New lab 3 Flashcards
Describe the condition and it’s features
cavernous hemangioma:
- affects brain & liver
- stroma in between blood vessels
- Persist (need surgery)
- Neurodeficits, seizures, & memory loss
Overproduction of arginine vasopressin (antidiuretic hormone [ADH]) by a tumor causes syndrome of inappropriate ADH secretion (SIADH)
SIADH
Describe the condition and it’s features
Capillary hemangioma:
- Affects eyelids, face, neck, chest, & butt
- decreases vision (amblyopia) & droops eye
- DISAPPEARS over time
- Affects eyelids, face, neck, chest, & butt
- decreases vision (amblyopia) & droops eye
- DISAPPEARS over time
Capillary hemangioma
Describe the features of Von Hippel Lindau syndrome
Hemangioblastomas or retinal angiomas
- Pheochromocytomas
- Pancreatic cystadenomas or neuroendocrine tumors
- renal cell carcinoma
Hemangioblastomas or retinal angiomas
- Pheochromocytomas
- Pancreatic cystadenomas or neuroendocrine tumors
- renal cell carcinoma
Von Hipple Lindau syndrome
Describe the features of the condition
Lymphangioma:
- Benign congenital malformation of the lymph vessels that are usually cystic or cavernously dilated
Describe the features of this condition
Pulmonary Hamartoma
- Condensed tissue with a mix of pale myxomatous tissue
- benign lung (most common)
- Popcorn calcifications
- Coin lesions
- SOB, coughing, but minimal respiratory problems
- Condensed tissue with a mix of pale myxomatous tissue
- benign lung (most common)
- Popcorn calcifications
- Coin lesions
- SOB, coughing, but minimal respiratory problems
Pulmonary Hamartoma
Elderly patient comes in for routine checkup, has coughing, SOB and minimal respiratory problems. There is no Past Medical History or anything extraordinary. Pulmonary nodule is seen on CT and X-ray scans.
Pulmonary Hamartoma
Describe the features of the condition
Gastric/pancreatic choristoma
- Pancreatic lobules are seen within the submucosa of the GI lining & gall bladder
- Different organ cells in the tissue
- most common spots stomach, gall bladder, then eye
- Pancreatic lobules are seen within the submucosa of the GI lining & gall bladder
- Different organ cells in the tissue
- most common spots stomach, gall bladder, then eye
Gastric/pancreatic choristoma
Female) patient shows up with recurrent pain in the right hypochondriac region. Barium x-ray is done, or endoscopy is done, which shows mass in gallbladder or stomach. Patient says they have a burning sensation during digestion.
This is because there are pancreatic enzymes in the stomach. There is no further action that needs to take place.
Describe the tissue
normal bowel
Describe the features of the condition
Necrotizing enterocolitis
- Hemorrhagic necrosis in the mucosa and muscular wall
- gas bubbles inbetween the submucosa
- disintegrated vili
- Hemorrhagic necrosis in the mucosa and muscular wall
- gas bubbles inbetween the submucosa
- disintegrated vili
Necrotizing enterocolitis
After being born, 2 weeks later the baby is brought back with symptoms of bloody stool and abdominal distention. Gas tracks are seen along the bowel wall, cystic “bubbly” collections. Air is collected in intestinal wall
Necrotizing enterocolitis
After being born, 2 weeks later the baby is brought back with symptoms of bloody stool and abdominal distention. Gas tracks are seen along the bowel wall, cystic “bubbly” collections. Air is collected in intestinal wall, but if it is intraluminal air
Hirshsprung’s
Describe the features of Hirschsprung disease
hyperreactivity to bacteria which produces Toll-Like Receptors.
Mass is seen in duodenal area
Describe the features of the condition
Neonatal Respiratory Distress Syndrome / Hyaline Membrane Disease
- Eosinophilic hyaline membranes (made of fibrin & necrotic type 2 pneumocytes) line alveolar ducts & alveoli
- Increased vascular permeability
- lack of surfactant
signs:
- Respiratory distress/nasal flaring
- Eosinophilic hyaline membranes (made of fibrin & necrotic type 2 pneumocytes) line alveolar ducts & alveoli
- Increased vascular permeability
- lack of surfactant
signs:
- Respiratory distress/nasal flaring
Neonatal Respiratory Distress Syndrome / Hyaline Membrane Disease
Describe the features of the condition
Fibroadenoma of the Breast
-shows well circumscribed
- uniformly hypercellular stroma,
- uniform distribution of glands and stroma
- fibrous capsule covering breast mass
- mobile
-shows well circumscribed
- uniformly hypercellular stroma,
- uniform distribution of glands and stroma
- fibrous capsule covering breast mass
- mobile
Fibroadenoma of the Breast
Describe the features of the condition
Mature Cystic Teratoma of the Ovary/aka Dermoid Cyst
-shows all different types of layers: Ectoderm, Mesoderm, Endoderm,
-see blood vessels, sebaceous glands, smooth muscles (everything). Hair, teeth, sebaceous everything
-shows all different types of layers: Ectoderm, Mesoderm, Endoderm,
-see blood vessels, sebaceous glands, smooth muscles (everything). Hair, teeth, sebaceous everything
Mature Cystic Teratoma of the Ovary/aka Dermoid Cyst
: Mostly asymptomatic, may have increased abdominal girth, urine frequency increased due to increased pressure, lower abdominal pain sometimes.
30 y/o female pt with hyperthyroidism, weight loss, palpitations, tachycardia. Lab findings: Increased T3/T4, decreased TSH
Whats the differential diagnosis?
Differential Diagnoses:
- Graves Disease ~ Increased T3/T4, decreased TSH
- Confusion, Irritability, hallucinations 🡪 Lumbar puncture shows anti-NMDAR antibodies [autoimmune encephalitis]
- Ovarion Torsion
Radio iodine test uptake 🡪 normally increased but comes back normal.
Next step: Ultrasound of the abdominal area
Aflatoxin B1-associated hepatocellular carcinomas have a particular mutation in _______,
a G : C→T : A trans version in codon 249.
TP53
Describe the features of initiators
exposure to a carcinogen, DNA damage is fast and irreversible
Describe the features of Promoters
These induce tumors to arise from proliferating cells, they don’t directly damage DNA & are reversible
Describe the features of direct acting carcinogens
Weak carcinogens that don’t need to metabolically converted to damage DNA
Describe the features of indirect acting carcinogens
Chemicals that need to be metabolically converted to become carcinogenic
ex. polycyclic hydrocarbons or benzo (a) pyrene)
The main metabolic agent in cytochrome P450-dependent monooxygenase
Chemicals that need to be metabolically converted to become carcinogenic
ex. polycyclic hydrocarbons or benzo (a) pyrene)
The main metabolic agent in cytochrome P450-dependent monooxygenase
indirect acting carcinogens
Weak carcinogens that don’t need to metabolically converted to damage DNA
direct acting carcinogens
These induce tumors to arise from proliferating cells, they don’t directly damage DNA & are reversible
promoters
exposure to a carcinogen, DNA damage is fast and irreversible
initiators
Describe the features of HTLV-1
causes adult T-cell leukemia/lymphoma (ATLL), Japan, the Caribbean basin, South America, and Africa, USA
HTLV-1 targets CD4+ T cells and its transforming effect is caused by the Tax gene protein, which is crucial for viral replication.
Tax protein disrupts the cell cycle inhibitor p16/INK4a, promotes cyclin D activation, and hinders DNA repair functions by inhibiting ATM-mediated cell cycle.
HTLV-1 targets CD4+ T cells and its transforming effect is caused by the Tax gene protein, which is crucial for viral replication.
Tax protein disrupts the cell cycle inhibitor p16/INK4a, promotes cyclin D activation, and hinders DNA repair functions by inhibiting ATM-mediated cell cycle.
HTLV-1
Describe the features of HPV & cancer
HPVs (types 16 and 18) cause cervical, anogenital, and oropharyngeal cancers
E6 & E7 protein contributes to cancer development
How does E6 protein in long term HPV (16 & 18) infections cause cancers?
by binding and breaking proteins (p53 and BAX) & increasing the expression of TERT an enzyme involved in telomerase function. The p53 protein, with a specific variation at amino acid 72, is more vulnerable to degradation by E6, increasing the risk of cervical carcinomas.
How does E7 protein in long term HPV (16 & 18) infections cause cancers?
E7 protein binds RB protein, releasing E2F factors and promoting cell cycle progression. E7 also inactivates p21, p27 inhibitors and activates cyclins E and A.
What cancer does EBV cause
African form of Burkitt’s lymphoma.
B-cell lymphomas in immunosuppressed individuals
Hodgkin lymphoma.
Describe how EBV leads to cancer
It infects B lymphocytes and oropharynx cells, using CD21 receptors on B cells. The oncogene LMP-1 activates NF-κB and JAK/STAT pathways, preventing apoptosis with BCL2 activation. EBNA-2 triggers the expression of host genes like cyclin D.
In areas with EBV-related Burkitt lymphoma, some cells survive by reducing expression of these antigens.
EBNA2 & LMP-1
Lymphoma only develops with the acquisition of the t(__,___) translocation, activating the ________
8, 14
&
c-MYC oncogene.
How does H.pylori lead to cancer?
H. pylori causes gastric adenocarcinoma by producing CagA protein, which enters gastric cells and triggers a signaling cascade resembling uncontrolled growth factor stimulation
Location and impingement on adjacent structures
Functional activity (synthesis of hormones, cytokines)
Bleeding and infections
Rupture and infarction
Cachexia (wasting)
effects of tumor on the host
effects of tumor on the host
Location and impingement on adjacent structures
Functional activity (synthesis of hormones, cytokines)
Bleeding and infections
Rupture and infarction
Cachexia (wasting)
In young adults, malignant ________is a leading cause of SVCS.
lymphoma
Chest X-ray: Increased upper right-sided mediastinal mass
Compression of phrenic & right recurrent laryngeal nerve
Symptoms:
Neck and facial swelling
Shortness of breath
Cough
Hoarseness worsens with bending forward or when supine
Dilated neck veins
Increased number of collateral veins on anterior chest wall.
Superior vena cava syndrome due to a malignant lymphoma (young adults)
Describe the features of SVCS
Chest X-ray: Increased upper right-sided mediastinal mass
Compression of phrenic & right recurrent laryngeal nerve
Symptoms:
Neck and facial swelling
Shortness of breath
Cough
Hoarseness worsens with bending forward or when supine
Dilated neck veins
Increased number of collateral veins on anterior chest wall.
Paraneoplastic syndromes are important for 3 reasons
1) early indicator of hidden tumors
2) can cause severe clinical issues,
3) can mimic metastatic disease.
Describe the features of Cushing’s syndrome
- 50% develop Small cell carcinoma of the lung.
- Excessive production of corticotrophin or corticotrophin-like peptides causes it.
Excess ectopic ACTH = Excess cortisol
What is the precursor for corticotrophin?
pro-opiomelanocortin.
Describe the features of Lung cancer + Cushings
have high levels of pro-opiomelanocortin and corticotrophin in their blood.
Describe the features of Pituitary induced cushings
- Patients with pituitary disease-induced Cushing syndrome only have elevated serum corticotrophin levels.
- overproduction of cortisol, hirsutism, hyperglycemia
- muscle wasting
- hypokalaemia with metabolic alkalosis
- Hypertension
- Moon” face,
- abdominal striae and “Buffalo” hump
Symtoms of cushings
Describe the symptoms of Cushings
- overproduction of cortisol, hirsutism, hyperglycemia
- muscle wasting
- hypokalaemia with metabolic alkalosis
- Hypertension
- Moon” face,
- abdominal striae and “Buffalo” hump
Describe the features of SIADH
Over production of arginine vassopressin leads to Excessive ADH production by a tumor leads to SIADH
Syndrome of inappropriate ADH secretion (SIADH)
is associated with which cancer?
small cell lung carcinoma
Describe the symptoms of SIADH
Increased ADH–decreased urine output–decreased thirst–increased retention of water– hyponatremia.
-altered mental status
-seizures
-coma and sometimes death
Increased ADH–decreased urine output–decreased thirst–increased retention of water– hyponatremia.
-altered mental status
-seizures
-coma and sometimes death
Describe the symptoms of SIADH
Describe the features of hypercalcemia leading to cancer
1) Osteolysis induced by cancer, whether primary in bone, such as multiple myeloma, or metastatic to bone from any primary lesion
2) Production of calcemic humoral substances by extra osseous neoplasms.
What cancer is most commonly associated with hypercalcemia
small cell carcinoma of the lung
Tumors most associated with paraneoplastic hypercalcemia are carcinomas of the _____, ______, _______ & ________
breast, lung, kidney, and ovary.
Describe the features of condition
Acanthosis nigricans is a skin disorder with gray-black patches, typically seen in people over 40. These patches are associated with gastrointestinal cancer and can manifest before the cancer is diagnosed
Antibodies, presumably induced against tumor cell antigens that cross-react with neuronal cell antigens, have been detected.
Neuromyopathic paraneoplastic syndromes
Describe the features of Neuromyopathic paraneoplastic syndromes
the body produces antibodies (defensive proteins) against antigens found on tumor cells. These antibodies may also interact with antigens on neuronal cells (cells in the nervous system).
akaimmune response against tumors might accidentally affect the healthy neurons as well.
Describe the features of the condition
Myasthenia Gravis usually associated with a thymoma
-Ptosis,
Diplopia
-Skeletal muscle weakness which increases with exercise
Myasthenia gravis (ass with thymoma)
Describe the symptoms of Myasthenia gravis (ass with thymoma)
-Ptosis,
Diplopia
-Skeletal muscle weakness which increases with exercise
Describe the features of Lambert Eaton Myasthenia syndrome
Disease of the neuromuscular junction Autoantibodies to the calcium channel (PQ-type voltage-gated calcium channels)
Associated with SCLC
Describe the symptoms of LEMS
Clinical Symptoms:
1. Affected individuals develop proximal muscle weakness and autonomic dysfunction.
2. No clinical improvement is produced by anticholinesterase agents
Clinical Symptoms:
1. Affected individuals develop proximal muscle weakness and autonomic dysfunction.
2. No clinical improvement is produced by anticholinesterase agents
symptoms of LEMS
Disease of the neuromuscular junction Autoantibodies to the calcium channel (PQ-type voltage-gated calcium channels)
Associated with SCLC
Describe the features of Lambert Eaton Myasthenia syndrome
Describe the features & symptoms of Hypertrophic osteoarthropathy
Associated with bronchogenic carcinomas
(1) periosteal new bone formation, primarily at the distal ends of long bones, metatarsals, metacarpals, and proximal phalanges;
(2) arthritis of the adjacent joints;
(3) clubbing of the digits
Describe the features of Migratory Thrombophlebitis (Trousseau syndrome)
associated carcinomas of the pancreas.
Acute disseminated intravascular coagulation is most associated with acute promyelocytic leukemia and prostatic adenocarcinoma
associated carcinomas of the pancreas.
Acute disseminated intravascular coagulation is most associated with acute
Describe the features of Migratory Thrombophlebitis (Trousseau syndrome)
Describe the features of Nonbacterial thrombotic endocarditis
Bland, small, nonbacterial fibrinous vegetation’s form on the left sided cardiac valve leaflets in individuals with advanced mucin-secreting adenocarcinomas
can lead to emboli
Bland, small, nonbacterial fibrinous vegetation’s form on the left sided cardiac valve leaflets in individuals with advanced mucin-secreting adenocarcinomas
can lead to emboli
Describe the features of Nonbacterial thrombotic endocarditis
Cushings ass
SCLC
Pancreatic cancer
Neural tumors
caused by Excess ACTH
SIADH ass
SCLC
Intracranial neoplasms
caused by Excess ADH or ANP
Hypercalcemia ass
Squamous cell carcinoma of the lung
Breast cancer
Renal cancer
Adult T-cell lymphoma
Caused by excess Parathyroid related protein (PTRP), TGFa, TNF, & IL1
Hypoglycemia ass
Ovarian cancer
Fibrosarcoma
Mesenchymal sarcomas
Caused by excess Insulin or insulin-like subs
Polycythemia ass
renal cancer
cerebellar hemangioma
liver cancer
Excess erythropoietin
Myasthenia ass
Bronchogenic cancer
Thymoma
Imunno issue
CNS/PNS disorders ass
breast cancer
Hypertrophic osteoarthropathy ass
bronchogenic tumor
thymic tumor
Trousseaus ass
pancreatic cancer
bronchogenic cancer
mucins activate clotting
DIC ass
acute promyelocytic leukemia
prostatic cancer
tumor products activate clotting
Nonbacterial thrombotic endocarditis ass
Advance cancers
hypercoagulability
well differentiated
moderately differentiated
poorly differentiated
N(0–3): degree of spread to regionallymph nodes
N0:
N1:
N2:
N3:
0 = No tumor cells spread to regionallymphnodes
1= : regional lymph node metastasis present; (tumor spread to closest regional lymph nodes)
2= Tumor spread to an extent between N1 and N3 (N2 is not used at all sites)
3 = Tumor spread to more distant lymph nodes
T1 N0 M0
Small, low-grade cancer, no metastasis, no spread to regional lymph nodes
consideredStageI.
Small, low-grade cancer, no metastasis, no spread to regional lymph nodes
T1 N0 M0
consideredStageI.
Large, high-grade cancer, with spread to regional lymph nodes and other organs
T4 N3 M1
considered Stage IV.
T4 N3 M1
Large, high-grade cancer, with spread to regional lymph nodes and other organs
considered Stage IV.
assessment of readily palpable lesions in sites such as the breast, thyroid, and lymph nodes.
Fine-needle aspiration cytology:
suspected malignancy in which tumor cells are easily accessible or shed and widely used to screen for carcinoma of the cervix
Cytologic smears:
generally removes the entire area of the tumor with surrounding the part of normal tissue
excisional biopsy
procedure in which a small area of tissue is taken to identify the composition
Incisional biopsy
specific antibodies facilitate the identification of cell products
or surface markers.
Immunohistochemistry:
prostate-specific antigen (PSA) and thyroglobulin are markers of carcinomas of the ______,_____
prostate and thyroid.
ERBB2 or HER2
breast cancers
