Neoplasia 3

Question 1

in Dx: If malignant, think

Answer 1

primary? metastatic?

Question 2

What causes weight loss and anorexia in tumours?

Answer 2

late stage make TNF-A and IL-1, increases metabolism

Question 3

clinical presentation of lung tumour

Answer 3

cough
haemoptysis
wheeze
dyspnoa
pneumonia
Pancoast syndrome

Question 4

What are paraneoplastic effects?

Answer 4

side effects of cancers such as endocrine, immunological (rashes), clubbing, vascular

Question 5

What kinds of paraneoplastic effects in lung cancer?

Answer 5

hypercalcemia

cushings, inapropriate ADH, ACTH

Question 6

Are tumour markers used in dx?

Answer 6

not really, more in follow up because it’s not specific or elevated in every case

Question 7

Why do x-rays and CTs besides for Dx?

Answer 7

staging and follow-up

Question 8

Another way to investigate lung tumours besides radiology?

Answer 8

bronchoscopy

Question 9

Tissue sampling cytology is what?

Answer 9

fine need aspiration, only look at cells

Question 10

Histopathology in tissue sampling is:

Answer 10

H&E, stains, immunohistochemistry

Question 11

What kind of sample needed for histopathology of neoplasia?

Answer 11

full piece of tissue

Question 12

Why do immunohistochemistry anyways?

Answer 12

helps distinguish primary from metastatic lesions

Question 13

Once diagnosis of malignancy is made, what other info?

Answer 13

tumour type/subtype
grade
stage
lymph invasion?
other

Question 14

Want to gather lots of info on tumours for what?

Answer 14

Prognosis
management
comparing treatments

Question 15

4 main types of lung carcinomas:

Answer 15

squamous cell carcinoma
adenocarcinoma
large cell
small cell

Question 16

lung cancer is one of most common in the world: Incidence?

Answer 16

13%

Question 17

More males of females lung cancer?

Answer 17

2.7:1 males

Question 18

average age of lung cancer Dx?

Answer 18

60

Question 19

3 big predisposing factors for lung cancer

Answer 19

tobacco
asbestos
arsenic

Question 20

a non smoker is most likely to get which cancer?
squamous cell carcinoma
adenocarcinoma
large cell
small cell

Answer 20

adenocarcinoma

Question 21

What pathogenesis are the following part of?
Goblet Cell hyperplasia
reserve cell hyperplasia
squamous metaplasia
squamous dysplasi
carcinoma in situ
invasive carcinoma

Answer 21

Pathogenesis of Small cell carcinoma in lung

Question 22

Does SCC form cavities?

Answer 22

yes, has necrotic core

Question 23

What paraneoplastic effects does SCC predispose you to?

Answer 23

pneumonia
bronchiectasis
recurrent infections

Question 24

Adenocarcinomas are more proximal or peripheral?

Answer 24

peripheral

Question 25

SCC are more proximal or peripheral bronchi?

Answer 25

proximal

Question 26

What is you can't determine tumour type on H&E?

Answer 26

other stains available S100 LCA CAM5.2 (liver cells stain, but not the tumour)

Question 27

Which are more aggressive? poorly differentiated or well differentiated?

Answer 27

poorly differentiated ones will mess you up

Question 28

What the gleason score for?

Answer 28

prostate cancer grading

Question 29

what is the modified bloom and richarson for?

Answer 29

breast ca grading

Question 30

what is stage of a cancer?

Answer 30

progression of malignancy

Question 31

What is TMN system? what is the acronym stand for?

Answer 31

For staging tumours T= primary tumour N= lymph node involvement M= distant metastases

Question 32

What does 'X' mean in staging?

Answer 32

unknown or cannot be assessed

Question 33

TNM is universal for all organs?

Answer 33

Nope. Different parameters for different organs!

Question 34

eg. of predictive factors in breast cancer?

Answer 34

HER2 amplification | oestrogen and progesterone receptors

Question 35

5 main treatments for cancer

Answer 35

``` surgery radiotherapy chemotherapy targeted therapy other(immuno, bone marrow) ```

Question 36

targeted therapy is different how for cancer?

Answer 36

less harmful to normal cells, more specific for tumour oncoproteins

Question 37

Two main categories for cancer targeted therapy:

Answer 37

1. small molecules (inhibit growth factors/tyrosine kinase) | 2. monoclonal antibodies that target proteins/receptors

Question 38

2 most important mutations in lung carcinoma?

Answer 38

EGFR | ALK

Question 39

What's so significant about EGFR?

Answer 39

significant rate of mutations in young non/light smoking female asians with low-stage disease

Question 40

What does EGFR tyrosine kinase doman increase downstream?

Answer 40

hyperactivation of signaling pathways leading to abnormal proliferation

Question 41

How to treat EGFR mutations?

Answer 41

target therapies like Gefitinib and Erlotinib inhibit EGFR

Question 42

Can all lung carcinomas be treated with targeted therapies?

Answer 42

No, tumour need to be tested, could be resistant

Question 43

What is cachexia

Answer 43

wasting syndrome due to loss of appetite and the body just not processing nutrition appropriately

Question 44

3 ways to die from cancer

Answer 44

1. cachexia 2. secondary infection 3. damage to vital organ by primary/secondary tumours

Question 45

Prevention of cancer? 4 things

Answer 45

public education lifestyle screening program laws for workplace exposure