neoplasia 3

Question 1

screening
ex:
whats taken into account?

Answer 1

asymptomatic patients - healthy, preventative measure. screen for pre-malignant process.
ex: pap smears, breast, colon (FIT testing, colonoscopy), testicle, prostate.
take into account family history of genetic disease (HNPCC & BRCA)

Question 2

HNPCC

Answer 2

hereditary nonpolyposis colorectal cancer

- DNA repair hindered. screen annually/bi-annually.

Question 3

BRCA

Answer 3

breast cancer susceptibility gene

high risk for breast and ovarian cancer. screening , after child bearing years, prophylactic removal.

Question 4

papanicoloau test

Answer 4

swab outside lining of cervis. superficial epithelial to test for infected cells.
in lab, stained. if dark blue positive for HPV.

Question 5

mammography

Answer 5

parallel plates compress breast tissue.

lmages show breast tissue

Question 6

colon screening

Answer 6

FIT - fecal immunochemical test - detect blood in stool.

Question 7

warning signs

Answer 7

change in bowel, bladder habits,
sore doesnt heal
unusual bleeding/discharge
lump in breast
indigestion or difficult swallowing
change in wart or mole

Question 8

serious signs

Answer 8

– usually waited too long
weight loss
night sweats
enlarged lymph nodes

Question 9

clinician - tests they ask for

Answer 9

imaging - (family doc, specialist) -US, x-ray, CT
blood test (fam doc, surgeon) - prostate specific antigen, hCG, CA-125
cytopathology (radiologist, specialist) - FineNeedleAspirate, cavity taps (suck out cells)
biopsy (fam doc, specialist, surgeon) - skin, GI, endobronchial biopsies.
resection - surgeon

Question 10

cytopathology

Answer 10

diagnosis of disease at cytological level.
assess nuclei
assess cellularity and basic architecture.

screening - pap smear
diagnosis - fine needle aspiration. fluids

Question 11

tissue diagnosis

Answer 11

biopsies – resection specimen observation, treatment

Question 12

biopsies - purpose

Answer 12

making diagnosis, guiding next step.

Question 13

purpose resection specimens

Answer 13

staging tumor, grading tumor, guiding further therapy, prognostic info

Question 14

treatment types

Answer 14

surgery
radiation therapy
chemo
immune therapy
tumor specific therapy
additional investigations. - molecular studies

Question 15

screening for tumor associated antigens.

Answer 15

there are sometimes false negatives, false positives.

ex: PSA for prostate is garbage. only do if in family history

Question 16

diagnosis for tumor associated antigens.

Answer 16

testicular cancer: hCG, LG, AFP –> no biopsy, just remove whole testicle.
ovarian mass: CA-125 - secreted by neoplasms and non-malignant conditions

Question 17

follow up for tumor associated antigens

Answer 17

treatment for effectiveness and recurrnece.

CEA for colon cancer. if tumor is secreting something treatment should reduce

Question 18

invasiveness - key

Answer 18

key to malignancy.
colonic adenoma vs adenocarcinoma = same genetic mutation, when confined to surface = not malignant.
melanoma-in-situ vs melanoma = mole changes colour
high grade vs invasive.
ductal carcinoma in-situ vs invasive.
- risk of metastasis once tumor invades beyond basement membrane

Question 19

tumor staging.
breast
prostate
colon

Answer 19

breast = nottingham score
prostate = gleason score
colon = based on architecture

Question 20

staging is both subjective and objective

Answer 20

nuclear atypia = subjective - how abnormal is nucleus
architecutre abnormalities - subjective - how abnormal is gland/organ
mitotic counts: counting mitosis - objective

Question 21

breast cancer grading

Answer 21

nottingham grade
- tubule formation
nuclear pleomorphism
mitotic counts.

Question 22

tumor stage - assesses?

Answer 22

assesses extent of spread.
info about risk of metastasis.
info about prognosis.

Question 23

pathological staging -TNM

Answer 23

T = tumour (size,depth, invasion)
N= nodes( number, size of deposit, matting)
M = metastasis (distance varies between organ)

Question 24

clinical stage groupings

Answer 24

combo of pathological stage.

guides treatment decisions