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STEP1-FirstAid > PATHOLOGY-Gen.Principles > Flashcards

PATHOLOGY-Gen.Principles Flashcards

1
Q

Key player in the intrinsic pathway of apoptosis?

What activates this pathway?

A

Key player= cyt c
Release of cytochrome c from the mitochondria means death (suicide) will occur.

Activated by: Signal comes from within the cell e.g toxin, radiation, hypoxia

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2
Q

Name 2 pro-apoptotic proteins and 1 anti-apoptotic protein in the intrinsic pathway of apoptosis?

A

PRO: Bax
Bak

ANTI: Bcl2….which inhibits Apaf1 which would normally activate caspases

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3
Q

In the extrinsic pathway, how does the binding of the Fas-Ligand to the Fas receptor lead to apoptosis?

A

Binding of ligand creades binding site for FADD…a death adaptor protein that then activates caspases…Caspases then activate proteases

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4
Q

Major differences between Necrosis and Apoptosis?

-Name 2

A

Necrosis is murder and Apoptosis = suicide

After necrosis, Inflammatory ensues but there is no inflammation in this “organized” way of dying

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5
Q

Difference in sequence of events between Coagulative Necrosis and Liquefactive Necrosis

A

COAG: proteins denature first, then enzymatic degradation occurs

LIQUI: Enzymatc degradation due to release of lysosomal enzymes occurs first.

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6
Q

Three diseases or species associated with Caseous Necrosis?

A
  • TB
  • Systemic Fungi
  • Nocadia (a Gram.P.Rod)
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7
Q

Two pathways of activating the extrinsic pathway of apoptosis?

A
  1. Via the binding of a Fas ligand to a Fas receptor (CD95)
  2. Via cytotoxix release of
    a. Granzymes
    b. Perforin
    by CD8+ cells
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8
Q

Two organs/disease processes associated with Fatty Necrosis?

What causes the “chalky” appearance in Fatty necrosis?

A

Pancreatitis (enzymatic saponification)

Breast Trauma (non-enzymatic sapofication)
Nb: Saponification = binding with resulting in chalky deposit
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9
Q

What kind of damage is inflicted by “Fibrioid Necrosis”?

Name 2 classic diseases associated with this type of necrosis?

A

DEF: this is damage to a vessel wall

EXAMPLES:

  • Henoch-Schonlein Pupura,
  • Churg Strauss Syndrome

**Also see in malignant HTN

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10
Q

What is the major difference between wet gangrenous necrosis and dry?

Which two parts of the body are most susceptible to gangrenous necrosis?

A

DRY: regular Ischemic coagulative necrosis

WET: Same as above, but with infection superimposed on top.

COMMON SITES:
-GI Tract and limbs (think diabetes)

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11
Q

Which organs undergo coagulative necrosis?

A

Everything except the brain! Brain = liquefactive necrosis due to high fat content

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12
Q

What is the hallmark of reversible cellular injury? i.e. reversible with re-oxygenation

-Name at least 3 other findings in reversible damage?

A

HALLMARK= cellular swelling

OTHER FINDINGS:

  • low Na+/K+ activity due to low ATP
  • Fatty changes
  • low glycogen
  • Membrane Blebbing
  • Ribosomal Detachment and low protein synthesis
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13
Q

What is the hallmark of Irreversible cellular injury?

-Name at least 3 other findings in irreversible damage?

A

HALLMARK: Membrane damage from degradation of phospholipid and increasing Calcium concentration

OTHER FINDINGS:

  • Nuclear: Pyknosis, karyorrhexis, karyolysis
  • Lysosomal rupture
  • Mitochondrial permeability and vacuolization
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14
Q

the following organs, which areas are more susceptible to hypoxia/ischemia and infarction:

a. Brain
b. Heart
c. Colon

A

BRAIN:
- ACA/MCA/PCA boundary areas

HEART:
-LV Subendocardium

COLON:

  • Splenic Flexure
  • Rectum
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15
Q

In the following organs, which areas are more susceptible to hypoxia/ischemia and infarction:

a. Kidney
b. Liver

A

KIDNEY:
-Straight segment of the proximal tubule
-Thick ascending limb
(both are found in the medulla)

LIVER:
-Zone III…the area around the central vein

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16
Q

In Hypoxic Ischemic Encephalophathy (HIE), which 2 areas are most susceptible?

A
  • Pyramidal cells of the hippocampus

- Purkinje cells of the cerebellum

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17
Q

What is the difference between a RED and a PALE infarct?

A

PALE:

  • usually due to occlusion
  • occurs in solid tissues with a single blood supply (heart, kidney, spleen)

RED:

  • usually hemorrhagic
  • occurs in loose tissue with multiple blood supply (liver, lungs, intestines, etc)
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18
Q

What causes reperfusion injury?

A

Damage by free radicals…so enzymes that quench free radicals will minimize this damage.

