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Surgery JMC > oncology > Flashcards

oncology Flashcards

1
Q

what are the hallmarks of cancer?

A

self-sufficiency of growth signals, insensitivity to growth-inhibitory signals, evasion of apoptosis
(programmed cell death), potential for limitless replication,
angiogenesis, and invasion and metastasis.

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2
Q

Tumorigenesis is proposed to have three steps?

A

initiation, promotion, and progression.

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3
Q

events such as gain of function of
genes known as oncogenes or loss of function of genes known as
tumor-suppressor genes may lead a single cell to acquire a distinct growth advantage

A

Initiation

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4
Q

many normal-appearing cells may have an increased malignant potential. This is referred to as

A

field effect

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5
Q

Cell-Cycle Dysregulation in Cancer

A

-The proliferative advantage of tumor cells is a result of their ability to bypass a quiescent state.
-alterations in signal transduction pathways
-Mutations or alterations
in the expression of cell-cycle proteins

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6
Q

Normal cellular genes that contribute to cancer when abnormal
are called?

A

oncogenes

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7
Q

The normal counterpart of an oncogene is

referred to as as

A

proto-oncogene

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8
Q

Proto-oncogenes can be activated (show

increased activity) or overexpressed (expressed at increased protein levels) by?

A
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9
Q

Oncogenes may be?

A 
growth factors (e.g., platelet-derived 
growth factor), growth factor receptors (e.g., HER2), intracellular signal transduction molecules (e.g., ras), nuclear transcription factors (e.g., c-myc), or other molecules involved in 
the regulation of cell growth and proliferation.
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10
Q

-also known as neu or c-erbB-2, is a member of
the epidermal growth factor receptor (EGFR) family and is one
of the best-characterized tyrosine kinases. Unlike other receptor tyrosine kinases, it does not have a direct soluble
ligand. It plays a key role in signaling.
-Heterodimerization potentiates recycling of receptors rather than degradation, enhances
signal potency and duration, increases affinity for ligands, and
increases catalytic activity

A

HER2

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11
Q

HER2 gene is frequently amplified and the protein over expressed in many cancers, including?

A

breast, ovarian, lung,

gastric, and oral cancers.

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12
Q

overexpression is associated with
increased cell proliferation and anchorage-independent growth
as well as resistance to proapoptotic stimuli
3% of patients with lung cancer

A

HER2 mutation

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13
Q

HER2-targeted drugs

with different mechanism of action

A

monoclonal antibodies trastuzumab and pertuzumab, small molecule inhibitor lapatinib,
and antibody-drug conjugate ado-trastuzumab emtansine.

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14
Q

reported number of gene mutations?

A

g/t 300

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15
Q

percentage of mutated genes at the somatic or tumor level?

A

90%

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16
Q

<p>percentage of mutated genes that show germline mutation?</p>

A

20%

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17
Q

<p>percentage of mutated genes that show both somatic and germline mutations</p>

A

10%

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18
Q

cancer heterogeneity

A

heterogeneity among patients, Heterogeneity between primary and metastatic sites, intramural spatia heterogeneity

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19
Q

factors may suggest the presence of a

hereditary cancer

A

<p>1. Tumor development at a much younger age than usual
2. Presence of bilateral disease
3. Presence of multiple primary malignancies
4. Presentation of a cancer in the less affected sex (e.g., male
breast cancer)
5. Clustering of the same cancer type in relatives
6. Occurrence of cancer in association with other conditions
such as mental retardation or pathognomonic skin lesions</p>

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20
Q

cancer invasion involves:

A

changes in adhesion, proteolysis of the ECM, initiation of motility

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21
Q

initiation of motility involves?

A

autocrine motility facvtor, autotaxin, scatter factor, TGFa, EGF anfd insulin-like growth factors

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22
Q

angiogenic factor:

A

VEGF, PDGFs, angiopoietins

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23
Q

seed and soil theory states that?

A
  • spread of metastatic cells was organ specific
  • metastases developed only when the seed ans soil were compatible
  • metastases can only develop in specific organs
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24
Q

principles of seed and soil

A
  • primary neoplasms consist of both tumor cells and host cells
  • process of metastasis is selective for cells
25
Q

arising from the retina

3% of childhood cancers

A

retinoblstoma

26
Q

a germline mutation alters one allele in all cells, later somatic mutation alters the other allele

A

retinoblastoma, hereditary form

27
Q

involves somatic mutation of both alleles in a retinal cell

A

retinoblastoma, nonhereditary form

28
Q

Breast carcinoma, soft tissue sarcoma, osteosarcoma,
brain tumors, adrenocortical carcinoma, Wilms’ tumor, and
phyllodes tumor of the breast are strongly associated
-cancer predisposition syndrome

A

Li-Fraumeni Syndrome.

