MoD - neoplasia

Question 1

what is neoplasm?

Answer 1

abnormal growth of cells that persist after removal of initial stimulus

Question 2

what is grading used for?

Answer 2

planning treatment and estimating prognosis

Question 3

what are the different types of grading?

Answer 3

G1: well differentiated
G2: moderately differentiated
G3: poorly differentiated
G4: undifferentiated or anaplastic

Question 4

which carcinoma uses the Bloom Richardson grading system?

Answer 4

breast cancer

Question 5

what does the Bloom Richardson grading system assess?

Answer 5

tubule formation
number of mitoses
nuclear pleiomorphism (nuclear variation)

Question 6

which cancers use grading?

Answer 6

primary brain tumours, lymphomas, breast & prostate

Question 7

what are the dukes staging used for?

Answer 7

colorectal carcinoma

Question 8

what are the different dukes staging?

Answer 8

A: invasion onto the wall
B: invasion through the wall
C: node involvement
D: distant metastasis

Question 9

What is tumour staging used for?

Answer 9

measure of the malignant neoplasms’ overall burden

Question 10

what are the different tumour staging systems?

Answer 10

Ann Arbor
TNM
Dukes

Question 11

what are the 4 stages of cancer?

Answer 11

1; early local disease

2: advanced local disease
3: regional metastasis (node involvement)
4: advance disease with distant metastasis

Question 12

Describe the TNM staging?

Answer 12

T: size 1-4 (size of primary tumour
N: regional node involvement 0-3
M: distant metastatic spread 0-1

Question 13

which cancer uses the Ann Arbor staging?

Answer 13

lymphoma

Question 14

describe the ann arbor staging

Answer 14

1. single node
2. 2 nodes but same side of diaphragm
3. nodes spread to both sides of diaphragm
4. diffuse or disseminated involvement (organ involvement)

Question 15

which cancers are screened in the UK?

Answer 15

BBC

breast, bowel, cervical

Question 16

which tumour markers are released by testicular tumours?

Answer 16

HCG released into circulation

Question 17

which cancer marker released by hepatocellular carcinoma?

Answer 17

alpha foetoprotein

Question 18

which cancer marker for prostate cancer?

Answer 18

PSA

Question 19

which marker for ovarian cancer?

Answer 19

CA 125

Question 20

what are the different treatment types for cancer?

Answer 20

radiotherapy (rapidly dividing cells, trigger apoptosis through free-radical induce DNA damage)
chemotherapy (alkalytaing, platinum drugs, plant-derived drugs, antibiotics)
hormone therapy (tamoxifen bind to oestrogen receptors preventing oestrogen from binding)
neoadjuvant (before surgery - reduce size of primary tumour)
adjuvant (after surgery - eliminate subclinical disease)

Question 21

what are the 6 hallmarks of cancer?

Answer 21

self sufficiency in growth signalling e.g. RAS / HER2
resistance to growth stop signals (CDK gene deletion)
grow indefinitely (telomerase)
induce new blood vessels (VEGF)
resist apoptosis (BCL2)
invade & produce metastases (e-cadherin mutation)

Question 22

what is tumour suppressor gene?

Answer 22

inhibit neoplastic growth

need both aleles to be mutated to inactivate

Question 23

what prevents apoptosis cascade from occurring?

Answer 23

mutation to BCL-2 (both alleles - type of TSG)

Question 24

what is the function of p53?

Answer 24

recognises DNA damage and induces apoptosis

Question 25

what is the function of RB protein?

Answer 25

cell cycle checkpoint between G1 and S

looks for DNA damage and induces apoptosis prior to DNA replication in S phase

Question 26

what are oncogenes?

Answer 26

enhance neoplastic growth

1 allele inactivated for the mutation to occur

Question 27

what is the function of RAS?

Answer 27

activates cyclin to enter cell cycle
cyclin bind to CDK, cyclin-CDK complex phosphorylates protein RB to allow the cell cycle to be pushed beyond RB

RAS is an oncogene

Question 28

what is the function of c-myc?

Answer 28

TF role in cell cycle progression and upregulates cyclin

(encourages cell to be pushed past

Question 29

what is function of HER2?

Answer 29

DNA damage repair

when mutated aposes apoptosis