Neoplasia VI Flashcards by tcarlso 3

What type of UV light is particularly damaging?

UVB 280-320 nm

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What does UVB light damage?

Pyrimidine dimers formed

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What is the repair mechanism in the body to repair DNA?

Nucleotide excision repair (NER pathway)

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What is xeroderma pigmentosum?

Patients without the enzyme needed for DNA repair in the NER pathway

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What is the indirect effect of ionizing radiation? Direct?

indirect = Free radical generation

Direct = chromosome breakage

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High LET (such as what) are more damaging than low LET (such as what)?

High = neutrons and alpha rays

Low = x-rays, gamma rays

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Atomic bomb causes what CAs?

Leukemia (except CLL)

Thyroid cancer

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What are the two CAs associated with x-ray workers?

Radiation dermatitis

Skin cancers

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What is the CA associated with Radium use (like painting dials of watches with luminous radium)?

Osteosarcoma

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What 3 organs are the least susceptible to atomic bomb radiation?

Skin
Bone
Gut

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What are the two MOAs of hep B is causing hepatocellular carcinoma?

Chronic liver injury and regeneration

HBx protein activates IGF and binds to p53

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What is the MOA of hep C causing CA?

Chronic liver cell injury and regeneration

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What are the tumors associated with EBV? (4)

Burkitt’s lymphoma
Hodgkins
B-cell lymphoma
Nasopharyngeal carcinoma

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Which HPV viruses are associated with cervical CA? Why?

16
18
31
33

These viruses integrate their DNA into the host

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What is the function of E6 and E7 that HPV viruses produce?

E6 inhibits p53

E7 inhibits Rb

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What are the two “low risk” virus strains of HPV? Why?

6 and 11–these do not integrate their DNA into the host

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What virus causes T-cell leukemia/lymphoma?

HTVL-1 (human T-cell leukemia virus type I)

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What is the mode of transmission for HTLV-1?

Intercourse
Blood
Breast feeding

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What is the MOA of HTLV-1?

Tax gene has CD4 tropism.

Activates IL-2 (T cell growth factor)
c-Fos, GM-CSF

Inactivates p16INK4a

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What is the molecule that HTLV-1 inactivates? What is the function of this molecule?

p16INK4a (an antiCA gene)

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What is the virus that causes Kaposi’s sarcoma? What other virus is this associated with (but not caused by)?

HHV-8

Associated with HIV

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How is helicobacter pylori infection associated with neoplasia?

CagA cytotoxin–stimulates growth factor pathway

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What is the CA associated with H.Pylori?

MALT lymphoma (gastric lymphoma)

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What are the CAs that estrogen promotes?

Breast CA
Cervical
Leiomyoma of uterus

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What are the CAs associated with contraceptive hormones?

Breast CA | Benign/malignant liver tumors

What are the CAs associated with anabolic steroids?

Benign/malignant liver tumors

Leiomyomas are (encapsulated/not encapsulated)

Encapsulated

CA's local or hormone production effects are related to what?

Location

What causes cancer cachexia?

TNFalpha production

What is paraneoplastic syndrome?

Distant effects of a tumor unrelated to primary tumor or metastasis

Lung CAs are known to produce what hormone? What does this cause?

ACTH--causes Cushing's syndrome

Small cell carcinoma of the lung are known to produce what hormone? What is this syndrome called, an what metabolic disturbance is commonly found with this?

ADH SIADH (hyponatremia)

What is acanthosis nigricans?

Black verrucoid appear leision of the skin (usually located in the axilla)

What is the CA associated with Acanthosis nigricans?

Stomach CA

What is the Leser Trelat sign associated with?

Gastric carcinoma that produces multiple outcroppings of pigmented seborrheic keratosis

What is carcinoid syndrome?

Tumors that produce 5HT, (associated with neuroendocrine tumors)

What is the tumor location of carcinoid tumors? What does the tumor produce?

Appendix | Serotonin

What are the clinical features of carcinoid syndrome?

Flushing of face, diarrhea, tachycardia

How do you diagnose carcinoid syndrome?

Urinary excretion of 5-hydroyindolacetic acid (5-HIAA)--a metabolite of serotonin

What causes hypercalcemia in malignancies? What is the CA associated with this?

Release of PTH **related peptide** | squamous cell carcinoma of the lung

What are the PTH levels in squamous cell carcinomas that release a PTH like hormone?

Low d/t hypercalcemia

Osteolytic bony metastasis is caused by what osteolytic factors? What CA is this associated with?

Release of osteolytic factors (PGE2, IL-1) Breast CA

Medullary CA of the thyroid is associated with what condition? HOw does this occur?

Hypocalcemia--production of calcitonin

Gynecomastia is caused by what? What CA is this associated with?

B-HCG secretion | ChorioCA testis

What is Eaton-Lambert syndrome?

Autoimmune attack of neuromotor plate

What is the CA associated with Eaton-Lambert syndrome?

Small cell carcinoma of the lung

What are the morphological methods to diagnose CA?

1. Biopsy 2. Frozen section 3. FNAC 4. Cytology 5. IHC

What are the two molecular methods for diagnosing CA?

Flow cytometry | DNA probe

What is the biochemical assay utilized to diagnose CA looking for?

Tumor markers

Why should you use IHC?

Diagnose an undifferentiated tumor Categorize leukemias and lymphomas

If the tumor is positive for cytokeratin or epithelial membrane antigen, it indicates that the CA came from what type of cells?

Epithelial cells

Vimentin and desmin are markers for what CA types?

Mesenchymal origin

LCA (leukocyte common antigen) is a marker for what type of CA?

Leukocyte origin

Neuron-specific enolase (NSE) is associated with what?

Neuronal tumors

Chromogranin is associated with what CAs?

Neuronal tumors

Synaptophysin is associated with what CAs?

Neuronal tumors

Thyroglobulin marker for a tumor = what origin for a tumor?

Thyroid CA

CD10 (CALLA) = what origin?

Acute lymphoblastic leukemia

Placental alkaline phosphatase is a marker for what CA?

Seminoma

vWF, CD31 is a marker for what types of CA?

Vascular neoplasms

What is a tumor marker?

A substance found in the blood, urine, or body tissues that can be elevated in CA, among other tissue types

Increase in CEA = what CAs?

Colon CA Breast Stomach Pancrease

Increase in PSA= what CAs?

Prostate

Increase in beta-HCG= what CAs?

Trophoblastic tumors (choriocarcinoma)

Increase in CA-125= what CAs?

Ovarian carcinoma

Increase in a-fetoprotein (AFP)= what CAs?

Hepatocellular carcinomas Germ cell tumors of testes or ovaries

Increase in NSE= what CAs?

Small cell carcinoma of the lung

Increase in Calcitonin = what CAs?

Medullary thyroid carcinoma

Increase in CA 19-9= what CAs?

Colon | Pancreatic

Increase in CA 15-3= what CAs?

Breast carcinoma