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Foundations of Medicine 1 > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is the difference between a tumor and neoplasia?

A

A tumor is a swelling

Neoplasia is a new growth –> cancer is a subset of neoplasia

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2
Q

What is the definition of neoplasia?

A

A tumor or overgrowth resulting from purposeless proliferation or intrinsically derived abnormal cells

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3
Q

What is the actively growing portion of a tumor called?

A

parenchyma

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4
Q

What is the difference between dysplasia and anaplasia?

A

Dysplasia is an abnormality of development or an epithelial anomaly of growth and differentiation
Anaplasia is a condition of cells in which they have poor cellular differentiation.

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5
Q

What is the difference between positional and cellular anaplasia?

A

Positional- cells are morphologically normal but have abnormal relationships to one another
Cellular- individual cells show structural abnormalities and from each other

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6
Q

What is a key feature seen in aplastic cells?

A

hyperchromasia–> darker staining of nuclei

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7
Q

Name four biological behaviors of tumors

A

1) shorter doubling time
2) necrosis
3) invasion
4) metastasis

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8
Q

What is Carcinoma in Situ (CIS)?

A

malignant epithelial cells with cytologic anaplasia have not yet broken through the barrier of the associated basement membrane

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9
Q

What are the four routes of metastasis?

A

1) hematogenous spread
2) lymphatic spread
3) Serosal spread–> may cross natural passages (pleural or peritoneal spaces)
4) mechanical implantation

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10
Q

What is neoplastic transformation?

A

When the DNA of a cell is “garbled” usually effecting cellular reproduction and/or cell death –> leads to immortal cells
defined by autonomous, dysregulated proliferation

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11
Q

What is an adenoma?

A

A benign epithelial neoplasm with glandular or secretory characteristics (example: adrenal adenoma)

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12
Q

What is a papilloma?

A

A benign epithelial neoplasm resulting from a multilayered epithelium projecting above the surface of the normal epithelium (example: wart)

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13
Q

What is a polyp?

A

A benign epithelial neoplasm protruding from a secretory surface

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14
Q

What is a carcinoma?

A

A malignant epithelial neoplasm

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15
Q

What is a sarcoma?

A

A malignant stromal neoplasm

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16
Q

What is a lymphoma?

A

malignant tumors of the lymphoid tissue

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17
Q

What are tertomas?

A

tumors derived from germ cells, usually found in the gonads. may be malignant or benign

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18
Q

What are the three most common fatal cancers in the US for men and women?

A

Men–> lung, prostate, colon/rectum

women –> lung, breast, and colon/rectum

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19
Q

What is the most common way for a cancer patient to die?

A

infection due to suppressed immune systems (happens with or without chemo)

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20
Q

What are paraneoplastic syndromes?

A

some tumors produce atypical substances or hormones that can have an effect upon the host–> not related to invasion or metastasis

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21
Q

What is tumor grading?

A

how undifferentiated the cells are microscopically –> defined by pathologist

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22
Q

what is tumor staging?

A

How far the tumor has spread. Defined by clinician

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23
Q

What is the initial event in the development of cancer?

A

nonlethal genetic mutation –> mutation of DNA

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24
Q

What is the clonal evolution model of tumorigenesis?

A

tumors start out monoclonal in origin, but they become very heterogeneous as multiple cells acquire different mutation with time

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25
Q

What is the most vulnerable stage of the cel cycle?l

A

The S phase (replication)

26
Q

What are the four principal targets of genetic damage that lead to cancer?

A

1) DNA repair genes (inactivate)
2) oncogenes (activate)
3) tumor suppressors (inactivate)
4) cell survival genes (activate)

27
Q

What are the 7 molecular features of cancer?

A

1) the acquisition of self-sufficiency in growth signals
2) insensitivity to growth inhibitory signals
3) evasion of apoptosis
4) limitless replicative potential
5) sustained angiogenesis
6) tissue invasion and/or metastasis
7) defect in DNA repair–> genomic instability

28
Q

What are cellular oncogenes?

A

Structural mutations in these genes or their promoters leads to increased function or over-expression

29
Q

What are viral oncogenes?

A

genetically altered proto-oncogenes found in retroviruses that can lead to tumors and transformation. Not currently found in humans

30
Q

What are the 5 functional classes of oncogenes and list an example of each

A

1) Growth factors- Platelet derived growth factor is a potent mitogen that leads to astrocytoma and osteosarcoma
2) Growth factor receptors-PDGF and EGF receptors
3) signal transducing proteins- ras signalling (mutated GTPase)
4) Nuclear transcription factors- c-myc leading to Burkitt’s lymphoma and neuroblastoma
5) proteins involved in regulating the cell cycle- CDKs and cyclins (D)

31
Q

Describe the pathogenesis of Burkitt’s lymphoma?

A

It is the result of a chromosomal translocation in a mature B cell so that it produces lots of c-myc

32
Q

Describe the pathogenesis of mantle cell lymphoma?

