Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Principles of Science > Oncology > Flashcards

Oncology Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

What causes neoplastic disorders?

A

Interaction between genetic and environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be classed as an environmental carcinogenic?

A

Chemical - Radiation - Radionuclie - Mitogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can environmental mitogens cause neoplasia?

A

Stimulate cell proliferation and promote oncogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What factors can increase susceptibility to neoplastic disorders?

A

Genetic - Hormonal - Environmental carcinogenics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the definition of an oncogene?

A

A gene, when inappropriately activated, can cause the formation of a tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give two examples of two anti-oncogenes

A

Rb - p53

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When would mutations of genes normally become clinically significant?

A

Cumulative mutations of oncogenes and tumour suppressor genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the six ‘Hallmarks of Cancer’ that a cell needs to be cancerous?

A

1) Sustaining proliferative signalling
2) Evading growth suppressors
3) Resisting cell death
4) Enabling replicative immortality
5) Inducing angiogenesis
6) Activating invasion and metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define combination chemotherapy. What are the benefits of it?

A

Targeting more than one property of cancer cells to try and destroy them - Less dosage of each agent so less adverse affects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the three ways in which cancer cells become self sufficient in terms of growth signals.

A

1) Secretion of endogenous growth factors - autocrine/paracrine manner
2) Mutation of GF receptors - overexpressed or active receptors even in absence of ligand
3) Mutation of intracellular signalling molecules - proto-oncogenes such as Ras and Raf activate MAPK pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give an example of where a cancer cell overexpresses GF receptors

A

In Mast Cell tumours - on the KIT receptor (about 50% of mast cell tumours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do Rb and p53 decide? How else are they known?

A

Whether a cell enters mitosis or goes into senescence/apoptosis - Tumour suppressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does a) Rb and b) p53 operate?

A

a) Transduces growth-inhibitory signals that originate outside the cell
b) Receives information from intracellular operating systems (such as cell viability is subnormal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the cellular apoptotic machinery divided into?

A

Upstream regulators - Downstream effectors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the apoptotic regulators divided into?

A

Extrinsic pathway (receive extracellular death-inducing signals) - Intrinsic pathway (receive intracellular signals - p53)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do the extrinsic and intrinsic pathways culminate the activation of?

A

Caspase cascade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give an example of anti-apoptosis molecules

A

Bcl-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why do cells have a proliferative limitation?

A

Associated with erosion of telomeres that protect the end of chromosomes during cell division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the function of telomerase? How is it utilised in cancer cells?

A

Specialised DNA polymerase which adds telomere repeat segments to the end of DNA - Up-regulated to give replicative immortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is angiogenesis vital to cancer cells?

A

Cells in the centre of a cluster of tumour cells will undergo hypoxia-induced necrosis so require a dedicated blood supply - Can facilitate metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give an example of an angiogenic factor used by cancer cells

A

Vascular Endothelial Growth Factor (VEGF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the steps of metastatic invasion by malignant tumours?

A

Local invasion - Intavasation into local lymph/blood vessels - Disseminate via lymphatic or haematogenic - Extravasate into other tissues - Metastatic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What two factors influence the ability of a tumour to metastasis?

A

Ability to get through tissues (enzyme production) and ability to detach from primary tumour (loss of cell adhesion molecules)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the emerging hallmarks and characteristics found in cancer cells?

A

Deregulating cellular energetics - Avoiding immune destruction - Genome instability and mutation - Tumour-promoting inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why does an inflammatory response, which seems detrimental for a tumour, in fact promote it?

A

Release of growth factors, angiogenic cytokines and immunosuppressive mediators by inflammatory cells enhance malignant potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When presented with an animal with a mass, what should you try to find out about it from the owner?

A

How long present? - Trauma? - Hot/painful? - Solid/fluid filled? - Well or ill-defined?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the first port of call when taking samples of a mass? Why?

A

Cytology - using a Fine Needle Aspiration (FNA) - Cheap, quick and easy to perform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the main difference of cellular content of inflammatory masses and neoplastic masses?

A

Inflammatory has a range of cells (neutrophils, macrophages, etc) whereas a neoplastic mass will have one cell which predominates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What information can cell morphology give?

A

If a tumour is malignant or benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

If cytology doesn’t give definite diagnosis, what other sample can be taken? What in particular does this tell us that cytology doesn’t?

A

Histopathology (biopsy of tissue) - Gives the tissue architecture, mitotic index, invasion of vasculature, degree of necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What can be used in conjunction with histopathology to further investigation?

A

Special stains - Immunochemistry - Flow cytometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is tumour grade?

A

Given by the pathologist - Helps predict the behaviour of tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How is tumour grade found?

