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Step 1 2019 First Aid Flashcards > Patho - FA 220 - 229 Neoplasia > Flashcards

Patho - FA 220 - 229 Neoplasia Flashcards

1
Q

tissue origin of carcinoma vs sarcoma?

A

Carcinoma implies epithelial origin, whereas sarcoma denotes mesenchymal origin.

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2
Q

define hamartoma and choristoma

A

Hamartoma (disorganized overgrowth of tissues in their native location, eg, Peutz-Jeghers polyps) and Choristoma (normal tissue in a foreign location, eg, gastric tissue located in distal ileum in Meckel diverticulum).

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3
Q

define anaplasia

A

—complete lack of differentiation of cells in a malignant neoplasm

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4
Q

What leads to the ability of cancer to continuously replicate?

A

Reactivation of telomerase –>maintenance and lengthening of telomeres –>prevention of chromosome shortening and cell aging.

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5
Q

Warburg effect?

A

Shift of glucose metabolism away from mitochondrial oxidative phosphorylation toward glycolysis.

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6
Q

How do tumor cells decrease immune response against them? (regarding cancer immune therapies) What are the Targets for the immune therapies?

A
  1. Interaction between PD-1 (on T cells) and PD-L1/2 (on tumor cells or immune cells in tumor microenvironment) –> T cell dysfunction (exhaustion).
    Rx. Ab vs PD1 - pembrolizumab, nivolumab or vs PDL1 - durvalumab, atezolizumab, avelumab
  2. CTLA-4 on T cells outcompetes CD28 for B7 on APCs –>loss of T cell costimulatory signal.
    Rx. Ipilimumab (anti-CTLA4 antibody)
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7
Q

Cancer rx that fight T cell exhaustion?

A

Inhibited by antibodies against PD-1 (eg, pembrolizumab, nivolumab) or
PD-L1 (eg, atezolizumab, durvalumab, avelumab).

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8
Q

How is T cell co stimulatory signal lost in neoplasia? Rx that fights it?

A

CTLA-4 on T cells outcompetes CD28 for B7 on APCs –>loss of T cell costimulatory signal. Inhibited by ipilimumab (anti-CTLA-4 antibody)

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9
Q

Most common cancers in men (incidence)?

A
  1. Prostate 2. Lung 3. Colon/rectum
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10
Q

most common cancers that cause mortality in men?

A
  1. Lung 2. Prostate 3. Colon/rectum
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11
Q

Most common cancers in women?

A
  1. Breast 2. Lung 3. Colon/rectum
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12
Q

Most common cancers that cause mortality in women?

A
  1. Lung 2. Breast 3. Colon/rectum
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13
Q

Most common cancers in children (incidence & mortality)?

A
  1. Leukemia 2. CNS 3. Neuroblastoma
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14
Q

1 cause of death in US?

A

Heart disease

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15
Q

Most common cancer - what types?

A

Skin cancer (basal > squamous&raquo_space; melanoma) is the most common cancer

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16
Q

How do sarcomas and carcinomas usually spread?

A

Most sarcomas spread hematogenously; most carcinomas spread via lymphatics

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17
Q

Which carcinomas spread hematogenously?

A

Four Carcinomas Route Hematogenously: Follicular thyroid carcinoma, Choriocarcinoma, Renal cell carcinoma, and Hepatocellular carcinoma.

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18
Q

Which tumors commonly metastasize to the brain?

A

Lung > breast > melanoma, colon, kidney.

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19
Q

Which tumors commonly metastasize to the liver?

A

Colon&raquo_space; Stomach > Pancreas (Cancer Sometimes Penetrates liver).

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20
Q

Which tumors commonly metastasize to the bone?

A

Prostate, Breast > Kidney, Thyroid, Lung (Painful Breasts Kill The Lungs to the Bone).

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21
Q

Most common sites of metastasis (other than lymph nodes) for GI cancers (colon,stomach, pancreas)?

A

Liver and lung are the most common sites of metastasis after the regional lymph nodes.

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22
Q

Bone cancers are more likely to occur where?

A

axial skeleton

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23
Q

3 types of bone metastasis?

A

Bone metastasis can be: ƒ Lytic (non Hodgkins, non-small cell lung cancer, RCC, melanoma, multiple myeloma) ƒ Blastic (eg, prostate, small cell lung cancer, Hodgkins) ƒ Mixed (eg, breast, GI)

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24
Q

Name the gene product and assoc neoplasm: ALK

A

ALK - Receptor tyrosine kinase; Lung Adenocarcinoma (Adenocarcinoma of the Lung Kinase)

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25
Q

Name the gene product and assoc neoplasm: BCR-ABL

A

non receptor tyrosine kinase; CML, ALL

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26
Q

Name the gene product and assoc neoplasm: BCL-2

A

antiapoptotic; Follicular and diffuse large B Cell Lymphomas

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27
Q

Name the gene product and assoc neoplasm: BRAF

A

ser/thr kinase; Melanoma, non-Hodgkin lymphoma, papillary thyroid carcinoma, hairy cell leukemia

