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Principles > Oncology > Flashcards

Oncology Flashcards

1
Q

what is the acquisition of overt specialised morphology or function?

A

differentiation

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2
Q

what is tissue/organ development?

A

disorganisation

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3
Q

what is the term for an increase in cell number?

A

hyperplasia

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4
Q

what is the term for an increase in cell size?

A

hypertrophy

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5
Q

what is the term for a reduction in cell of organ/muscle that was normal size?

A

atrophy

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6
Q

what is the term for reduced size of an organ that was never fully developed to normal size?

A

hypoplasia

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7
Q

out of the list, which is not potentially reversible?

atrophy, hypoplasia, hypertrophy, hyperplasia?

A

hypolasia

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8
Q

what is the term for an acquired form of altered differentiation? (ie one fully mature cell type to another fully mature cell type?)

A

metaplasia

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9
Q

for what physiological reason can metaplasia occur

A

an adaptive response to stress

(eg Barrett’s oesophagus_

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10
Q

what can metaplasia progresses to if the stimuli is persistent?

A

dysplasia and even malignancy

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11
Q

what type of cells are continuously dividing?

A

labile cells

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12
Q

what type of cells have a low level of replicative activity but may divide rapidly if stimulated?

A

stable cells

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13
Q

which part of the cell cycle are stable cells stuck in?

A

G(0) but can be stimulated to go to G(1) if needed

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14
Q

what type of cells are non-dividing and are not able to re-enter the cell cycle?

A

permanent cells

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15
Q

in which part of the cell cycle are cells quiescent? (ie inactive)

A

G(0)

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16
Q

what are the 4 phases of cell division?

A

G1, S, G2, M

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17
Q

are adult stem cells differentiated?

A

no, they are not differentiated but they are committed so they can only differentiate into a certain cell type

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18
Q

what is a neoplasm?

A

an abnormal mass of tissue, who’s growth exceeds normal tissues and persists in the same excessive manner after cessation of the stimuli that evoked the change

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19
Q

compare benign and malignant neoplasms in terms of differentiation.

A

benign: well differentiated- resembles normal tissue
malignant: degree of differentiation is variable, usually poorly differentiated

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20
Q

compare benign and malignant neoplasms in terms of invasion and encapsulation

A

benign: non invasive and encapsulated
malignant: invasive and not encapsulated

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21
Q

compare benign and malignant neoplasms in terms of mitotic figures.

A

benign: few mitotic figures and normal mitotic figures
malignancy: frequent mitotic figures and abnormal mitotic figures

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22
Q

compare benign and malignant neoplasms in terms of necrosis.

A

benign: no necrosis
malignant: necrosis

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23
Q

compare benign and malignant neoplasms in terms of pleomorphism. (ie the variability in size and shape of cells/nuceli

A

benign: minimal pleomorphism
malignant: pleomorphic

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24
Q

compare benign and malignant neoplasms in terms of nuclei pigment.

A

benign: not hyperchromatic
malignant: hyperchromatic

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25
Q

compare benign and malignant neoplasms in terms of their chromosomes.

A

benign: diploid
malignant: aneuploid (ie not an exact multiple of the haploid)

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26
Q

compare benign and malignant neoplasms in terms of metastases.

A

benign: dont metastasise
malignant: metastasise

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27
Q

name both benign and malignant forms of a squamous epithelial neoplasm

A

benign: squamous papilloma
malignant: squamous carcinoma

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28
Q

name both benign and malignant forms of a glandular epithelial neoplam

A

benign: adenoma
malignant: adenocarcinoma

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29
Q

name both benign and malignant forms of a fat neoplasm

A

benign: lipoma
malignant: liposarcoma

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30
Q

name both benign and malignant forms of an endothelial neoplasm

A

benign: angioma
malignant: angiosarcoma

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31
Q

name both benign and malignant forms of a chondrocyte neoplasm

A

benign: chondroma
malignant: chondrosarcoma

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32
Q

name both benign and malignant forms of osteoblast neoplasm

A

benign: osteoma
malignang: osteosarcoma

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33
Q

name both benign and malignant forms of a smooth muscle neoplasm

A

benign: leimyoma
malignant: leimyosarcoma

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34
Q

name bothe benign and malignant forms of skeletal muscle neoplasm

A

benign: rhabdomyoma
malignant: rhabdomyosarcoma

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35
Q

all neoplastic cells in a lesion are derived from a single common ancestor. what is the term for this?