A

Assessment of mitotic index, cellular differentiation, invasion of tissues/vasculature/lymphatics, amount of necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the categories of tumour grading?

A

Patnaik system - 1=low grade (benign) 2=intermediate 3=high grade (malignant)
Kiupel system - either good or bad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does Staging the tumour mean?

A

Assess the extent of the disease in the patient performed by clinician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does staging the tumour involve the assessment of?

A

Primary tumour - Drainage lymph nodes - Distant metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the TNM system used for? Define each letter

A

Staging tumours
T = Primary tumour
N = Node
M = Distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are paraneoplastic syndromes?

A

The systemic effects of a tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How do paraneoplastic syndromes occur?

A

Result of secretion of hormone, hormone-like substance, enzyme or cytokine by tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the four baseline tests to assess the cancer patient?

A

Haematology/complete blood count - Biochemistry - Urinalysis - Coagulation parameters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which test is the best to use when investigating paraneoplastic syndromes?

A

Biochemistry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the common paraneoplastic effects?

A

Hypercalcaemia - Hypoglycaemia - Hyperviscosity - Gastric ulceration (vomiting) - Endocrine problems - Pyrexia - Immune-mediated diseases - Hypertrophic osteopathy - Dermatologic manifestations - Cancer cachexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

When is surgery a viable option for treatment of cancer?

A

Carcinomas - Sarcomas - Mast cell tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When is Radiation treatment a viable option for treatment of cancer?

A

Primary - nasal tumours, localised radiosensitive

Adjunctive - following incomplete recession/prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When is Chemotherapy (anti-cancer drug therapy) a viable option for treatment of cancer?

A

Treatment of systemic disease - lymphoma, leukaemias, myeloma, systemic mast cell
Highly metastatic tumour
Also used as adjunctive treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is fundamental for accurate diagnosis of neoplasia?

A

Good communication between the pathologist and clinician

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Give the characteristics macroscopically of a benign tumour

A

Low to moderate growth rate - Demarcated from surrounding tissue - Surrounding connective tissue capsule - Freely mobile on palpation - Homogeneous cut surface - Little haemorrhage or necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Give the microscopic features of a benign tumour

A

Similar to tissue of origin - Well organised - Can be functional - Tumor doesn’t broach capsule - Few or mitosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Give the macroscopic characteristics of a malignant tumour

A

Growth by invasion - Not encapsulated - Not mobile - Frequent internal necrosis and haemorrhage - Metastasise

50
Q

Give the microscopic features of a malignant tumour

A

Variable cell/nuclei size and shape - Increased nucleus:cytoplasm ratio - Prominent nucleoli - Normal and abnormal mitoses - Secondary changes

51
Q

What are the names of benign tumors of epithelial origin?

A

Surface of epithelia = papilloma - Glandular = adenoma

52
Q

What are the names of malignant tumors of epithelial origin?

A

Surface of epithelia = carcinoma - Glandular = adenocarcinoma

53
Q

What are the names of benign tumors of mesenchymal origin?

A

Fibrous = fibroma - Bone = osteoma - Cartilage = chondroma - Adipose = lipoma - Smooth muscle = leiomyoma - Endothelium = haemangioma - Skeletal muscle = rhabdomyoma

54
Q

For malignant tumors of mesenchymal origin, what is the difference in name than benign tumours?

A

Add sarcoma on the end

55
Q

What are the different types of tumour metastasis?

A

Lymphatic - Vascular - Trans-cavity - Local

56
Q

What sort of metastasis are typical of carcinomas?

A

Lymphatic

57
Q

What sort of tumour type typically has vascular metastasis?

A

Sarcoma

58
Q

What type of tumor typically has trans-cavity metastasis?

A

Mesothelioma

59
Q

What’s a multicentric tumour?

A

Malignant tumour with multiple sites with no way to determine the primary origin

60
Q

If a tumour can not be diagnosed by morphology, what other tests can be performed to diagnose?

A

Immunohistochemistry

61
Q

Give examples of cell surface markers that may assist identification of tumours? What do they identify?

A

Cytokeratin - epithelial marker (carcinoma)
Vimentin - mesenchymal marker (sarcoma)
CD3 - T cell marker (lymphoma)
CD79a - B cell marker (lymphoma)

62
Q

What is tumour grading?

A

Measure of differentiation - High grade = poor differentiation - Low grade = good differentiation

63
Q

What are the four methods used for tumour grading?

A

Light microscopy - Immunophenotyping - Detection of genetic mutations - Proliferation markers

64
Q

What is looked for when tumour grading with light microscopy?

A

Do the tumour cells look like the parent cell

65
Q

How can immunohistochemistry be used to grade tumours?

