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PP correction fc Flashcards

1
Q

which cancers are routinely screened for in the UK?

A
  • cervical
  • breast
  • bowel
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2
Q

what is the name for malignant neoplasms of the following tissue type:
- adipose tissue
- glandular epithelium
- blood vessels
- striated muscles

A
  • liposarcoma = adipose tissue
  • adenocarcinoma = glandular epithelia
  • angiocarcinoma = blood vessel
  • rhabdomyosarcoma = striated muscle
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3
Q

Which virus is associated with Kaposi’s sarcoma?

A

HIV
(people with kaposis sarcoma present with purple ish skin lesions)

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4
Q

what is p53 gene and what is its normal function?

A

p53 is a type of TSG
it is normally involved in DNA repair and programming cell apoptosis if DNA repair is not possible

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5
Q

what are the 2 main risk factors associated with cervical cancer?

A

HPV:
* creates E6 + E7
* E6 blocks P53 which stops the cell from undergoing apoptosis
* E7 takes over the retinoblastoma gene (TSG)
* activates cyclins

smoking

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6
Q

what are the 2 main risk factors associated with liver cell carcinoma?

A

Hep B:
* chronic inflammation causes increased cell repair
* increased risk of bringing forth pre-existing DNA mutations or causing new mutations

Aphlatoxins:
* toxin that works with Hep B and increases the effects of Hep B

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7
Q

what is the main risk factor associated with colorectal carcinoma?

A

low fibre diet:
* slower passage of faeces through gut
* carcinogens present are in contact with cells for a longer period of time
* increased risk of cancer

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8
Q

what are the 2 main risk factors associated with Burkitts lymphoma?

A

malaria:
* malaria can reactivate dormant EBV (epstein-barr virus)

EBV:
* promotes B cell proliferation so increased risk of mutations arising

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9
Q

what are the 2 main risk factors associated with bladder cancer?

A

schistosomiasis:
* eggs cause chronic inflammation
* results in squamous metaplasia
* increased risk of dysplasia
* causes squamous cell carcinoma

long term cathoderisation:
* basically same as above except eggs

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10
Q

what are the 2 main risk factors associated with a gastric adenocarcinoma?

A

Helicobacter pylori:
* causes chronic inflammation
* results in metaplasia
* increased risk of dysplasia
* malignancy

smoking

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11
Q

how does asbestos (insulation fibres) cause cancer?

A
  • fibres absorb toxins
  • generate free radicals
  • cause chronic inflammation
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12
Q

what are the 3 types of skin cancers?

A
  1. squamous cell carcinoma
  2. basal cell carcinoma
  3. melanoma
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13
Q

what agent in smoking causes cancer?

A

polycyclic aromatic hydrocarbon

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14
Q

how does smoking cause cancer?

A
  • smoking acts as an initiator carcinogen
  • causes chronic inflammation (then everything associated with this)
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15
Q

what is Li-Fraumeni syndrome?

A
  • fault in the TP53 TSG
  • increased risk of developing num of cancers:
    1. breast
    2. brain
    3. bone
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16
Q

What is the mechanism of action of statins?

A

Inhibit HMG-CoA reductase - an enzyme involved in the formation of cholesterol
Less cholesterol is produced which causes up regulation of LDL receptors on cell membrane so reduces circulating LDL
Less LDL in blood that can be caught up in atherosclerotic plaques

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17
Q

What is meant by the term stage and grade in relation to cancers?

A

Stage = how much a cancer has spread
Grade = how aggressive the cancer is

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18
Q

What 3 microscopic features help to asses the grade of a tumour?

A

Mitosis
Nuclear pleomorphism
Tubules

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19
Q

Who is offered bowel cancer screening in the UK and how are they screened?

A

Men and women aged 60-74 every 2 years
At home FIT testing then a colonoscopy if needed

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20
Q

Who is invited for cervical screening and how is it done?

A

Women and people with cervix aged 25-64
(25-50 is every 3 years, 50-64 is every 5 years)
Smear test - scrape cells and test for HPV

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21
Q

Who is offered breast cancer screening and how is it screened?

A

Women aged 50-70
Mammogram

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22
Q

why do patients with prostate cancer present with back pain?