  • Superoxide Dismutase
  • Glutathione Peroxidase
  • Catalase
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19
Q

How does the PCWP IN cardiogenic versus hypovolemic shock?

How is the PCWP (high or low) in a distributive shock e.e. one including septic, neurogenic, or anaphylactic

A

Increased in Cardiogenic
Decreased in Hypovolemic

Decreased in distributive

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20
Q

How do the vessels differ in cardiogenic (or hypovolemic) as compared to distributive shock?

How do these differences contribute to the differences in the appearance of the patients?

A

CARDIOGENIC/HYPOVOLEMIA:
–The vessels are constricted and the patient is cool and clammy

DISTRIBUTIVE SHOCK:
—Vessels are vasodilated and therefore, the patient is warm and has dry skin (flushing too)

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21
Q

Name 7 processes that could cause atrophy?

A
  1. Reduction of endogenous hormones eg post-menopausal ovaries
  2. Increase in exogenous hormones e.g. factitious thyrotoxicosis or steroid hormones
  3. Decreased innervation…e.g. muscle damage
  4. low blood flow or nutrients
  5. decreased metabolic demand e.g. inpatient
  6. increased pressure e.g. nephrolithiasis
  7. occlusion of secretory ducts e.g cystic fibrosis
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22
Q

Name three enzymes that lower free radicals

A
  • Superoxide Dismutase
  • Glutathione Peroxidase
  • Catalase
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23
Q

In inflammation, which two agents cause pain and how do they accomplish this?

A

PGE2 and Bradykinin.

They sensitize nerve endings and that’s how they cause pain

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24
Q

Which 3 cells types are the key players in acute inflammation?

Which 3 cells types are the key players in chronic inflammation?

A

ACUTE:

  • neutrophils
  • eosinophils
  • antibodies

CHRONIC:

  • Macrophages
  • T-cells
  • Fibroblasts
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25
Q

Define chromatolysis.

Name 3 findings in chromatolysis?

A

DEF:
-Changes observed in a cell body of a nerve during axonal damage. The changes reflect increased protein synthesis to try and repair the damaged axon.

FINDINGS:

  • nucleus to the periphery
  • Round cellular swelling
  • Nissl substance dispersed throughout the cytoplasm
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26
Q

What are the two types of calcification?

How do they differ from one another. Give a classic example of each.

A

DYSTROPHIC:

  • calcium deposition in tissues secondary to necrosis
  • tends to be localized
  • Examples: psammona bodies, TB, infarcts, thrombi, schistosomiasis, Moceknberg arteriosclerosis, congenital CMV + toxoplasmosis, fact necrosis, liquefactive necrosis of chronic abscessses

METASTATIC:

  • calcim deposition in tissues secondary to increased serum calcium
  • tends to be diffuse in multiple organs

Examples: Sarcoidosis, primary hyperparathyroidism, hypervitamin D, high calcium-phosphate product (chronic renal failure + 2ndary hyperparathyroidism, long-ter dialysis, CALCIPHYLAXIS, warfarin)

Tissue that loses acid quickly (kidney, lungs, gastric mucosa)favor deposition since deposition likes alkaline pH

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27
Q

How do the calcium levels compare in the two types of calcification?

A

DYSTROPHIC:
-normal calcium levels

METASTATIC
-high calcium level

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28
Q

During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:

  • margination and rolling?
A
  1. E-SELECTIN on endothelium binds to Sialyl-Lewis on Leukocyte
  2. P-SELECTIN (from WP body!!)on endothelium binds to Sialyl-Lewis on Leukocyte
  3. GlyCAM-1 and CD34 on endothelium bind to L-selectin on leukocyte
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29
Q

During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:

  • tight binding I.E. firm adhesion?
A

ICAM-1 (CD54) on endothelium binds to LFA1 (CD18)/Mac-1 on leukocyte

V-CAM1 (CD106) on endothelium binds to VLA-4 integrin on leukocyte

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30
Q

During the 5 stages of leukocyte extravasation, which elements on leukocytes and on endothelium facilitate:

  • diapesdesis?
A

PECAM-1 (CD31) on endothelium binds to PECAM-1 (CD31) on leukocyte

EASY TO REMEMBER—haha**

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31
Q

Name 3 major chemotactic factors for leukocyte (think=PMN) migration and 2 other less-high yiled ones?

A

MAJOR (esp for PMNs):

  • C5a
  • LTB4
  • IL-8

MINOR:

  • kallikrein
  • platelet activating factor
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32
Q

Besides the three common enzymes, what 2 other non-enzymatic processes eliminate free radicals?

A
  1. spontaneous decay

2. antioxidants

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33
Q

Of the following processes, which ones generate free radicals?

  • Radiation (e.g. cancer therapy)
  • metabolism of drugs e.g. acetaminophen
  • redox reactions
  • nitric oxide
  • transition elements
  • leukocyte oxidative burst
A

ALL OF THEM!!!

