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neoplasm 6 Flashcards

1
Q

describe radiation carcinogenesis

A
  • Skin cancer = basal cell carcinoma, squamous cell carcinoma, MELONOMA
    MECHANISM:
  • pyrimidine dimers –> DNA damage
  • normal DNA repair - NER pathway (nucleotide excision repair)
  • individuals with enzyme defects mediating DNA repair are particularly susceptible (xeroderma pigmentosum)
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2
Q

describe ionizing radiation

A
  • direct effect
  • indirect effect via free radicals
  • increased risk with higher dose or high LET
  • MECHANISMS = chromosome breakage, translocation and point mutation
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3
Q

define atomic bomb cancers

A
  • normally occurs Leukemias (except CLL)
  • also causes Thyroid cancer (papilary type)
  • breast/lung cancer (less common)
  • Skin, bone, gut are LEAST susceptible
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4
Q

Define X ray workers

A
  • radiation dermatitis

- develop skin cancer

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5
Q

what type of cancer does painting dials of watches with lumnious radium cause

A
  • osteosarcoma
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6
Q

describe teh pathogenesis of hepatitis B in causing cancer

A
  • Chronic liver cell injury and regenerative hyperplasia
  • encodes regulatory protein HBx protrein that is responsible for:
  • -> activating growth promoting genes (insulin-like GF)
  • -> binds to p53 (inhibition)
  • causes hepatocellular carcinoma
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7
Q

describe the pathogenesis of hepatitis C in causing cancer

A
  • chronic liver cell injury and regeneration

- causes hepatocellular carcinoma

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8
Q

describe Epstein-Barr virus as it is releated to cancer

A
  • Associated neoplasms
  • -> burkitt lymphoma
  • -> hodgkin lymphoma
  • -> B-cell lymphoma in immunosuppressed patients
  • -> nasopharyngeal carcinoma
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9
Q

describe HPV as it is related to cancer

A
  • HPV 6 and 11 = low risk episomal (non-integrated form) –> cause benign squamous papiloma (warts)
  • HPV 16,18,31 = high risk; viral DNA integrated in host genome (E6 inhibits p53; E7 inhibits Rb)
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10
Q

describe Human T-cell leukemia virus Type 1 (HTLV-1)

A
  • Causes T-cell leukemia/lymphomas
  • Mode of transmission = intercourse, blood, breast feeding
  • Pathogenesis = CD4 tropism
  • Contains Tax gene:
    1) stimulates transcription of viral mRNA
    2) activates c-Fos, IL-2(T-cell GF) and FM-CSF = all involved in proliferation
    3) inactivates p16INK4a (is an anti-proliferative molecule)
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11
Q

Describe HIV as it is related to cancer

A
  • causes lymphoma
  • human herpes virus 8 (HHV-8) causes kaposi sarcoma
  • -> associated with HIV
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12
Q

describe how H. Pylori is releated to cancer

A
  • Assocaited with gastric lymphoma (MALT lymphomas), and Gastric carcinoma
  • CONTAINS CagA (cytotoxin associated gene A) which stimulates growth factor pathway
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13
Q

describe estrogen

A
  • related to breast cancer, squamous cell carcinoma of cervix and leiomyoma of uterus
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14
Q

how to determine between benign and malignant

A
  • benign have a capsule
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15
Q

describe contraceptive hromoens

A
  • assocaited with breast cancer and benign/malignant liver tumors
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16
Q

describe anabolic steroids

A

-associated with benign/malignant liver tumors

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17
Q

describe cancer cachexia

A
  • clinical feature in a patient with a tumor
  • loss of body fat, wasting and profound weakness
  • CAUSED by TNF being produced
  • symptoms are loss of appetite, metabolic changes
18
Q

define para-neoplastic syndromes

A
  • distant effects of a tumor unrelated to primary tumor or metastasis
  • may represent earliest manifestation of a cancer
19
Q

describe examples of para-neopalstic sydnromes

A
  • endocrinopathies –> lung cancer secretes ACTH which devels cushing syndrome and diabetes resulting in wt loss, hypertension, hyperpigmentation (due to ACTH)
  • Hyponatremia/SIADH = small cell carcinoma lung secretes ADH causes too much water to be in the body leading to HYPOnatremia
20
Q

describe Acnathosis nigricans

A
  • example of para-neoplastic syndrome
  • causes a black, verrucoid appearing lesion of the skin (usually located in axilla)
  • associated with GASTRIC CARCINOMA
  • -> also another skin lesion associated with stomach carcinoma is leser-trelant sign (multiple, outcroppings of pigmented seborrheic keratosis
21
Q

describe Carcinoid syndrome

A
  • assocaited with carcinoid tumors (neuro-endocrine tumors)
  • tumor location is found in appendix or small intestine
  • PRODUCES SEROTONIN
  • CLINICAL FEATURES = flushing, diarrhea, bronchospams, tachycardia
  • DIAGNOSED by urinary excretion of 5-hydroxy-indoleacetic acid, a metabolite of serotonin
22
Q

describe hypercalcemia

A
  • malignancy accounts for 40% of all cases of hypercalcemia
  • causes for hypercalcemia in malignancy
  • -> RELEASE OF PTH related peptide CAUSES Squamous cell carcinoma of lung or Renal cell carcinoma
  • -> osteolytic bony metastasis (release of osteolytic factors PGE2, IL-1) cause breast cancer
23
Q

describe Hypocalcemia

A
  • produces CALCITONIN

- develops into medullary carcinoma of thyroid

24
Q

describe gynecomastia

A
  • produces hormone Beta-HCG

- assocaited with choriocarcinoma testis

25
describe eaton-lambert syndrome
- Myasthenia gravis-like syndrome | - assocaited with SMALL CELL CARCINOMA OF LUNG
26
when should you use IHC to diagnose cancer
- diagnosis of undifferentiated tumors - categorization of leukemias and lymphomas - to determine site of origin of metastasis - detecting molecules having prognostic or therapeutic significance
27
how would you know that a tumor is epithelial in origin
- if the tumor is POSITIVE for CYTOKERATIN, keratin or eptihelial membrane antigen (EMA), indicates an epithelial origin.
28
what marker is used in mesenchymal origin
- vimentin (some mesenchymal origin) | - desmin; muscle-specific actin (origin-muscle)
29
what markers are used in LCA
- leukocyte common antigen | - origin - leukocytes
30
what markers are used in neuronal tumors
- Non-specific enolase (NSE) - -> neuroendocrine tumors such as SMALL CELL CARCINOMA of the lung and carcinoids stain with NSE - chromogranin - synaptophysin
31
what is a tumor marker
- a tumor marker is a sustance found in blood, urine, or body tissue that can be elevated in cancer, among other tissue types
32
What does increase in carcino-embryonic antigen (CEA) indicative of
- carcinomas of colon, pancreas, stomach, breast
33
what does iincrease in prostate-specfic antigen (PSA) indicative of
- Prostate cancer
34
what does increase in beta-human chorionic gonadotropin (B-HCG) indicative of
- trophoblastic tumors (choriocarcinoma)
35
what does increase in CA-125 indicative of
- ovarian carcinoma
36
what does increase in alpha-fetoprotein (AFP) indiciative of
- hepato-cellular carcinomas | - germ cell tumors of testes or ovary
37
what does increase in NSE indicative of
- SMALL CELL CARCINOMA OF LUNG
38
what does incease in calcitonin indicative of
- medullary thyroid carcinoma
39
what does increase in CA 19-9 indicative of
- colon cancer, pancreatic cancer
40
what does increase in CA 15-3 indicative of
- breast carcinoma

Path 2 (11 decks)

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