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BFOM Exam 3 > Neoplasia NC > Flashcards

Neoplasia NC Flashcards

1
Q

What is a tumor?

A

A swelling or morbid enlargement

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2
Q

What is cancer?

A

A neoplastic disease, the natural course of which is progressive and possibly fatal

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3
Q

What is malignancy?

A

To act maliciously; cancer with the potential to cause death

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4
Q

What is a neoplasm?

A

Any new, abnormal growth, specifically a new growth of tissue in which the growth is uncontrolled and progressive

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5
Q

What is oncology?

A

The sum of knowledge concerning tumors

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6
Q

What two criteria do neoplasms have to have met?

A

Escaped normal regulatory mechanisms (apoptosis, proliferation, differentiation) and Varying degrees of autonomy without regard for their cellular environment

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7
Q

What do neoplasms have in regard to function?

A

Abnormal function/activity which leads to abnormal structure (structure is how it is diagnosed)

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8
Q

Are all tumors comprised of cells/tissue neoplasms?

A

No

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9
Q

What are two types of non-neoplastic tumors?

A

Hamartoma and Choristoma

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10
Q

What is a hamartoma?

A

A mass of irregularly formed tissue at the site where such tissue is NORMALLY found; some are neoplastic

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11
Q

What is a choristoma?

A

A mass of irregularly formed tissue at the site where such tissue is normally NOT found; not neoplastic

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12
Q

How do neoplastic tumors arise?

A

A normal cellular process or processes that have gone awry

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13
Q

How do neoplastic tumors come to consist of multiple cell types?

A

The initial neoplastic cell will undergo clonal expansion and some of those clones may develop mutations and expand again; after a few clonal expansions you may have a mass that consists of multiple cells with different mutations

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14
Q

What are the four general categories of “cancer genes”?

A

1.) Proto-oncogenes 2.) Tumor suppressor genes 3.) Apoptosis genes 4.) DNA repair genes

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15
Q

What are proto-oncogenes?

A

Growth promoting genes

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16
Q

How can proto-oncogenes cause cancer?

A

If a mutation alters a proto-oncogene to stay on continuously they cause replication out of control (called oncogenes)

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17
Q

What are tumor suppressor genes?

A

Growth inhibiting genes

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18
Q

How can tumor suppressor genes cause cancer?

A

If a mutation occurs that causes loss of function in a tumor suppressor gene it can cause a cell with DNA mutations to go unchecked into replication (usually occurs with other mutations)

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19
Q

What are the 8 fundamental changes in cell physiology that are hallmarks of cancer?

A

Avoiding immune destruction, Evading growth suppressors, Enabling replicative immortality, Activating invasion and metastasis, Inducing angiogenesis, Resisting cell death, Deregulating cellular energetics, Sustaining proliferative signaling

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20
Q

What is a driver mutation?

A

A mutation responsible for the tumors irregular behavior and metastatic/persistent behavior

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21
Q

What is a passenger mutation?

A

A mutation that is not needed for the tumors irregular behavior but is a mutation nonetheless

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22
Q

What extracellular receptors do oncogenes increase the presence of?

A

Growth hormones: c-ret (MEN), c-kist (GIST), Her-2/neu (breast/lung)

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23
Q

What is the most common intracellular proto-oncogene abnormality?

A

Mutation is Ras

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24
Q

What are two important tumor suppressor genes?

A

Rb (retinoblastoma), p53 family

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25
Q

How does HPV cause cancer?

A

Product E6 promotes degradation of p53

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26
Q

How does Li Fraumeni syndrome occur?

A

It is a germ line mutation in p53 so every cell in different tissues will have the mutation causing multiple cancers

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27
Q

Over expression of which gene can extend cell survival and permit proliferation?

A

BCLA2

28
Q

What occurs in hereditary nonpolyposis colon cancer (HNPCC)?

A

MLH1, MSH2 are mutated to mismatch repair genes

29
Q

What two care taker genes are mutated in the majority of breast and ovarian cancers?

A

BRCA-1 and BRCA-2

30
Q

What are three common sources of cancer genes?

A

Inherited germ line, spontaneous somatic mutations, Viral

31
Q

What is tumor invasion?

A

A tumor growing into a new part of the tissue or body

32
Q

What is metastasis?

A

Spread of a tumor to a new tissue or body part that is not connected to the primary or initial tumor

33
Q

What are routes of metastasis?

