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Neoplasia Flashcards

0
Q

Chorisoma, hamartoma

A

Normal act topic tissue

Normal tissue location but poorly organized

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1
Q

Nomenclature

A
  • Benign tumors typically end in “Oma”
  • Epithelial malignancies; carcinomas
  • Mesenchymal Malignancies; sarcoma
  • Hematopoietic Malignancies; leukemia
  • Lymphoid Malignancies; lymphoma
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2
Q

Grading versus staging

A
  • Staging is based on how far the metastases travel

- Grading is how undifferentiated they are; a measure of Anaplasticity

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3
Q

MYC

A
  • Amplification indicates a poor prognosis in many cancers

- This pathway emerges heavily with other intracellular pathways

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4
Q

VHL

A
  • Associated with von Hippel-Lindau syndrome
  • Clear-cell renal carcinoma And CNS malignancies
  • degrades HIFIa In the presence of oxygen (Activates various growth factors)
  • Hypoxia induces H1FIa To initiate Angiogenesis (VEGF/bEGF)
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5
Q

Imanitib

A

MAb TRK inhibitor

- bcr-abl: Philadelphia chromosome

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6
Q

Philadelphia chromosome

A

Merging of two proto-oncogenes chromosome locations Resulting in overexpression of Cell cycle advancing factors

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7
Q

RAS

A

One of the most commonly mutated proto-oncogenes

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8
Q

Rb

A

Ubiquitous tumor suppressor genes that inhibits E2F.

  • E2F have initiates transcription of S-phase genes
  • Mutation represents “first hit” in retinoblastoma development
  • Is active in a hypophosphorylated state in quiescent cells
  • Cyclin D/ CDK/6 Complex phosphorylates Causing it to become in active in replicating cells
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9
Q

ATM/ATR

A

Mediates damage repair

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10
Q

P53

A

One of the primary tumor suppressor genes

  • p 53 activation is considered a primordial response To damage
  • Can initiate quiescence (Temporary cycle arrest) senescence (permanent cell cycle arrest)or apoptosis
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11
Q

INK4/ARF

A

Blocks cyclin D/CDK 2 phosphorylation of RB protein

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12
Q

TGF-beta

A

Inhibition of proliferation
SMADs
- Mutation found in 100% of pancreatic cancers and 80% of colon cancers

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13
Q

PTEN

A

Inhibits mTOR via PI3K/AKT

Associated with Cowden syndrome

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14
Q

NF-1

A

Associated with neurofibromatosis via the RAS pathway

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15
Q

BCL-2

A

Anti-Apoptotic gene

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16
Q

Telomerase

A

Imparts cellular immortality by elongating telomeres and preventing degradation

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17
Q

Warburg effect

A

In the presence of an oxygen-rich environment metabolism shifts to anaerobic Glycolysis. Allows tumor cells to gain energy very quickly For rapid reproduction

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18
Q

Typical lymphoid mutations

A

Swapping translocations With proto-oncogenes, Resulting in overexpression

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19
Q

Typical hematopoiesis mutations

A

Formation of Chimeric proteins promoting growth and survival

- E.g. chronic myelogenous leukemia

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20
Q

Solid tumor mutations

A

Tend to be deletions

21
Q

N-MYC

A

Proto-oncogene of which amplification is implicated in lots of tumors
- Increased amplification is associated with poor prognosis

