Oncology/Hematology Flashcards
What is the gene mutation in follicular nonHodgkin lymphoma?
t(14,18) involving BCL2
What is the gene mutation in Burkitt’s lymphoma?
t(8,14) involving C-myc
What is the most aggressive non Hodgkin’s lymphoma? its gene mutation?
Mantle cell t(11,14)
What lymphoma is associated with MALToma and H. pylori? What is the treatment?
Marginal t(11,18) treat for H pylori
What is the treatment for diffuse B cell lymphoma?
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
Which target therapy is a PD1 blocker
pembrolizumab
Which target therapy is a BCL-2 inhibitor and increases apoptosis
Venetoclax
Which is a proteasome inhibitor and increases apoptosis?
bortezomib
Which is an anti B cell (CD20) antibody?
Rituximab
Which target therapy is a BCL-2 inhibitor and increases apoptosis
Venetoclax (for CLL)
Multiple Myeloma meds
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.
Mechanism of chemo resistant cells
Have P Glycoproteins that upregulate ATP pump and pump out meds from cell, coded by multidrug resistant 1 gene (MDR1) gene
What control cell cycle progression from G1 to S?
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
What is a CDK 4/6 regulation medication to stop rapidly dividing cells?
Palbociclib
Which chemo is specifically for HER2NEU breast cancer?
Trans2zumab (watch out for cardiomyopathy)
Which disease is it when neoplastic megalokaryocytes secrete cytokine transforming growth factor Best which stimulates bone marrow fibroblast to fill medullary space with collagen?
Primary Myelofibrosis (pancytopenia, hepatosplenomegaly, teardrop cells)
Which organs take over hematopoeisis with myelofibrosis?
liver and spleen
What is the gene disruption in young smokers who develop non small cell lung carcinoma
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
What is the gene disruption in melanoma? and a treatment?
BRAF600E changes valine to glutamate; good treatment is BRAF inhibitor VEMURAFENIB
melanocyte markers
S100 and AMB45 AMB45 monoclonal Ab binds to immature melanosomes
What is pembrolizumab used for?
it is a PD1 inhibitor so the cancer cell cannot evade apoptosis
HPV MOA
E6 binds p53/ E7 binds Rb
What are the surface epithelial ovarian tumors?
“cells that support normal ovulation”: serous, mucinous, clear, epithelial
What are the sex cord stroma ovarian tumors?
“Cells that surround oocyte”: granulosa (secretes estrogen); Sertoli-Leydig (testosterone)
What are the germ cell ovarian tumors?
“develop into embryo or placenta”: have germ layers (mesoderm, endoderm, ectoderm); yolk sac tumors, choriocarcinomas (placenta) up hCG, up aFP
What is a struma ovarii?
germ cell tumor with oily substance inside
Where does cutaneous lymph from umbilicus down drain into ?
superficial inguinal lymph nodes
Where do glans penis and popliteal LN drain into?
deep inguinal LN
What is the marker for serous adenocarcinoma of ovary?
CA-125
What is the marker for trophoblastic tumor?
beta hCG
What is the marker for yolk sac, nonseminomatous testicular cancer?
AFP
What does theca interna secrete?
progesterone
What does granulosa secrete?
estrogen
What does LH elevate?
progesterone
What does FSH elevate?
estrogen
What are some treatments for polycythemia vera?
phlebotomy, hydroxyurea, ruxolitinib and gout meds (colchicine)
Explain the use of temozolomide for glioblastoma?
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
What is ABETACEPT
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