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FOM 3 wks 7-9 > neoplasia > Flashcards

neoplasia Flashcards

1
Q

what is the most common characteristic of neoplasia

A

autonomous cell proliferation

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2
Q

what is a neoplasm in general terms

A

a new growth

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3
Q

what is a neoplasm in technical terms

A

an abnormal mass of tissue, that grows more & differently than normal tissue

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4
Q

2 basic components that all tumors have (benign or malignant)

A

-parenchyma
-supportive stroma

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5
Q

what is parenchyma

A

neoplastic proliferating cells

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6
Q

what is supportive stroma

A

reactive / non-neoplastic component (connective tissue, blood vessels, etc.)

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7
Q

2 types of supportive stroma

A

-desmoplasia
-scirrhous

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8
Q

what is desmoplasia stroma

A

abundant collagenous stroma

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9
Q

what is scirrhous stroma

A

dense, fibrous stroma (stony hard)

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10
Q

prefix for glandular epithelium neoplasms

A

adeno-

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11
Q

prefix for fibroblast neoplasms

A

fibro-

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12
Q

prefix for skeletal muscle neoplasms

A

rhabdomyo-

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13
Q

prefix for smooth muscle neoplasms

A

leiomyo-

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14
Q

prefix for fat cell neoplasms

A

lipo-

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15
Q

prefix for cartilage neoplasms

A

chondro-

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16
Q

prefix for bone neoplasms

A

osteo-

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17
Q

prefixes for vascular neoplasms

A

angio-, lymphangio-

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18
Q

prefixes for hematopoietic cell neoplasms

A

lympho-, myelo-

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19
Q

prefix for endothelium neoplasms

A

hemangioendothelio-

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20
Q

suffix of benign neoplasms

A

-oma

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21
Q

suffixes of malignant neoplasms

A

-carcinoma
-sarcoma

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22
Q

tumor from somatic cell is derived from what tissue layers

A

ONE of 3 germ layers (endoderm, mesoderm, ectoderm)

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23
Q

tumor from gonadal or embryonic cell is derived from what tissue layers

A

ALL 3 germ layers

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24
Q

5 main characteristics of benign tumors

A

-encapsulation
-smooth borders
-remain localized
-differentiated
-slow growth/proliferation

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25
Q

benign tumor cells closely resemble _____

A

the normal cell in morphology & function

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26
Q

cycstic teratoma arises from _____ cells, and can give rise to tissue originating from _____

A

arise from totipotential germ cells

originate from all 3 germ layers

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27
Q

what is a papillary cystadenoma

A

papillary epithelial proliferation protruding into cystic spaces

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28
Q

6 main characteristics of malignant tumors

A

-poorly circumscribed (no capsule)
-firm, fixed (not freely moveable)
-enlarged, prominent nuclei, maybe more # nuclei in cytoplasm
-hyperchromasia- darkly staining (bc more DNA)
-coarsely clumped chromatin
-increased # of mitoses, some abnormal

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29
Q

7 additional characteristics of malignant neoplasm

A

-nuclear pleomorphism
-loss of polarity
-necrosis
-immune response
-differentiation
-rapid rate of growth
-local invasion

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30
Q

what is the most important criteria of malignancy

A

distant metastasis

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31
Q

malignant tumors are _____ & have _____ potential

A

invasive
&
have metastatic potential

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32
Q

what factors influence tumor growth

A

-hormone dependence
-adequacy of blood supply
-genetics

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33
Q

metastasis unequivocally implies _____

A

malignancy

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34
Q

what % of newly diagnosed solid tumors (excluding most skin cancers) have metastases

A

30%

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35
Q

most common pathway of metastasis

A

lymphatics

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36
Q

most common pathway of hematogenous spread

A

venous ->
drains to liver & lung

37
Q

is it true that neoplasia is most often sporadic

38
Q

8 hallmarks of cancer

A

1) self-sufficiency in growth signals
2) insensitivity to growth-inhibitory signals
3) altered cellular metabolism
4) evasion of apoptosis
5) limitless replicative potential (immortality)
6) sustained angiogenesis
7) ability to invade & metastasize
8) ability to evade the host immune response

39
Q

self-sufficiency in growth GOF mutations convert _____ to _____

A

proto-oncogenes to oncogenes

40
Q

major proto-oncoprotein signaling pathways

A

RTK
GPCR
JAK/STAT
WNT
Notch
Hedgehog
TGFB/SMAD
NK-kB

41
Q

2 methods for diagnosing overexpression of growth factors

42
Q

some growth factors can synthesize their own receptors that they respond to, which creates a _____

A

autocrine loop

43
Q

2 examples of growth factor mutations that create an autocrine loop

A

-PDGF-B in glioblastoma
-TGF-a in some sarcomas

44
Q

2 examples of growth factor mutations that constitutively activate tyrosine kinases

A

ERBB1 (EGFR) -point mutation in lung adenocarcinoma

ERBB2 (HER2) -amplification in breast & gastric adenocarcinomas

45
Q

Alk (a tyrosine kinase) is activated by _____ & seen in _____

A

gene rearrangement

lung cancers

46
Q

mutations that cause oncogenic activity often occur in what 2 locations of the cell