A

Tumours loose antigenic markers as they become less differentiated - have less stain

66
Q

What does a pathologist require in order to make an accurate diagnosis?

A

Representative sample - Correctly submitted sample - Full clinical history

67
Q

When making an incision for a pathology lab, what should be avoided? What is the exception?

A

Necrotic and cavitated areas - Except bone tumours where most cavitated area required

68
Q

Why is it better to treat a tumour with chemotherapy as early as possible? Why is this not normally possible?

A

Drugs more effective in the log growth phase of tumour (earlier on) - Clinical signs generally not shown until later in development when tumour is nearing plateau of growth

69
Q

What is the cell kill hypothesis?

A

Tumour cell kill follows first order kinetics - a given dose of drug with kill a certain percentage of population instead of a given number of cells

70
Q

What are the principles that should be considered when doing combination therapy for chemotherapy?

A

Each drug is individually effective - Different modes of action that don’t interfere with each other - Act on different stages of cell cycle - No overlapping toxicities

71
Q

Give a couple of exams of chemotherapy protocols used in cats and dogs

A

COP-based - Doxorubicin-containing (CHOP)

72
Q

How do you figure out the doses of cytotoxic chemotherapy agents? What is the exception?

A

Maximum tolerated dose = mg/m2 - Small dogs and cats so measured on mg/kg

73
Q

What is metronomic chemotherapy? How does it work?

A

Low doses of cytotoxic drug are given on continuous basis alongside a NSAID - Inhibits angiogenesis and immunomodulatory effects

74
Q

What is another method of chemotherapy apart from conventional and metronomic? How does it work?

A

Receptor tyrosine kinase inhibitors - Inhibit aberrant signalling which inhibits angiogenesis, reduces proliferation and promotes apoptosis

75
Q

What is MDR1? What does it do?

A

Mult-drug resistance gene acquired - Leads to increased P-glycoprotein (Pgp) which pumps cytotoxic drugs out of the cell

76
Q

What are the four main cytotoxic effects caused by chemotherapy drugs?

A

Myelosuppression - Gastrointestinal toxicity - Poor hair/whisker loss - Drug extravasation

77
Q

What is the mechanism of action of Alkylating agents?

A

Substitute alkyl group for H+ ion in DNA - cause cross-linkage and breaking of DNA - Interfering with DNA replication and transcription

78
Q

Give some examples of Alkylating agents

A

Cyclophosphamide - Lomustine - Melphalan - Chlorambucil - Procarbazine - Dacarbazine

79
Q

What are the toxic effects of Cyclophosphamide? What type of anti-cancer agent is it?

A

Haemorrhagic cystitis in dogs - Metabolite irritant to bladder lining
Alkylating agent

80
Q

What is the mechanism of action for Mitotic Spindle inhibitors?

A

Bind to tubulin - Prevent normal microtubule assembly - Arrest of mitosis in metaphase - Cell cycle specific

81
Q

Give some examples of Mitotic Spindle inhibitors

A

Viscristine - Vinblastine - Vinorelbine - Taxanes

82
Q

What are the toxic effects of Viscristine? What type of anti-cancer drug is it?

A

Peripheral neuropathies - Constipation in cats - Skins sloughs if injected perivascularly
Mitotic Spindle inhibitor

83
Q

What is the mechanism of action of Anti-metabolites?

A

Mimic normal metabolites used by nucleic acid metabolism - Interfere with DNA synthesis - Cell cycle specific

84
Q

Give some examples of Anti-metabolite drugs

A

Cytosine arabinoside/cytarabine - Methotrexate - Hydroxycarbamide

85
Q

What is the mechanism of action of Anti-tumour antibiotics?

A

Inhibition of topoisomerase II which untangles DNA strands - Breaking DNA strands - Cross-linking of DNA pairs - Free radical oxidative damage

86
Q

Give examples of Anti-tumour antibiotics

A

Doxorubicin - Epirubicin - Mitoxantrone - Actinomycin-D

87
Q

What are the toxic effects of Doxorubicin? What kind of anti-cancer drug is it?

A

Cardiotoxicity in dogs - Chronic toxicity leading to dilated cardiomyopathy - Mast cell degranulation (rare) - Nephrotoxicity in cats

88
Q

What is the mechanism of action of Platinum compounds?

A

Work the same as alkylating agents - Cause inter and intrastrand crosslinks in DNA - Interfere with DNA synthesis and transcription

89
Q

Give some examples of Platinum compounds

A

Cisplatin - carboplatin

90
Q

What other miscellaneous agents that aren’t classed as cytotoxic drugs can be used in cancer treatment?

A

Corticosteroids (prednisolone) - L-asparaginase - NSAIDs - Receptor Tyrosine Kinase Inhibitors (RTKIs)

91
Q

Why do margins for surgery need to be bigger than the tumour?

