Neofuckingplasia - Putthoff Flashcards by Jes Testa | Brainscape

Q

Cancer by incidence in US

A

Breast/prostate
Lung
Colorectal

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Q

Cancer by mortality in US

A

Lung
Breast/prostate
Colorectal

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Q

Should you smoke cigarettes? Why or why not?

A

Nope.
Cause it will fucking kill ya.
Very painfully

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Q

3 things that define neoplasia

A

Uncontrolled
Irreversible
Monoclonal

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Q

What is the proof for monoclonality?

A

G6PD enzyme isoforms

–it has multiple isoforms, one inherited from each parent, only one present in ALL tumor cells

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Q

Metaplasia

A

One mature cell into another
Reversible
Can progress to CA if stress not removed

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Q

Dysplasia

A

Ugly, but NOT cancer
Loss of cell shape, size, orientation
Reversible

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Q

Anaplasia

A

CANCER - the big dog

Irreversible

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Q

How does cancer look (in general) histologically?

A

Many mitotic figures - dividing
High nuclear to cytoplasmic ratio
Prominent nucleoli

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Q

3 characteristics of benign tumors

A

Well differentiated
Slow with low mitotic activity
Well demarcated borders, can be encapsulated

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Q

4 characteristics of malignant tumors

A

Poorly/undifferentiated
Erratic growth with many mitotic figures
Locally invasive
Possibly metastasis

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Q

-oma generally means

A

Benign

NOT always - melanoma, lymphoma

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Q

What is a malignancy of epithelial tissue?

A

Carcinomas

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Q

3 types of carcinoma

A

Squamous
Adeno - glands
Transitional - aka urothelial

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Q

Where do carcinomas metastasize to?

A

Lymph nodes

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Q

4 exceptions to the carcinomas metastasize to LN rule?

A

Renal cell carcinoma
Hepatocellular carcinoma
Follicular carcinoma of the thyroid
Choriocarcinoma
They like to go blood

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Q

What type of malignancy comes from mesenchymal tissue?

A

Sarcomas

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Q

What are some examples of where sarcomas occur?

A

Muscle, fat, bone, CT, blood vessels

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Q

Where do sarcomas metastasize to?

A

Hematogenously

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Q

Leukemia

A

Malignancy of stem cells in the bone marrow

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Q

Lymphoma

A

Malignancy of the lymph nodes

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Q

If you see a keratin pearl what type of cancer do you have?

A

Squamous cell carcinoma

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Q

What is the max number of cell layers you should have in urothelial lining?

A

6

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Q

Respiratory passages
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - bronchial adenoma
M - bronchogenic carcinoma

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Q

Renal epithelium
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - renal tubular adenoma
M - renal cell carcinoma

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Q

Liver
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - Hepatic adenoma
M - hepatocellular carcinoma

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Q

Connective Tissue
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - fibroma, lipoma, chondroma, osteoma
M - fibrosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma

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Q

Blood vessels
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - Hemangioma
M - angiosarcoma

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Q

Lymph vessels
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - lymphangioma
M - lymphangiosarcoma

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Q

Urinary tract
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - transitional cell papilloma
M - transitional cell (urothelial) carcinoma

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Q

Placental
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - hydatidiform mole
M - choriocarcinoma

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Q

Mesothelium
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - —–
M - mesothelioma

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Q

Testicular
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - —–
M - seminoma, embryonal carcinoma

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Q

Brain coverings
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - meningioma
M - invasive meningioma - very rare

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Q

Melanocytes
Tissue of origin?
Benign name?
Malignant name?

A

Epithelial
B - nevus
M - melanoma

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Q

Smooth muscle
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - Leiomyoma
M - Leiomyosarcoma

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Q

Striated muscle
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - rhabdomyoma
M - rhabdomyosarcoma

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Q

Salivary glands
Tissue of origin?
Benign name?
Malignant name?

A

Mixed tumor
B - pleomorphic adenoma
M - malignant mixed tumor of salivary gland origin

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Q

Hematopoietic stem cells
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - —-
M - Leukemia

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Q

Lymphoid tissue
Tissue of origin?
Benign name?
Malignant name?

A

Mesenchymal
B - —
M - Lymphoma

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Q

Mixed tumor of the kidney
Benign name?
Malignant name?

A

B - —–

M - Wilm’s Tumor

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Q

Teratoma
Benign name?
Malignant name?

A

From totipotent cells in gonad
B - mature teratoma, dermoid cyst
M - immature teratoma, teratocarcinoma

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Q

How many times do cells need to divide before they are detectable?