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34
Q

Name 3 pathologies that can result from free radical injury?

A
  1. Reperfusion injury
  2. aCETA
    3.

look this up

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35
Q
  1. What is the most common pulmonary complication after exposure to fire?
  2. What are the 3 manifestations of this complication?
A
  1. Inhalation Injury i.e. ingestion of carbon particles and toxic fumes from the combustion
  2. MANIFESTATIONS:
    - Chemical Tracheobronchitis
    - Edema
    - Pneumonia
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36
Q

What is the difference in the collagen types laid in
a) HYPERTROPHIC SCAR

b) KELOID SCAR

A

a) HYPERTROPHIC SCAR
- increased scar tissue localized to the wound
- Excess Collagen Type I (stronger type that is laid at the end of healing)

b) KELOID SCAR
- exuberant response to scar which extends beyond the borders of the original wound
- Excess collagen Type III (the temporary one that is usually laid in temporary scar)

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37
Q

In wound healing, which mediator stimulates all aspects of angiogenesis and skeletal development?

A

FGF

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38
Q

In wound healing, which mediator stmulates cell growth via tyrosine kinases such as EGFR, as expressed by ERBB2?

A

EGF

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39
Q

In wound healing, which mediator stimulates angionesis, FIBROSIS,cell-cycle arrest and INHIBITS INFLAMMATION?

A

TGF-B

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40
Q

In wound healing, which mediator stimulates Tissue Remodelling?

A

Metalloproteases

-requires Zinc as co-factor

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41
Q
  1. In wound healing, which induces vascular remodeling and smooth muscle igration as well as stimulating fibroblast gworth for caollagen synthesis?
  2. Where does this factor come from?
A

PDGF

–made by platelets!!

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42
Q

During the remodeling phase of wound healing (after inflammation and the proliferative), which factor is responsible for wound contraction?

A

Myofibrolasts!!

That’s why people get contractures?

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43
Q

What are the 3 major phases of wound healing and which mediators are the major players?

A
  1. INFLAMMATORY:
    - platelets
    - PMNs
    - Marophages
  2. PROLIFERATIVE:
    - fibroblasts
    - myofibroblasts
    - endothelial cells
    - keratinocytes
    - macrophages
  3. REMODELLING:
    - Fibroblasts
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44
Q

What is the key switch that happens in the 3rd phase of wound healing?

A

Collagen Type III is replaced with Type I

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45
Q

Which granulomatous disease forms stellate granulomas with central necrosis?

A

Cat Scratch Disease caused by Bartonella Henselae

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46
Q

Which granulomatous disease results in the formation of “gummas”

A

Tertiary Syphillis

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47
Q

Which granulomatous disease seeds inmultiple tissues in the body?

A

Sarcoidosis

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48
Q

Which granulomatpus disease results from a parasitic worm?

A

Schistosomiasis (a.k.a. bilharzia)

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49
Q

Which granulomatous disease results in the loss of sensation?

A

Leprosy..caused by Mycobacterium Leprae

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50
Q

Three major differences in the constituents of exudate vs. transudate?

A

EXUDATE:

  • thick fluid
  • lots of cells
  • protein rich

TRANSUDATE:

  • thin fluid
  • hyPOcellular
  • s.gravity <1.012
  • protein poor
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51
Q

What are the causes of transudation vs. exudation

A

EXUDATION:

  • lymphatic obstruction
  • malignancy
  • inflammatory/infection

TRANSUDATION:

  • increase on hydrostatic pressure or
  • decrease in oncotic pressure
  • increase Na+ retention [remember that it’s Na+ that regulates volume]
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52
Q

What causes the ESR to increase?

A

Inflammatory products such as fibrinogen cause deposit on surfaces of RBCs and cause the cells to aggregate and hence fall faster:

Seen in diseases like multiple myeloma, most anemias, infections, inflammation, or pregnancy

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53
Q

Which disease processes lead to a reduction in the ESR?

-Name 3

A
  • CHF
  • Sickle Cell Anemia due to altered shape
  • Polycythemia (increase RBCs dilute aggregation factors)
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54
Q

How does Fe2+ poisoning lead to cell death?

How to treat Fe2+ poisoning?

A

Cell death due to peroxidation of membrane lipids

Treatment:
Chelation (IV deferoxamine, or oral deferasirox) and dalysis

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55
Q

Which amyloid protein is deposited in primary amyloidosis?

Name the disease(s) associated with this type.

Which organ(s) is/are involved?

A

AL type which is due to deposition of Ig Light chains

CONDITION:
-multiple myeloma usually

Affects multiple organs:

  • Renal-nephrotic syndrome
  • Cardiac-restrictive cardiomyopathy and arrhythmia
  • Hematological (easy bruising)
  • GI (hepatomegaly)
  • Neurologic (neuropathy)
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56
Q

Which type of amyloid protein is deposited in secondary amyloidosis?

-Which diseases, conditions, and systems are affected?

