Monday - Dr. Nelson - Hypersensitivity Reactions and molecular basis of cancer

Question 1

Reactive follicular hyperplasia

Answer 1

Just means that the follicles of a lymph node (where the B cells are) are enlarged because they are reacting to a pathogen

Question 2

How can you tell the difference between a B lymphocyte reactive proliferation and a monoclonal (neoplastic proliferation)

Answer 2

“B lymphocyte immunoglogulin gene rearrangement analysis”

Also can look at the kappa lambda ratio

…also can look at the protein serum electrophoresis

Question 3

Ratio of light chains usually seen when you do a flow cytometry of a lymph node

What does an abnormal ratio imply?

Answer 3

1.5 kappa/1 lambda

abnormal ratios imply there is some sort of monoclonal neoplasm

Question 4

Ratio of lypmocytes in the peripheral blood

Answer 4

~85% T cells

~15% B cells

Question 5

What type of response would you see looking at an electrophoresis of plasma from a cirrhotic alcoholic

Answer 5

polyclonal immunological response (gamma fraction increases in general)

albumin might also be low

Question 6

Atopy

Answer 6

refers to the predisposition to develop immediate hypersensitivity reactions

Question 7

immediate part of a hypersensitivity reaction

late-phase reaction

Answer 7

immediate: vasodilation, congestion, edema

Late-phase: inflammatory infiltrate rich in eosinophils, neutrophils, T cells.

Question 8

when do you see fibrinoid necrosis

Answer 8

in immune complex formation and deposition into tissues of vessels (type III hypersensitivity)

neutrophils digest this deposition, causing the tissue to become necrotic and full of fibrin.

Question 9

What are you thinking if you see low C3 levels of comlement?

Answer 9

low levels indicate disease. The complement is being used up to fight a pathogen (can be low in type III hypersensitivity)

Question 10

Foreign body granulomas

Answer 10

see foreign material within histiocytes/giant cells, sometimes called “foreign body giant cell reaction”

Question 11

histiocyte

Answer 11

just a macrophage that has transformed into an “epithelial-like” cell because of a pathogen

Question 12

Caseating granulomas

Answer 12

Granulomas that induce cell mediated immune response with central necrosis; these are usually associated with infection (e.g. mycobacterial, fungal infection)

infection that is difficult to erradicate

Question 13

non-caseating granulomas

Answer 13

Granulomas that induce cell mediated immune response without central necrosis (e.g. sarcoidosis, crohn’s disease)

Question 14

four types of genes typically mutated in cancer

Answer 14

Growth-promoting proto-oncogenes

Growth-inhibiting tumor suppressor genes

genes that regulate programmed cell death

genes involved in DNA repair

Question 15

RAS

Answer 15

mutation in ras causes uncontrolled DNA creation

Question 16

HER2/neu

Answer 16

epidermal growth factor receptor that is over expressed in 25% of breast cancer

Question 17

warburg effect

Answer 17

Even in the presence of ample oxygen, cancer cells participate in fermentation.

used in diagnostics, (pet scan, give radioactive glucose)

Question 18

BCL2

Answer 18

increases in BCL2 cause the cell to be able to bypass apoptosis.

can make cancer resistant to chemo

Question 19

breast cancer metastasis

Answer 19

liver and bone mostly

Question 20

What chromosome is immunoglobulin expressed on that usually has a translocation in lymphomas

Answer 20

14

Question 21

can you get cancer from one mutation?

Answer 21

no, you need more than one complementary drive mutation in order to get cancer, Even though some mutations are diagnostic for some cancers.