MOD Etc. I Flashcards
When I think of Burkitt lymphoma, I must think of:
MYC
La-Fraumeni syndrome is associates with what mutation?
p53
Which cancer is associated with an overexpression of BCL2 due to a (14;18) translocation?
Follicular B cell leukemia
How do cancers create their own circulation?
Hypoxia induces angiogenesis through HIF-a leading to increased VEGF.
VEGF inhibitors can be used to treat some advanced cancers.
HNPCC syndrome
Defects in mismatch repair, leading to development of carcinomas of the colon.
Hereditary nonpolyposis colorectal carcinoma
What gene products can cause genetic instability leading to lymphoid neoplasms? (3)
RAG1, RAG2, AID
What is the function of long intervening noncoding RNA (linc-DNA)?
They regulate the activity of chromatin by modifying histones and thereby control gene expression.
What are direct carcinogens?
They require no metabolic breakdown to become toxic. Most are weak, but some may be omportant because they are cancer chemotherapeutic drugs. Those agents can delay recurrence/onset of certain cancers, but lead to a secondary form of cancer, usually acute myeloid leukemia.
Indirect carcinogens
Carcinogens that require metabolic breaksdown to become carcinogenic
What is the most common secondary cancer?
AML
What breaks down most carcinogens?
CYP-450-dependent mono-oxygenases
What does aflatoxin B1 do?
It is a chemical carcinogen produced by Aspergillus that can target a hotspot and lead to hepatocellular carcinoma.
What does HTLV-1 infect?
CD4+ cells
What are 3 AIDS defining malignancies?
Kaposi sarcoma, B cell non Hodgkin lymphoma, cervical cancer
What are the 2 most common EBV associated tumors?
Burkitt lymphoma
Nasopharyngeal carcinoma
H. pylori can lead to (2):
Gastric adenocarcinomas and gastric lymphomas
Cancer cachexia is associated with (3):
Equal loss of fat and muscle
Elevated BMR
Systemic inflammation
5 neoplastic syndromes
Endocrinopathies Hypercalcemia Neuromyopathic Acanthosis nigricans Hypertrophic osteoarthropathy
Cushing syndrome-type features is associated with which malignancy?
Small cell carcinoma of the lung
What malignancy is associated with hypercalcemia?
Squamous cell carcinoma
Migratory thrombophlebitis is associated with which cancers?
Carcinomas of pancreas and lung
DIC is associated with which cancer?
Acute promyelocytic leukemia
Staging of tumors 0/4 , 0/3, 0/2, T0
0/4 tumor
0/3 nodes
0/2 mets
T0 CIS
What are the trends for:
CVD Cancer Neonatal diseases Diarrhea-related disease HIV/AIDS
CVD - up Cancer - up Neonatal diseases - down Diarrhea-related disease - down HIV/AIDS - up slightly
4 categories of DZs that are worsening w/ climate change:
CVS/repiratory
GI infections/foodborne/waterborne DZs
Vector-borne DZs
Malnutrition
P-450 reaction w/ carbon tetrachloride creates:
Trichloromethyl free radical in the liver
Where do particulates larger than 10 um removed from?
The nose or trapped in mucociliary epithelium of the airways.
How does CO kill?
CNS depression -> widespreak ischemic changes, primarily at the basal ganglia and lenticular nuclei.
Where is Pb found?
Paint
Soil
Occupational: batteries, pigments, radiators, tin cans
Pb poisoning in adults
In kids:
Adults: peripheral neuropathies -> wrist drop, then foot drop.
Kids: intellectual, behavioral, hyperactivity, poor organization.
What can ensue from Pb poisoning at the kidneys?
PCT damage -> interstitial fibrosis and renal failure
Where are lead lines found?
At joints and gums
Minamata disease
Due to Mg poisoning and leads to cerebral palsy, deafness, blindness, MR and CNS damage to kids in utero.
What organs does Mg affect?
CNS (developing brain) and kidneys
Where is Mg found?
Fish and vapors from dental amalgams
Where is arsenic found?
