Neoplasia 2

Question 1

What is 2-napthylamine

Answer 1

Industrial carcinogen used in the dye industry which causes malignant neoplasm

Question 2

What did 2-naphthylamine show

Answer 2

• there is a long delay sometimes decades between carcinogen exposure and malignant neoplasm onset
• the risk of cancer depends on total carcinogen dosage
• there is sometimes organ specificity for particular carcinogens- bladder carcinoma

Question 3

How does HPV affect DNA

Answer 3

It is a direct carcinogen because it expresses the E6 and E7 proteins that inhibit p53 and pRB protein function respectively which re both important in cell proliferation

Question 4

How do hepatitis B and C affect the body

Answer 4

They are indirect carcinogens that cause chronic liver cell injury and regeneration

Question 5

What does helicobacter pylori do

Answer 5

It causes chronic gastric inflammation

Question 6

What do parasitic flukes do

Answer 6

They cause inflammation in bile ducts and bladdder mucosa increasing the risk for gastric inflammation in bile ducts an bladder mucosa increasing the risk or gastric, cholangio- and bladder carcinomas

Question 7

How can HIV increase susceptibility to cancer

Answer 7

Acts indirectly by lowering immunity and allowing other potentially carcinogenic infections to occur

Question 8

Wha are tumour suppressor genes

Answer 8

Genes that inhibit neoplastic growth

Question 9

What are oncogenes

Answer 9

Genes that enhance neoplastic growth- mutations of proto-oncogenes

Question 10

What does the RAS gene do

Answer 10

The RAS encodes a protein that is always active ultimately producing a constant signal to pas through the cell cycles restriction point

Question 11

What does the RB gene

Answer 11

retinoblastoma- It restrains cell proliferation by inhibiting passage through the restriction point

Question 12

What are the hall marks of cancer

Answer 12

1- self sufficiency in growth signals
2-resistance to growth stop signals
3-no limit on the number of times a cell can divide - cell immortalisation
4- sustained ability to induce new blood vessels- angiogenesis
5- resistance to apoptosis
6-the ability to invade and produce metastasis

Question 13

What are promotors

Answer 13

That cause sustained proliferation

Question 14

Wha are initiators

Answer 14

Cause mutation in DNA

Question 15

what is the adenoma-carcinoma sequence

Answer 15

ordered sequence of mutations that need to occur in specific genes in a specific order

the accumulation of mutations that normal epithelium undergoes to become the carcinoma

early adenoma, late adenoma carcinoma in situ, invasive carcinoma

Question 16

What is T IN TNM

Answer 16

Size of the primary tumour and is typically expressed as T1 through fo T4

Question 17

N in TNM

Answer 17

Extend of regional node metastasis

Question 18

M in TNM

Answer 18

denotes the extent of distant metastatic spread

Question 19

Stage 1

Answer 19

Early Local disease

Question 20

Stage 2

Answer 20

Advanced local disease N0 M0

Question 21

Stage 3

Answer 21

Regional metastasis

Any T, N1 or more, M0

Question 22

Stage 4

Answer 22

Advanced disease with distant metastasis

Any T, Any N and M1

Question 23

How is lymphoma staged

Answer 23

Ann Arbor staging.

Question 24

G1 stage

Answer 24

Well differentiated

Question 25

G2

Answer 25

Moderately differentiated

Question 26

G3

Answer 26

Poorly differentiated

Question 27

G4

Answer 27

Undifferentiated or anaplastic

Question 28

When is the grading systems used

Answer 28

Squamous cell carcinoma and colorectal carcinoma

Question 29

How is cancer treated

Answer 29

Surgery Radiotherapy Chemotherapy Hormone therapy

Question 30

Adjuvant therapy

Answer 30

After surgical removal of a primary tumour to eliminate subclinical disease

Question 31

Neoadjuvant treatment

Answer 31

Given to reduce the size of primary tumour prior to surgical excision

Question 32

What is radiotherapy

Answer 32

Focused on the tumour with shielding of surrounding healthy tissue Given in fractionated doses to minimise damage to normal tissue

Question 33

Hormone therapy

Answer 33

Selective oestrogen receptor modulators (SERMs), such as tamoxifen, bind to oestrogen receptors, preventing oestrogen from binding. They are used to treat hormone receptor- positive breast cancer. Androgen blockade is used for prostate cancer.

Question 34

What do trastuzamab and Imatinib work

Answer 34

Identify cancer specific alterations such as oncogene mutations which provide an opportunity to target drugs specifically at cancer cells

Question 35

how is the dye industry involved in cancer

Answer 35

2-napthylamine was a chemical used in the dye manufacturing industry. However, it was later found to be a carcinogen which causes bladder cancer, so is now no longer used.

Question 36

what is an oncogene

Answer 36

A mutated proto-oncogene

Question 37

normal function of p53

Answer 37

Normally encodes for a transcription factor involved in repairing DNA. Repairs damage in the S phase of the cell cycle or causes apoptotic cell death if the damage is too extensive.

Question 38

what is the 2 hit hypothesis

Answer 38

a person with a germline mutation of a tumour suppressor gene on one chromosome is more likely to develop a neoplasm. If one tumour suppressor gene is inherited as mutated – the “first hit” - then the second gene can still protect the cell to supress tumour growth. However, if the second gene becomes mutated and the cell is no longer protected – the “second hit” – then the chance of tumour growth is very high.

Question 39

what is RAS

Answer 39

a proto-oncogene Codes for a G protein which signals for a cell to get past the restriction point in the cell cycle. A mutation causes this protein to always be active, and therefore the cell constantly moves through the cell cycle and divides.

Question 40

what is HER-2

Answer 40

- Codes for growth factor receptors. - Overexpression of this gene leads to many growth factor receptors being expressed on the tumour cell surface, increasing the sensitivity of the cell to growth factors. - This accelerates growth of the neoplasm, and is particularly associated with breast cancer.

Question 41

what is xeroderma pigmentosa

Answer 41

reduced ability to repair UV damage, and therefore they are more likely to develop skin cancer at a young age.

Question 42

familial breast carcinoma

Answer 42

associated with mutations to the BRCA1 or BRCA2 genes, which are normally involved in repairing double strand DNA breaks.

Question 43

Hereditary non-polyposis colon cancer (HNPCC)

Answer 43

condition affecting DNA mismatch repair genes, which increases the risk of developing colon cancer.

Question 44

what are the 6 hallmarks of cancer

Answer 44

Self-sufficiency in growth signals Resistance to growth stop signals Cell immortalisation through the action of telomerase Angiogenesis; the ability to produce new blood vessels Resistance to apoptosis Ability to invade and produce metastases