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SP16- Gen Path Exam 1 > Neoplasia 3 > Flashcards

Neoplasia 3 Flashcards

1
Q

The _____ family of regulators is involved with blocking apoptosis.

A

BCL

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2
Q

What is the “prototypic anti-apoptosis gene?”

A

BCL2

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3
Q

How is BCL2 activated?

A

by TRANSLOCATION from chromosome 18 to the Ig heavy locus of chromosome 14

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4
Q

BCL is activated by translocation from chromosome 18 to the _______ locus on chromosome 14.

A

Ig heavy chain

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5
Q

What is the problem with over-expression of BCL2 protein?

A

cells are protected from apoptosis and are able to survive for prolonged periods

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6
Q

Over-expression of BCL2 results in the steady _______ of cells that is often seen in “low-grade” ______.

A

accumulation

lymphomas

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7
Q

_______ to a tumor is critical for sustained growth.

A

blood supply

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8
Q

Tumors cannot grow larger than ______ in diameter unless they are vascularized (nutrients and oxygen)

A

1 to 2 mm

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9
Q

______ facilitates metastases by providing access to the vasculature.

A

angiogenesis

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10
Q

True or False: Anti-angiogenesis treatment is sufficient in controlling tumors.

A

False: it is not sufficient on its own

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11
Q

What are the two characteristics most often associated with malignancy?

A

invasion

metastasis

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12
Q

Only certain _____ may be capable of metastasizing.

A

subclones

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13
Q

The complex process of invasion/metastasis involves what two major phases?

A
  1. invasion of the ECM

2. vascular dissemination and adhesion/homing of tumor cells

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14
Q

Describe the process for invasion of the ECM.

A
  • tumor cells detach from each other
  • attach to ECM components (basement membrane and CT) : collagens, glycoproteins, and proteoglycans
  • degradation of matrix components
  • migration
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15
Q

To which ECM components do tumor cells attach to?

A

collagen
glycoprotein
proteoglycan

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16
Q

______ is considered the hallmark of malignancy although not all tumors will have this characteristic. What is always characteristic of malignancy?

A

Metastasis

always = invasion

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17
Q

Tumor metastasis is usually a function of what two cellular traits?

A
  1. function of the site

2. vascular/lymphatic drainage

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18
Q

What is “organ tropism” associated with cancer?

A

the tendancy of metastasis to occur at specific sites due to possible chemoattraction or receptors
ex: skeletal muscle cancer is rare (possibly fewer receptors on skeletal muscle)

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19
Q

Humans are constantly exposed to _______ such as ionizing radiation, sunlight, and dietary agents.

A

environmental carcinogens

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20
Q

Errors in DNA replication occur naturally, so why isn’t cancer more common?

A

DNA repair genes!

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21
Q

Hereditary Nonpolyposis Colon Cancer Syndrome and Xeroderma Pigmentosum are two examples of conditions with ______ ____.

A

Unstable DNA

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22
Q

What is Hereditary Nonpolyposis Colon Cancer Syndrome?

A

mismatch repair defect (microsatellite instability)

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23
Q

______ ______ is an inability to repair UV damage that commonly results in skin cancers.

A

xeroderma pigmentosum

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24
Q

Which proteins are associated with familial breast cancers?

A

BRCA1 and BRCA2

DNA control and tumor suppression

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25
Q

True or False: A single mutation could result in cancer.

A

False, cancers exhibit multiple genetic alterations

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26
Q

Cancers exhibit multiple genetic alterations including activation of several _______ and two or more ____ ____ _____.

A

oncogenes

cancer suppressor genes

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27
Q

As DNA damage goes un-repaired, the risk for mutations increases dramatically once reaching the _____ ______ stage.

A

clonal expansion

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28
Q

True or False: Over time, many tumors become more aggressive locally and have greater metastatic potential.

A

True

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29
Q

Why do many tumors become more aggressive locally?

A

due to the acquisition of multiple mutations during tumor growth, resulting in numerous “subclones” with different characteristics

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30
Q

How do “subclones” survive?

A

they develop different characteristics that are survival selective such as drug resistance, resistance to hypoxia, etc.

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31
Q

What is the most common karyotypic change seen in tumors?

A

Balanced Translocations (for example: 22 and 9 in Philidelphia chromosome)

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32
Q

What are the three types of karyotypic changes seen in tumors?

A
  1. Balanced translocations
  2. Deletions
  3. Gene amplifications
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33
Q

Retinoblastoma is associated with which type of karyotypic change?

A

Deletion (Rb)

34
Q

Neuroblastoma and breast cancers are associated with which karyotypic change?

A

gene amplification

35
Q

Chronic Myelogenous Leukemia is associated with the Philidelphia chromosome which involves chromosomes ____ and ____. This results in what kind of mutation?

A

22 and 9

Tyrosine Kinase Mutation

36
Q

N-MYC is associated with _______.

A

neuroblastoma

37
Q

What are “double minutes?”

A

chromosomes that enter circulation in the cytoplasm and can be transcribed when the re-enter the nucleus later

38
Q

What are the three major classes of carcinogenic agents (factors associated with genetic damage)?

A
  1. Radiant Energy
  2. Chemicals
  3. Oncogenic Viruses
39
Q

Over 200 years ago, Sir Percival Pott linked soot exposure to ______ cancer in chimney sweeps.

