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Neoplasia Flashcards

1
Q

Define neoplasm

A

Abnormal growth of tissue, which is partly or completely autonomous of normal growth controls

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2
Q

How are tumours graded

A

According to the degree of histological resemblance to the cell of origin

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3
Q

What are tumours labelled if they defy histogenetic classification

A

Anaplastic

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4
Q

What is a carcinoma

A

Malignant epithelial neoplasm

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5
Q

What is a sarcoma

A

Malignant connective tissue neoplasm

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6
Q

Define carcinoma in situ

A

A lesion with all the cytological features of cancer but no evidence of invasion through the epithelial basement membrane

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7
Q

Define teratoma

A

Germ cell neoplasm representing all three germ layers i.e. ectoderm, mesoderm, endoderm

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8
Q

Define blastoma.

A

Tumours bearing histological resemblance to the embryonic form of the organ which they arise

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9
Q

Define hamartoma

A

Tumour-like lesion which lacks autonomy but in which the elements are fully differentiated and are normally found in the tissue of origin

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10
Q

What is a labile cell

A

Cell that is constantly renewed

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11
Q

What is a stable cell

A

Usually quiescent but can be stimulated to divide (e.g. hepatocyte)

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12
Q

What is a permanent cell

A

Do not undergo mitoses in postnatal life

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13
Q

List the 4 DNA amino acids

A
  • Adenine
  • Thymine
  • Cytosine
  • Guanine
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14
Q

In what form is DNA stored in the cell nucleus

A

Chromatin - which are wrapped around histones to form nucleosome complexes

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15
Q

Describe G1 phase of the cell cycle

A

Pre-synthetic phase - cellular contents, excluding chromosomes, are duplicated

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16
Q

Describe the S phase of the cel cycle

A

DNA synthesis - each of the 46 chromosomes is duplicated

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17
Q

Describe G2 phase of the cell cyclce

A

Premitotic - the cell double checks the duplicated chromosomes for errors and makes repairs

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18
Q

What is G0 phase of the cell cycle

A

Quiescent (resting) phase

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19
Q

List the phases of mitosis (7)

A
  1. Interphase
  2. Prophase
  3. Prometaphase
  4. Metaphase
  5. Anaphase
  6. Telophase
  7. Cytokinesis
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20
Q

Describe Interphase

A

Comprises G1, S, and G2 phases of the cell cycle when the cell is in preparation for division

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21
Q

Describe Prophase

A
  • Chromatin begins to condense and is seen as chromosomes

- Centrioles move to the opposing end of the cell and the mitotic spindle is formed

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22
Q

Describe Prometaphase

A
  • Nuclear membrane dissolves

- Chromosomes start to move to the centre of the cell under the control of microtubules

