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SAM II > Principles of Oncology > Flashcards

Principles of Oncology Flashcards

1
Q

what is the average number of cells formed in any individual during an average lifetime?

A

10^16

10 million cells replaced every second!

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2
Q

_____ result in defects in the regulatory circuits of a cell

A

DNA mutations

results in disruption of normal cell proliferation & behavior

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3
Q

what are the two main factors that cause cancer? (think broad)

A

genes and lifestyle & environment

“bad genes load the gun, lifestyle & environment pull the trigger”

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4
Q

name four major lifestyle and environment factors that contribute to causing cancer?

A
  • diet (high fat, low fiber linked to bowel, pancreatic, breast & prostate cancer)
  • exposure (carcinogens, mutagens)
  • viruses (hepatitis B, papillomavirus, HIV = nasopharyngeal/cervical carcinomas & Kaposi’s sarcoma, FIV/FeLV =LSA/sarcomas
  • age (decreased immune surveillance)
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5
Q

what are the three steps of carcinogenesis?

A

initiation, promotion, and progression

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6
Q

carcinogens induce DNA damage but not enough to induce neoplastic transformation

A

initiation (rapid)

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7
Q

original carcinogens or normal growth promoters/hormones cause reversible tissue & cellular changes

A

promotion

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8
Q

progressing agents are able to irreversibly convert an initiated cell into cell exhibiting malignancy

A

progression (slow)

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9
Q

name the six hallmarks of a cancer cell

A
  • evading apoptosis
  • self-sufficiency in growth signals
  • insensitivity to anti-growth signals
  • tissue invasion & metastasis
  • limitless replicative potential
  • sustained angiogenesis
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10
Q

T/F: all (most) cancer comes from four distinct cell types

A

FALSE, three

1) round cell 2) mesenchymal 3) epithelial

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11
Q

rank the cell types in order from most exfoliation to lease

A

round (very good), epithelial (good), mesenchymal (ok, sometimes poor)

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12
Q

individualized ___ cells arranged in monolayer

A

round

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13
Q

spindle-shaped, stellate or oval cells arranged individually or in non-cohesive aggregates

A

mesenchymal

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14
Q

round, cuboidal, columnar or polygonal cells arranged in cohesive sheets or clusters

A

epithelial

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15
Q

what are the differential diagnoses for round cell tumors?

A

lymphoma, MCT, plasmacytoma, histiocytoma, TVT, melanoma

“please help me learn this”

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16
Q

what are the differential diagnoses for mesenchymal cell tumors?

A

sarcomas (osteo, chondro, fibro, hemangio)

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17
Q

what are the differential diagnoses for epithelial cell tumors?

A

carcinomas (squamous cell, adeno, undifferentiated)

18
Q

what are the characteristics of malignancy?

A

homogenous vs. heterogenous, pleomorphic, cellular/cytoplasmic criteria (anisocytosis, variable N:C ratio, hyperchromasia), nuclear criteria (anisokaryosis, multiple nuclei, increased mitosis)

19
Q

anisocytosis

A

variation of cell size

20
Q

anisokaryosis

A

variation of nucleus size

21
Q

T/F: cytopathology is highly sensitive but has low specificity

A

FALSE, opposite

cytopathology has low sensitivity meaning it can yield more false negative results

22
Q

of the cancer cell types, which one is most sensitive and which one is least sensitive?

A

round cells are most sensitive (exfoliate well!) and mesenchymal cells are least sensitive (known for being firm and not wanting to give up cells)

23
Q

in what four types of tumors is cytopathology more known to fail you?

A

oral (ALWAYS GET BIOPSY), splenic, liver, and mammary gland

24
Q

in what type of tumor would you be concerned with needle tract implantation?

A

urogenital neoplasms (carcinomas)

25
Q

T/F: in terms of slide preparation the vertical pull-apart method is used for fragile cells (LN’s) and the horizontal pull-apart is overall the preferred technique

A

TRUE, horizontal pull-apart creates a feathered edge

26
Q

when obtaining a needle biopsy of a liver tumor, accuracy is more than or equal to ___% hence you should interpret with caution (warn owners!)

A

50%

27
Q

what type of stain used, when POSITIVE in cytology via US guided percutaneous technique of a bone tumor is 100% sensitive for OSA?

A

ALP sarcoma stain

  • ALP required for osteoblasts for bone mineralization
  • marker of osteoblastic lineage
28
Q

______ answers the question “is the tumor localized, spread regionally or diffusely?”

A

staging

based on WHO TNM (tumor, node, metastasis system), 0-IV

29
Q

_____ establishes inherent aggressiveness of tumor using systematic approaches, allows definitive prognostication & may alter therapeutic recommendations

A

grading

requires BLOCK of tissue, I (least aggressive, II & III (most aggressive)

30
Q

T/F: grading is determined using the TNM system

A

FALSE, staging

31
Q

what tests might you utilize for staging a tumor?

A

MDB (CBC/chem/T4/UA/FIV & FeLV), regional LN cytology, 3-view thoracic met check, abdominal US (+/- FNA), CT/MRI

32
Q

what is locoregional LN sampling based on?

A

sentinel node = unique to each patient and cancer

33
Q

___% of dogs with oral malignant melanoma had local LN metastasis when _______ WAS NOT present and 49% of dogs with enlarged lymph nodes DID NOT have metastasis

A

40%, lymphadenomegaly

why you NEVER assume normal sized LN’s are not metastatic

34
Q

metastatic process occurs in an orderly progression w/in the lymphatic system w/ tumor cells draining into a specific LN in a regional lymphatic field before draining into other regional or distant LN’s

A

SLN concept

distant metastasis should NOT be present if SLN does NOT have evidence of tumor

35
Q

a change in dx (i.e. missed mets) would have been made in ______ of patients when 3-view thoracic studies were compared to only 2-view

A

12-15%

ALWAYS TAKE 3 VIEWS FOR STAGING THORACIC RADS

36
Q

what is the minimum threshold size of pulmonary nodules to reliably detect them on rads?

A

7-9 mm

37
Q

what organ is the most common receptacle of blood-borne metastasis?

A

liver = major “generalizing site”

38
Q

tumor associated alterations in bodily structure or function that occur distant to the tumor

A

paraneoplastic syndrome

often first sign of malignancy and can be HALLMARK of certain malignancies

39
Q

what usually causes paraneoplastic syndromes?

A

secondary to small molecules (cytokines/hormones/peptides) secreted by tumor which mimic native substances causing effect

40
Q

what are the five classic paraneoplastic syndromes?

A

hypercalcemia, neurologic (myasthenia gravis), cutaneous (nodular dermatofibrosis), hypoglycemia, and bone (hypertrophic osteopathy)

41
Q

what are the four main cancers associated with hypercalcemia (PNS)?

A

anal sac ACA, LSA, multiple myeloma, mammary tumor

42
Q

what is a common cancer associated with hypoglycemia (PNS)?

A

intestinal leiomyosarcoma

SAM II (3 decks)

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