromocytomas are not associated with __
A
  1. extra adrenal = called parangangliomas
  2. bilateral
  3. malignant
  4. hypertention

so, they are mostly adrenal, non malignant, cause hypertention

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12
Q

___may be associated with MEN (multiple endocrine neoplasia), neurofibromatosis (von Recklinghausen’s disease), or von Hipple-Lindau disease - multiple hemangiomas

A

pheochromocytomas

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13
Q

most common malignant tumor of childhood

A

neuroblastoma =catecholamine producing tumor originating from adrenal medulla

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14
Q

First symptoms in this disease is a LARGE ABDOMEN, SENSATION OF FULLNESS AND ABDOMINAL PAIN. FOLLOWED LATER BY AN ABDOMINAL MASS. THIS TUMOR CUASES HYPERTENTION

A

NEUROBLASTOMA

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15
Q

____Can convert to more differentiated form called ganglioneuroma

A

neuroblastoma

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16
Q

most malignant neoplasm of lungs

A

bronchogenic carcinoma

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17
Q

bronchogenic carcinoma spreads first to _ then to

A

Spreads to lymph nodes then liver/brain/bone (think LLBB) = lymph liver brain bone

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18
Q

___ carcinomas form a mass in the periphery of the lung

A

adenocarcinoma

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19
Q

epidermoid (squamous cell) carcinoma is a type of bronchogenic carcinoma most common in men/women and closely related to

A

men and smoking

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20
Q

adenocarcinomas are smaller than bronchogenic carcinomas and located in the __ of the lung. and most common in men/women, smoker/non?

A

periphery, women non smokers

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21
Q

___ is the most aggressive and highly malignant form of bronchogenic carcinoma.

A 
small cell (oat cell) carcinoma
Usually has already metastasized at time of diagnosis
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22
Q

___carcinoma is composed of large undifferentiated malignant cells with variable location

A

large cell (anaplastic) carcinoma

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23
Q

____ is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that generally arises from cells originating in the endodermal or ectodermal germ layer during embryogenesis. More specifically, a carcinoma is tumor tissue derived from putative epithelial cells

A

carcinoma

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24
Q
  1. Most cancers are cancers of the ___. 2. Cancers of the epithelial cells are called ___.
A
  1. epithelial cells
  2. carcinomas
    Carcinomas make up about 85 out of every 100 cancers (85%).
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25
Q

different types of epithelial cells can develop into diff kinds of cancer:
where are these:
1. Squamous cell carcinoma (of squamous cells)
2. Adenocarcinoma (of glandular cells)
3. Transitional cell carcinoma (of transitional cells)

A
  1. Flat, surface covering cells called squamous cells - for example, the skin or the lining of the throat or food pipe (oesophagus).
  2. Glandular cells called adenomatous cells - for example, kidney cells or breast cells
  3. Layers of stretchy cells called transitional cells - for example, the lining of the bladder
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26
Q

Connective tissue is the name for the supporting tissues of the body - the bones, cartilage, tendons and fibrous tissue that support the body organs. Connective tissue cancers are called ___

A

sarcomas

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27
Q
  1. Sarcomas are much___common than carcinomas. They are usually grouped into two main types - bone sarcomas (osteosarcoma) and soft tissue sarcomas. Altogether, these make up less than 1 in every 100 (1%) cancers diagnosed.
  2. Cancer of the cartilage is called __,
  3. cancer of a muscle is called ___
A
  1. less
  2. chondrosarcoma
  3. rhabdomyosarcoma
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28
Q
  1. Cancers of the blood cells - 2. Cancers of the lymphatic system - __
A
  1. leukemia

2. lymphomas

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29
Q

Burkitt’s lymphoma involves __ organs and is closely linked to __ virus

A

abdomenial,

Epstein Barr virus (herpes simplex virus 4)

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30
Q

Non-Hodjkins Lymphoma = malignant tumors of lymph system. Most are B/T cell origin?

