Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CMD Block 2 > Neoplasia 2 (Doc + Ppt) > Flashcards

Neoplasia 2 (Doc + Ppt) Flashcards

1
Q

Gatekeeper or Caretaker gene?

DNA repair

A

caretaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gatekeeper or Caretaker gene?

tumor suppressor gene or oncogene

A

gatekeeper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Gatekeeper or Caretaker gene?

ecodes products that monitors cell death and proliferation

A

gatekeeper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When DNA is damaged, evading apoptosis is mediated by ____

A

p53 (mutated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the genetic mechanism that leads to 85% of follicular B cell lymphoma?

A

translocation bwtn chromosome 14 and 18 that fuses the BCL-2 gene on 18 to the IgH gene promoter on 14 –> BCL2 is OVER expressed -> anti-apoptotic environment

**IgH promoter is VERY active bc it is involved in heavy chain rearrangements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Growth of a new blood vessel is required for tumors to grow over _____

A

2 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe what sort of molecular changes have occurred in tumor cells to allow them to sustain angiogenesis.

A
  • mutated p53 decreases the expression of TSP-1 -> agiogenesis is NOT inhibited
  • Tumor hypoxia -> decrease expression of VHL -> HIF-1alpha is not degraded -> HIF-1alpha causes VEGF production -> angiogenesis induced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the anti-angiogenic factors that tumors must overcome in order to inc in size?

A

angiostatin
endostatin
vasculostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the significance of bevacizumab.

A

anti-VEGF agent that was developed in hopes of being a cure all for solid tumors

BUT it was not a cure all bc tons of tiny foci of cancer (less than 2 mm each) can have their lethal effect without sustained angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is TSP-1 (thrombospondin-1)?

A

induced by p53 and it inhibits angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are potent inducers of angiogeneis?

A

VEGF and FGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some examples of syndromes caused by defective DNA repair/caretaker genes? (6)

A
  1. BRCA1 and BRCA2 assc breast and ovarian cancer
  2. HNPCC (hereditary nonpolyposis colorectal cancer)
  3. Xeroderma pigmentosum
  4. ataxia telangiectasia
  5. Bloom syndrome
  6. Fanconi anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

___% of breast cancers are assc with mutations in BRCA1 or BRCA2

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 4 steps of invasion by malignancy?

A
  1. detachment of tumor cells from e/o
  2. degrade basement membrane
  3. attachment of tumor cells to basement membrane
  4. migration thru interstitium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do tumor cells detach from e/o?

A
  • downreg E-cadherin
  • mutate catenin

*E-cad is extracell “glue” and B-cat is intracell part of the anchoring complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do tumor cells degrade the basement membrane and ECM?

A

secrete MMPs (spc MMP-9)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do tumor cells migrate thru the interstitium once they passed thru the basement membrane?

A

Secrete autocrine motility factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the pattern of colon cancer metastases.

A

-> lymph nodes -> liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the pattern of prostate and breast cancer metastases.

A

-> lymph nodes -> bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the mechanism of metastatic organ tropism (aka movement of cancer to a different organ)

A

differential conc of adhesion molecule expresson on endothlium of diff organs and chemokines (CXCR4 and CCR7)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the significance of tumor embolism?

A

tumor cells invade veins -> right heart -> lungs -> clot forms -> clot organized by fibroblasts -> pulmonary hypertension -> right heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the categories of chemical carcinogens?

A

promoter, initiator, direct, or indirect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What type of carcinogen causes a mutation that are reversible in the cell but are irreversible in the progeny if it is not repaired?

A

Initiators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of chemical carcinogen causes reversible proliferation (aka induces proliferation not causes mutation)

A

promoter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What type of chemical carcinogen are reactive electrophiles?

A

direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What type of chemical carcinogens require metabolic activation? (commonly by CYP450s)

A

indirect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 3 most common and important chemical carcinogens in Dr. Nichols’ world?

A

estrogen
anti-cancer drugs
alcohol

28
Q

What are the microbial carcinogens listed in the doc and what type of cancer do they cause?

A
  • HPV: uterine cervival, mouth , upper GI
  • HCV and HBV: liver
  • EBV: lymphoma (in immunocompromised)
  • H. pylori: stomach and lymphoma
29
Q

What immune cells are the principle effectors cells of the immune system that mediate a response to a tumor?

A

CD8 T cells (secondary = NK cells, macrophages, and Abs)

30
Q

What does the immune system recognize in defense against tumors?

A
  1. Tumor Ags
  2. mut oncogene products and other mut gene products
  3. overly or abnormally expressed protein
  4. oncogenic viral protéins
  5. oncofetal protein
  6. altered self cell surface glycolipids and glycoprotiens
31
Q

What are examples of oncofetal Ags that are recognized by CD8 T cells?