A

It is the result of a chromosomal translocation in B cells so that lots of cyclin D exists in the cell keeping in the replicative phase.

33
Q

Describe the pathogenesis of follicular lymphoma?

A

It is the result of a chromosomal translocation in B cells resulting in overexpression of BCL2 –> an antiapoptosis gene

34
Q

What are the 5 mechanisms by which oncogenes become activated?

A

1) mutational activation (frameshift, point…)
2) chromosomal translocation
3) Transcriptional activation
4) Epigenetics
5) microRNAs

35
Q

What is the function of the retinoblastoma gene product?

A

It is a tumor suppressor. It is normally hypophosphorylated and binds to transcription factor, E2F, keeping it in its inactive form. Cyclin D phosphorylates retinoblastoma and it separates from E2F which can then go on to increase transcription in the S phase.

36
Q

Inherited mutation of p53 result in which disease?

A

Li-Fraumeni syndrome

37
Q

What is the function of p53?

A

It is a tumor suppressor that prevents the propagation of genetically damaged cells. It is activated when a cell is mutated and it up regulates p21 which induces cell cycle arrest in G1 and up-regulates GADD45 which is a repair gene that attempts to fix the damage. If it cannot be fixed p53 up-regulates bax which causes apoptosis.

38
Q

If p53 is damaged in a tumor what would NOT be a good therapy?

A

radiation

39
Q

What are 5 characteristics of tumor suppressor genes?

A

1) Recessive at the cell level (loss of function)
2) tissue specificity
3) germline inheritance frequently leads to cancer
4) No known analogues in oncogenic viruses (in humans)
5) Germline mutations may initiate, but mutation to neoplasia only occurs during progression

40
Q

What 3 things can inactivate a tumor suppressor?

A

1) DNA mutations
2) epigenetic changes
3) microRNAs

41
Q

What are the proapoptotic proteins?

A

Bax, Bak, Bid and Bim

42
Q

What are the antiapoptotic proteins?

A

Bcl-2, Bcl-XL, Bcl-W

43
Q

What are the three general classes of signaling factors that mediate angiogenesis?

A

1) soluble factors and their receptors –> VEGF and fibroblast growth factors
2) integrins and adherins
3) extracellular proteases

44
Q

What classes of molecules are involved in metastasis and tissue invasion?

A

1) cell-cell adhesion molecules like CAMs, cadherins, and inegrins
2) extracellular proteases like MMps

45
Q

What is the Warburg Effect?

A

Most cancers shift glucose metabolism and ATP production away from mitochondria to aerobic glycolysis –> used in PET scanning

46
Q

Describe some key features of the initiation phase of the multistage model of carcinogenesis

A

occurs in single cells
irreversible
dose dependent
usually involves a single mutational event
Not all initiated cells go on to become cancer

47
Q

Describe some key features of the promotion phase of the multistage model of carcinogenesis

A

reversible
exogenous signaling that is usually receptor mediated
has a detectable dose response and threshold
increases proliferation or decreases apoptosis

48
Q

Describe some key features of the progression phase of the multistage model of carcinogenesis

A

irreversible

acquisition of multiple mutations often resulting in genomic instability

49
Q

What are some examples of autosomal dominant monogenetic inheritance?

A

retinoblastoma, p53 and APC (familial adenomatous polyposis coli)

50
Q

What are some examples of autosomal recessive monogenic inheritance?

A

DNA repair genes that result in disorders like ataxia telangiectasia and xeroderma pigmentosa

51
Q

T/F most inherited cancers are monogenic

A

FALSE. polygenic

52
Q

What is a procarcingogen?

A

a chemical substance that becomes a carcinogen only after it is altered by metabolic processes (becomes an electrophile)

53
Q

What examples of procarcinogens?

A

polycyclic aromatic hydrocarbons (tobacco and animal fats)
Aromatic amines and azo dyes like b-naphthylamine–> bladder cancer
Aflatoxin B1–> hepatocellar carcinomaq

54
Q

What kind of cancers does EBV lead to?

A

Burkitt’s lymphoma
Nsopharyngeal carcinoma
some Hodgkins and some B cell lymphoma

55
Q

What kind of cancers does HBV lead to?

A

hepatocellular carcinoma

56
Q

What kind of cancers does herpes virus 8 lead to?

A

karposi sarcoma

57
Q

What kind of cancers does HTLv1 and 2 lead to?

A

T cell leukemia/lymphoma

58
Q

What kind of cancers does helicobacter pylori lead to?

A

gastric carcinoma

MALT lymphoma

59
Q

What kind of cancers does schistosoma hematobium lead to?

A

bladder cancer

60
Q

What kind of cancers does opisthorchis viverrini lead to?

A

hepatic cholangiocarcinoma (bile duct epithelium)

Foundations of Medicine 1 (12 decks)

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