A

B

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31
Q

which cancer is associated with HIV, helicobacter pylori, EBV, herpes virus 8

A

non-hodjkins lymphoma

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32
Q

first indication of malignant lymphoma is

A

swelling of the lymph glands

enlarged tonsils and andenoids, painless nodes

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33
Q

as malignant lymphoma progresses symptoms

A

fatigue, malaise, weight loss, fever, NIGHT SWEATS

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34
Q

Burkitt’s lymphoma is an aggressive B/T cell lymphoma

A

B cell

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35
Q

the___ form of Burkitt’s lymphoma involves the maxilla or mandible.

A

african

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36
Q

the __ form of Burkitt’s lymphoma involves the abdominal organs

A

american

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37
Q

Reed Sternberg cells are found in patients with ___ disease

A

Hodgkin’s lymphoma

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38
Q

Does malignant lymphoma have Reed Sternberg cells

A

no

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39
Q

malignant lymphoma show a STARRY SKY appearance of non neoplastic ___

A

macrophages

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40
Q

how can you differentiate bw malignant lymphoma and hodgkins disease

A

biopsy

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41
Q

extra-nodal presentation common in hodgkins/non hodgkins lymphoma

A

non

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42
Q

the ___ form of Burkitt’s lymphoma is most closely associated with EBV (95% of cases) and affects children of ___ regions. Usually begins as a LARGE MASS IN THE JAW

A

African form

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43
Q

the __ form is less closely associated with EBV and usually begins as AN ABDOMINAL MASS. tumors of the jaw are rare

A

American form

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44
Q

invasion of dermis by sheets and islands of neoplastic epidermal cells with “KERATIN PEARLS” and related to sun exposure (mostly), chemical carcinogens such as arsenic, and radiation is characteristic of

A

squamous cell carcinoma

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45
Q

which is ore aggressive tumor:

basal cell carcinoma or squamous cell carcinoma

A

squamous cell carcinoma bc can metastasize if untreated

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46
Q

squamous cell carcinoma (SCC) is most common on sun exposed sites in later life with ulcerated lesions on the lower/upper lip and ear are most aggressive

A

lower lip

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47
Q

SCC develops from what pre cancerous condition relating to sun exposure around the lips

A

actinic cheilitis

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48
Q

SCC = cancerous changes to __ cells

A

keratinoctyes (middle portion of epidermal skin layer)

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49
Q

SCC is most often __ invasive

A

locally. but can metastasize into lymph channels

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50
Q

SCC resembles what other cancer in histologic appearance and biological behavior

A

cervical cancer

to remember think: sCC = CC (cervical cancer)

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51
Q

malignant epithelial cells have an increased number of ___ receptors

A

Laminin = a glycoprotein in the basement membrane that promotes cell adhesion, migration, growth and differentiation

52
Q

90% of all malignant cancers of the ORAL CAVITY ARE?

A

SQUAMOUS CELL CARCINOMA (SCC)

53
Q

Cirrhosis is most common in men or women

A

men

54
Q

most common invasive cancer in humans

A

basal cell cacinoma

55
Q

basal cell carcinoma is the most common invasive cancer in humans but do they metastasize

A

rarely

56
Q

is basal cell carcinoma ulcerative and indurated ( become firm or hard especially by increase of fibrous elements) and locally destructive

A

yes

57
Q

___ carcinoma present as pearly papules containing prominent dilated subepidermal blood vessels (telangiectasias)

A

basal cell carcinoma

58
Q

why are basal cell carcinomas (BCC) aka rodent ulcers

A

bc can ulcerate and locally invade bone or sinuses after many years of neglect

59
Q

prognosis for BCC is

A

good = usually cured with surgery

60
Q

basal cells are normal skin cells that may develop cancerous changes causing a __ that is painful/painless

A

painless lump. a new skin growth that ulcerates bleeds easily or does not heal well hints it may be BCC

61
Q

darkly staining PALISADE ARRANGEMENT of nuclei cells at periphery of tumor cell is seen in

A

BCC

62
Q

a __ is a stable, heritable change in the nucleotide seq of DNA resulting in an alteration in the products coded for by the gene

A

mutation

63
Q

3 kinds of mutations:

  1. ___ one base is inserted in place of another = results in a missense or non sense mutation
  2. ___ occurs when one or more base pairs are added or deleted
  3. ___ insertion sequences or deletions integrated into DNA
A
  1. base substitution
  2. frame shift mutation
  3. transposons
64
Q

mutations are caused by

A

chemicals, ionizing radiation, uv light, viruses

65
Q

BENZPYRENE = chemical found in __ that binds to DNA bases and causes __ mutations

A

tobacco smoke = frame shift mutation

66
Q

___ produce free radicals that can attack DNA bases

A

ionizing radiation (gamma and xrays)

67
Q

UV light has lower energy than xray = causes what damage?