A

Type AA is deposited

  • Associated with chronic conditions such as IBD, Chrohn’s RA
  • It s also multi-system like the other primary amyloidosis
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57
Q

Which kind of amyloidosis is associated with deposition of fibrils B2-Microglobulin.

What is the condition that they often present with?

A

Dialysis-related amyloidosis which is often seen in patients with ESRD who are on dialysis.

OFTEN PRESENT WITH:
-Carpal Tunnel…since this b2 microglobulin deposits in joints

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58
Q

In the heritable form of amyloidosis, which gene is involved and how does this form of amyloidosis compare to another related form?

A

HERITABLE:
Mutated serum transthyretin is deposited in various organs includes nerves (loss of sensation), myocardium, leptpmeninges..

In normal-AGE-RELATED (SENILE) SYSTEMIC type,

It’s the wild type of transthyretin that will be deposited in heart and other tissues in this form of amyloidosis.
–However, it’s usually asymptomatic and cardiac dysfunction lower relative to AL amyloidosis

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59
Q

Which amyloid protein is deposited in Alzheimer’s disease and from where is it derived?
–where does is deposit?

A

A-B amyloid which is derived from amyloid precursor protein (on chromosome #21)

-CNS

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60
Q

Which amyloid protein is deposited in Down’s Syndrome and from where is it derived?
–where does is deposit?

A

A-B amyloid which is derived from amyloid precursor protein (on chromosome #21)

-deposited in the CNS

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61
Q

Which amyloid protein is deposited in Type II diabetes and from where is it derived?
–where does is deposit?

A

Amylin (Islet amyloid polypeptide-IAPP) derived from insulin

Deposited onto pancreatic islets

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62
Q

A Positive Congo Red stain which shows apple green birefringence under polarized light is a classic finding in _________?

A

AMYLOIDOSIS!!!!!

High High High High Yield!

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63
Q

Yellow-brown “wear and tear” pigment found in heart liver kidney eye, and most organs on autopsy in older patients indicate what?

Where does this substance come from?

What disease does it cause?

A

Lipofuscin

Formation:
Lipofuscin is a pigment formed by oxidation and polymerization of autophagocytosed organellar membranes

Harmless!!

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64
Q

What are the five steps in neoplastic progression from a normal cell to metastasis?

A

Normal Cell——Hyperplasia & Dysplasia——Carcinoma-in-situ—–invasive Carcinoma—–Metastatic Carcinoma

65
Q

Name 2 enzymes used by an invasive carcinoma to destroy the basement membrane as it progressed closer and closer to metastasis?

A

Hydrolases and Collagenases

66
Q

In cancer, hematogenous spread is typical of which kinds of cancers and lymphatic spread is typical of which?

–What are the exceptions?

A

HEMATOGENOUS SPREAD:
-sarcomas usually

LYMPHATIC SPREAD:
-carcinomas usually

A few carcinomas spread hematogenoously though:

  • -Renal Cell Cracinoma (via Renal Vein)
  • -Hepatocellular carcinoma (via Hepatic Vein)
  • –Follicular Carcinoma of the thyroid
  • –Choricarcinoma = malignancy of the placenta…sreads hematogenously
67
Q

What is P-glycoprotein?

Where is it expressed? i.e. on which cells will you find it?

What is its relevance in the treatment o of cancer?

A

DEF:
this is also known as “multidrug resistance protein”
–a transmembrane ATP-dependent efflux transporter

LOCATION:
-found on some cancer cells esp colon and liver

RELEVANCE to Rx:
-It pumps out toxins, including chemotherapeutic agents and hence decreases responsiveness or increases resistance to Rx over time

68
Q

Define the following terms:

a. DESMOPLASIA

b. ANAPLASIA

A

a. DESMOPLASIA
- fibrous tissue formation in response to neoplasm e.g. “Linitis Plastcica ” in diffuse stomach cancer

b. ANAPLASIA
- lack of structural differentiation and function of cells and they start to resemble primitive cells of the same tissue

69
Q

What is the difference between tumor grade and tumor stage?

Which measure has more prognostic value?

A

GRADE (range 1 to 4):
-measures degree of differentiation
4=anaplastic/poor differentiation and 1=well-differentiated

STAGE (TNM system):

  • measures
    i. localization/spread based on site
    ii. size of primary lesion
    iii. spread to lymph nodes
    iv. metastasis

Stage is more prognostic because it asseses metastasis (most important factor)

T= tumor size
N= spread to lymph nodes
M= metastasis
e.g. cT3N1M0

70
Q

What is Hallmark difference between a benign tumor and a malignant tumor?

A

Malignant tumor has the ability to metastasize

71
Q

In terms of cell origin, what is the difference between:

CARCINOMA and

SARCOMA?