A

the tumour metastisises, spreads through blood stream and causes sclerotic bone lesions

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23
Q

Answer the following questions about keloid scars:
1. where are keloid scars common?
2. where are keloid scars rare?
3. do keloid scars recur if exised?
4. what are keloid scars composed of?
5. do keloid scars remain within the wound margins?
6. are keloid scars prone to malignant changes?

A
  1. sternum, shoulder, neck and cheeks
  2. eyelids
  3. yes, recur if exised
  4. thickened collagen bands
  5. grow beyond wound margins
  6. dont undergo malignant changes
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24
Q

what factors adversely affect wound healing?

A

anaemia
obstructive jaundice
radiation therapy
chemotherapy

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25
Q

what type of sutures are preferred for wound healing?

A

monofilament
polyfilament sutures arent preffered as they have a larger surface area which means its easier for bacteria to grow causing infection

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26
Q

does bone have good regeneration capacity?

A

yes very good

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27
Q

in the brain what tissue replaces neuronal damage?

A

glial cells

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28
Q

what impact does scurvy have on wound healing?

A

breakdown of previously healed scars

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29
Q

What is the importance of TNF in regeneration and repair?

A

Stimulates migration and proliferation of fibroblasts

30
Q

the loss of which molecule allows tumour cells to detach from their neighbours?

A

cadherins

31
Q

why is there an up regulation of integrin in malignant cells?

A

integrin allows the malignant tumour cells to attach to the stromal cells during invasion

32
Q

what is meant by the term carcinomatosis?

A

extensive metastatic disease

33
Q

which of the 12 clotting factors arent numbered but named?

A

calcium is factor IV
thromboplastin is factor III

34
Q

what abnormal clotting times are detected in von willebrand disease?

A

raised APTT and bleeding time

35
Q

what are the vitamin K dependent clotting factors?

A

II (prothrombin), VII, IX and X

36
Q

what is the most common inherited thrombophilia in caucasians?

A

factor V leiden

37
Q

what are prostaglandins produced from?

A

Cell membrane phospholipid

38
Q

What is alpha-1 antitrypsin deficiency and what does it cause?

A

Autosomal recessive disorder
Low levels of alpha-1 trypsin (usually function is a protease inhibitor which deactivates enzymes at site of inflammation)
Emphysema and cirrhosis due to destruction of normal tissue

39
Q

What type of infection causes eosinophilia?

A

Parasites

40
Q

what are 3 differences between benign and malignant cells?

A
  1. benign cells have expasive growth whereas malignant cells have expansive and invasive growth
  2. benign cells grow locally whereas malignant cells have potential to metastisise
  3. benign cells retain the function of original cell but malignant cells are less likely to retain original function
41
Q

what are 3 hallmarks of cancer (special characteristics of cancer cells) and how do they benefit the cancer cells?

A
  1. resistance to growth stop signals so arent inhibited by molecules which inhibit cell proliferation - cell has proliferative advantage
  2. cell immortalisation - unrestricted proliferative capacity
  3. sustained ability to induce new blood vessels - cell microenvironment is adapted for growth and survival
  4. resistance to apoptosis - cell has survival advantage
42
Q

what are 4 things that can cause damage to DNA and subsequent tumourigenesis?

A
  1. smoking
  2. obesity
  3. UV radiation
  4. Alcohol consumption
43
Q

What are D dimers?

A

protein fragments in blood which are present due to fibrinolysis of a clot

44
Q

How do statins work?

A

Inhibit HMG-CoA reductase which inhibits cholesterol forming

45
Q

what colour would the infarct be in a MI?

A

white/pale - occlusion of end artery causes cell death with little haemmorhage

46
Q

why does ischaemia cause cells to swell?

A

loss of funtion of energy dependent membrane pump causes Na+ and H2O to accumulate in cell
(process is reversible)

47
Q

what are 4 differences between apoptosis and necrosis?

A

necrosis: cells swell, sheets of cells affected, associated inflammation, membrane breaks down
apoptosis: cells shrink, single cell affected, no associated inflammation, membrane is intact

48
Q

why is swelling seen in an inflammed area?

