Pathoma Chapter 3A

Question 1

Neoplasia is

Answer 1

new tissue growth that is unregulated, irreversible, and monoclonal

Question 2

What features distinguish neoplasia from hyperplasia and repair?

Answer 2

unregulated, irreversible, and monoclonal

Question 3

Monoclonal means

Answer 3

that the neoplastic cells are derived from a single mother cell

Question 4

Clonality can be determined by?

Answer 4

glucose-6-phosphate dehydrogenase (G6PD) enzyme isoforms.

Question 5

Multiple isoforms

Answer 5

G6PDA, G6PDb, and G6PDc exist; only one isoform is inherited from each parent.

Question 6

lyonization

Answer 6

In females, one isoform is randomly inactivated in each cell by lyonization

Question 7

G6PD is present on what chromosome

Answer 7

X

Question 8

Normal ratio of active isoforms in cells of any tissue is

Answer 8

1:1 (e.g 50% of cells have G6PDa , and 50% ofcells have G6PDG)

Question 9

In hyperplasia what happens to the ratio?

Answer 9

1:1 ratio is maintained in hyperplasia, which is polyclonal (cells are derived from multiple cells).

Question 10

In neoplasia what can be said about the isoform?

Answer 10

Only one isoform is present in neoplasia, which is monoclonal

Question 11

Clonality can also be determined by

Answer 11

androgen receptor isoforms, which are also present on the X chromosome.

Question 12

Clonality of B lymphocytes is determined by

Answer 12

immunoglobulin (Ig) light chain phenotype.

Question 13

Ig is comprised of

Answer 13

heavy and light chains.

Question 14

Each B cell expresses

Answer 14

light chain that is either kappa or lambda.

Question 15

Normal kappa to lambda light chain ratio is

Answer 15

3:01

Question 16

Kappa to lambda ratio in hyperplasia

Answer 16

This ratio is maintained in hyperplasia, which is polyclonal

Question 17

kappa to lambda ratio in lymphoma?

Answer 17

Ratio increases to > 6:1 or is inverted (kappa to lambda ratio = 1:3) in lymphoma, which is monoclonal

Question 18

Neoplastic tumors are

Answer 18

benign or malignant

Question 19

Benign tumors

Answer 19

remain localized and do not metastasize

Question 20

Malignant tumors

Answer 20

(cancer) invade locally and have the potential to metastasize.

Question 21

Tumor nomenclature is based on

Answer 21

lineage of differentiation (type of tissue produced) and whether the tumor is benign or malignant

Question 22

What benign growths result from the epithelium?

Answer 22

Adenoma, papilloma

Question 23

What malignant growths result from the epithelium?

Answer 23

Adenocarcinoma and papillary carcinoma

Question 24

What benign growths result from the mesenchyme?

Answer 24

Lipoma

Question 25

What malignant growths result from the mesenchyme?

Answer 25

Liposarcoma

Question 26

What benign growths result from the lymphocyte?

Answer 26

Does not exist

Question 27

What malignant growths result from the lymphocyte?

Answer 27

Lymphoma/Leukemia

Question 28

What benign growths result from the melanocyte?

Answer 28

Nevus (mole)

Question 29

What malignant growths result from the melanocyte?

Answer 29

Melanoma

Question 30

What is the 2nd leading cause of death in both adults and children?

Answer 30

cancer

Question 31

What are the leading causes of death in adults?

Answer 31

(1) cardiovascular disease (2) cancer (3) cerebrovascular disease

Question 32

What are the leading causes of death in children?

Answer 32

(1) accidents (2) cancer (3) congenital defects

Question 33

What are the most common cancers by incidence in adults?

Answer 33

(1) breast/prostate (2) lung (3) colorectal.

Question 34

What are the most common causes of cancer mortality in adults?

Answer 34

(1) lung (2) breast/prostate (3) colorectal

Question 35

Cancer begins as a

Answer 35

single mutated cell.

Question 36

Approximately how many divisions occur before the earliest clinical symptoms arise?

Answer 36

30

Question 37

Cancers that do not produce symptoms until late in disease

Answer 37

will have undergone additional divisions and, hence, additional mutations.

Question 38

Cancers that are detected late

Answer 38

tend to have a poor prognosis.

Question 39

Goal of screening is

Answer 39

to catch dysplasia (precancerous change) before it becomes carcinoma or carcinoma before clinical symptoms arise.

Question 40

Common screening methods include

Answer 40

1. Pap smear 2. Mammography 3. PSA and DRE 4. Hemoccult test and colonoscopy

Question 41

Pap smear

Answer 41

detects cervical dysplasia (CIN) before it becomes carcinoma

Question 42

Mammography

Answer 42

detects in situ breast cancer (e.g DCIS) before it invades or invasive carcinoma before it becomes clinically palpable

Question 43

PSA and DRE

Answer 43

Prostate specific antigen (PSA) and digital rectal exam detects prostate carcinoma before it spreads

Question 44

Hemoccult test

Answer 44

for occult blood in stool

Question 45

colonoscopy

Answer 45

detect colonic adenoma before it becomes colonic carcinoma or carcinoma before it spreads

Question 46

Cancer formation is initiated by

Answer 46

damage to DNA of stem cells. The damage overcomes DNA repair mechanisms, but is not lethal.

Question 47

Carcinogens are

Answer 47

agents that damage DNA, increasing the risk for cancer.

Question 48

Important carcinogens include

Answer 48

chemicals, oncogenic viruses, and radical ions

Question 49

DNA mutations eventually disrupt

Answer 49

key regulatory systems, allowing for tumor promotion (growth) and progression (spread)

Question 50

Disrupted key regulatory systems include

Answer 50

proto-oncogenes, tumor suppressor genes, and regulators of apoptosis