A

10^9

~ 30 doublings

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Q

Carcinogen

A

Agent that damages dna

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Q

Sequence of events in carginogenesis

A

Initiation - mutation
Promotion - multiple copies of mutations made
Progression

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Q

4 things that are disrupted by the accumulation of DNA mutations

A

Proto-oncogenes
Tumor suppressor genes
Apoptotic genes
DNA repair genes

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Q

CA epigenetics

A

Alterations to histones that indirectly affect DNA

ie. methylation of tumor –> turns off gene –> unregulated cell growth

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Q

8 Hallmarks of CA

A

Cell division without growth signals
Growth in spite of growth inhibitory factors
Immortality by self renewal
Angiogenesis
Invasion and metastasis
Evasion of apoptosis
Evasion of host defense
Inflammation

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Q

How does cancer invade and metastasize

A

Loss of cell to cell by loss of E-cadherin function
ECM broken down by proteolytic enzymes
Proteolytic enzymes responsible for chemotactic and angiogenic factors

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Q

Dormancy

A

Tumor cells can go to sleep and appear if they have been eradicated

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Q

3 ways for metastasis

A

Lymphatic spread - carcinomas
Hematogenous spread - sarcomas
Seeding into body cavities

Q

How does cancer evade apoptosis in follicular lymphoma

A

t(14;18) moves Bcl2 from 18 to Ig heavy chain locus on 14 that is always on = increase in Bcl2 = no apoptosis of B cells that would normally and leads to lymphoma

Q

What do tumor antigens do? Few examples?

A

with T cells they kill tumor cells
Ex: mutated proto-oncogenes, tumor suppressor genes, aberrant proteins, oncofetal antigens, altered glycolipids and glycoproteins

Q

4 Ways tumors evade the immune system?

A

Failure to produce tumor antigen
Mutation in MHC genes
Apoptosis of T-cells (by FasL)
Production of immunosuppressive cytokines or expression of inhibitory cell surface proteins

Q

Cancer and inflammation

A

Stimulated by the same physiological processes
Anemia - iron sequestration and down regulation of EPO
Fatigue
Cachexia

Q

What cytokine is implicated in cachexia

A

TNF-a

Q

Proto-oncogenes

A

Normal genes that regulate cell growth and proliferation

Q

Oncogenes

A

Gas pedal

Mutated proto-oncogene –> gain of function –> abnormal growth and proliferation

Q

How many alleles do oncogenes need mutated or knocked out?

A

ONE

Q

Tumor suppressor genes

A

aka anti-oncogenes
Traffic cop of the cell cycle
Stop to repair stuff

Q

How many alleles need to be knocked out for tumor suppressor genes?

A

TWO

Q

What are the two ways tumor suppressors can be KO?

A

Sporadic - acquire mutations

Familial - inherit one copy

Q

Function of normal Rb gene?

A

Governor of cell cycle
Holds E2F (necessary to progress from G1 to S)
E2F released when RB is phosphorylated –> goes through cell cycle

Q

What happens to mutated Rb?

A

Free E2F –> cell cycle continues

Q

Rb and 2 Hit hypothesis

A

Both genes must be knocked out

Q

Rb and sporadic mutations

A

Both hits are somatic

Leads to unilateral retinoblastoma

Q

Rb and familial mutations

A

One hit inherited, one somatic

Leads to bilateral retinoblastoma and osteosarcoma

Q

Tp53

A

Guardian of the genome

Most frequently mutated gene in cancer

Q

4 functions of Tp53

A

Regulates cell cycle progression
Regulates DNA repair
Regulates cell senescence
Regulates apoptosis

Q

APC gene and colon cancer - 3 steps

A

APC mutations increase risk for polyp formation
KRAS mutation leads to formation of polyp
p53 mutation + increased expression COX progresses to carcinoma

Q

Von Hippel Lindau - 4 cancers associated with it

A

Hemangioblastoma of the cerebellum
Retinal hemangioblastoma
Pheochromocytoma
Bilateral renal cell carcinoma

Q

Characteristics of Von Hippel Lindau

A

VHL - tumor suppressor
Autosomal dominant
Chr 3
Angiogenesis stimulator
Think blood vessels

Q

Chronic Myelogenous Leukemia

A

(CML)
t(9;22)
“philadelphia chromosome”
Fusion of BCR-ABL genes

Q

MCY oncogene

A

Transcription factor –> roles in cell cycle progression and apoptosis
c-MYC
N-MYC
L-MYC