22
Q

Benzopyrine

A

Indirect carcinogen produced from the combination of heat and tobacco

23
Q

P450 and cancers

A

Most known carcinogens are metabolized by P450

24
Oncofetal antigens
Expressed as glycoprotein markers cancers and developing fetuses - AFP, CEA
25
Cancer markers (4)
PSA - Marker for prostate cancer but better marker for treatment efficacy AFP/CEA-Marker for recurrence CA-125-Ovarian cancer Bence-Jones Immunoglobulins-Multiple myeloma
26
Typical tumor progression
Progression from one cell to 10^9 in about 30 doublings: Represents a tumor mass of about 1 g -> In 10 more doublings tumor mass typically is about 1 kg, Which usually is incompatible with life. Detection usually occurs in the last 10 doublings, Hence many have already metastasized
27
Progression to metastasis
TGIF - Transformation - Growth - Invasion - fucked (Metastases)
28
Invasion process
- Degradation of cell to cell junctions (E-cads) - Mutations in catenin contribute to loosening of cells - matrix metalloproteinases: Degrades type for collagen in basement membrane And allows for penetration - Develops novel extracellular matrix attachments and uses it as Migration path
29
Lung and lymphatic metastases
Originate from the liver due to portal blood supply
30
FISH assay in prognosis: eg
Fish assay can determine overexpression of proto-oncogenes indicating favorable or unfavorable Prognosis - HER-2 Amplification indicates susceptibility to trastuzumab - N-MYC Amplification indicates poor prognosis in Neuroblastoma
31
MUC-1
Induces antibody/T-cell response in breast tissue
32
CD 20
B cell stimulation factor | - Target for Rituximab
33
Immune cells in cancer
Cytotoxic T lymphocytes are the Primary immune response In malignancy, But require sensitization - Encase cells are secondary but do not require sensitization - CD4 cells play a minor role - Antibodies playing no immune function but can be used for identification
34
Immune avoidance mechanisms of neoplasms
- Antigen negative overgrowth - Decreasing HLA 1 expression - Immunosuppression via TGF-beta - Decrease costimulation receptor B7 - Fas ligand apoptosis of CTLs
35
Cachexia Syndrome
- Often the first sign of occult Cancer | - MAWW: Malaise, Anorexia, Weakness, Wasting
36
Carcinoid syndrome
Inflammatory cytokines released causing flushing, cyanosis, G.I. symptoms, bronchoconstriction attacks
37
Acanthrosis Nigricans
Associated with up to 50% of neoplasms
38
Cancer trends in men versus women
Incidence in men: Prostate, lung, colon Incidence in women: Breast, lung, colon Mortality in men: Lung, prostate, colon Mortality in women: Lung, breast, colon
39
Screening recommendations
Breast: Mammogram at 40; MRI if significant family history Prostate: combo PSA and prostate exam at 50 (45 if black) Colon: Colonoscope at 50 every 10 years Cervix: Pap smear at 21 Q3 years, HPV only if abnormal. At 35 Pap smear HPV combo Q5 years
40
Cushing's perineoplastic syndrome
Lung neoplasm constitutively releases glucocorticoids
41
Familial cancer syndromes (4)
Familial retinoblastoma: Rb Familial Adenomatous polyposis: APC (FAPC) Multiple endocrine neoplasia: RET mutation Hereditary non-polyposis colorectal cancer: mismatch repair mutation
42
Carcinogens; initiators and promoters
- Initiators cause Irreversible DNA damage - Promoters Do not directly damage the DNA Complete carcinogens initiate and promote, Incomplete carcinogens initiate only
43
Carcinogens associated with specific conditions
Aromatic amines -> Bladder cancer Aflatoxin b1 -> liver carcinoma All other As -> lung skin
44
H pylori and neoplasms
Associated with inflammation from chronic gastritis | CAG Associated with higher incidence of malignancy
45
MALTomas
Germinal center neoplasm, Form in response to chronic inflammation and irritation.
46
Bacteria in malignancy
In both cases of H. pylori and MALToma's removing the bacteria or stimulus takes away the cancer
47
- HPV
most strains associated with benign growths - 6,11,16,18 (esp. 16 and 18) - E6 protein: p53 - E7 protein: p53, p21, Rb
48
EBV
Associated with African Burkitt's lymphoma - LMP-1 Activates CD40 ligand initiating proliferation - inhibits BCL-2 -> No apoptosis
49
Human T-cell leukemia virus type one
Associated with Japan the west Indies and the Pacific Islands -TAX gene Initiates polyclonal T cell proliferation and NFKB (survival) -
50
MAWW
``` Cachexia syndrome Malaise Anorexia Wasting Weakness ```

PB+T (20 decks)

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