Neoplasia (Final Exam)

Question 1

this means “new growth”. implies an abnormality of cellular growth/tumor. it is associated with an altered expression of cellular genes. can be benign or malignant

Answer 1

neoplasia

Question 2

also called surface cells—line papillae and cysts and form tubules. These cells are voluminous eosinophilic cytoplasm and prominent nuclei. Intranuclear inclusions and multinucleation are often observed

Answer 2

cuboidal

Question 3

stromal cells—fill the papillary cores and form the sheets in solid areas. having well-defined borders, clear to eosinophilic cytoplasm, centrally located round to oval nuclei with fine dispersed chromatin, and usually indiscernible nucleoli.

Answer 3

round cells

Question 4

are round cells (stroll cells) usually larger or smaller then cuboidal cells (surface cells)

Answer 4

smaller

Question 5

what does the suffix “-oma” indicate

Answer 5

benign tumor

Question 6

what does the suffix “-carcinoma” or “-sarcoma” indicate

Answer 6

malignant tumor

Question 7

this is a malignant tumour of epithelial origin

Answer 7

carcinoma

Question 8

this is a malignant tumour of mesenchymal origin

Answer 8

sarcoma

Question 9

what are some risk factors for cancer/neoplasia

Answer 9

• tobacco use
• nutrition
• obesity
• sun exposure (skin cancer)
• sexual exposure to HPV (cervical cancer)

Question 10

normally cancerous cells are destroyed by _____ and _______

Answer 10

cell-mediated immunity and humeral immunity

Question 11

true or false: normally there is an imbalance in oncogenes and tumor suppressor genes so that you have more tumour suppressor genes so cancer doesn’t occur

Answer 11

false - usually have a balance between them. if a mutation occurs then you get an imbalance

Question 12

these are normal cellular genes transformed into oncogenes by activating mutation. they code for:
- growth factors
- growth factor receptors
- cytoplasmic signalling molecules
- nucelar transcription factors

Answer 12

proto-oncogenes

Question 13

these are small cell-manufactured peptides. are coded for by proto-oncogenes
- they secrete into extracellular space
- diffuse into nearby cells
- interact with receptors on target cell surface
- activate signalling cascade: can produce autocrine signalling if overproduction

Answer 13

growth factors (mitogens)

Question 14

these are transmembrane proteins and are coded for by porto-oncogenes; the mitogen binding area is on ht outside of the cell and the enzyme activating area is on the inside of the cell. will only bind with one particular mitogen. binding activates cell proliferation. HER2 - over expression

Answer 14

growth factor receptors

Question 15

this is coded for by porto-oncogenes. it involves numerous enzymes and chemicals. mutant proto-oncogene is due to overproduction of pathway components
RAS gene: codes defective protein
- unable to hydrolyse GTP
- 30% of all human cancers

Answer 15

cytoplasm signalling pathways

Question 16

these are the three proto-oncogenes that code for transcription factors. they are normally sequestered until appropriate signals occur
examples: lung and breast cancer, leukemia, neuroblastoma

Answer 16

Myc, Jun, Fos

Question 17

true or false: oncogenes become activated proto-oncogenes

Answer 17

false other way around
proto-oncogenes become oncogenes!

Question 18

what are the four ways proto-oncogenes become activated oncogenes?

Answer 18

1. oncogenes introduced to host cell by retrovirus
2. a mutagenic event
3. loss/damage of regulatory DNA sequence
4. error in chromosome replication produce extra copies of proto-oncogene (amplification)

Question 19

this can cause a proto-oncogene to become an activated oncogene. it is composed of RNA and contains reverse transcriptase enzyme (which directs syntheses of a DNA copy of viral RNA). examples include:
- HIV (Kaposi’s sarcoma)
- Epstein-Barr virus (Burkitt lymphoma)
- Human T-lymphocyte virus type 1 (adult T cell leukemia/lymphoma)

Answer 19

retrovirus

Question 20

these contribute to cancer only when not present, otherwise they inhibit cell proliferations. both copies of these are usually inactivated in order for cancer to develop