A

cross-linking of the adjacent pyrimidine bases to form dimers Uthymine dimers result in inability of the dna to replicate properly)

68
Q

____ virus causes frame shift mutations or deletions

A

bacterial virus Mu (mutator bacteriophage)

69
Q

cells with high/low proliferation are more sensitive to radiation

A

high

70
Q

lymphocytes, bone marrow blood forming cells, reproductive cells and epithelial cells in GI tract are high/low radiosensitive cells

A

high bc proliferate a lot

71
Q

nerve cells, mature bone cells, and muscle cells are low/high radiosensitive cells

A

low, bc don’t regenerate much

72
Q

what part of GI tract is the most common site of malignancy? least common?

A

most common is the colon. least common is the small intestine (makes up 75% of overall length of GI tract)

73
Q

most common malignancy of the colon is sarcoma/adenocarcinoma/lymphoma

A

adenocarcinoma

74
Q

most common malignancy of the SI is sarcoma/adenocarcinoma/lymphoma/carcinoid tumor

A

adenocarcinoma and carcinoid > lymphomas and sarcomas

75
Q

colorectal adenocarcinoma represents 15% of all cancer related deaths in US and is second to? common in what age? men/women

A

lung cancer

60-70 y/o males

76
Q

most colon cancers begin as

A

benign polyps that after many years develop into cancer. predisposing factor is ulcerative colitis

77
Q

increased serum concentration of carcinoembryonic antigen (CEA) is related to what cancer

A

colorectal cancer

78
Q

up to 4x increase in colorectal cancer if

A

relatives have the disease

79
Q

a low fiber diet that is high in __ may predispose you to colorectal cancer

A

animal fat.

80
Q

what part of colon is most common site of colorectal cancer

A

sigmoid colon

81
Q

colorectal cancer: tumors on the __ side usually cause constipation and destruction while tumors on the __ side usually do not obstruct early

A

descending (LEFT) = obstruct

ascending (RIGHT) = not obstruct early

82
Q

Most common cancer in men

A

prostate

83
Q

which cancer causes the most deaths in both men and women

A

lung

84
Q

how can you confirm prostate cancer

A

biopsy

85
Q

Prostate specific antigen (PSA) and acid phosphatase are elevated in

A

prostate cancer

86
Q

most prostate cancers are adenocarcinoma/sarcoma?

A

adenocarcinoma

87
Q

nodular hyperplasia of prostate:
benign or malignant?
causes?
is it premalignant?

A

benign enlargement of prostate due to hyperplastic nodules of stroma and glands distorting the prostate.
causes urinary tract obstruction.
It is NOT PREMALIGNANT

88
Q

most common neoplasm in women?

A

leiomyomas =

89
Q

Leiomyosarcoma is the malignant type.

Leiomyoma = __ type

A

benign

90
Q

good prognosis. profuse, painful menses and infertility are characteristic of this cancer

A

leiomyomas

91
Q

cause of fibroid tumors are unknown. however it is suggested that fibroids may enlarge with

A

estrogen therapy (oral contraceptives) or pregnancy = shrink after menopause.

92
Q

most common pelvic tumor

A

uterine fibroids

93
Q

___arise from arrector pili muscles found in skin, nipples, scrotum, and labi

A

leiomyomas

94
Q

neoplasms of muscles are rare but when encountered they are usually malignant/benign

A

malignant

95
Q

rhabdomyosarcoma = malignant/benign neoplasm from SKELETAL (STRIATED) MUSCLE

A

poor prognosis
malignant
affects throat, bladder, prostate, vagina

96
Q

the benign variety can arise in ___skeletal muscle of the body.