29
Q

Criteria for classic LFS in an individual (the proband) include

A

(a) a bone or soft tissue sarcoma when younger than 45 years,
(b) a first-degree relative with cancer before age 45 years, and
(c) another first- or second-degree relative with either a sarcoma diagnosed at any age or any cancer diagnosed before
age 45years

30
Q

. It is estimated that 5% to 10% of breast cancers
are hereditary. Of women with early-onset breast cancer (age
40 years or younger), nearly 10% have a germline mutation in
one of the breast cancer genes

A

BRCA1 or BRCA2

31
Q

For a female __ mutation carrier, the cumulative risks of developing breast cancer and ovarian cancer by
age 70 have been estimated to be 87% and 44%

A

BRCA1

32
Q

The cumulative risks of breast cancer and ovarian cancer by
age 70 in families with ____ mutation have been estimated
to be 84% and 27%,

A

BRCA2

33
Q

mutation are more likely

to be estrogen receptor negative

A

BRCA1-associated tumors

34
Q

re more likely to be estrogen receptor positive.

A

BRCA2-associated

tumors

35
Q

60-90% of cancers are due to?

A

environmental factors

36
Q

initiate carcinogens by causing a mutation

A

genotoxins

37
Q

enhances the potency of genotoxins

A

cocarcinogens

38
Q

enhances tumor formation when given after exposure to genotoxins

A

tumor promoters

39
Q

can occur through induction of inflammation and cell proliferation over a period of time or through
exposure to physical agents that induce DNA damage

A

Physical Carcinogens

40
Q

is the best-known agent of physical carcinogens
and is classified as ionizing radiation (X-rays, gamma rays, and
alpha and beta particles) or nonionizing radiation (UV).

A

Radiation

41
Q

cells that have not been directly irradiated appear to be at
risk, a phenomenon referred to as

A

bystander effect.

42
Q

Most nonmelanoma human skin cancers are thought to

be induced by

A

repeated sun exposure

43
Q

are retroviruses and contain a reverse transcriptase. After the viral infection, the single-stranded RNA viral genome is transcribed into
a double-stranded DNA copy, which is then integrated into the
chromosomal DNA of the cell.

A

oncogenic RNA viruses

44
Q

American Cancer Society recommends routine HPV vaccination for girls and boys

A

starting at age 11 or 12
The vaccination series can be started as early as age 9.
HPV vaccination is also recommended for females 13 to 26 years old and for males 13
to 21 years old who have not started the vaccines, or who have
started but have not completed the series.
Males 22 to 26 years old may also be vaccinated.
HPV vaccination is also recommended up until age 26 for men who have sex with men and for
people with weakened immune systems

45
Q

prediction of BRCA1 and BRCA2 mutations, accurately predicted the age-specific familial relative risk

A

Breast and ovarian analysis incidence carrier estimation algorithm (BOADICEA)

46
Q

predict a person’s risk for developing breast CA based on family history

A

Claus model

47
Q

mutation of BRCA1, BRCA2 or both on the basis of the person’s cancer status and the history of breast and ovarian cancer in 1st and 2nd degree relatives

A

BRCAPRO computer program

48
Q

accurate in predicting the incidence of breast cancer in American and European females
5 year risk exceeding 1.67% -high risk

A

Gail model

49
Q

__ of screening mammograms are suggestive of an abnormality

A

10%

50
Q

in mammogram and USD screening, how many percent is determined to have breast cancer

A

5-10%

51
Q

after biopsy how many percent is determined to have breast CA?

A

25-40%

52
Q

age where women with average risk should undergo screening for breast CA

A

20-39 yo

53
Q

mammography should start at what age for average risk patients

A

40 yo

54
Q

cervical CA should begin at the age of?

A

21 yo

55
Q

gfobt for colorectal CA shoul begin at the age of?

A

50 yo

56
Q

DRE and PSE for men should be started at the age of?

A

50 yo

57
Q

uses gauge 23 needle to extract tissues, limits size of tissue

A

fine needle aspirate

58
Q

treatment for cancer

A

surgery,chemotherapy, hormonal therapuy, targeted tx, immunotherapy

Surgery JMC (2 decks)

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