A

Assume there are invasive cells locally around the tumour

92
Q

What are the two ways that ionizing radiation destroy cells?

A

Direct damage to the DNA - Indirect damage via creating free radicals which then damage the DNA

93
Q

What are the units for Radiation Therapy?

A

Greys

94
Q

What would a) <1 grey cause b) cause cells to not divide c) between 10 and 100 greys cause?

A

a) Mitosis delayed
b) <10 greys
c) Intermitotic death after 1 or 2 tries

95
Q

What are the most radiation sensitive sensitive cells in the body?

A

Undifferentiated cells with a high mitotic rate - bone marrow, intestinal crypt cells, germinal layer of epidermis, TUMOURS

96
Q

Why are tumour cells more susceptible to radiation therapy than normal cells?

A

Have a poor DNA repair mechanism

97
Q

What is fractionation of radiation therapy?

A

Total dose of radiation used to treat a tumour is divided into a number of fractions

98
Q

What are the four R’s of radiation therapy?

A

Repair - Repopulation - Reoxygenation - Redistribution

99
Q

What may happen after a dosing of RT in tumour cell population? What are the consequences for RT?

A

Tumour cells may counteract cell death with accelerated repopulation - Need to treat again before they gain the opportunity to repopulate

100
Q

Which cells of a tumour may only die when treated with RT?

A

Oxygenated cells - Necrotic cells aren’t susceptible

101
Q

Which phase of the cell cycle are cells more sensitive to RT?

A

G1 and G2

102
Q

What is the name of the main modern machine which does RT?

A

Linear accelerator (megavoltage)

103
Q

What can be used for RT?

A

X-rays - Gamma rays - Particles

104
Q

An animal has a superficial tumour, what type of RT would be best to use on this? Why?

A

Electron beam - Therapeutic penetration of 1.5-5.6cm - RT will attack tumour whilst not attacking underlying organs

105
Q

What sort of RT are Proton beams used for?

A

High penetration - Used for deep tumours such as Lungs and Intestinal

106
Q

What is necessary to perform before undergoing Proton beam RT?

A

An accurate CT scan

107
Q

What can be used to keep an animal in the same position for RT?

A

Multi-leaf collimator, vacuum pillows and a Bitebloc

108
Q

When is Radiotherapy used as a curative measure?

A

Brain tumours - Tumours of head and neck (oral and nasal) - Mast cell tumours - Epulis (gingival)

109
Q

What are the adverse a) Acute and b) Late effects of radiation therapy?

A

a) Damage to skin, mucosa, GI epithelium

b) Permanent damage to bone, muscle, brain, CNS, lens, retina, etc

110
Q

What is needed in order to perform a successful surgical excision of neoplasia?

A

Thorough understanding of anatomy and physiology

111
Q

What is the role of surgery in management of cancer?

A

Diagnosis - Resection for cure - Palliative care - Debulking - Prevention of neoplasia

112
Q

How should a biopsy sample be properly fixated?

A

10% neutral buffered formalin - 1 part tissue to 10 parts fixture - Tissue less than 1cm thick

113
Q

What is prophylactic surgery?

A

Surgery where either normal (eg gonads) or abnormal (eg pre-malignant changes) tissue is excised to reduce incidence of occurrence/recurrence of neoplasia

114
Q

Give an example of prophylactic surgery and what it prevents

A

Gonadectomy - mammary tumours, perianal adenomas and testicular tumours - recurrence of vaginal leiomyomas

115
Q

What are tell-tale signs that a local lymph node is effected by metastases rather than inflammation or infection?

A

Firm - Irregular - Fixed to surrounding tissue

116
Q

What are the three types of excision?

A

Local - Wide local - Radical local

117
Q

What two circumstances should lymph nodes be removed?

A

Positive for tumour and is not fixed to surrounding tissues

Normal-appearing lymph nodes which drain the primary tumour may be sampled (biopsy)

118
Q

What two circumstances should lymph nodes not be removed?

A

Lymph nodes in critical areas attached to surrounding tissue (should only be biopsied in situ)
If intending to remove prophylactically with no intention of sampling

119
Q

When would you perform a local excision of a tumour?

A

Benign tumours - no infiltration

120
Q

For which types of tumour would you perform a wide local excision?

A

Benign tumours with infiltration - Malignant tumours with limited infiltration potential (well differentiated)

121
Q

What are the three methods of radical excision?

A

Compartmental excision - Muscle group excision - Amputation

122
Q

Define cytoreductive surgery

A

Surgery performed to debulk the tumour to make way for other forms of cancer treatment (chemo/RT)

Principles of Science (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions