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PB+T > Neoplasia > Flashcards

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
Q

Oncofetal antigens

A

Expressed as glycoprotein markers cancers and developing fetuses
- AFP, CEA

25
Q

Cancer markers (4)

A

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
Q

Typical tumor progression

A

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
Q

Progression to metastasis

A

TGIF

  • Transformation
  • Growth
  • Invasion
  • fucked (Metastases)
28
Q

Invasion process

A
  • 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
Q

Lung and lymphatic metastases

A

Originate from the liver due to portal blood supply

30
Q

FISH assay in prognosis: eg

A

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
Q

MUC-1

A

Induces antibody/T-cell response in breast tissue

32
Q

CD 20

A

B cell stimulation factor

- Target for Rituximab

33
Q

Immune cells in cancer

A

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
Q

Immune avoidance mechanisms of neoplasms

A
  • Antigen negative overgrowth
  • Decreasing HLA 1 expression
  • Immunosuppression via TGF-beta
  • Decrease costimulation receptor B7
  • Fas ligand apoptosis of CTLs
35
Q

Cachexia Syndrome

A
  • Often the first sign of occult Cancer

- MAWW: Malaise, Anorexia, Weakness, Wasting

36
Q

Carcinoid syndrome

A

Inflammatory cytokines released causing flushing, cyanosis, G.I. symptoms, bronchoconstriction attacks

37
Q

Acanthrosis Nigricans

A

Associated with up to 50% of neoplasms

38
Q

Cancer trends in men versus women

A

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
Q

Screening recommendations

A

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
Q

Cushing’s perineoplastic syndrome

A

Lung neoplasm constitutively releases glucocorticoids

41
Q

Familial cancer syndromes (4)

A

Familial retinoblastoma: Rb
Familial Adenomatous polyposis: APC (FAPC)
Multiple endocrine neoplasia: RET mutation
Hereditary non-polyposis colorectal cancer: mismatch repair mutation

42
Q

Carcinogens; initiators and promoters

A
  • Initiators cause Irreversible DNA damage
  • Promoters Do not directly damage the DNA
    Complete carcinogens initiate and promote, Incomplete carcinogens initiate only
43
Q

Carcinogens associated with specific conditions

A

Aromatic amines -> Bladder cancer
Aflatoxin b1 -> liver carcinoma
All other As -> lung skin

44
Q

H pylori and neoplasms

A

Associated with inflammation from chronic gastritis

CAG Associated with higher incidence of malignancy

45
Q

MALTomas

A

Germinal center neoplasm, Form in response to chronic inflammation and irritation.

46
Q

Bacteria in malignancy

A

In both cases of H. pylori and MALToma’s removing the bacteria or stimulus takes away the cancer

47
Q
  • HPV
A

most strains associated with benign growths

  • 6,11,16,18 (esp. 16 and 18)
  • E6 protein: p53
  • E7 protein: p53, p21, Rb
48
Q

EBV

A

Associated with African Burkitt’s lymphoma

  • LMP-1 Activates CD40 ligand initiating proliferation
  • inhibits BCL-2 -> No apoptosis
49
Q

Human T-cell leukemia virus type one

A

Associated with Japan the west Indies and the Pacific Islands
-TAX gene Initiates polyclonal T cell proliferation and NFKB (survival)
-

50
Q

MAWW

A 
Cachexia syndrome
Malaise
Anorexia
Wasting 
Weakness

PB+T (20 decks)

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