A

Both are malignant cancers but they are distinguished by the origin of the cells:

  1. CARCINOMA:
    - –derived from epithelial origin

SARCOMA?
—-derived from mesenchymal origin

72
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Epithelium

A

BENIGN:

  • Adenoma
  • Papiloma

MALIGNANT:

  • Adenocarcinoma
  • Papillary carcinoma
73
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-Blood Cells

A

BENIGN:
-do not exist!!

MALIGNANT:

  • Leukemia
  • Lymphoma
74
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-Smooth Muscle

A

BENIGN:
-leiomyoma

MALIGNANT:
leiomyosarcoma

75
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-bood vessel

A

BENIGN:
-hemangioma

MALIGNANT:
-angiosarcoma

76
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-striated muscle

A

BENIGN:
rhabdomyoma

MALIGNANT:
-rhabdomyosarcoma

77
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-connective tissue

A

BENIGN:
-fibroma

MALIGNANT:
-fibrosarcoma

78
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-bone

A

BENIGN:
osteoma

MALIGNANT:
Osteosarcoma

79
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-fat

A

BENIGN:
-lipoma

MALIGNANT:
-liposarcoma

80
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-Cartilage

A

BENIGN:
-chondroma

MALIGNANT:
-chondrosarcoma

81
Q

For the tissue below, what do we call the benign tumor and what do we call the malignant one?

Mesenchyme:
—-melanocytes?

A

BENIGN:
-nevus (mole)

MALIGNANT:
-melanoma

82
Q

Name 4 features of cachexia?

What 3 inflammatory mediators promote cachexia?

A

FEATURES:

  • weight loss
  • muscle atrophy
  • fatigue
  • occurs in chronic diseases such as (cancer, AIDS, heart failure, TB)

MEDIATORS:

  • TNF-alpha
  • IFN-gamma
  • IL-6
83
Q

Which Neoplasms are associated with the following conditions:

ACANTHOSIS NIGRICANS:

ACTINIC KERATOSIS:

AIDS:

A

ACANTHOSIS NIGRICANS:
-visceral malignancy (esp stomach)

ACTINIC KERATOSIS:
-Squamoust Cell Carcinoma

AIDS:

  • Kaposi Sarcoma
  • Aggressive Malignant Lymphomas (non-Hodgkin)
84
Q

Which Neoplasms are associated with the following conditions:

AUTOIMUNE DISEASES (e.g. SLE, Hashimoto Thyroiditis):

BARRERTT’S ESOPHAGUS:

CHRONIC ATROPHIC GASTRITIS:

PERNICIOUS ANEMIA/POST-SURGICAL GASTRIC REMNANTS:

A 
AUTOIMUNE DISEASES (e.g. SLE, Hashimoto Thyroiditis):
-Lymphoma

BARRERTT’S ESOPHAGUS:
-Esophageal adenocarcinoma

CHRONIC ATROPHIC GASTRITIS:
-Gastric adenocarcinoma

PERNICIOUS ANEMIA/POST-SURGICAL GASTRIC REMNANTS:
–Gastric adenocarcinoma

85
Q

Which Neoplasms are associated with the following conditions:

CIRRHOSIS:

CHUSHING SYNDROME:

DERMATOMYOSITIS:

DOWN’S SYNDROME:

A

CIRRHOSIS:
-hepatocellualr carcinoma

CUSHING SYNDROME:
-small cell cancer

DERMATOMYOSITIS:
-Lung Cancer

DOWN’S SYNDROME:
-ALL, AML

86
Q

Which Neoplasms are associated with the following conditions:

DYSPLASTIC NEVUS:

HYPERCALCEMIA:

IMMUNODEFICIENCY:

LAMBERT-EATON MYASTHENIC SYN:

A

DYSPLASTIC NEVUS:
-malignant melanoma

HYPERCALCEMIA:
-squamous cell lung cancer

IMMUNODEFICIENCY:
-malignant lymphomas

LAMBERT-EATON MYASTHENIC SYN:
-small cell carcinoma

87
Q

Which Neoplasms are associated with the following conditions:

MYASTHENIA GRAVIS or PURE RBC APLASIA:

PAGET’S DISEASE OF THE BONE:

PLUMMER VINSON SYNDROME:

POLYCYTHEMIA:

A

MYASTHENIA GRAVIS or PURE RBC APLASIA:
-thymoma

PAGET’S DISEASE OF THE BONE:
-2ndary osteosarcoma and fibrosarcoma

PLUMMER VINSON SYNDROME:
-squamous cell carcinoma of the esophagitis

POLYCYTHEMIA:

  • renal cell carcinoma,
  • hepatocellulalr carcinoma
88
Q

Which Neoplasms are associated with the following conditions:

RADIATION EXPOSURE:

SIADH:

TUBEROUS SCLEROSIS:

A 
RADIATION EXPOSURE:
-leukemia
-sarcoma
-papillary thyroid cancer
Breast cancer

SIADH:
-small cell lung cancer

TUBEROUS SCLEROSIS:

  • giant cell astrocytoma
  • renal angiomyolipoma
  • cardiac rhabdomyoma
89
Q

Which Neoplasms are associated with the following conditions:

ULCERATIVE COLITIS:

XERODERMA PIGMENTOSUM/ALBINISM:

A

ULCERATIVE COLITIS:
-colonic adenocarcinoma

XERODERMA PIGMENTOSUM/ALBINISM:

  • melanoma
  • basal cells carcinoma
  • squamous cell carcinoma of the skin
90
Q

What gene product results from the following oncogene?
BCR-ABL

What is the associated tumor?