A

CEA and AFP

32
Q

What are examples of altered self cell surface glycoproteins and glycolipids that are recognized by CD8 T cells?

A

CA-125 and CA-19-9

33
Q

How can tumors resist the immune system? (8)

A
  1. selective growth of Ag-negative cells
  2. dec MHC
  3. no costimulatory molecules made
  4. Ag masking
  5. make TGF-beta
  6. engage CTLA-4 (T cell inhib receptor)
  7. activate T regs\
  8. express FasL which can engage Fas receptor on immune cells to kill them
34
Q

What are direct effects (négative ones) that benign tumors can have? (5)

A
  1. cause obstruction
  2. secrete hormones
  3. ulcerate -> bleeding -> infection
  4. infarct
  5. rupture
35
Q

What is the term for symptoms not attributable to direct effects of tumors?

A

paraneoplastic

36
Q

T or F: Cachexia is a paraneoplastic condition

A

F

37
Q

Paraneoplastic condition arise in ___% of cancer pts.

A

10%

38
Q

What is Cachexia?

A

catabolic state of severe wasting that is mediated by TNF

39
Q

What is the most common paraneoplastic condition?

A

Hypercalemia

40
Q

What are the symptoms of paraneoplastic hypercalemia?

A

nausea, vomiting, and altered mental status (disorientation, lethargy, seizures)

41
Q

T or F: Paraneoplastic syndroms manifest in the more progressive phases of cancer?

A

F: they can be the earliest manifestation of occult tumor

42
Q

T or F: paraneoplastic syndroms are never fatal

A

F: they can be fatal

43
Q

T or F: Paraneoplastic conditions can mimic metastatic disease

A

T

44
Q

What is cushing syndrome? What causes it? (assuming the paraneoplastic kind)

A

pituitary adenomas or small cell carcinoma of the lung that make ACTH

causes. ..
- weight gain (central obesity)
- inappropriate antidiuretic hormone (SIADH)
- hypoglycemia
- carcinoid syndrome (serotonin)
- Eaton-Lambert syndrome

45
Q

What consists of attacks of cutaneous flushing?

A

carcinoid syndrome

46
Q

Cancer causes a _____ state.

A

hypercoagulable

47
Q

What is the différence between cancer stage and cancer grade?

A

stage = anatomical extent of tumor (size and spread)

Grade = extent of tumor cell differentiation

48
Q

T or F: Stage carries far more prognosis than grade.

A

T

49
Q

What are examples of tumor serum markers?

A 
PSA
CA-125
CA-19-9
HCG
AFP
CEA
Igs
50
Q

What is a tissue sample obtained by surgical or endoscopic forceps, incision, or excision?

A

Biopsy

51
Q

What is a sample of cells exfoliated or aspirated from te body?

A

cytology

52
Q

_____ gene directly control tumor growth

A

Gatekeeper

53
Q

_____ genes affect genetic stability

A

caretaker

54
Q

Are BRCA gene gatekeepers or caretakers?

A

DNA repair genes = caretaker

55
Q

What is the difference between normal and cancerous glandular tissue of the breast?

A 
Cancer = 1 layer of cells
Normal = 2 layers of cells
56
Q

What tumor cell surface receptors mediate invasion into tissues?

A

Laminin and fibronectin receptors

57
Q

What mediates migration of tumor cell migration (after it breaks thru the basement membrane?

A

Secretion of autocrine motility factor and fibronectin

58
Q

What chemokines mediate metastases in breast cancer?

A

CXCR4 and CCR7

59
Q

What is the difference between initiators and promoters?

A

Initiators cause irreversible mutations in progeny if not reversed in mutated cells while promoters cause reversible proliferation of initiated cells

60
Q

T or F: radiation exposure causes cancer almost immediately after the exposure

A

F: it has long latent periods before cancer develops (years to decades)

61
Q

What type of malignant tumors does radiation cause?

A

Sarcomas

62
Q

Nuclear power plat leaks cause what kind of cancer?

A

Thyroid

63
Q

What is the mechanism of paraneoplastic hypercalcemia?

A

Parathyroid hormone related protein (PTHRP)

64
Q

What is the treatment for paraneoplastic hyperkalemia?

A

Hydration and bisphosphates

65
Q

What is the most common type of lung cancer type to cause hypercalcemia?

A

Squamous cell carcinoma

**microscopically seen w/ keratin pearl

66
Q

What tests are run on biopsies?

A

Immunohistochemistry
Flow cytometry
Molecular testing

CMD Block 2 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions