Notes from Robbins

Question 1

RAS oncogene

Answer 1

• most common oncogene.
• Mutations of RAS reduce GTPase activity, and RAS is trapped in an activated GTP-bound state. RAS signal to the nucleus is constitutive love you on (through cytoplasmic kinases)

Question 2

The APC gene can cause activation of____

Answer 2

WNT signaling pathway.

Question 3

MYC

Answer 3

• oncogene, a transcriptional activator/TF that is overexpressed in many tumors

Question 4

p53

Answer 4

tumor suppressor gene, encodes a protein involved in cell cycle control.

Question 5

Shortness of breath, hyper resonant barrel chest are symptoms for ___

Answer 5

Emphysema

Question 6

Diagnose emphysema if pft shows ___ and signs of obstruction

Answer 6

Decreased diffusion capacity (DLco)

Question 7

Centriacinar emphesema affects ___ lobes of lungs, and dilation is specific to ____

Answer 7

Top lobes

Respiratory bronchioles and alveolar duct

Question 8

Complications of reflux

Answer 8

Ulcer
Bleeding
Development of structures
Barrerts esophagus

Question 9

Uterine cervix, (Pap smear) – Compared with normal cervical squamous cells, dysplastic cells have increased _____ with enlarged nuclei and coarsely granular chromatin. The presence of ___ indicates that an adequate specimen was obtained.

Answer 9

• increased nucleus-to-cytoplasm ratios (nucleaus is big)
• endocervical cells
  Normal squamous cell = see-through blob with tiny nucleus.
  Dysplastic squamous cells = big nucleaus, small cell, clumps.
  Endocervical cells = from transition zone, nucleus is same size as the sq cells of cervix.

Question 10

risk factors for development of cervical dysplasia?

Answer 10

• multiple lifetime sexual partners (5+);
• high-risk partners (with condyloma/penile cancer, cervical cancer/dysplasia, or multiple sexual partners)
• early coitarche

Question 11

Crohn’s:

Answer 11

“Old strict chrone skipping on cobble stones jumps over the wall.”

• rectal sparing (colon/SI), mouth to anus
• cobblestone appearance, strictures, fistulas, granulomas
• transmural inflammation (goes through entire thickness of bowel wall)

Question 12

UC

Answer 12

• Bleeds! Friability of mucosa (easy breaks away)
• Continuous, but limited to rectum and colon
• Ulceration, crypt absess (pseudopolyps around)
• Inflammation restricted to submucosa and mucosa
• RISK of cancer! (20%) dysplasia –> cancer

Question 13

Why would fallopian tube be blocked?

Answer 13

PID-pelvic inflammatory disease, caused by chlymedia and gonnrea

Question 14

Which HPV serotypes are associated with high-grade dysplasia and carcinoma?

Answer 14

16, 18

31, 33, 35.

Question 15

How does HPV cause cancer?

Answer 15

• viral oncoproteins E6 and E7 inactivate tumor suppressor proteins p53 and RB (respectively) allowing cell cycle to progress.

Question 16

Flattening of mucosa, means ____

Answer 16

celiac disease (a malabsorption syndrome)
- low proteins in blood, difficient in ADEK (lipid vitamins)

Question 17

ovarian granulosa cell tumors may also be associated with endometrial hyperplasia or carcinoma. Why?

Answer 17

These tumors often produce lots of estrogen, resulting in unopposed estrogen –> endometrial hyperplasia.