A

monoclonal

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36
Q

what is a dysplasia?

A

a pre-malignant process

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37
Q

what are the different degress of dysplasia?

A

mild
moderate
severe
(as severity increases, progression to invasive malignancy increases)

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38
Q

what are the 5 stages of tumour growth?

A
  1. normal
  2. initial event
  3. mild dysplasia
  4. severe dysplasia
  5. invasive malignancy
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39
Q

what 2 ways can single cells that have detached from the primary tumour migrate?

A
  1. mesenchymal migration
    - proteolysis
  2. amoeboid movement
    - propulsion
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40
Q

what do a group of cells which want to migrate from a primary tumour need?

A

cell-cell adhesion and communication

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41
Q

what is a desmoplasia?

A

a stromal tissue

growth of the connective tissue

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42
Q

what is desmoplasia secondary to?

A

an insult

such as an invasive growth or after surgery

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43
Q

after angiogenesis occurs, what happens to the growth of a tumour?

A

exponential growth

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44
Q

what is angiogenesis?

A

formation of new blood vessels

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45
Q

what is the name of the process of controlling of angiogenesis?
(this control is lost in tumours)

A

angiogenic switch

46
Q

what 3 things can stimulate angiogenesis?

A

hypoxia
growth factors
cytokines

47
Q

what are metastases?

A

tumours that are discontinuous with the primary lesions- secondaries

48
Q

what are the 4 routes of metastasis?

A

lymphatic
haematogenous
across body cavities
direct invasion

49
Q

carcinomas favour metastases by which route?

A

lymphatic route

50
Q

sarcomas favour metastases by which route?

A

haematogenous

51
Q

what 2 malignant neoplasms are at high risk of direct invasion?

A

mesothelioma

chondrosarcoma

52
Q

what is tumour progression?

A

the irreversible change in one or more characterist of a neoplasm

53
Q

what are the 6 key elements in cancer development?

A
  1. self sufficiency in growth signals
  2. insensitivity to growth inhibition and escape from senescence
  3. evasion of apoptosis
  4. limitless replication potential
  5. angiogenesis
  6. invasion and metastasis
54
Q

what genomic instability can result in a malignancy?

A

defective DNA repair mechanisms

55
Q

what are the 5 major and the 3 minor risk factors for oral cancer?

A 
major: 
smoking
alcohol
HPV
immunosuppression
prev oropharyngeal cancer
minor:
oral lesions
diet (veg intake)
sun exposure -lip cancer
56
Q

what 2 carcinogens have been linked to lung cancer?

A

smoking

asbestos

57
Q

why can radiation cause cancer?

A

causes oxidative stress with production of free radicals which can damage macro-moleules eg DNA

58
Q

why can carcinogens bind to DNA?

A

electrophilic

59
Q

chemical carcinogenesis requires what 2 steps for tumour development?

A
  1. initiation
    (electrophilic molecules cause DNA damage)
  2. proliferation
60
Q

what is the name of a normal gene that helps regulate cell growth and differentiation?

A

proto-oncogene

61
Q

what type of gene is formed when a proto-oncogene is altered in a way that will lead to a tumour?

A

oncogene

62
Q

which type of viral carcinogen contains specific viral oncogenes?

A

RNA viruses

not DNA viruses

63
Q

is HPV a DNA or RNA virus?

A

DNA

64
Q

how do RNA viruses cause a carcinogenic effect?

A

use their viral oncogenes for insertational mutagenesis

65
Q

how do DNA viruses cause a carcinogenic effect?

A

encode proteins that bind to and inactivate host proteins (ie tumour supressor proteins)

66
Q

what are the 4 ways human proto-onogenes can be activated into oncogenes?

A

amplification
translocation
point mutation
insertional mutagenesis (ie using RNA viruses)

67
Q

what is translocation?

A

a chromosome mutation where chromosome segments change positions

68
Q

for mutational loss of proto-genic function how many alleles need to be affected?

A 
one allele
(dominant gene)
69
Q

for mutational loss of tumour supressor function how many alleles need to be affected?

A

both alleles

recessive genes

70
Q

what is p53?

