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Pathological Processes > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Name 5 clinical problems associated with benign tumours.

A 
Obstruction
Hormone production 
Pressure 
Anxiety 
Transform -> neoplasm
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2
Q

Name some clinical problems associated with malignant tumours.

A 
Pressure and destruction - adjacent tissues
Metastasis - secondary tumour
Blood loss - ulceration
Hormone production 
Paraneoplastic effect 
flow obstruction 
Anxiety/ pain 
Pruritis 
Abnormal pigmentation
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3
Q

Name a type of mixed tumour.

A

Epithelial lined glands or clefts embedded in a loose fibrous tissue matrix.

Fibroadenoma^^^^

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4
Q

What 3 factors contribute to cellular immortalisation?

A

Autocrine growth receptors
Reduced apoptosis
Telomerase

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5
Q

What carcinogen is scrotal cancer associated with?

A

Soot

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6
Q

What carcinogens is lung carcinoma associated with?

A

Smoking
Alcohol
Atmospheric pollutants

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7
Q

What carcinogen is bladder carcinoma associated with?

A

Beta-naphthylamime

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8
Q

Name some chemical carcinogens.

A 
Aromatic amines (B-naphthylamine)
Azo dyes
Alkylating agents
Polycyclic aromatic hydrocarbons 
Nitrosamines
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9
Q

What are the following oncogenic viruses associated with

HPV
EBV
HepB/C
RNA retrovirus

A

HPV - carcinoma of the cervix
EBV - Burkitt’s lymphoma
Hep B/C - hepatocellular carcinoma
RNA retrovirus - T cell leukaemia/ lymphoma

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10
Q

What two cells does UVB have an associated risk of?

A

Basal cell carcinoma

Malignant melanoma

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11
Q

What cancers are the following hormones associated with

Exogenous oestrogens
Androgens and anabolic steroids
Oestrogenic steroids

A

Mammary and epithelia carcinomas
Hepatocellular tumouras
Pre-existing lesions - more vascular

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12
Q

What are the 3 genetic alterations that are needed to transform a cell into a neoplastic cell?

A

Telomerase expression
Reduced expression of tumour suppressor genes
Increased or abnormal expression of dominant oncogenes.

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13
Q

Give 2 examples of tumour suppressor proteins.

A

pRB

P53

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14
Q

What is the difference between a initiator and a promoter?

A

Initiators are mutagenic agents whereas promotes cause cellular proliferation.

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15
Q

What is a fungal carcinogen?

A

Aflatoxin B

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16
Q

What cancer is UC linked to?

A

Colorectal

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17
Q

What do mutations in the following genes result in

BRCA1
BRCA2

A

BRCA1 - ovarian and breast

BRCA2 - breast, prostate and pancreatic

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18
Q

What are 2 things that can happen to a proto-onco gene that turns it into an oncogene?

A

Mutated

Abnormally expressed

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19
Q

Name 4 key features of the metastatic cascade.

A

Downregualtion of Catherine’s
Cycling-regulation of integrins
Reduced MHC I - defence from NK cells
Endothelial adherence - CD44 upregulation

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20
Q

What is neoadjuvant treatment compared to adjuvant treatment?

A

Neoadjuvant reduces the size of the primary tumour whereas adjuvant focuses on eliminating any sub-clinical conditions following surgery.

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21
Q

What type of doses is radiation therapy administered in and what is the overall effect of it?

A

Fractionated

Generates free radicals + directly damages DNA of rapidly diving cells - especially during G2 - preventing M phase.

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22
Q

Name 3 types of drugs that can be used in chemotherapy

A 
Alkylating/platinum drugs
(Cis-platinum + cyclophosphamide)
Antibiotics 
Anti-metabolite (fluorouracil)
Plant derived (interferes with microtubule assembly)
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23
Q

What type of drug is tamoxifen and what is it used to treat?

A

SERM

Oestrogen receptor positive breast cancers

24
Q

How can prostrate cancers be treated?

A

Androgen blockade

25
Q

What can herceptin be used to treat and how?

A

Breast cancers by blocking HER-2 signalling

26
Q

What inhibits BCR ABL?

A

Imatinib

27
Q

What do drugs nivolumab and ipilimumab do?

