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PRIN 5 Neoplasia Flashcards

1
Q

Gatekeepers
VS
Caretaker

A

Gatekeepers
prevent abnormal proliferation of cells and promote cell death

Caretaker
maintain genomic stability

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2
Q

What does p53 do?

A

p53 protects cell from going from G1 to S in the presence of DNA damage

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3
Q

What are cyclins?

A
  • expressed briefly at specific phases of the cell cycle
  • activates specific CDK
  • rapidly degraded
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4
Q

What are CDKs?

A

Cyclin-dependent Kinases

  • activated by its partner cyclin
  • regulated by CDK inhibitors
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5
Q

How many copies of a tumor supressor must be lost?

A

BOTH copies must be lost

(as in the example of Rb according to Knudson’s 2-hit Hypothesis

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6
Q

What percent of cancers are hereditary?

A

only 5%

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7
Q

How does viral insertion lead to cancer?

A

Virus inserts itself upstream to oncogene which then gets hyper-replicated under the control of a new promoter

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8
Q

What happened with HER-2 in breast cancer?

A

Over-expression of GF receptor results in inappropriate interaction and dimerization of receptors causing them to transduce signals in absence of GF ligand

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9
Q

How many copies of an oncogene need to be lost for things to go wrong?

A

Only 1 copy!

One mutation is enough to cause accelerated cell division.

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10
Q

What is HNPCC?

A

Hereditary Non-polyposis Colorectal Cancer

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11
Q

Hallmarks of Cancer

A

(1) Genomic Instability
(2) Inappropriate Cell Proliferation
(3) Angiogenesis
(4) Invasion & Metastisis

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12
Q

At what point must a tumor develop its own blood supply to continue growing?

A

2mm

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13
Q

What are MMPs?

A

factors that cause the tissue to draw towards the cancer cells

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14
Q

What is the name for the pattern in which cancer cells grow?

A

Gompertzian

sigmoidal shape

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15
Q

At what stage in tumor development can we actually detect it?

A

1cm (10 to the 9 cells)

At this point the accelerated growing rate has already occurred. Most of the growth BEFORE we can even detect it!

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16
Q

Define neoplasm

A

abnormal accumulation of cells

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17
Q

Hypertrophy vs Hyperplasia

A

Hypertrophy: Increase in size of cells

Hyperplasia: increase in number of cells

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18
Q

Define Dysplasia

A

Dys = unright

Premalignant cells

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19
Q

What is one of the hallmarks of Dysplasia

A

Nucleus get bigger

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20
Q

Define Scirrhous or Desmoplastic

A
  • Term given to a tumor when large quantities of fibrous tissue are present in the supporting tissue
  • clinically the tumor is firm and shrunken
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21
Q

“oma” vs “carcinoma”

A

oma = precancerous, benign

carcinoma = cancerous
refers to epithelial

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22
Q

What is an adenocarcinoma?

A

Type of carcinoma that involves a gland

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23
Q

What is a chondrosarcoma?

A

Malignant cancer of cartilage

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24
Q

What is a Leiomyoma?