A

a tumour supressor protein which is a transcription factor which regulates expression of many other genes
(especially those coding for slowing down/arresting cell cycle or apoptosis)

71
Q

what type of gene is BRCA-1

A

tumour supressor gene

72
Q

what is the function of oncogenes? (ie mutated proto-oncogenes)

A

stimulate cell proliferation and inhibit cell death

73
Q

what gene mutation gives the patient a high risk of breast cancer?

A

BRCA-1 mutation

mutation of tumour supressor genes

74
Q

what are the 5 common emetastatic sites?

A 
liver
bone
brain
adrenal glands
lungs
75
Q

what are paraneoplastic syndromes?

A

symptoms in cancer patients that cannot be explained by the effects of local or distant spread of tumours

76
Q

what 2 hormones can small cell lung cancer secrete?

A

ACTH
ADH
(or similar substances)

77
Q

what paraneoplastic syndromes can small cell lung cancer cause??

A

cushings syndrome (due to ACTH syndrome)

inappropriate ADH levels (due to ADH secretion)

78
Q

what paraneoplastic syndrome can squamous carcinoma of the lung and t-cell leukaemia/lymphoma cause?

A

hypercalcaemia

79
Q

what paraneoplastic syndrome can a renal carcinoma cause?

A

polycytheamia (increased RBC concentration ofblood)

80
Q

what paraneoplastic syndromes can bronchogenic carcinoma cause?

A

myasthenia
(weakening of the body muscles)

hypertrophic osteoarthropathy

81
Q

what paraneoplastic syndrome can gastric carcinoma cause

A

acanthosis nigricans (dark hyperpigmentation of the skin)

82
Q

what paraneoplastic syndromes can pancreatic carcinoma cause?

A

venous thrombosis (due to activated clotting by mucin)

83
Q

what paraneoplastic syndrome can most advanced cancers cause?

A

non-bacterial thrombotic endocarditis (due to hypercoaguability)

84
Q

what paraneoplastic syndromes can colo-rectal cardinoma cause?

A

nephrotic syndrome

85
Q

what is hodgkins disease?

A

a cancer within the lymphatic system

86
Q

what paraneoplastic syndrome can hodgkin’s disease cause?

A

nephrotic syndrome

87
Q

what type of tumours have a better prognosis? well differentiated or poorly differentiated?

A

well differentiated

88
Q

What is Duke’s Stage A?

A

tumour confined to wall, no lymph node metastases

89
Q

What is Duke’s Stage B?

A

tumour penetrates wall, no lymph node metastasis

90
Q

What is Duke’s Stage C?

A

lymph node metastasis

91
Q

What is Duke’s Stage D?

A

metastatic disease

92
Q

What is T1? (TNM staging)

A

invasion of submucosa

93
Q

what is T2? (TNM staging)

A

invasion of muscularis propria

94
Q

What is T3? (TNM staging)

A

invasion to subserosa and no perforation of the visceral peritoneum

95
Q

what is T4? (TNM staging)

A

invasion of adjacent organs or perforation of visceral peritoneum

96
Q

what is N0? (TNM staging)

A

no regional lymph node metastasis

97
Q

what is N1? (TNM staging)

A

1-3 regional nodes contain metastatic tumour

98
Q

what is N2? (TNM staging)

A

4+ regional nodes contain metastatic tumour

99
Q

what is M0? (TNM staging)

A

no distant metastasis

100
Q

what is M1? (TNM staging)

A

distant metastasis

101
Q

what is clinical staging I?

A

T1/2
N0
M0

102
Q

what is clinical staging IIA?

A

T3
N0
M0

103
Q

what is clinical staging IIB?

A

T4
N0
M0

104
Q

what is clinical staging IIIA?

A

T1/2
N1
M0

105
Q

what is clinical staging IIIB?

A

T3/4
N1
M0

106
Q

what is clinical staging IIIc?

A

any T
N2
M0

107
Q

what is clinical staging IV?

A

any T
any N
M1

108
Q

what is Nottingham Prognostic Index?

A

breast cancer prognosis calculator

109
Q

Nottingham Prognostic Index =

A

[0,2 x size] + N score + G score

where:
N score = number of nodes
0 = score 1
1-3 = score 2
>3 = score 3
G score = grade of tumour: 1, 2 or 3
110
Q

what is indicated if a breast tumour biopsy contains lots of HER2 protein?

A

HER2 gene amplification

indications for treatment: Herceptin will be effective to treat

111
Q

how can HER2 be tested for?

A

FISH testing

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