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PRIN > PRIN 5 Neoplasia > Flashcards

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
Q

What is a Leiosmyosarcoma?

A

Malignant cancer of smooth muscle

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26
Q

What is a Rhabdomyoma?

A

Benign cancer of striated muscle

cardiac or skeletal

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27
Q

What is a Rhabdomysarcoma?

A

Malignant cancer of striated muscle

cardiac or skeletal

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28
Q

bcl-2 vs bax

A

bcl-2 promotes cell survival

bax promotes apoptosis

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29
Q

How long does it take for an adenoma to become malignant?

A

Unknown, but probably at least 5 yrs

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30
Q

In tubular adenomas, what do we observe at the histological level?

A

nuclei are no longer basal oriented

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31
Q

What is necessary to diagnose cancer?

A

BIOPSY

Must have a biopsy done before referring to oncologist

32
Q

Universal System for Cancer Staging

A

TNM
T: Primary tumor characteristics (size: 0-4)

N: Nodal status (number of nodes involved)

M: Metastasis (present or absent)

33
Q

What does lymph node metastases indicate?

A

Indicates probably widespread disease to distant organs

34
Q

What is the goal of Curative Therapeutic Intent?

A

Complete removal of all malignant tissues

via surgery, radiation

35
Q

What is the goal of Adjuvent / Non-adjuvent Therapeutic intent?

A

Increase probability of cure
ADJUVENT: eradicated microscopic cancer deposits
NON-ADJUVENT: shrink tumor prior to surgery

36
Q

When is Chemotherapy MOST effective?

A

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
Q

What is the goal of Maintenance Treatment?

A

Delay or prevent relapse after completion of main treatment (usually via low dose chemo)

38
Q

What is the goal of Palliative Treatment?

A

Relief of symptoms

39
Q

What is Brachytherapy?

A

Radiation Theraphy involving radiation source being placed in contact with the tumor
(eg)radioactive gold seeds inserted into prostate cancer)

40
Q

Teletherapy vs Stereotactic Radiotherapy

A

Teletherapy: uses bigger beam
Stereotactic: uses smaller beam for more specificity and spare surrounding tissues

41
Q

Which radiology modality can be used to detect early cancer?

A

PET scan because it can detect cells that are rapidly uptaking glucose

42
Q

When do we give chemotheraphy?

A

We give chemo when we think the risk of recurrence is high

43
Q

When do we give radiation?

A

We give radiation when we think the cancer is very localized.

44
Q

Expressivity
VS
Penetrance

A

Expressivity: what the condition actually LOOKS like

Penetrance: all or nothing phenomenon

45
Q

Why is diagnosis for ovarian cancer made late?

A

There is no screening test for ovarian cancer

46
Q

When is colon cancer hereditary?

A

FAP: less than 1% of all cancers
HNPCC: 4-6% of cancers

47
Q

Amsterdam Criteria

A

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
Q

When is susceptibility testing performed?

A

where mutation confers a probability, but not a certainty of disease

49
Q

FAP facts

A

&autosomial dominant
*APC mutation on chromosome 5
100% risk of malignancy by age 40

50
Q

How to detect HNPCC?

A

regular colonoscopy required as it occurs proximal / ascending tract of large intestine
(flex-sig not enough)

51
Q

How many cells in a typical cancer are actually proliferating at any given time?

A

only a minority of cells in a typical cancer are actively proliferating at any given time

52
Q

What do cells undergoing apoptosis look like under an EM?

A

NUCLEI that:
*have peripheral crescents of compacted chromatin

*nuclei that are uniformly dense or fragmented

53
Q

How are cyclins able to control various parts of the cell cycle?

A

Cyclins are synthesized and degraded at specific points in the cell cycle

54
Q

Neoplastic invasion is characterized by:

A

alterations in cell adhesion molecules

55
Q

The types of genes most commonly associated with hereditary cancer syndromes are:

A

tumour suppressor genes

56
Q

Carcinoma in situ (CIS) is synonymous with …

A

high-grade dysplasia

57
Q

high-grade dysplasia is synonymous with …

A

Carcinoma in situ (CIS)

58
Q

What is the mechanism of action of oxaliplatin?

A

Platinum Compounds damage DNA structure

59
Q

What class of drug does 5-fluorouracil belong to?

A

Anti-metabolite:
Pyrimidine Analogue

Inhibitor of DNA Synthesis & Repair

60
Q

Philadelphia Chromosome

A

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
Q

What is the difference between hyperplasia and dysplasia?

A

Dysplasia - abnormal cell growth

Hyperplasia - an increase in cell number

62
Q

The 2nd curve of the Gompertzian growth curve represents …

A

represents a secondary tumour that has arisen as a result of METASTASIS

63
Q

Therapeutic intent in cancer treatment includes:

A 
CAMP:
Curative
Adjuvant / Neo-adjuvent
Maintenance
Palliative
64
Q

What is the goal of adjuvant treatment?

A

To increase the probability of a cure

65
Q

What are modes of adjuvent treatment?

A 
ALL OF THESE:
I. Biological therapy
II. Chemotherapy
III. Hormone therapy
IV. Radiation therapy
V. Surgery
66
Q

Do oral cancers occur more frequently in men or women?

A

MEN

67
Q

What is the most important investigation in cancer diagnosis?

A

tissue diagnosis (e.g. histology).

GET A BIOPSY!

68
Q

The TNM classification system uses what criteria to stage cancers?

A

Tumour invasiveness

Lymph Node involvement

Metastatic disease

69
Q

What does Lymph node involvement indicate?

A

indicates cancer spread from epithelial cancers

70
Q

What does radiation therapy include?

A

Teletherapy
Brachytherapy
Isotope therapy

(NOT chemotherapy)

71
Q

(HNPCC) is an inherited form of colon cancer due to …

A

Defect in DNA nucleotide repair mechanisms

72
Q

What ethical principles are included in cancer susceptibility testing?

A

Autonomy
Beneficence
Nonmaleficence
Justice

73
Q

When do we use radiation?

A

when surgery is not an option and the cancer is localized

74
Q

What does Vincristine do?

A

Antimitotic agent

Binds cytoplasmic tubulin

75
Q

Do cancer treatment centers around the world use the same staging classification system?

A

YES

Staging systems are standardized worldwide.

76
Q

Is radiation a cure?

A

In some situations, yes.

77
Q

What is the purpose of radiation?

A

increases the chance of cure when surgery alone is insufficient

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