Q

Burkitt’s Lymphoma

A

EBV
translocation of chr 8 & 14
c-MYC

Q

N-MYC

A

Neuroblastoma

Q

L-MYC

A

Lung carcinoma - small cell

Q

2 Steps of chemical carcinogens

A

Initiation - carcinogen exposure –> permanent dna damage –> capable of tumor formation
Promotion - can induce tumor formation but only AFTER initiation

Q

Direct acting carcinogens

A

Require NO metabolic conversion to become carcinogenic

Ex. alkylating agents like chemo

Q

Indirect acting carcinogens

A

Require metabolic conversion to become carcinogenic
Ex. polycyclic hydrocarbons in grilled meat

MOST chemical carcinogens

Q

Polycyclic hydrocarbons

A

In cigarette smoke

Q

Azo dyes in dye factories

A

Bladder CA

Q

Betel nut

A

Oropharyngeal CA

Q

Aflatoxins from aspergillus

A

Hepatocellular carcinoma

Q

Pickled fish and veggies

A

Throat and esophageal CA

Q

Vinyl chloride

A

Angiosarcoma of the liver

Q

Reading Big Robbins

A

Not 100% sure, but I think it is a cystosarcoadenocarinomasarcoma
AND it is deadly

Q

Chromium salts

A

Lung CA

Q

Nickel salts

A

Lung and upper airway CA

Q

Asbestos

A

Lung CA and mesothelioma

Q

Arsenic

A

Squamous cell skin CA, lung CA, angiosarcoma

Q

Anabolic steroids

A

Hepatocellular carcinoma

Q

Iron overload - free radical damage

A

Hepatocellular carcinoma

Q

Nitrosamines (smoked foods)

A

Stomach CA

Q

Radium and uranium

A

Leukemia

Q

Radium painters

A

Osteosarcomas

Q

Ionizing radiation

A

ie. Hiroshima –> DNA mutations

AML, CML, Papillary carcinoma of the thyroid

Q

Non-ionizing radiation

A

ie. UVB sunlight –> pyrimidine dimers

Basal cell skin CA, squamous cell skin CA, melanoma

Q

Thorotrast (injected dye)

A

Liver CA

Q

EBV

A

Burkitt’s lymphoma, nasopharyngeal carcinoma, CNS lymphoma in AIDS

Q

HPV

A

Cancer of the cervix, vulva, anus, vagina, penis

Q

HHV-8

A

Kaposi’s sarcoma in AIDS pt

Q

HBV and HCV

A

Hepatocellular carcinoma

Q

HTLV-1

A

Adult T-cell leukemia/lymphoma

Q

Merkel cell polyomavirus

A

Merkel cell melanoma

Q

Only bacteria associated with development of CA?

A

Helicobacter pylori

–stomach adenocarcinoma

Q

Tumor Grading

A

The degree of cellular differentiation and mitotic activity

How does it look?

Q

Low grade CA

A

Well differentiated, low mitotic activity

Q

High grade CA

A

Poorly differentiated, anapestic, high mitotic activity

Q

Tumor staging - 3 components

A

TMN Staging system
T - tumor size
N - node involvement
M - metastases

Q

IgG

A

Plasma cell myeloma

Q

CEA

A

Carcinoembryonic antigen

Colorectal and pancreatic carcinomas

Q

AFP

A

Alpha-fetoprotein

-yolk sac tumors, hepatocellular carcinoma, testicular CA

Q

hCG

A

Germ cell cancer, hydatidiform moles

Q

Calcitonin

A

Medullary thyroid carcinoma

Q

CA-125

A

Ovarian CA

Q

CA-19-9

A

Pancreatic adenocarcinoma

Q

Acanthosis nigricans

A

Visceral malignancy - esp stomach CA

Q

Cushing’s

A

Small cell lung carcinoma

Q

SIADH (low serum sodium)

A

Small cell lung carcinoma, intracranial neoplasms

Q

Lambert-Eaton

A

Small cell lung carcinoma

Q

Hypercalcemia

A

Squamous cell lung carcinoma, renal cell carcinoma, breast CA

Q

Fever, night sweats from cytokines

A

Lymphomas, Hodgkin and non-Hodgkin’s

Q

Low blood glucose

A

Insulinoma (pancreatic)

Q

Erythrocytosis/polycythemia

A

Renal cell carcinoma
Hepatocellular carcinoma
Pheochromocytoma
Hemangioblastoma
Thymoma

Q

Who is gonna kick ass on this test?

A

WE ARE!!!!

Q

Why are we gonna kick ass on this test?

A

Cause we are not gonna fucking remediate!! :)))