Neo Part 2 Flashcards

1
Q

Familial cancers

A

Breast
Ovarian
Colon

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2
Q

Inhereted autosomal dominant cancer

A

Familial retinoblastoma (40% familial)

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3
Q

Autosomal recessive

A

Xerodermal pigmentosim

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4
Q

Features that characterize familial cancers include:

A

early age at onset
tumors arising in two or more close relatives
sometimes multiple or bilateral tumors

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5
Q

cancers that are not associated with specific marker phenotypes, e.g. The transmission pattern is not clear.

A

Familial

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6
Q

cancers can be linked to the inheritance of mutant genes. Examples include linkage of BRCA1 and BRCA2 genes to familial breast and ovarian cancers.

A

Familial

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7
Q

Acquired Preneoplastic Disorders

A

Regenerative
Hyperplastic

Atrophic

Ulcerative

Dysplastic

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8
Q

Acquired Preneoplastic Disorders in:

hepatocellular carcinoma in

endometrial carcinoma in

Lung cancer in

gastric carcinoma in

colorectal carcinoma in

A

Regenerative (e.g. hepatocellular carcinoma in cirrhosis)
Hyperplastic (e.g. endometrial carcinoma in endometrial hyperplasia)
Dysplastic (e.g. Lung cancer in bronchial dysplasia)
Atrophic (e.g. gastric carcinoma in atrophic gastritis)
Ulcerative (e.g. colorectal carcinoma in ulcerative colitis)

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9
Q

Clinical Features of Neoplasia

A
Local effect
   Pressure effect
   Functional activity (e.g. hormone synthesis)
   Bleeding
   Infection
Cachexia (wasting) 
Paraneoplastic syndromes
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10
Q

loss of body fat and body mass associated with weakness, anorexia, and anemia
Often correlates with tumor size and extent of metastases

A

Cachexia

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11
Q

Origin of cancer cachexia is multifactorial:

A

reduced calorie intake due to loss of appetite
increase in basal metabolic rate
central effects of tumor on hypothalamus, probably related to macrophage production of TNF & IL-1

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12
Q

Symptoms other than cachexia that cannot be explained by local or distant spread of the tumor They appear in 10-15% of patients with cancer

A

Paraneoplastic Syndromes

Most common ones: hypercalcemia, Cushing syndrome, and nonbacterial thrombotic endocarditis

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13
Q

Paraneoplastic Syndromes Often associated with the following neoplasms:

A

bronchogenic and breast cancers and hematologic malignancies

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14
Q

Paraneoplastic Syndromes

A
Endocrinopathies
Neuromyopathies
Osteochondral Disorders
Vascular Phenomena
Fever
Nephrotic Syndrome
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15
Q

Cushing’s Syndrome

Mechanism and example

A

ACTH Like substance

Lung oat cell carcinoma

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16
Q

Hyponatremia Mechanism and example

A

Inappropriate ADH secretion

Lung oat cell carcinoma

17
Q

Trousseau’s Syndrome

Mechanism and example

A

Hyper coagulable state

Various carcinomas

18
Q

Endocrinopathies

A

Hypercalcemia

Hypoglycemia

Carcinoid syndrome

Polycythemia

WDHA syndrome watery diarrhea, hypokalemia, and achlorhydria

19
Q

Causes of hypercalcemia in cancer:

A

Hormonal (e.g. PTHrP synthesis in squamous cell lung carcinomas)
Osteolytic metastatic disease of bone (e.g. metastatic breast carcinoma)
Tumor-derived factors (e.g. TGF-α, that activates osteoclasts and the active form of vitamin D)

20
Q

Hypoglycemia - caused by

A

tumor over-production of insulin or insulin like activities

Fibrosarcoma, Cerebellar hemangioma, Hepatocarcinoma

21
Q

Carcinoid syndrome - Caused by

A

serotonin and bradykinin produced by the tumor

Bronchial carcinoids, Pancreatic carcinoma, Carcinoid tumors of the bowel

22
Q

Neuromyopathies

A

Myasthenia - A block in neuromuscular transmission possibly caused by host antibodies against the tumor cells
(e.g. Bronchogenic carcinoma)

23
Q

Osteochondral Disorders

A

Hypertrophic osteoarthropathy and clubbing of the fingers

e.g. Bronchogenic carcinoma

24
Q

Vascular & hematoligical changes

A

Hyper-coagulability leading to:
venous thrombosis (Trousseau’s phenomenon) e.g.Pancreatic and bronchogenic carcinomas
nonbacterial thrombotic endocarditis
e.g. sterile vegetations on valves that occur with advanced carcinomas.
Anemia (e.g. Thymic neoplasms)

25
Fever
Associated with bacterial infections Common where blockage of drainage occurs Not associated with infection Likely caused by response to necrotic tumor cells and/or immune response to necrotic tumor proteins.
26
Nephrotic Syndrome
probably caused by damage to renal glomeruli by tumor antigen-antibody complexes.
27
What Are The Final Complications Of Malignancy (Causes Of Death)
``` metastases cachexia severe anemia, throbocytopeina hypercoagulability rupture into major vessels e.g. bleeding compression of vital organs organ failure e.g. renal failure infection e.g. pneumonia ```
28
Tumor Diagnosis
``` History and Clinical examination Imaging - X-Ray, US, CT, MRI Tumor markers- laboratory analysis Cytology –Pap smear, FNAB Biopsy - Histopathology. Molecular Tech – Gene detection. ``` Immunohistochemistry Flow cytometry Electron microscopy In Situ Hybridization
29
Tumor markers: sometimes diagnostic or prognostic Some serological markers associated with malignant tumors
``` hCG AFP Calcitonin Prolactin CA 125 PSA ```
30
hCG associated with
Choriocarcinoma
31
AFP
hepatocellular carcinoma
32
Calcitonin
Thyroid medullary carcinoma
33
Prolactin
Pituitary adenomas
34
CA 125
Ovarian cancer
35
PSA
prostate carcinoma