BRAF 4 letters
Melanoma
Non Hodkin 
Oh Hairy cell
Papillary thyroid
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28
Q

Name the gene product and assoc neoplasm: c-kit

A

CytoKIne receptor; Gastrointestinal stromal tumor (GIST) (I’ll give you the GIST if you seek it (c-kit) )

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29
Q

Name the gene product and assoc neoplasm: c-myc

A

Transcription factor; Burkitt lymphoma (c-myc rhymes with Burkitt)

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30
Q

Name the gene product and assoc neoplasm: Her2/neu (c-erbB2)

A

Receptor tyrosine kinase Breast and gastric carcinoma (Her2 new boobs give me butterflies in the stomach)

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31
Q

Name the gene product and assoc neoplasm: JAK2

A

Tyrosine kinase; Chronic myeloproliferative disorders

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32
Q

Name the gene product and assoc neoplasm: KRAS

A

GTPase; Colon cancer, lung cancer, pancreatic cancer

KRAS - CLAS (Colon, Lung, pancreAS)

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33
Q

Name the gene product and assoc neoplasm: MYCL1

A

Transcription factor; Lung tumor

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34
Q

Name the gene product and assoc neoplasm: N-myc

A

Transcription factor; Neuroblastoma

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35
Q

Name the gene product and assoc neoplasm: RET

A

Receptor tyrosine kinase; MEN 2A and 2B, papillary thyroid carcinoma

RET (wREcks the Thyroid - who does? MEN)

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36
Q

Name the gene product and assoc neoplasm: APC

A

Negative regulator of β-catenin/WNT pathway; Colorectal cancer (associated with FAP)

APC = A Poopy Colon

37
Q

Name the gene product and assoc neoplasm: BRCA1, BRCA2

A

DNA repair protein Breast, ovarian, and pancreatic cancer

38
Q

Name the gene product and assoc neoplasm: CDKN2A

A

p16, blocks G1 –>S phase Melanoma, pancreatic cancer

CDKN2A - No 2nd Amendment - blocks Guns from Shooting - N2A stops G1–> S.
p16 - 16 yr olds drink and stay out in the sun - melanoma, pancreas cancer

39
Q

Name the gene product and assoc neoplasm: DCC

A

DCC—Deleted in Colon Cancer Colon cancer

40
Q

Name the gene product and assoc neoplasm: SMAD4

A

DPC—Deleted in Pancreatic Cancer Pancreatic cancer

41
Q

Name the gene product and assoc neoplasm: MEN1

A

Menin Multiple Endocrine Neoplasia 1

42
Q

Name the gene product and assoc neoplasm: NF1

A

Neurofibromin (Ras GTPase activating protein) Neurofibromatosis type 1

43
Q

Name the gene product and assoc neoplasm: NF2

A

Merlin (schwannomin) protein; Neurofibromatosis type 2

44
Q

Name the gene product and assoc neoplasm: PTEN

A

Negative regulator of PI3k/AKT pathway; Breast, prostate, and endometrial cancer

PTEN = Prostate Tits Endometrial Neoplasia

45
Q

Name the gene product and assoc neoplasm: Rb

A

Inhibits E2F; blocks G1 –>S phase Retinoblastoma, osteosarcoma

Rb = Retinoblastoma + Bone cancer

46
Q

Name the gene product and assoc neoplasm: Tp53

A

p53, activates p21, blocks G1 –>Sphase; Most human cancers, Li-Fraumeni syndrome (multiple malignancies at early age, aka, SBLA cancer syndrome: Sarcoma, Breast, Leukemia, Adrenal gland)

47
Q

Name the gene product and assoc neoplasm: TSC1

A

Hamartin protein Tuberous sclerosis

48
Q

Name the gene product and assoc neoplasm: TSC2

A

Tuberin protein Tuberous sclerosis - TSC2 - 2-berin

49
Q

Name the gene product and assoc neoplasm: VHL

A

Inhibits hypoxia-inducible factor 1a; von Hippel-Lindau disease
HIPpel = HIFfel (HIF for hypoxia inducible factor)

50
Q

Name the gene product and assoc neoplasm: WT1

A 
Transcription factor that regulates urogenital development
Wilms tumor (nephroblastoma)
51
Q

3 tumor suppressor genes that stop G1 –> S

A

Rb, p53, p16 (CDKN2A)

52
Q

Cancers associated with EBV?

A

Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, 1° CNS lymphoma (in immunocompromised patients)

53
Q

Cancers associated with HBV, HCV

A

Hepatocellular carcinoma

54
Q

Cancers associated with HHV8

A

Kaposi sarcoma

55
Q

Cancers associated with HPV

A

Cervical and penile/anal carcinoma (types 16, 18), head and neck cancer

56
Q

Cancers associated with H pylori

A

Gastric adenocarcinoma and MALT lymphoma

57
Q

Cancers associated with HTLV1

A

Adult T-cell leukemia/lymphoma

58
Q

Cancers associated with Liver fluke

A

Cholangiocarcinoma

59
Q

Cancers associated with Schistosoma?