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23
Q

Describe Metaphase

A

Spindle fibres align with the chromosomes along the metaphase plate

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24
Q

Describe Anaphase

A

The paired chromosomes separate and are dragged to the poles of the cell

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25
Describe Telophase
Chromatids arrive at the opposite ends of the cell and disperse after new nuclear membranes are formed
26
Describe Cytokinesis
Actin fibre forms around the centre of the cell and contracts to pinch off two daughter cells
27
When are the two crucial regulatory points of the cell cycle
1. Entry of G0 cells into G1 | 2. G1 to S phase
28
What causes the cell to move from G1 to S phase and also G2 to M phase
Cyclin-dependent Kinases (CDKs)
29
What blocks the cells in G1 if DNA is damaged
Protein p53
30
What occupation is associated with scrotal cancer and why
Chimney Sweeps - polycyclic aromatic hydrocarbon exposure
31
What cancer is associated with Beta-naphthylamine
Bladder TCC
32
What cancers are associated with EBV
- Burkitt's lymphoma - Nasopharyngeal carcinoma - Beta-cell lymphoma in the immunocompromised
33
What virus is strongly associated with cervical cancer
HPV 16 and 18
34
What cancer is associated with wood dust
Paranasal sinus cancer
35
What gene is affected in Li-Fraumeni syndrome
p53
36
What neoplasms result from Li-Fraumeni syndrome
- Breast - Ovarian - Astrocytoma - Sarcoma
37
What gene is affected in retinoblastoma
Rb1
38
What other neoplasms are associated with retinoblastoma
Osteosarcoma
39
What gene is affected in Familial polyposis coli
APC
40
What cancers are associated with Von-Hippel-Lindau syndrome
- Renal - Phaeochromocytoma - Haemangioblastoma
41
What gene is affected in MEN syndromes
RET
42
What gene is affected in Von-Hippel-Lindau syndrome
VHL
43
What causes the conversion of hyperproliferative colonic epithelium to adenoma
- APC inactivation | - K-ras mutation
44
What causes the conversion of colonic adenoma to carcinoma
- DCC deletion | - p53 deletion
45
What cancer may develop from Paget's disease of the bone
Osteogenic sarcoma
46
What haematological malignancy is associated with Down's Syndrome
Acute Leukaemia
47
How do oncogenes contribute to cancer development
Instruct cells to make proteins that stimulate excessive growth and cell division
48
What is a proto-oncogene
Family of normal genes that code for proteins involved in the normal growth-control pathway of cels
49
How do oncogenes arise
From mutation of proto-oncogenes
50
What are the 2 classes of tumour suppressor genes
1. Caretaker genes | 2. Gatekeeper genes
51
What is the role of caretaker genes
Maintain integrity of the genome by repairing DNA damage
52
What is the role of gatekeeper genes
Inhibit proliferation, or promote the death of cells with damaged DNA
53
How many tumour suppressor genes must be affected to cause cancer
Both of the gene PAIR
54
Where is the p53 gene situated
Short-arm of chromosome 17
55
What type of tumour suppressor genes are BRCA 1 and 2
Caretaker
56
What does the rate of cell proliferation within a population of cells depend on
1. Rate of tumour cell division 2. Fraction of cells within the population undergoing division 3. Rate of cell loss from the replicating pool due to regulated apoptosis
57
Define 'Growth Fraction'
The fraction of cells within a population undergoing cell division - typically 20% of rapidly growing tumours
58
What is Gompertzian growth
The way neoplasms initially grow exponentially and then slow as they increase in size
59
Why does Gompertzian growth occur
- Decrease in growth fraction - Increase in cell loss e.g. necrosis - Nutritional depletion of tumour cells as they outgrow blood supply
60
Why does 'debulking' or radiation improve the effectiveness of chemotherapy
Pushes more cells into the cell cycle and therefore increases the number of cells susceptible to chemotherapy
61
What are the 4 routes of metastases
1. Lymphatic 2. Haematogenous 3. Transcoelomic 4. Seeding
62
Which cancers favour haematogenous spread to the bone
1. Breast 2. Prostate 3. Lung 4. Kidney 5. Thyroid (follicular)
63
How do sarcomas metastasise
Haematogenous
64
Tumour marker for B-cell lymphoma
CD20
65
Investigation for suspected lymphoma
Excision biopsy
66
Tumour marker for choriocarcinoma
beta-HCG
67
Tumour markers for testicular cancer
- Beta-HCG - AFP - Placental alkaline phosphatase
68
What has been the outcome of the UK breast screening programme
35% reduction in mortality from breast cancer among screened women for 50-69
69
What is the structure of the UK breast screening programme
Women aged 50 (47) -70 are invited for screening every 3 years
70
What is the structure of the UK cervical screening programme
All women aged 25-64: - 25-49 screened 3-yearly - 50-64 screened 5-yearly
71
What is the structure of the UK colorectal cancer screening programme
2-yearly FIT test for men and women aged 60 (56) - 74
72
Define Resection en bloc
Surgical removal of the entirety of the tumour without disrupting its capsule
73
What type of radiotherapy is used to treat cutaneous and subcutaneous lesions
Particulate radiotherapy
74
Which phase of the cell cycle are cells most sensitive to radiotherapy
S phase
75
Describe stereotactic radiotherapy
Radiotherapy that is given from many different angles around the body e.g. used in brain tumours
76
What is the mechanism of action of classic alkylating agents e.g. cyclophosphamide
Act by forming covalent bonds with nucleic acids, proteins, nucleotides, and amino acids, and so inactivate the enzymes involved in DNA production
77
What is the mechanism of action of non-classic alkylating agents e.g. Cisplatin
Act by causing cross-linking of DNA strands
78
What is the mechanism of action of antimetabolites e.g. Methotrexate
Act by interfering with purine or pyrimidine synthesis and hence interfere with DNA synthesis
79
What is the mechanism of action of Vinca Alkaloids e.g. Vincristine
Act by inhibiting mitosis, by preventing spindle formation (they are M-phase specific)

Pathology (7 decks)

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