GI
NS
Skin
Heart
Where is arsenic found?
Soil and water
Wood preservatives
Herbicides
Herbal meds
Where is cadmium toxic?
How?
Kidneys and lungs
How do the following toxicities occur?
Pb
Mg
Ar
Cd
Pb: binds sulfhydryl groups in proteins and interferes w/ Ca++ metabolism.
Mg: sulfhydryl groups.
Ar: interferes with cellular metabolism.
Cd: increasing ROS
Where are chloroform and carbon tetrachloride found?
Degreasing and dry cleaning agents
Paint removers
What does acute vs. chronic exposure to chloroform and carbon tetrachloride cause?
Acute: dizziness and confusion -> CNS depression and coma.
Chronic: toxic to liver and kidneys.
Benzene and 1,3-butadiene increase the risk for:
Acute myeloid leukemia
Vinyl chloride word association:
Angiosarcoma of the liver
Dioxins and PCBs cause:
Folliculitis and a dermatosis = chloracne (acne, cysts, hyperpigmentation, hyperkeratosis, etc.)
How long does the excess risk of smoking exist for after quitting?
30 yrs
What is a multiplier of tobacco use?
What cancers can occur?
Alcohol.
Laryngeal and oral cancers.
10x higher incidence of lung carcinomas in which 2 settings with smokers?
Asbestos workers
Uranium miners
3 effects of maternal smoking:
Spontaneous abortions
Preterm births
IUGR
Multiplicative effect on MIs when combined with:
Smoking w/ HTN and hypercholesterolemia
What leads to the steatosis in alcoholics?
Increased NADH -> increased lactic acid levels
Risks associated w/ oral contraceptives (3)
Cervical cancer
Venous thrombosis
Hepatic adenoma
Analgesic neuropathy
HA, dizziness, tinnitus, bleeding, coma from chronic aspirin use.
Acetaminophen is usually metabolized to non toxic (95%). What happens in the other 5%?
CYP2E1 -> NAPQ -> protein and lipid damage -> necrosis and liver failure
5 determinants of ionizing radiation
Rate of delivery Field size Cell proliferation O2 effects and hypoxia Vascular damage
Curie
Gray
Sievert
Curie - radiation emitted
Gray - energy absorbed
Sievert - takes into account the relative biological effectiveness in association w/ Ci and Gy.
2 big effects of total body ionizing radiation
Chronic radiation dermatitis
Mediastinal fibrosis after radiotherapy for lung carcinoma
Vit A functions:
Deficiency syndromes:
Vit A functions: vision, maintenance of epithelia, resistance to infection.
Deficiency syndromes: night blindness, squamous metaplasia, vulnerability to infection.
Vit D deficiency causes:
Osteomalacia in adults and Rickets in kids
Thiamine (Vit B1) deficiency syndromes (2)
Beriberi, Wernicke-Korsakoff
Niacin deficiency syndrome
Pellegra - dementia, dermatitis, diarrhea
Vit B6 (pyridoxine) deficiency syndromes (5)
Cheilosis Glossitis Dermatitis Peripheral neuropathy Myelination of SC
Which patients can have a secondary Vit A malabsorption?
Patients with fat malabsorption - celiac, Crohn’s, CF, bariatric surgery)
Hypocalcemic tetany is a sign of:
Vit D deficiency
Features of zinc deficiency
Rashes around eyes, mouth, nose and anus.
Anorexia and diarrhea
Poor growth
Depressed mental function
Features of copper deficiency
Muscle weakness
Neuro defects
Abn collagen cross-linking
Features of iron deficiency
Hypochromic microcytic anemia
Features of iodine deficiency
Goiter, hypothyroidism
Features of fluoride deficiency
Dental caries
Features of selenium deficiency
Myopathy
Cardiomyopathy
What is pickwickian syndrome?
A hypoventilation syndrome associated with obesity
Sources of:
Leptin
PYY
Ghrelin
Leptin - adipose, inhibits hunger signals
PYY - intestines, decrease food intake
Ghrelin - stomach, stimulates appetite