A

Lymphatics, Hematogenous, Body surface/Cavity spread, Iatrogenic (surgical)

34
Q

How do invading cells make it through the basement membrane?

A

By degrading type IV collagen

35
Q

What are the clinical presentations of cancer?

A

1.) Direct tumor effects 2.) Indirect tumor effects 3.) Screening 4.) Incidental findings

36
Q

What are local/direct tumor effects?

A

Mass effect: visible/palpableDestructive effects: Bleeding, bone changes, painAlterations in function: increased or decrease in function

37
Q

What are paraneoplastic syndromes?

A

Distant or systemic effects of neoplasms

38
Q

What are the four classifications of paraneoplastic syndromes?

A

Endocrinopathies, Nerve and muscle symptoms, Dermatologic, Vascular/Hematologic

39
Q

What are examples of endocrinopathies?

A

Cushing syndrome: ACTH from small cell lung cancer; Hypercalcemia: PTHRP from squamous cell carcinoma of lung

40
Q

How are paraneoplastic neoplasms typically found?

A

Based on their symptoms we infer there is a tumor because of their clinical manifestations

41
Q

What are cancer screening examples?

A

Pap smear, PSA, mammography, colonoscopy

42
Q

What are incidental findings?

A

Cancer findings by accident typically through imaging for another issue, typically how kidney cancers are found

43
Q

How is cancer pathologically evaluated?

A

Histology: biopsy or surgical specimenCytology: fluid, exfoliative (Pap smear)Chemistry or molecular diagnostics

44
Q

What are the key elements of tumor diagnosis?

A

Tissue type (resemblance to normal tissue), Stage (function behavior), Grade (structure appearance)

45
Q

What is angiogenesis?

A

Growth of new blood vessels to supply the tumor with nutrients

46
Q

What happens if a malignant tumor grows too fast?

A

The center of the cell mass can become necrotic due to the slow process of angiogenesis and the lack of blood supply

47
Q

What is the only classification of lymphoma?

A

Malignant lymphomas

48
Q

What is pre-invasive epithelial neoplasm?

A

A neoplasm still contained within the epithelial layers and therefore is in situ

49
Q

What is a DCIS and LCIS?

A

A tumor that has not breached the basement membrane in breast cancer (Ductal and lobular)

50
Q

What are the following intraepithelial neoplasms PIN, PanIN, CIN?

A

Prostate, pancreas, cervix

51
Q

What is an intraepithelial neoplasm?

A

A neoplasm that has broken through the basement membrane of the epithelium

52
Q

What are the two criteria for degree of differentiation of malignant neoplasms?

A

Histologic (tissue architecture) and Cytologic (size, shape/contour of individual cells)

53
Q

What are the four grade differentiations for neoplastic tumors?

A

Grade 1: Well differentiated (low grade)Grade 2: Moderately differentiated (low grade)Grade 3: Poorly differentiated (high grade)Grade 4: Undifferentiated (anaplastic)

54
Q

What is the most common system for tumor staging?

A

TNM

55
Q

What does TNM stand for?

A

Tumor, Nodal status, Metastasis

56
Q

What is the classification system for T?

A

Tumor T1-T4: Size/extent of primary tumor

57
Q

What is the classification system for N?

A

Nodal status N0-N3: Presence and extent of lymph node metastasis

58
Q

What is the classification system for M?

A

Metastasis M0-M1: Presence of distant metastasis

59
Q

What is important to consider in the prognosis of a tumor?

A

Type of tumor, extent of tumor growth/spread at the time of diagnosis, co-morbidities

60
Q

What are the three most common cancers in men?

A

Prostate, lung, colorectal

61
Q

What are the three most common cancers in women?

A

Breast, lung, colorectal

62
Q

What cancers cause the most deaths in men? Test question

A

Lung, prostate, colorectal

63
Q

What cancers cause the most deaths in women? Test question

A

Lung, breast, colorectal

64
Q

What are the 5 primary treatments for cancer?

A

Surgery, Radiation, Thermal, Chemotherapy, Biologics

65
Q

What are important proto-oncogenes?

A

ras, Her-2

66
Q

What are important tumor suppressor genes?

A

BRCA-1, APC, Rb, p53

67
Q

What are important apoptotic genes?

A

bcl-2

BFOM Exam 3 (17 decks)

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