A

Squamous cell bladder cancer

60
Q

Cancer associated with alfatoxins?

A

hepatocellular carcinoma

61
Q

Cancer associated with dyes (textiles) and cigarette smoke?

A

Exposure to aromatic amines:

Bladder cancer - transitional cell carcinoma

62
Q

A person that works with herbicides or metal smelting is at risk for?

A

Arsenic poisoning:
Angiosarcoma of liver
Lung cancer
Squamous cell carcinoma

63
Q

Exposure to old roofing material or shipyards risk for?

A

Bronchogenic carcinoma > mesothelioma

64
Q

A person that eats too much smoked food at risk for?

A

Gastric cancer

65
Q

A plumber is at risk for?

A

Angiosarcoma of the liver (exposure to vinyl chloride - used to make PVC pipes)

66
Q

Disease associated with tumor marker alkaline phosphatase?

A

Metastases to bone or liver, Paget disease of bone, seminoma (placental ALP).

67
Q

Disease associated with tumor marker alpha-fetoprotein?

A

Hepatocellular carcinoma, Endodermal sinus (yolk sac) tumor, Mixed germ cell tumor, Ataxia-telangiectasia, Neural tube defects. (HE-MAN is the alpha male!)

68
Q

Disease associated with tumor marker hcG

A

HCG
Hydatidiform moles
Choriocarcinomas (Gestational trophoblastic disease),
G - Gonads (testicular cancer), mixed Germ cell tumor.

69
Q

Disease associated with tumor marker CA 15-3/CA 27-29

A

Breast cancer.

70
Q

Disease associated with tumor marker CA 19-9

A

Pancreatic adenocarcinoma.

71
Q

Disease associated with tumor marker CA 125

A

Ovarian cancer.

72
Q

Disease associated with tumor marker Calcitonin

A

Medullary thyroid carcinoma (alone and in MEN2A, MEN2B).

73
Q

Disease associated with tumor marker CEA

A

colorectal and pancreatic cancers. C-colon pancrEAs

74
Q

Disease associated with tumor marker Chromogranin

A

Neuroendocrine tumors.

75
Q

Disease associated with tumor marker LDH

A

LDH

Testicular germ cell tumors, ovarian dysgerminoma, other cancers.

76
Q

Disease associated with tumor marker Neuron-specific enolase

A

Neuroendocrine tumors (eg, small cell lung cancer, carcinoid tumor, neuroblastoma

77
Q

Disease associated with tumor marker PSA

A

prostate cancer

78
Q

This stain indicates what target cell? Assoc Tumor? Chromogranin and synaptophysin

A

Neuroendocrine cells; Small cell carcinoma of the lung, carcinoid tumor

79
Q

This stain indicates what target cell? Assoc Tumor? Cytokeratin

A

Epithelial cells; Epithelial tumors (eg, squamous cell carcinoma)

80
Q

This stain indicates what target cell? Assoc Tumor?

Desmin

A

Muscle; Muscle tumors (eg, rhabdomyosarcoma)

81
Q

This stain indicates what target cell? Assoc Tumor? GFAP

A

NeuroGlia (eg, astrocytes, Schwann cells, oligodendrocytes)

Astrocytoma, Glioblastoma

82
Q

This stain indicates what target cell? Assoc Tumor? Neurofilament

A

Neurons; Neuronal tumors (eg, neuroblastoma)

83
Q

This stain indicates what target cell? Assoc Tumor? S-100

A

Neural crest cells;

Melanoma, schwannoma, Langerhans cell histiocytosis

84
Q

This stain indicates what target cell? Assoc Tumor? TRAP

A

Tartrate-resistant acid phosphatase ; Hairy cell leukemia

85
Q

This stain indicates what target cell? Assoc Tumor? Vimentin

A 
Mesenchymal tissue (eg, fibroblasts, endothelial cells, macrophages)
Mesenchymal tumors (eg, sarcoma), but also many other tumors (eg, endometrial carcinoma, renal cell carcinoma, meningioma)
86
Q

Another name for multidrug resistance protein 1?

A

P-glycoprotein

87
Q

Laminated, concentric spherules with dystrophic calcification

A

Psammoma bodies

88
Q

Where are Psammoma bodies seen?

A

ƒ Papillary carcinoma of thyroid ƒ Somatostatinoma ƒ Meningioma ƒ Malignant Mesothelioma ƒ Ovarian serous papillary cystadenocarcinoma ƒ Prolactinoma (Milk)

89
Q

Mediators of cachexia?

A

TNF-α, IFN-γ, IL-1, and IL-6.

Step 1 2019 First Aid Flashcards (63 decks)

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