A

Benign cancer of smooth muscle

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25
What is a Leiosmyosarcoma?
Malignant cancer of smooth muscle
26
What is a Rhabdomyoma?
Benign cancer of striated muscle | cardiac or skeletal
27
What is a Rhabdomysarcoma?
Malignant cancer of striated muscle | cardiac or skeletal
28
bcl-2 vs bax
bcl-2 promotes cell survival | bax promotes apoptosis
29
How long does it take for an adenoma to become malignant?
Unknown, but probably at least 5 yrs
30
In tubular adenomas, what do we observe at the histological level?
nuclei are no longer basal oriented
31
What is necessary to diagnose cancer?
BIOPSY | Must have a biopsy done before referring to oncologist
32
Universal System for Cancer Staging
TNM T: Primary tumor characteristics (size: 0-4) N: Nodal status (number of nodes involved) M: Metastasis (present or absent)
33
What does lymph node metastases indicate?
Indicates probably widespread disease to distant organs
34
What is the goal of Curative Therapeutic Intent?
Complete removal of all malignant tissues | via surgery, radiation
35
What is the goal of Adjuvent / Non-adjuvent Therapeutic intent?
Increase probability of cure ADJUVENT: eradicated microscopic cancer deposits NON-ADJUVENT: shrink tumor prior to surgery
36
When is Chemotherapy MOST effective?
During the Undetectable Cancer stage of the Gompertzian manner curve Therefore, chemo is used to keep it from coming back (chemo is not a cure, but an attempt to slow the growth)
37
What is the goal of Maintenance Treatment?
Delay or prevent relapse after completion of main treatment (usually via low dose chemo)
38
What is the goal of Palliative Treatment?
Relief of symptoms
39
What is Brachytherapy?
Radiation Theraphy involving radiation source being placed in contact with the tumor (eg)radioactive gold seeds inserted into prostate cancer)
40
Teletherapy vs Stereotactic Radiotherapy
Teletherapy: uses bigger beam Stereotactic: uses smaller beam for more specificity and spare surrounding tissues
41
Which radiology modality can be used to detect early cancer?
PET scan because it can detect cells that are rapidly uptaking glucose
42
When do we give chemotheraphy?
We give chemo when we think the risk of recurrence is high
43
When do we give radiation?
We give radiation when we think the cancer is very localized.
44
Expressivity VS Penetrance
Expressivity: what the condition actually LOOKS like Penetrance: all or nothing phenomenon
45
Why is diagnosis for ovarian cancer made late?
There is no screening test for ovarian cancer
46
When is colon cancer hereditary?
FAP: less than 1% of all cancers HNPCC: 4-6% of cancers
47
Amsterdam Criteria
3-2-1 RULE * 3 family members with HNPCC associated cancer; two of whom are first degree relatives * 2 successive generations affected * 1 relative diagnosed at less than 50yrs
48
When is susceptibility testing performed?
where mutation confers a probability, but not a certainty of disease
49
FAP facts
&autosomial dominant *APC mutation on chromosome 5 100% risk of malignancy by age 40
50
How to detect HNPCC?
regular colonoscopy required as it occurs proximal / ascending tract of large intestine (flex-sig not enough)
51
How many cells in a typical cancer are actually proliferating at any given time?
only a minority of cells in a typical cancer are actively proliferating at any given time
52
What do cells undergoing apoptosis look like under an EM?
NUCLEI that: *have peripheral crescents of compacted chromatin *nuclei that are uniformly dense or fragmented
53
How are cyclins able to control various parts of the cell cycle?
Cyclins are synthesized and degraded at specific points in the cell cycle
54
Neoplastic invasion is characterized by:
alterations in cell adhesion molecules
55
The types of genes most commonly associated with hereditary cancer syndromes are:
tumour suppressor genes
56
Carcinoma in situ (CIS) is synonymous with ...
high-grade dysplasia
57
high-grade dysplasia is synonymous with ...
Carcinoma in situ (CIS)
58
What is the mechanism of action of oxaliplatin?
Platinum Compounds damage DNA structure
59
What class of drug does 5-fluorouracil belong to?
Anti-metabolite: Pyrimidine Analogue Inhibitor of DNA Synthesis & Repair
60
Philadelphia Chromosome
bcr-abl * part of a gene from chromosome 22 has fused with an oncogene on chromosome 9 * associated with over 90% of the cases of CML
61
What is the difference between hyperplasia and dysplasia?
Dysplasia - abnormal cell growth Hyperplasia - an increase in cell number
62
The 2nd curve of the Gompertzian growth curve represents ...
represents a secondary tumour that has arisen as a result of METASTASIS
63
Therapeutic intent in cancer treatment includes:
``` CAMP: Curative Adjuvant / Neo-adjuvent Maintenance Palliative ```
64
What is the goal of adjuvant treatment?
To increase the probability of a cure
65
What are modes of adjuvent treatment?
``` ALL OF THESE: I. Biological therapy II. Chemotherapy III. Hormone therapy IV. Radiation therapy V. Surgery ```
66
Do oral cancers occur more frequently in men or women?
MEN
67
What is the most important investigation in cancer diagnosis?
tissue diagnosis (e.g. histology). GET A BIOPSY!
68
The TNM classification system uses what criteria to stage cancers?
Tumour invasiveness Lymph Node involvement Metastatic disease
69
What does Lymph node involvement indicate?
indicates cancer spread from epithelial cancers
70
What does radiation therapy include?
Teletherapy Brachytherapy Isotope therapy (NOT chemotherapy)
71
(HNPCC) is an inherited form of colon cancer due to ...
Defect in DNA nucleotide repair mechanisms
72
What ethical principles are included in cancer susceptibility testing?
Autonomy Beneficence Nonmaleficence Justice
73
When do we use radiation?
when surgery is not an option and the cancer is localized
74
What does Vincristine do?
Antimitotic agent | Binds cytoplasmic tubulin
75
Do cancer treatment centers around the world use the same staging classification system?
YES Staging systems are standardized worldwide.
76
Is radiation a cure?
In some situations, yes.
77
What is the purpose of radiation?
increases the chance of cure when surgery alone is insufficient

PRIN (13 decks)

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