A

any

97
Q
  1. most common cancer in men

2. most common cancer in women

A
  1. prostate

2. breast

98
Q

strongest association w increased risk for breast cancer is

A

family history = esp in first degree relatives: mom/sister/daughter

99
Q

breast cancer occurs more commonly in which breast and in what quadrant

A

outer upper quadrant of left breast

100
Q 
early menarche
late menopause
obesity
first pregnancy after 30 years of age
diet high in animal fat
positive family history
history of breast cancer in one breast
proliferative fibrocystic disease with atypical epithelial hyperplasia are all predisposing factors to
A

breast cancer

101
Q
  1. A painful/painless mass in the breast is usually initial sign of breast cancer.
  2. retraction of ___
  3. peau d’orange
  4. enlarged
A
  1. painless
  2. nipple/skin
  3. swollen pitted skin
  4. axillary lymph nodes
102
Q

most valuable prognostic predictor of breast cancer

A

lymph node involvement

103
Q

___ of breast is most common cause of clinically palpable breast mass in women 28-44 years old

A

fibrocystic disease

104
Q

5 year survival rate of bronchogenic carcinoma is

A

10% = leading cause of death from cancer in both men and women

105
Q

Reed Sternberg cells = neoplastic cells of ___

A

Hodgkins lymphoma

reed sternberg are binucleated/multinucleated giant cells with eosinophilic inclusion like nucleoli

106
Q

first sign of Hodgkin lymphoma

A

enlarged lymph node

107
Q

Hodgkin lymphoma affects young/old more? women/men

A

young men

except for nodular sclerosis = more in young women

108
Q

Non Hodgkin lymphoma is a malignant lymphoma characterized by the absence of

A

Reed Sternberg cells

109
Q 
benign/malignant:
well differentiated
slow growth
encapsulated/well circumscribed
localized 
movable
A

benign

110
Q

benign/malignant:

less well differentiated (anaplastic)
rapid growth
invasion
metastasis
immovable
A

malignant

111
Q

“punched out” bone lesions
bence jones protein (urine with immunoglobin light chains-kappa or lamda)
B-cell proliferation

A

multiple myeloma = plasma cell neoplasm

elderly

112
Q

NON-MALIGNANT cell growth. May proceed to malignant changes in the tissue. Associated w chronic irritation to tissue by a chemical agent, ie cigarette smoke or by chronic inflammatory inflammation. Tissue appears disorganized, atypical cells w/o invasion. Epithelium exhibits acanthosis = abnormal thickening of prickle cell layer.

A

dysplasia

113
Q

substitution of one tissue normally found at a site for another. GERD = ex

A

metaplasia

114
Q

Most common type of epithelial metaplasia is replacement of __ cells by ___epithelium

A

columnar

stratified squamous

115
Q

desmoplasia =

A

neoplasms that form fibrous stroma that makes tumor feel hard on palpation.

116
Q

Most common primary MALIGNANT tumor of BONE:

A

osteogenic sarcoma

117
Q

choristoma

A

benign mass of normal tissue MISPLACed WITHIN another organ

ex liver tissue in intestinal wall

118
Q

hamartoma

A

benign tumor like overgrowth of cell types that are regularly found within the affected organ. ex. hamangioma = irregular accumulation of bv’s

119
Q

Ewing sarcoma and primitive neuroectodermal tumor (PNET) are two variants of the same tumor but differ in the degree of neural differentiation:

  1. tumors that demonstrate neural differentiation are
  2. tumors that are undifferentiated are
A
  1. differentiated = PNET’s
  2. undifferentiated = Ewing sarcoma

distinction has no clinical signifigance

120
Q
  1. most common malignant bone tumor

2. 2nd most common

A
  1. osteosarcoma

2. Ewing sarcoma (undifferentiated neural tissue)

121
Q

majority of Ewing sarcoma are in ages 10-20 and result from

A

chromosome rearrangement

122
Q

Ewing sarcoma patients present with

A

severe bone pain

123
Q

Schilling test used to detect

A

pernicious anemia

124
Q

you need __ and ___ for dna synthesis

A

vitamin B-12 and folate

125
Q

you need __ for heme synthesis

A

iron

NBDE PART 1 MICRO/PATH (20 decks)

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