A

Block immune checkpoints

28
Q

In which cancers do you get the following elevated markers?

hCG
alpha fetoprotein
Prostate-specific antigen
CA-125

A

Testicular tumour
Hepattocellular carcinoma
Prostate carcinoma
Ovarian cancer

29
Q

What are the 4 common sites of blood borne metastasis?

A

Liver Bone Brain Lung

BBLL(ood)

30
Q

2 ways in which a colon cancer can present as an emergency?

A

Perforation

Bowel obstruction

31
Q

Colloquial and correct name for tumour of uterine myometrium?

A

Fibroid

Leiomyoma

32
Q

What is a struma ovarii?

A

Teratoid tumour of the ovaries - mainly thyroid tissue

33
Q

Name 4 primary neoplasms that occur within the brain

A

Oliodendroglioma
Glioma
Astrocytoma
Ependyoma

34
Q

How does malaria cause Burkitt’s lymphoma?

A

Inactivate p53 gene causing polyclonal proliferation of B cells.
EBV becomes reactivated which is latent in the B cells

35
Q

What cancer does fibre reduced the risk of and how?

A

Binds - carcinogens

Increased transit time - less exposure of gut to carcinogens

36
Q

What effect does early first pregnancy have in terms of developing the following cancers

Breast cancer

Cervical Carcinoma

A

Low incidence of breast cancer
- Breast cells proliferate during pregnancy therefore an early first pregnancy means initially there is less DNA damage

Increased incidence of cervical carcinoma
- Prolonged exposure to HPV

37
Q

What cancer is schistosomiasis linked to?

A

Bladder carcinoma

38
Q

What cancer are aflatoxins linked to?

A

Liver cell carcinoma

39
Q

How does HPV cause cervical cancer?

A

E6 binds/ degrades p53 + activates telomerase

E7 binds RB protein

40
Q

What cancers are associated with asbestos?

A

Lung
Malignant mesothelioma
GI carcinoma

41
Q

What cancer is Helicobacter pylori associated with?

A

Gastric adenocarcinoma

42
Q

What is a triple negative breast cancer?

A

No oestrogen, progesterone or HER-2 receptors.

43
Q

What is FAP?

What is the risk?

What gene is defective?

A

Familial adenomatous polyposis

Many polyps in the large intestine

Untreated - colon cancer

APC

44
Q

What is HNPCC?

A

Hereditary non-polyposis colon cancer

45
Q

Out of FAP and HNPCC which one has a higher chance of development of colon cancer?

Which one has more polyps developing?

A

FAP

FAP

46
Q

What is a tumour marker for monitoring cancers of the large intestine?

A

Carcinoembryonic antigen

47
Q

What age do you have to be to be offered bowel cancel screening?

How often?

A

55

Every two years
Bowel scope screening test first time then home testing kit from then on

48
Q

What are the 2 most common aetiologies for cervical cancer?

A

HPV and chlamydia

49
Q

Who is eligible for cervical cancer screening and when will they be invited for screening?

What is another name for a cervical screening test?

A

All registered women
25-49 - every 3 years
50-64 - every 5 years
>65 - only women who haven’t been screened since 50 or have abnormal tests

Smear test

50
Q

Why do both alleles of tumour suppressor genes need to be mutated in order for cancer to develop whereas proto-onco genes need only one allele to be mutated?

A

Mutations - TSGs - inactivating - therefore btoh need to be mutated to be ineffective
Mutation - protooncogenes - activating - only one allele needed to favour and enhance neoplastic growth.

51
Q

What are the 2 classes of tumours that can occur in the testis?

A

Seminomatous and non-seminomatous

52
Q

Name some non-seminomatous tumours.

A

Teratomas
Embryonal carcinomas
Choriocarcinoma
Yolk sac tumours

53
Q

Describe Ann Arbor staging for Lymphomas.

A

Stage I - single node region
Stage II - 2 or more nodes on one side of the diaphragm
Stage III - 2 or more nodes on both sides of the diaphragms
Stage IV - Diffuse involvement of one or more extra-lymphatic organs - lungs, bone marrow etc.

54
Q

Describe the T1-T4 stages for TNM Classification for breast cancer.

A

<2cm
2-5cm
5+
Skin or chest wall involvement

55
Q

Name 5 tumours that produce ectopic EPO.

A 
Hepatocellular carcinoma
Renal cell carcinoma
Cerebellar haemangioblastoma
Uterine tumours
Phaeochromocytoma

Pathological Processes (11 decks)

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