A

scrotal skin

40
Q

Chemical carcinogens can be of what two types?

A

natural

synthetic

41
Q

True or False: Chemical carcinogens are synthetically produced to kill cancer cells.

A

True, some are produced for that reason

42
Q

True or False: Direct-reacting carcinogens require chemical transformation.

A

False, they require no transformation

43
Q

Most cancer-causing chemical are _______ carcinogens.

A

indirect

44
Q

What is an “indirect” carcinogen?

A

they become active only after metabolic conversion

45
Q

Indirect carcinogens are _________

A

pro-carcinogens

46
Q

What are the “true” carcinogens?

A

Active metabolites (ultimate carcinogens)

47
Q

All chemical carcinogens are highly reactive ______.

A

Electrophiles

48
Q

True or False: Chemical carcinogens affect anything with a positive charge.

A

False, NEGATIVE charge (such as DNA, RNA, proteins)

49
Q

How can chemical carcinogens be enhanced?

A

by other chemicals called “promoters” that drive cells to divide and thus immortalize DNA alterations

50
Q

True or False: Promoters are carcinogens.

A

False, not in-and-of themselves. They have LITTLE mutagenicity on their own

51
Q

What are examples of radiation carcinogens?

A
  • UV light
  • X-rays
  • Radionuclides
  • Gamma Radiation from nuclear fission
52
Q

True or False: Early dental practitioners developed squamous cell carcinomas from x-radiation.

A

True

53
Q

What is an example of radionuclide carcinogenesis?

A

miners of radioactive elements (uranium) and the development of lung cancer

54
Q

Why did atomic bomb survivors develope leukemia/cancer 8-12 years after the explosion?

A

gamma radiation is hematopoetic and can go latent for decades

55
Q

Human T-cell Leukemia Virus Type I is an example of an ___ ____ virus.

A

RNA Oncogenic

56
Q

Where is Human T-cell Leukemia most prevalent?

A

parts of Japan and Caribbean basin

57
Q

HPV with Cervical/Oropharyngeal Cancer, or EBV with Burkitt’s lymphoma are two examples of what type of carcinogenesis?

A

DNA oncogenic Viruses

58
Q

HHV8 is associated with what type of cancer?

A

Kaposi’s Sarcoma

59
Q

What are four important anti-tumor mechanisms?

A

cytotoxic T-cells (CD8+)
natural killer cells
macrophages
humoral factors

60
Q

What is “immunosurveillance?”

A

increased frequency of cancer observed in immunocompromised

61
Q

What is PSA?

A

Prostate Specific Antigen (it is used to monitor current or past disease)

62
Q

A tumor is exposed to the immune system which will exert local controls. What is an example of cell alteration that could be a potential avenue for melanoma therapy?

A

Dendritic Cell alterations

63
Q

How does a tumor evade the immune system?

A
  • selects for antigen-negative variants
  • reduces expression of HLA antigens
  • lacks T-cell co-stimulation (requires 2nd signal)
  • immunosuppression
64
Q

What are four clinical features of neoplasia?

A
  1. Location
  2. Functional Activity
  3. Ulceration
  4. Cachexia
65
Q

True or False: A benign tumor can be lethal.

A

True, if its in the wrong place (i.e: blocking a major artery)

66
Q

What is cachexia?

A

progressive wasting state (mediated by IL-1 and TNFalpha)

67
Q

10-15% of cancer patients develop ______ syndromes due to hormone and peptide alterations.

A

paraneoplastic

68
Q

Why would Cushing’s syndrome or hypercalcemia develop secondarily to cancer?

A

they are paraneoplastic syndromes associated with an alteration in the body’s ability to mobilize calcium

69
Q

What are the two steps in evaluating cancer?

A
  1. Grading

2. Staging

70
Q

What is “grading” in regards to evaluation of a neoplasm?

A

grading is an estimate of the aggressiveness of a cancer based on the MICROSCOPIC appearance

71
Q

What is “staging” of a neoplasm?

A

staging describes the cancer EXTENT (size, node involvement, spread) as estimated by CLINICAL EXAM and IMAGING

72
Q

True or False: Staging involves the use of microscopy.

A

False, “look and see”

73
Q

True or False: Grading is an estimation of aggressiveness.

A

True, based on microscope analysis

74
Q

Biopsy can be _____ or _____.

A

incisional

excisional

75
Q

Why is “frozen section biopsy” sometimes a difficult method to rely on?

A

artifacts can form due to crystal formation

76
Q

True or False: Fine-needle aspiration biopsy is actually better termed “cytology”

A

True

77
Q

What is a common example of a “cytology?”

A

Pap Smear (tissue cells)

78
Q

Which laboratory diagnosis is used to evaluate a blood malignancy?

A

Flow Cytometry

79
Q

What is the difference between incisional and excisional biopsy?

A

incisional is a “small part”

excisional is “the entire thing”

80
Q

When evaluating a pap smear, what do you want to see?

A

almost all cytoplasm, if the cells are hyperchromatic and have a high ratio of nucleus to cytoplasm that is indication of cancer

81
Q

Prostate Specific Antigen (PSA), Carcinoembryonic Antigen (CEA), and alpha-fetoprotein are examples of ________.

A

biochemical assays for diagnosing cancer

82
Q

ISH, FISH, and PCR are _______ diagnosis methods for cancer.

A

molecular

SP16- Gen Path Exam 1 (10 decks)

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