A
  1. Chemical mediators, such as histamine, serotonin and bradykinin, are released and formed
  2. They cause arterioles to dilate and endothelial cells to contract - resulting in the formation of spaces between the endothelial cells
  3. increased hydrostatic pressure within the capillaries and venules and fluid is pushed out of the venules through the gaps between the endothelial cells into the tissue spaces
  4. concentration of protein within the tissue spaces is increased, the osmotic pressure of the tissue spaces increases which serves to pull further fluid into the tissue spaces and to hold it there.
49
Q

what is the function of the complement system?

A

C3b + C4b - opsonisation
C3a + C5a - chemotaxis

50
Q

what are 4 functions of the macropage?

A
  1. phagocytosis
  2. antigen presentation
  3. production of chemical mediators
  4. inducing fibrosis
51
Q

what is a granuloma?

A

chronic inflammatory process - contains giant cells which aim to sorround and destroy difficult to eliminate microorganism

52
Q

what are the different type of giant cells and how are their nuclei arroanged?

A
  1. touton giant cells - circle in centre of cell
  2. langhans giant cell - nuclei in peripheray of cell
  3. foreign body giant cells - nuclei arranged randomly
53
Q

how do granulomas differ in tuberculosis and sarcoidosis?

A

tuberculosis - shows caseous necrosis so central zone of necrosis which appears structureless, eosinophilic + granular

54
Q

name 3 conditions in which granulomas are seen?

A

chron’s disease
fungal infection
chronic granulomatous disease

55
Q

when are eosinophils seen in large numbers?

A

allergic reaction
large parasitic infection e.g. worms
some cancers

56
Q

what are 3 tissues which heal with a scar?

A

skeletal muscle
neural tissue
cardiac muscle

57
Q

what are the principal cells in granulation tissue?

A

endothelial cells
giant cells

58
Q

what are 4 factors which could impair healing of any wound?

A
  1. large size of wound
  2. poor surgical technique
  3. presence of foreign bodies
  4. poor blood supply
59
Q

how does a thrombus differ to a blood clot?

A

thrombus: pathogenic + formation of mass of blood in vessls
clot: physiological process involved in repair + formation of mass of blood outside of vessels

60
Q

what are 4 causes of atrophy?

A
  1. poor nutrition
  2. reduced workload (atrophy of disuse)
  3. loss of innervation (atrophy of denervation)
  4. ageing (senile atrophy)
61
Q

what causes metaplasia?

A

stem cells are reprogrammed + result in production of one type of cell from another

62
Q
  1. what is barrets oesophagus?
  2. which cancer does barrets oesophagus most commonly cause?
A
  1. metaplasia of stratified squamous epithelia to gastric or intestinal type epithelia
  2. adenocarcinoma
63
Q

how do mutations of TSG differ from those of proto-oncogenes?

A

TSG:
* loss of function mutation
* both alleles need to be mutated in order for TSG (which prevents cell proliferation) to stop working

Proto-oncogene:
* gain of function mutation
* 1 allele needs to be mutated for proteins (which cause cell proliferation) to favour neoplastic growth

64
Q

what is meant by the term progression in cancer?

A
  • malignant tumours require alterations affecting a combination of TSG + proto-oncogenes
  • step like accumulation of mutations which occurs over time
  • steady accumulation of multiple mutations = cancer progression
65
Q

what are 3 tumour markers and which cancers are they associated with?

A
  1. calcitonin - medullary carcinoma of thyroid
  2. prostate specific antigen - prostate cancer
  3. human chorionic gonadotropin - trophoblastic tumours
66
Q

what is the most common type of cervical cancer?

A

squamous cell carcinoma

67
Q

HPV plays an important role in causing CIN, how does HPV cause cancer?

A
  1. produces 2 proteins E6 + E7 that inactivate TSG (P53)
  2. cells move through cell cycle faster
  3. inhibits apoptosis + combats cellular senescence
68
Q

which cancers frequently metastasise to bone?

A

breast
prostate
kidney
thyroid
bronchus

69
Q

which cancer causes production of parathyroid hormone related protein?

A

bronchial squamous cell carcinoma

70
Q

which cells are primarily infected by mycobacterium tuberculosis?

A

Alveolar macrophages
- blocks formation of phagolysosome + replicates unchecked within the phagosome
- MT is protected from the mechanisms of the lysosome

PP (16 decks)

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