Answer 20

tumor supressor genes

Question 21

true or false: one can inherit a defective copy of tumor suppressor genes from one or both parents

Answer 21

true

Question 22

this is a critical tumour suppressor gene that blocks the cell cycle progression by inhibiting transcription factors when unphosphorylated

Answer 22

Rb (retinoblastoma) gene

Question 23

what is the normal process of the Rb gene when a growth factor (such as EGF) binds to its receptor

Answer 23

growth factor binds to receptor -> activation of cyclins/Cdk -> phosphorylation of pRB -> release of transcription factors -> gene transcription occurs -> S-phase/DNA replication can occur

Question 24

this provides instructions for making a protein called tumour protein p53 (TP53) which is a tumour suppressor.

Answer 24

p53 gene

Question 25

when ionizing radiation, carcinogens or mutations are presented to a normal cells (TP53) normal, DNA damage occurs -> TP53 is activated and binds to DNA -> DNA repair -> sucessful cell repair -> normal cells. what happens when the cell has a mutation or a loss of TP53?

Answer 25

after DNA is damaged -> TP53-dependant genes are not activated -> no cycle arrest/DNA repair -> there is an expansion and additional mutations -> malignant tumour

Question 26

these are tumour suppressor genes. e.g. breast cancer genes. early onset compared with sporadic. usually bilateral

Answer 26

BRCA1 & BRCA2

Question 27

family history and inherited defect in ______ increases risk of breast (85%) and ovarian (40-60%) cancer

Answer 27

BRCA1

Question 28

which of the following will produce a tumour A. Ras -> anchorage independant B. Myc -> immortal C. Ras & Myc -> anchorage independent and immortal

Answer 28

C

Question 29

what will happen to cells if there is a homozygous loss of APC locus on 5q

Answer 29

cells will look normal

Question 30

what will happen to cells if there is a mutation of ras on 12p

Answer 30

cells proliferate and form an adenoma

Question 31

what will happen to cells if there is a homozygous loss of DCC on 18q

Answer 31

more proliferation, larger adenoma and cells look abnormal

Question 32

what will happen to cells if there is a homozygous loss of p53 on 17p

Answer 32

invasive carcinoma

Question 33

in the multistep nature of carcinogenesis, DNA damage (mutation) leads to

Answer 33

initiation

Question 34

in the multistep nature of carcinogenesis, proliferations (growth promoters) leads to

Answer 34

promotion

Question 35

in the multistep nature of carcinogenesis, development of the cancerous phenotype leads to

Answer 35

progression

Question 36

this stage in the multistep nature of carcinogenesis, genetic mutations occur which inappropriately activate porto-oncogenes and inactivate tumour suppressor genes. proliferation occurs which is required for cancer development

Answer 36

initiation

Question 37

this stage in the multistep nature of carcinogenesis, the mutant cell proliferation occurs (activation of another oncogene, inactivation of tumour suppressor gene, nutritional factors, infection).

Answer 37

promotion

Question 38

this stage in the multistep nature of carcinogenesis is regulated by many hormonal growth factors such as estrogen and testosterone

Answer 38

promotion

Question 39

this stage in the multistep nature of carcinogenesis is where mutant, proliferating cells begin to exhibit malignant behaviour. malignant cells can produce telomerase. cells whose phenotype gives them a growth advantage proliferate more readily

Answer 39

progression

Question 40

this is the process by which cancer cells escape their tissue of origin and initiate new colonies of cancer in distant sites - specialized enzymes and receptors enable them to escape their tissue of origin and _______

Answer 40

metastasis

Question 41

what are the 4 steps of metastasis

Answer 41

1. loosening of intercellular junctions 2. degradation 3. attachement 4. migration

Question 42

how do cancer cells generally spread

Answer 42

circulatory or lymphatic system

Question 43

these are used to help identify parent tissue of cancer origin. some may be released into circulation, others are identified through biopsy. they are usually enzymes and help track the tumour activity

Answer 43

tumor markers

Question 44

this is the process by which cancer tumour forms new blood vessels in order to grow. usually does not occur until late stages of development. inhibition of this process is an important therapeutic goal

Answer 44

angiogenesis

Question 45

why are tumours graded and staged?

