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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
compare benign and malignant neoplasms in terms of their chromosomes.
benign: diploid malignant: aneuploid (ie not an exact multiple of the haploid)
26
compare benign and malignant neoplasms in terms of metastases.
benign: dont metastasise malignant: metastasise
27
name both benign and malignant forms of a squamous epithelial neoplasm
benign: squamous papilloma malignant: squamous carcinoma
28
name both benign and malignant forms of a glandular epithelial neoplam
benign: adenoma malignant: adenocarcinoma
29
name both benign and malignant forms of a fat neoplasm
benign: lipoma malignant: liposarcoma
30
name both benign and malignant forms of an endothelial neoplasm
benign: angioma malignant: angiosarcoma
31
name both benign and malignant forms of a chondrocyte neoplasm
benign: chondroma malignant: chondrosarcoma
32
name both benign and malignant forms of osteoblast neoplasm
benign: osteoma malignang: osteosarcoma
33
name both benign and malignant forms of a smooth muscle neoplasm
benign: leimyoma malignant: leimyosarcoma
34
name bothe benign and malignant forms of skeletal muscle neoplasm
benign: rhabdomyoma malignant: rhabdomyosarcoma
35
all neoplastic cells in a lesion are derived from a single common ancestor. what is the term for this?
monoclonal
36
what is a dysplasia?
a pre-malignant process
37
what are the different degress of dysplasia?
mild moderate severe (as severity increases, progression to invasive malignancy increases)
38
what are the 5 stages of tumour growth?
1. normal 2. initial event 3. mild dysplasia 4. severe dysplasia 5. invasive malignancy
39
what 2 ways can single cells that have detached from the primary tumour migrate?
1. mesenchymal migration - proteolysis 2. amoeboid movement - propulsion
40
what do a group of cells which want to migrate from a primary tumour need?
cell-cell adhesion and communication
41
what is a desmoplasia?
a stromal tissue | growth of the connective tissue
42
what is desmoplasia secondary to?
an insult | such as an invasive growth or after surgery
43
after angiogenesis occurs, what happens to the growth of a tumour?
exponential growth
44
what is angiogenesis?
formation of new blood vessels
45
what is the name of the process of controlling of angiogenesis? (this control is lost in tumours)
angiogenic switch
46
what 3 things can stimulate angiogenesis?
hypoxia growth factors cytokines
47
what are metastases?
tumours that are discontinuous with the primary lesions- secondaries
48
what are the 4 routes of metastasis?
lymphatic haematogenous across body cavities direct invasion
49
carcinomas favour metastases by which route?
lymphatic route
50
sarcomas favour metastases by which route?
haematogenous
51
what 2 malignant neoplasms are at high risk of direct invasion?
mesothelioma | chondrosarcoma
52
what is tumour progression?
the irreversible change in one or more characterist of a neoplasm
53
what are the 6 key elements in cancer development?
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
what genomic instability can result in a malignancy?
defective DNA repair mechanisms
55
what are the 5 major and the 3 minor risk factors for oral cancer?
``` major: smoking alcohol HPV immunosuppression prev oropharyngeal cancer minor: oral lesions diet (veg intake) sun exposure -lip cancer ```
56
what 2 carcinogens have been linked to lung cancer?
smoking | asbestos
57
why can radiation cause cancer?
causes oxidative stress with production of free radicals which can damage macro-moleules eg DNA
58
why can carcinogens bind to DNA?
electrophilic
59
chemical carcinogenesis requires what 2 steps for tumour development?
1. initiation (electrophilic molecules cause DNA damage) 2. proliferation
60
what is the name of a normal gene that helps regulate cell growth and differentiation?
proto-oncogene
61
what type of gene is formed when a proto-oncogene is altered in a way that will lead to a tumour?
oncogene
62
which type of viral carcinogen contains specific viral oncogenes?
RNA viruses | not DNA viruses
63
is HPV a DNA or RNA virus?