A

cytoplasm
nucleus

47
Q

2 examples of non-receptor tyrosine kinase mechanism of oncogenesis

A

ABL tyrosine kinase (BCR-ABL gene) -> chronic myelogenous leukemia (CML)

JAK2 tyrosine kinase (JAK/STAT gene) -> chronic myeloproliferative disorders

48
Q

2 examples of signal-transducing proteins expressed in cancers

A

KRAS (colon, lung, pancreatic cancers)

BRAF (melanomas)

49
Q

1 example of nuclear regulatory protein expressed in cancers

A

MYC (Burkitt lymphoma)

50
Q

1 example of cell cycle protein expressed in cancers

A

cyclin D1 (mantle cell lymphoma)

51
Q

2 examples of mechanisms of oncogene activation (by MYC)

A

-amplification
-chromosomal translocation

52
Q

_____ mutation in CDK causes cancer

53
Q

_____ mutation in CDK1 causes cancer

54
Q

what does CDK1 do

A

CDK inhibitor (inhibits G1 / S phase of cell cycle)

55
Q

examples of LOF CDK1 mutations

A

-germline p16 mutations
-acquired p16 mutations
-retinoblastoma (RI) mutations
-p53 mutations

56
Q

what is p53

A

tumor suppressor gene

57
Q

major tumor suppressor genes

A

p53
APC
E-cadherin

58
Q

which tumor suppressor gene is still effective if only one gene is present

59
Q

what cancer results if BOTH APC genes are absent

A

familial adenomatous polyposis syndrome

60
Q

2 major mechanisms of apoptosis evasion in cancer

A

-loss of p53 -> inactive pro-apoptotic factors (ex. BAX)

-amplification of BCL-2 family (anti-apoptotic genes) -> protects against apoptosis (ex. BCL2 overexpression)

61
Q

example of cell with self-renewing capacity

A

hematopoietic stem cells in CML

62
Q

example of mutated differentiated cell without stem cell quality, but still leading to self-renewing

A

granulocytic progenitors in APML

63
Q

angiogenesis is essential for _____

A

tumor growth

64
Q

normally angiogenesis is regulated by _____

A

pro- & anti-angiogenic factors

65
Q

example of pro-angiogenic factor, which is upregulated by what factors

A

VEGF

upregulated by:
hypoxia
RAS
MYC

66
Q

example of anti-angiogenic factors

67
Q

p53 normal functions

A

stimulates thrombospondin-1 (anti-angiogenic factor)
&
inhibits pro-angiogenic factors

68
Q

2 phases of metastatic cascade pathway

A

1) invasion of ECM
2) vascular dissemination, homing of tumor cells, & colonization

69
Q

_____ determine the target tissues for metastasis

A

chemokines

70
Q

tumors can evade host immune response by _____ & _____

A

-decreasing expression of antigens, MHCs
-producing immunosuppressive cytokines (ex. PDL-1)

71
Q

example of antibody that is used to treat cancer

A

antibody against PDL-1 (inactivates PDL-1 -> now unable to inhibit tumor cell death)
= tumor cell death

72
Q

PDL-1 specifically inhibits _____

A

T-cell activation

73
Q

example of gene whose loss of heterozygosity results in cancer

A

RB (ocular retinoblastoma)

74
Q

ability of cells to metastasize requires _____

A

multiple driver mutation steps

75
Q

what are microsatellites (MS’s)

A

1 to 6 tandem normally constant nucleotide repeats in the genome

76
Q

in HNPCC, MS’s are _____

A

unstable (they increase / decrease)

77
Q

_____ normally correct unstable MS’s

A

4 mismatch repair (MMR) genes

78
Q

deficiencies in any of the 4 MMR genes can cause _____

A

increase in MS’s

promotes carcinogenesis
=
activate immune response

79
Q

what are chemical carcinogens

A

have highly reactive electrophile groups that damage DNA -> leading to mutations & eventually cancer

80
Q

direct vs indirect acting agents (in chemical carcinogenesis)

A

direct: do not need metabolic conversion to become carcinogenic

indirect: are active once converted to a carcinogen by a metabolic pathway

81
Q

what is the process of radiation carcinogenesis with ionizing radiation

A

ionizing radiation = chromosome breakage / translocation / point mutations
->
genetic damage & carcinogenesis

82
Q

what is the process of radiation carcinogenesis with UV rays

A

UV rays = formation of pyrimidine dimers within DNA
->
mutations & carcinogenesis

83
Q

what is the risk of radiation carcinogenesis with imaging such as CT

A

very small

84
Q

5 examples of viral & bacterial agents of oncogenesis

A

HTLV-1
HPV
EBV
hep B & C
h. pylori

85
Q

3 factors taken into account when grading tumors

A

-degree of differentiation of tumor cells
-cellular pleomorphism
-# of mitoses within tumor

86
Q

low grade tumor = _____ aggressive

87
Q

high grade tumor = _____ aggressive

88
Q

3 things that tumor staging is based on

A

(T) primary tumor size
(N) extent of spread to regional lymph nodes
(M) if distant (blood-borne) metastasis is present

89
Q

which checkpoint in cell cycle is affected by ionizing radiation

FOM 3 wks 7-9 (24 decks)

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