Answer 45

to predict clinical behaviour of a malignant tumour and guide therapeutic management

Question 46

does this describe grading or staging of a tumour? depends on: - histologic characterization of tumour cells - degree of anaplasia (cell differentiation)

Answer 46

grading

Question 47

does this describe grading or staging of a tumour? depends on: - locations and patterns of spread within the host - tumour size, extent of local growth, lymph node and organ involvement, distant metastasis <- TMN system

Answer 47

staging

Question 48

what are the warning signs of cancer

Answer 48

* CAUTION * C - change in bowel or bladder habits A - a sore that does not heal U - unusual bleeding or discharge T - thickening or lump in body part I - indigestion of difficulty swallowing O - obvious change in wart or mole N - nagging cough or hoarseness

Question 49

what are the warning signs of cancer in children

Answer 49

* CHILDREN * C - continued, unexplained weightloss H - headaches and vomitting in the morning I - increased swelling or persistent pain in bones or joints L - lump or mass in abdomen, neck or elsewhere D - development of whitish appearance in the pupil of the eye R - recurrent fevers - non infectious E - excessive bleeding or bruising N - noticeable paleness or prolonged tiredness

Question 50

what would cause pain with regards to cancer

Answer 50

- may be due to metastasis, tissue destruction/inflammation - may be caused by cancer tx

Question 51

this is overall weightless and generalized weakness that can be seen with cancer. may be caused by: - loss of appetite (anorexia) - increased metabolic rate - n/v

Answer 51

cachexia

Question 52

true or false: the immune system is suppressed by cancer cell secretions

Answer 52

true

Question 53

this is due to invasion and destruction of bone marrow cells, poor nutrition and chemotherapy. contributes to anemia, leukopenia and thrombocytopenia - can be managed by blood replacement therapy

Answer 53

bone marrow suppression

Question 54

this is a complication of chemotherapy and radiation. it is a primary source for cancer pain and anorexia and could provide a portal for infections

Answer 54

mucositis

Question 55

a group of rare disorders that occur when the immune system has a reaction to a cancerous tumor known as a "neoplasm." e.g hypercalcemia, cushings syndrome secondary to ACTH secretion, hyponatremia and water overload secondary to excess ADH secretion

Answer 55

paraneoplastic syndromes

Question 56

true or false: the majority of patients with solid tutors are treated surgically

Answer 56

true

Question 57

this type of therapy for cancer - kills tumour cells by damaging nuclear DNA - kills cells that are non-resectable due to location, missed by surgery or undetected - may not kill cells directly but initiates apoptosis - small doses over several treatments (due to cells being on different cycles) - some normal cells may also be killed

Answer 57

radiation

Question 58

this type of therapy for cancer - systemic administration of anticancer chemicals to treat cancers known or suspected to be disseminated in the body - finds cancer cell targets in the body - most are cytotoxic - not selective for tumour cells (normal cells may also be killed)

Answer 58

drug therapy

Question 59

review!!! describe the cell cycle

Answer 59

G0 = resting G1 = synthesis of components needed for DNA synthesis S = synthesis of DNA G2 = synthesis of components needed for mitosis M = mitosis G0

Question 60

this type of therapy for cancer primarily involves use of - interferons: glycoproteins produced by immune cells in response to viral infection - interleukins: peptides produced and secreted by WBCs - monoclonal antibodies: antibodies with identical structure that bind with specific target antigens

Answer 60

immunotherapy

Question 61

this type of therapy for cancer may have high therapeutic potential and may be used to suppress overactive oncogenes or replenish missing tumour suppressor function. - genetic alteration to tumour cells to make them more susceptible to cytotoxic agents or immune recognition - genetic alteration of immune cells to make them more efficient killers of tumour cells

Answer 61

gene and molecular therapy

Question 62

this is used to manage life threatening disorders in which patients bone marrow cannot manufacture WBCs, RBCs or platelets.

Answer 62

stem cell therapy