DNA
64
how do RNA viruses cause a carcinogenic effect?
use their viral oncogenes for insertational mutagenesis
65
how do DNA viruses cause a carcinogenic effect?
encode proteins that bind to and inactivate host proteins (ie tumour supressor proteins)
66
what are the 4 ways human proto-onogenes can be activated into oncogenes?
amplification translocation point mutation insertional mutagenesis (ie using RNA viruses)
67
what is translocation?
a chromosome mutation where chromosome segments change positions
68
for mutational loss of proto-genic function how many alleles need to be affected?
``` one allele (dominant gene) ```
69
for mutational loss of tumour supressor function how many alleles need to be affected?
both alleles | recessive genes
70
what is p53?
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
what type of gene is BRCA-1
tumour supressor gene
72
what is the function of oncogenes? (ie mutated proto-oncogenes)
stimulate cell proliferation and inhibit cell death
73
what gene mutation gives the patient a high risk of breast cancer?
BRCA-1 mutation | mutation of tumour supressor genes
74
what are the 5 common emetastatic sites?
``` liver bone brain adrenal glands lungs ```
75
what are paraneoplastic syndromes?
symptoms in cancer patients that cannot be explained by the effects of local or distant spread of tumours
76
what 2 hormones can small cell lung cancer secrete?
ACTH ADH (or similar substances)
77
what paraneoplastic syndromes can small cell lung cancer cause??
cushings syndrome (due to ACTH syndrome) inappropriate ADH levels (due to ADH secretion)
78
what paraneoplastic syndrome can squamous carcinoma of the lung and t-cell leukaemia/lymphoma cause?
hypercalcaemia
79
what paraneoplastic syndrome can a renal carcinoma cause?
polycytheamia (increased RBC concentration ofblood)
80
what paraneoplastic syndromes can bronchogenic carcinoma cause?
myasthenia (weakening of the body muscles) hypertrophic osteoarthropathy
81
what paraneoplastic syndrome can gastric carcinoma cause
acanthosis nigricans (dark hyperpigmentation of the skin)
82
what paraneoplastic syndromes can pancreatic carcinoma cause?
venous thrombosis (due to activated clotting by mucin)
83
what paraneoplastic syndrome can most advanced cancers cause?
non-bacterial thrombotic endocarditis (due to hypercoaguability)
84
what paraneoplastic syndromes can colo-rectal cardinoma cause?
nephrotic syndrome
85
what is hodgkins disease?
a cancer within the lymphatic system
86
what paraneoplastic syndrome can hodgkin's disease cause?
nephrotic syndrome
87
what type of tumours have a better prognosis? well differentiated or poorly differentiated?
well differentiated
88
What is Duke's Stage A?
tumour confined to wall, no lymph node metastases
89
What is Duke's Stage B?
tumour penetrates wall, no lymph node metastasis
90
What is Duke's Stage C?
lymph node metastasis
91
What is Duke's Stage D?
metastatic disease
92
What is T1? (TNM staging)
invasion of submucosa
93
what is T2? (TNM staging)
invasion of muscularis propria
94
What is T3? (TNM staging)
invasion to subserosa and no perforation of the visceral peritoneum
95
what is T4? (TNM staging)
invasion of adjacent organs or perforation of visceral peritoneum
96
what is N0? (TNM staging)
no regional lymph node metastasis
97
what is N1? (TNM staging)
1-3 regional nodes contain metastatic tumour
98
what is N2? (TNM staging)
4+ regional nodes contain metastatic tumour
99
what is M0? (TNM staging)
no distant metastasis
100
what is M1? (TNM staging)
distant metastasis
101
what is clinical staging I?
T1/2 N0 M0
102
what is clinical staging IIA?
T3 N0 M0
103
what is clinical staging IIB?
T4 N0 M0
104
what is clinical staging IIIA?
T1/2 N1 M0
105
what is clinical staging IIIB?
T3/4 N1 M0
106
what is clinical staging IIIc?
any T N2 M0
107
what is clinical staging IV?
any T any N M1
108
what is Nottingham Prognostic Index?
breast cancer prognosis calculator
109
Nottingham Prognostic Index =
[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
what is indicated if a breast tumour biopsy contains lots of HER2 protein?
HER2 gene amplification | indications for treatment: Herceptin will be effective to treat
111
how can HER2 be tested for?
FISH testing

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