A

GENE PRODUCT:
Tyrosine kinase
–Rx = gleevec (imatinib)

ASSOCIATED TUMOR:

  • CML
  • ALL
91
Q

What gene product results from the following oncogene?
BCL-2

What is the associated tumor?

A

GENE PRODUCT:
-anti-apoptotic molecule

ASSOCIATED TUMOR:
-follicular and undifferentiated lymphomas

92
Q

What gene product results from the following oncogene?
BRAF

What is the associated tumor?

A

GENE PRODUCT:
Serine/threonine kinase
–Rx = vemurafenib

ASSOCIATED TUMOR:
melanoma

93
Q

What gene product results from the following oncogene?
C-KIT

What is the associated tumor?

A

GENE PRODUCT:
-cytokine receptor for stem cell factor

ASSOCIATED TUMOR:
-gastrointestinal stromal tumor [GIST]

94
Q

What gene product results from the following oncogene?
C-MYC

What is the associated tumor?

A

GENE PRODUCT:
-transcription factor

ASSOCIATED TUMOR:
-Burkitt’s lymphoma

95
Q

What gene product results from the following oncogene?
HER2/neu (c-erbB2)

What is the associated tumor?

A

GENE PRODUCT:
Tyrosine kinase

ASSOCIATED TUMOR:
Trastuzumab

96
Q

What gene product results from the following oncogene?
L-MYC

What is the associated tumor?

A

GENE PRODUCT:
-transcription factor

ASSOCIATED TUMOR:
-lung tumor

97
Q

What gene product results from the following oncogene?
N-MYC

What is the associated tumor?

A

GENE PRODUCT:
-transcripton factor

ASSOCIATED TUMOR:
-neuroblastoma

98
Q

What gene product results from the following oncogene?
RAS

What is the associated tumor?

A

GENE PRODUCT:
-GTPase

ASSOCIATED TUMOR:

  • colon cancer
  • lung cancer
  • pancreatic cancer
99
Q

What gene product results from the following oncogene?
RET

What is the associated tumor?

A

GENE PRODUCT:
-tyrosine kinase

ASSOCIATED TUMOR:
MEN 2A and 2B

100
Q

What gene product results from the following tumor suppressor genes?
APC

What is the associated tumor?

A

ASSOCIATED TUMOR:
-colorectal cancer (associated with FAP)

101
Q

What gene product results from the following tumor suppressor genes?
BRCA1
BRACA2

What is the associated tumor?

A

GENE PRODUCT:
-dna repair protein

ASSOCIATED TUMOR:
-breast and ovarian cancer

102
Q

What gene product results from the following tumor suppressor genes?
BRCA1
BRACA2

What is the associated tumor?

A

GENE PRODUCT:
-dna repair protein

ASSOCIATED TUMOR:
-breast and ovarian cancer

103
Q

What gene product results from the following tumor suppressor genes?
CPD4/SMAD4

What is the associated tumor?

A

GENE PRODUCT:
-DPC (deleted in pancreatic cancer)

ASSOCIATED TUMOR:
-pancreatic cancer

104
Q

What gene product results from the following tumor suppressor genes?
DCC

What is the associated tumor?

A

GENE PRODUCT:
DCC (deleted in colon cancer)

ASSOCIATED TUMOR:
-colon cancer

105
Q

What gene product results from the following tumor suppressor genes?
MEN1

What is the associated tumor?

A

ASSOCIATED TUMOR:
-MEN Type 1

106
Q

What gene product results from the following tumor suppressor genes?
NF1
NF2

What is the associated tumor?

A

GENE PRODUCT:
-NF1=RAS GTPase activating protein (neurofibromin)

-NF2=Merlin (schwannomin) protein

ASSOCIATED TUMOR:

  • neurofromatosis type 1
  • neurofromatosis type 2
107
Q

What gene product results from the following tumor suppressor genes?
p16

What is the associated tumor?

A

GENE PRODUCT:
-cyclin-dependent kinase inhibitor 2A

ASSOCIATED TUMOR:
-melanoma

108
Q

What gene product results from the following tumor suppressor genes?
p53

What is the associated tumor?

A

GENE PRODUCT:
-TF for p1…block G1-S phase

ASSOCIATED TUMOR:

  • most human cancers
  • Li Fraumeni Syndrome
109
Q

What gene product results from the following tumor suppressor genes?
-PTEN

What is the associated tumor?

