Oncology/Hematology

Question 1

What is the gene mutation in follicular nonHodgkin lymphoma?

Answer 1

t(14,18) involving BCL2

Question 2

What is the gene mutation in Burkitt’s lymphoma?

Answer 2

t(8,14) involving C-myc

Question 3

What is the most aggressive non Hodgkin’s lymphoma? its gene mutation?

Answer 3

Mantle cell t(11,14)

Question 4

What lymphoma is associated with MALToma and H. pylori? What is the treatment?

Answer 4

Marginal t(11,18) treat for H pylori

Question 5

What is the treatment for diffuse B cell lymphoma?

Answer 5

CHOP
Cyclophoshamide (+Mesna to prevent bladder toxicity)
Hydroxydaunymicin (Doxorubicin) (+Dexrazoxan to reduce cardio toxicity because Doxorubicin increases Fe accumulation and this is a Fe chelator)
Oncovin (Vincristine)
Prednisone

Question 6

Which target therapy is a PD1 blocker

Answer 6

pembrolizumab

Question 7

Which target therapy is a BCL-2 inhibitor and increases apoptosis

Answer 7

Venetoclax

Question 8

Which is a proteasome inhibitor and increases apoptosis?

Answer 8

bortezomib

Question 9

Which is an anti B cell (CD20) antibody?

Answer 9

Rituximab

Question 10

Which target therapy is a BCL-2 inhibitor and increases apoptosis

Answer 10

Venetoclax (for CLL)

Question 11

Multiple Myeloma meds

Answer 11

Bortezomib (inhibit proteasome activity)
Lenalidomide (derivative of Thalidomide)–binds the affinity of E3 ubiquitin ligase complex to specific transcription factors: Lenalidomide also used for mantle cell and myelodysplastic syn.

Question 12

Mechanism of chemo resistant cells

Answer 12

Have P Glycoproteins that upregulate ATP pump and pump out meds from cell, coded by multidrug resistant 1 gene (MDR1) gene

Question 13

What control cell cycle progression from G1 to S?

Answer 13

Cyclin Dependent Kinase (CDK4 &6) activated by cyclin D (BIG D!!) inhibit Rb suppressor protein, allowing passage to S phase; cancers achieve growth through Cyclin D amplification or Rb gene suppression

Question 14

What is a CDK 4/6 regulation medication to stop rapidly dividing cells?

Answer 14

Palbociclib

Question 15

Which chemo is specifically for HER2NEU breast cancer?

Answer 15

Trans2zumab (watch out for cardiomyopathy)

Question 16

Which disease is it when neoplastic megalokaryocytes secrete cytokine transforming growth factor Best which stimulates bone marrow fibroblast to fill medullary space with collagen?

Answer 16

Primary Myelofibrosis (pancytopenia, hepatosplenomegaly, teardrop cells)

Question 17

Which organs take over hematopoeisis with myelofibrosis?

Answer 17

liver and spleen

Question 18

What is the gene disruption in young smokers who develop non small cell lung carcinoma

Answer 18

fusion between short arm of Ch2 & EML4 (echinoderm microtubule associated protein-like 4) & ALK (anaplastic lymphoma kinase)= active tyrosine kinase Tx: protein kinase inhibitor crizotinib

Question 19

What is the gene disruption in melanoma? and a treatment?

Answer 19

BRAF600E changes valine to glutamate; good treatment is BRAF inhibitor VEMURAFENIB

Question 20

melanocyte markers

Answer 20

S100 and AMB45 AMB45 monoclonal Ab binds to immature melanosomes

Question 21

What is pembrolizumab used for?

Answer 21

it is a PD1 inhibitor so the cancer cell cannot evade apoptosis

Question 22

HPV MOA

Answer 22

E6 binds p53/ E7 binds Rb

Question 23

What are the surface epithelial ovarian tumors?

Answer 23

“cells that support normal ovulation”: serous, mucinous, clear, epithelial

Question 24

What are the sex cord stroma ovarian tumors?

Answer 24

“Cells that surround oocyte”: granulosa (secretes estrogen); Sertoli-Leydig (testosterone)

Question 25

What are the germ cell ovarian tumors?

Answer 25

"develop into embryo or placenta": have germ layers (mesoderm, endoderm, ectoderm); yolk sac tumors, choriocarcinomas (placenta) up hCG, up aFP

Question 26

What is a struma ovarii?

Answer 26

germ cell tumor with oily substance inside

Question 27

Where does cutaneous lymph from umbilicus down drain into ?

Answer 27

superficial inguinal lymph nodes

Question 28

Where do glans penis and popliteal LN drain into?

Answer 28

deep inguinal LN

Question 29

What is the marker for serous adenocarcinoma of ovary?

Answer 29

CA-125

Question 30

What is the marker for trophoblastic tumor?

Answer 30

beta hCG

Question 31

What is the marker for yolk sac, nonseminomatous testicular cancer?

Answer 31

AFP

Question 32

What does theca interna secrete?

Answer 32

progesterone

Question 33

What does granulosa secrete?

Answer 33

estrogen

Question 34

What does LH elevate?

Answer 34

progesterone

Question 35

What does FSH elevate?

Answer 35

estrogen

Question 36

What are some treatments for polycythemia vera?

Answer 36

phlebotomy, hydroxyurea, ruxolitinib and gout meds (colchicine)

Question 37

Explain the use of temozolomide for glioblastoma?

Answer 37

many glioblastoma methylate the CpG region adjacent to MGMT gene wchich generates a protein that repairs damage DNA, Silencing MGMT allows for more cancer growth but also makes it susceptible to alkylating chemo (temozolomide) because they cannot be repaired by MGMT

Question 38

What is ABETACEPT

Answer 38

PD1 CTLA 4 inhibitor (Cancer cells bind PD1 and CTLA4 to hide from apoptosis, if inhibit this binding, then cancer cells more susceptible to apoptosis