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MFM > Paraneoplastic Syndrome/Skin Cancers > Flashcards

Paraneoplastic Syndrome/Skin Cancers Flashcards

1
Q

what are endocrinopathies associated with paraneoplastic syndrome?

A

cushing syndrome, ADH, hypercalcemia, hypoglycemia, polycythemia

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2
Q

what cancers do you see cushing syndrome in?

A

SCLC, pancreatic carcinoma, neural tumors, ACTH is high and includes high serum pro-opiomelanocortin

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3
Q

when is ADH secretion seen?

A

SCLC, intracranial neoplasms

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4
Q

when is hypercalcemia seen?

A

parathyroid hormone related protein is released, TGFalpha, IL-1, seen in squamous cell carcinoma, breast, renal, adult T cell leukemia, lymphoma

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5
Q

what is hypoglycemia seen in ?

A

ovarian carcinoma, fibrosarcoma, other mesenchymal sarcomas

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6
Q

what is polycythemia seen in

A

renal, cerebellar hemangioma, hepatocellular carcinoma

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7
Q

what is myasthenia gravis seen in

A

bronchogenic carcinoma, thymic neoplasms

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8
Q

what CNS/PNS disorders are likely seen in breast cancers?

A

peripheral neuropathies, cortical cerebrallar degeneration, polymyopathy resembling polymitosis

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9
Q

what is acanthosis nigricans?

A

derm disorder associated with paraneoplastic syndrome, seen in gastric carcinoma, lung and uterine, grey/black thickened keratotic, velvety skin

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10
Q

what is dermatomyositis seen in?

A

bronchogenic, thymic neoplasms

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11
Q

when would you see finger clubbing?

A

liver disease, diffuse lung disease, congenital cyanotic heart disease, ulcerative colitis

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12
Q

what is hypertrophic osteoarthropathy?

A

periosteal new bone formation at distal end of long bones, metacarpals, metatarsals, proximal phalanges, and arthritis of adjacent joints

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13
Q

when is trousseau phenomenon/venous thrombosis seen?

A

pancreatic, bronchogenic, when tumor products/mucins activate clotting

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14
Q

what is red cell aplasia associated with?

A

thymic neoplasms

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15
Q

what is thrombotic endocarditis associtaed with?

A

not bacterial, causes hypercoagulability, seen in advanced cancers

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16
Q

when is disseminated intravascular coagulation caused by tumor products that activate clotting seen?

A

acute promyelocytic leukemia, and prostatic cancer

17
Q

what is melanoma linked with?

A

acquired mutations caused by UV radiation/periodic sunburns early in life

18
Q

what gene is commonly mutated in melanoma?

A

familial form: CDKN2A, which encodes p15ink4b (loss of this is indicated in melanoma), p16/innk4a, and p14/ARF, sporadic form: activation in BRAF and NRAF is seen in sporadic form, activation of TERT

19
Q

what is p16/ink4a

A

tumor suppressor, inhibits cdk4 and cdk6, reinforces RB tumor suppressor to block cells in G1 phase of cell cycle - if this is lost, cdk binds and inactivates RB, sends E2F

20
Q

what is p14/ARF

A

enhances activity of p53 tumor suppressor by inhibiting MDM2 - if lost, MDM2 not inhibited, and p53 is degraded

21
Q

what are the 7 prognostic factors of melanoma

A
  1. tumor depth (breslow thickness)
  2. number of mitoses
  3. evidence of tumor regression (absence is good)
  4. ulceration of underlying skin (lack is good)
  5. presence and number of tumor infiltrating lymphocytes
  6. gender
  7. location
22
Q

usual location of melanoma on male and female

A

males usually on back and upper trunk, females on legs

23
Q

what are the ABCDE of melanoma

A

asymmetry, irregular borders, color, increasing diameter over 6mm, evolution over time

24
Q

what treatment is best and worst for melanoma

A

RAS and P13K/AKT pathway blockers, melanoma is resistant to chemo and radiation

25
Q

what is the most common non-melanoma skin cancer?

A

basal cell

26
Q

pathogenesis of squamous cell carcinoma?

A

degree of lifetime sun exposure, immunosuppression, industrial carcinogens, usually p53 is mutated leading to increased RAS and decreased notch

27
Q

what skin cancer is commonly seen in immunocompromised/immunosuppressive people and those with disorders of dna repair?

A

basal cell carcinoma

28
Q

pathogenesis of basal cell carcinoma

A

unbridled SHH signaling due to PTCH mutation

29
Q

indications for RAF blockers

A

familial melanoma is mutated in p16INK4a, so raf is wild type. treating with RAF blocker may actually induce growth of a tumor, so only treat sporadic melanoma with RAF inhibitor

MFM (39 decks)

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