A 
GENE PRODUCT:
-----
ASSOCIATED TUMOR:
-breast cancer
-prostate cancer
-endometrial cancer
110
Q

What gene product results from the following tumor suppressor genes?
Rb

What is the associated tumor?

A

GENE PRODUCT:
Inhibits E2F, blocks G1-S phase

ASSOCIATED TUMOR:

  • retinoblastoma
  • osteosarcoma
111
Q

What gene product results from the following tumor suppressor genes?

- TSC1
- TSC2

What is the associated tumor?

A

GENE PRODUCT:
TSC1-Harmatin protein
TSC2-Tuberin protein

ASSOCIATED TUMOR:
-tuberous sclerosis

112
Q

What gene product results from the following tumor suppressor genes?
-VHL

What is the associated tumor?

A

GENE PRODUCT:
-inhibits hypoxia inducible factor 1a

ASSOCIATED TUMOR:
-von Hippel-Lindau disease

113
Q

What gene product results from the following tumor suppressor genes?

  • WT1
  • WT2

What is the associated tumor?

A

GENE PRODUCT:
——

ASSOCIATED TUMOR:
-Wilms Tumor

114
Q

Which diseases/cancers are indicated by the following tumor markers?

**Alkaline Phosphatase

A
  • Metastases to bone, liver
  • Paget disease of bone
  • seminoma (placental ALP)
115
Q

Which diseases/cancers are indicated by the following tumor markers?

**Alpha-Fetoprotein

A

Normally made by fetus.

  • hepatocellular carcinoma
  • hepatoblastoma
  • yolk sac (endodermal sinus) tumor
  • testicular cancer
  • mixed germ cell tumor (co-secreted with B-hCG)
116
Q

Which diseases/cancers are indicated by the following tumor markers?

**B-hCG

A
  • Hyatidiform moles
  • Choriocarcinomas (gestational trophoblastic disease)
  • testicular cancer
117
Q

Which diseases/cancers are indicated by the following tumor markers?

  • ***CA-15-3
  • ***CA-27-29
A

Breast cancer

118
Q

Which diseases/cancers are indicated by the following tumor markers?

*****CA-19-9

A

Pancreatic adenocarcinoma

119
Q

Which diseases/cancers are indicated by the following tumor markers?

*****CA-125

A

Ovarian cancer

120
Q

Which diseases/cancers are indicated by the following tumor markers?

**calcitonin

A

Medullary thyroid carcinoma

121
Q

Which diseases/cancers are indicated by the following tumor markers?

  • ***CEA
    i. e. carcinoembryonic antigen
A

It’s very unspecific
~70% of colorectal and pancreatic cancers
-also produced by gastric breast and
Medullary thyroid carcinoma

122
Q

Which diseases/cancers are indicated by the following tumor markers?

*****PSA

A

Used to follow prostate adenocarcinoma

***Can also be elevated in BPH and prostatitis

123
Q

Which diseases/cancers are indicated by the following tumor markers?

*****S-100

A

Neural crest origin (e.g. melanoma, neural tumors, shchwannomas, Langerhans cell histiocytosis)

124
Q

Which diseases/cancers are indicated by the following tumor markers?

**TRAP

A

Hairy Cell Leukemia (a B-cell neoplasm)

125
Q 
Which cancer(s)  is/are associated with the following microbe:
      -EBV
A

Burkitt lymphoma

  • Hodgkin’s Lymphoma
  • Nasopharyngeal Carcinoma
  • CNC lymphoma (immunocomprised patients)
126
Q 
Which cancer(s)  is/are associated with the following microbe:
    -HBV, HCV
A

Hepatocellular carcinoma

127
Q 
Which cancer(s)  is/are associated with the following microbe:
 HHV-8
A

Kaposi sarcoma,

Body cavity fluid B-cell

128
Q 
Which cancer(s)  is/are associated with the following microbe:
   -HPV
A
  • cervical and penile/anal carcinoma (16,18)

- head and neck or throat cancer

129
Q 
Which cancer(s)  is/are associated with the following microbe:
     -H.Pylori
A

Gastric adenocarcinoma

MALT Lymphoma

130
Q 
Which cancer(s)  is/are associated with the following microbe:
   -HTLV-1
A

Adult- T-cell leukemia/lymphoma

131
Q 
Which cancer(s)  is/are associated with the following microbe:
-Liver Fluke (Clonorchis Sinensis)
A

Cholangiocarcinoma

132
Q 
Which cancer(s)  is/are associated with the following microbe:
   Schistosoma Haematobium
A

Bladder cancer (squamous cell)

133
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Aflatoxin (Aspergillus)

A

ORGAN:
-Liver

IMPACT/CANCER:
-hepatocellular carcinoma

134
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Alkylating agents

A

ORGAN:
Blood

IMPACT/CANCER:
Leukemia/Lymphoma

135
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

*****Aromatic amines (eg benzidine or 2-napthylamine)

A

ORGAN:
-bladder

IMPACT/CANCER:
Transitional cell carcinoma

136
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Arsenic

A

ORGAN:

  • liver
  • lung
  • skin

IMPACT/CANCER:

  • angiosarcoma
  • lung cancer
  • squamous cell carcinoma
137
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

****Asbestos

A

ORGAN:
-lung

IMPACT/CANCER:
Bronchogenic carcinoma»>mesothelioma

138
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Carbon tetrachloride*

A

ORGAN:
-liver

IMPACT/CANCER:

  • centrilobular necrosis
  • fatty change
139
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

cigarette smoke

A 
ORGAN:
Bladder
-esophagus
-kidney
-larynx
-lung
-pancreas
IMPACT/CANCER:
-Transitional cell carcinoma
-squamous cell carcinoma/adenocarcinoma
-renal cell carcinoma
-SCC
-SCC and small cell carcinoma
Pancreatic adenocarcinoma
140
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Ethanol (Alcohol)

A

ORGAN:
-liver

IMPACT/CANCER:
-hepatocellualr carcinoma

141
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**ionizing radiation

A

ORGAN:
-thyroid

IMPACT/CANCER:
-papillary thyroid carcinoma

142
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

***nitrosamines (smoked foods)

A

ORGAN:
-stomach

IMPACT/CANCER:
-gastric cancer

143
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

***radon

A

ORGAN:
-lung

IMPACT/CANCER:
-LUNG CANCER (2nd leading cause after cigaretted smoke)

144
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Vinyl Chloride

A

ORGAN:
-liver

IMPACT/CANCER:
-angiosarcoma of the lover

145
Q

For the carcinogen listed below, which organ is affected and what type cancer results?

**Nickel, Chromium, Beryllium, Silica

A

ORGAN:
-lung

IMPACT/CANCER:
-lung carcinoma

146
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?

1,25-(OH)2-D3

What is the effect of 1,25-(OH)2-D3?

A

EFFECT OF AGENT/HORMONE:
-hypercalcemia

NEOPLASM(S)

  • hodgkin’s lymphoma
  • some NHLs
147
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?

ACTH

What is the effect of ACTH?

A

EFFECT OF AGENT/HORMONE:
-cushing syndrome

NEOPLASM(S):
-small cell lung carcinoma
-

148
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?

-ADH

What is the effect of ADH?

A

EFFECT OF AGENT/HORMONE:
-SIADH

NEOPLASM(S):

  • small cell carcinoma
  • intracranial neoplasms
149
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?

-antibodies against pre-synaptic Ca2+ channels

What is the effect of this antibodies?

A

EFFECT OF AGENT/HORMONE:
-lambert eaton myasthenic syndrome

NEOPLASM(S):
Small cell lug carcinoma

150
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?

What is the effect of the hormone/agent?

A

EFFECT OF AGENT/HORMONE:

NEOPLASM(S)

151
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
—erythropoietin (EPO)

What is the effect of the hormone/agent?

A

EFFECT OF AGENT/HORMONE:
–polycythemia

NEOPLASM(S):

  • renal cell carcinoma
  • thymoma
  • hemangioblastoma
  • hepatocellular carcinoma
  • leiomyoma
  • pheochromocytoma
152
Q

Which paraneoplastic symptoms can result as a consequence of the hormone/agent listed below?
—PTHrP

What is the effect of the hormone/agent?

A

EFFECT OF AGENT/HORMONE:
–hypercalcemia

NEOPLASM(S):

  • squamous cell lung carcinoma
  • renal cell carcinoma
  • breast cancer
153
Q

Name the 5 conditons associated with Psammoma bodies?

A
  • Papillary Carcinoma of the thyroid
  • serous papillary cystadenocarcinoma of ovary
  • meningioma
  • malignant mesothelioma
154
Q

Name, in order of prevalence, the top 3 cancers in men and women in the US?

A

MEN:

  • Prostate cancer
  • lung cancer
  • colon/rectum cancer

WOMEN:

  • breast cancer
  • lung cancer
  • colon/rectum cancer
155
Q

Name, in order of mortality, the top 2 cancer killers in men and women in the US?

A

MEN:

  • lung
  • prostate

WOMEN:

  • lung cancer
  • breast cancer
156
Q

Rank, in order from most common, the cancers that metastasize to the:

BRAIN

A

Lung>breast>genitourinary >osteosarcoma>melanoma>GI

157
Q

Rank, in order from most common, the cancers that metastasize to the:

LIVER

A

Collon»stomach>pancreas

158
Q

Rank, in order from most common, the cancers that metastasize to the:

BONE

A

Prostate, Breast>Lung>thyroid

159
Q

Which amyloid protein is deposited in medullary carcinoma of the thyroid and from where is it derived?
–where does is deposit?

A

A Cal

Deposits in the kidney and derived from “procalcitonin”

STEP1-FirstAid (7 decks)

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