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Phase I Medicine > Principles of Cancer > Flashcards

Principles of Cancer Flashcards

1
Q

What are the hallmarks of cancer?

A 
Sustenance of proliferative signalling
Enabling replication immortality
Resisting cell death
Evasion of growth suppressors
Invasion and metastasis of tissues
Inducing angiogenesis
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2
Q

How can DNA be damaged?

A 
Chemical exposure
Replication errors
Radiation
Viral infection
Metabolic processes
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3
Q

What is p53 responsible for?

A

Cell cycle arrest.

This allows for DNA repair and when this is not possible, apoptosis.

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4
Q

Why does p53 trigger apoptosis?

A

If DNA can’t be fixed, you don’t want the damage being propagated to daughter cells.

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5
Q

What is the difference between exogenous and endogenous factors?

A

Exogenous - extracellular

Endogenous -intracellular

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6
Q

What are examples of exogenous DNA damaging factors?

A

UV light
X-rays
Natural isotopes
Chemicals

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7
Q

What are examples of endogenous DNA damaging factors?

A

Oxygen
Water
Reactive metabolism intermediates

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8
Q

How do exogenous factors damage DNA?

A

Alkylating agents add methyl groups to the DNA helix

They act as bulky lesions causing DNA distortion

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9
Q

How do endogenous factors damage DNA?

A

Biotransformation- metabolism of chemicals may lead to damaging intermediates.

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10
Q

For what condition is ATM low-absent?

A

Ataxia-telangiectasia (A-T)

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11
Q

What is ataxia-telangiectasia?

A
  • Autosomal recessive disorder
  • Progressive neurodegeneration
  • Impairment triggering cell cycle checkpoints in response to DNA damage (double strand breaks)
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12
Q

What allows for the accumulation of P53 protein?

A

ATM

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13
Q

How can p53 be mutated?

A

UV light
Aflatoxin B1 in diet
Benzo[a]pyrene in tobacco smoke

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14
Q

Where is p53 mutated most of the time?

A

CpG sites

Methylation of C

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15
Q

What is the MGMT enzyme responsible for?

A

Repair of alkylation damage

Transfer of alkyl group from modified base to cysteine residue

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16
Q

What is the function of DNA glycosylases?

A

Base removal

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17
Q

What is the function of AP endonucleases?

A

Repairing AP sites after base removal

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18
Q

What is the difference between base excision repair and nucleotide excision repair?

A

Base- use of DNA glycosylases and AP endonucleases to remove a single base

Nucleotide- removal of a nucleotide fragment that contains damaged base(s). Works on bulkier lesions

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19
Q

How are cut fragments repaired in NER?

A

The gap is filled by DNA polymerase

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20
Q

What is a possible consequence of NER defects with respect to UV damage

A

Xeroderma pigmentosum (XP) - extreme sensitivity to sunlight and 1000x higher risk of skin cancer

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21
Q

What kind of DNA damage does ionising radiation cause?

A

Double strand break

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22
Q

Why is a double strand break dangerous?

A

The broken bits are cleaned up and stuck together via ligation- no memory of bases lost

23
Q

What genetic instability is commonly responsible for HNPCC?

A

Inappropriate DNA repair

hMSH2 hMLH1 mismatch

24
Q

What genetic instability is commonly responsible for early breast and ovarian cancer?

A

Inappropriate repair of double strand break

Problems with checkpoint signalling

25
What is the importance of APC with respect to bowel cancer?
The absence of this DNA repair gene is responsible for FAP.
26
What is microsatellite instability?
Contraction/ elongation of a repeated sequence on replication
27
What is a tumour/ neoplasm?
Abnormal mass of cells resulting from poorly regulated cell proliferation and growth in the absence of a distinct initiating event
28
What are the normal regulatory genes for a cell?
Proto-oncogenes Tumour suppressor genes Apoptosis control genes DNA repair genes
29
What is penetrance?
The number of people who will show the effects of their inherited mutations
30
What is expressivity with respect to mutations?
Severity of symptoms of the same mutation may vary from person to person
31
How does HPV go on to cause cervical cancer?
Strains 16 and 18 Infects cervical epithelial cells -> E1-7 viral protein production E6 and 7 reduce pRb and p53 levels Promotion of DNA synthesis Interruption of p53 mediated cell cycle arrest and apoptosis
32
What strains of HPV are low risk?
6 and 11 | These cause anogenital warts
33
Is metaplasia reversible?
Yes
34
What is osseous metaplasia?
Areas of fibrous tissues exposed to chronic trauma forming bone
35
What is dysplasia?
Disordered growth of cells Increased cell division Incomplete maturation Loss of architectural relationship between cells
36
What is the difference between 'oma' and 'sarcoma'?
Oma- benign neoplasm | Sarcoma- malignant neoplasm
37
What is a teratoma?
Cancer containing elements of all three embryological germ cell layers. The cancer tissue type is not normally found in the space the cancer is occupying.
38
What is the difference between lymphomas and leukaemias?
Lymphoma - solid tumour mass | Leukaemia- circulating tumour cells
39
What is a hamartoma?
Disorganised mass of mature specialised cells indigenous to the site
40
What is a choristoma?
Collection of normal cells in an abnormal location
41
What is the difference between benign and malignant neoplasms?
Benign: Localised Expansile Fibrous capsule Malignant: Ill defined bordered Margins for infiltration
42
What does metastasis mean?
Distant spread of neoplastic cells away from primary neoplasm.
43
What are secondary neoplasms?
Subpopulations of neoplastic cells
44
What are the routes of metastasis?
Haematogenous- venous Lymphatic Transcoelomic
45
What is haematogenous metastasis?
Vein penetration-> tumour embolus follows flow of normal drainage
46
What is lymphatic metastasis?
Lymphatic vessels draining the primary site into regional lymph nodes.
47
What is transcoelomic metastasis?
Spreading across cavities and surfaces- through tumour penetration.
48
How do ovarian cancers normally metastasise?
Transcoelomically
49
What is differentiation with relation to cancer?
Extent to which neoplastic cells resemble normal ones
50
What is anaplasia?
Malignant neoplasm composed of undifferentiated cells
51
What is pleomorphism?
Variation in cell shape and size
52
What is intussusception?
The bowel folds in on itself like a telescope.
53
What are the hormonal effects of neoplasms?
Endocrine insufficiency via gland destruction | Elaboration of hormones
54
What is paraneoplastic syndrome?
Symptoms of hormone elaboration. This comes from tissues 'over-expression' that tumours have invaded.

Phase I Medicine (46 decks)

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