Session 9, 10, 11 - Self study

Question 1

What is the most likely cause of a space occupying lesion of the brain?

Answer 1

Glioma

Question 2

What are the four most common cancers in women?

Answer 2

Lung
Colon
Melanoma
Breast

Question 3

What must metastasis penetrate to reach the brain

Answer 3

BBB

Question 4

What is a carcinoid tumour?

Answer 4

Slow growing neuroendocrine tumour

Question 5

What is carcinoid syndrome?

Answer 5

Array of symptoms that occur secondary to carcinoid tumour, notably serotonin. Hot flushes and diarrhea common symptoms.

Question 6

Why is the lung a common site of metastasis?

Answer 6

High blood supply

Question 7

Why would you get a DVT in pancreatic cancer

Answer 7

Increased production of clotting factors, change in blood constituents

Question 8

Name and describe a mechanism via which a benign tumour could cause hypercalcaemia

Answer 8

Solitary parathyroid adenoma - Cyclin D expression, cyclin dependent kinase activated cause retinoblastoma protein deactivation which means unrestrained growth. Release PTH.

Question 9

By what mechanism can malignant tumours cause hypercalcamia?

Answer 9

Ectopic secretion of PTHrp, which mimics actions of PTH

Question 10

How can anaemia occur in cancer?

Answer 10

Haemolysis inudced
Blood loss
Decreased blood production (leaukaemia)

Question 11

What is cachexia?

Answer 11

Severe weight loss, weakness and loss of appetite.

Question 12

How is cachexia caused?

Answer 12

TNF - a - Produced by macrophages, induces fever, apoptosis, sepsis and cachexia
Increased lipolysis by tumour
Proteolysis inducing factor
Hormones involved in appetite
Increased energy expenditure

Question 13

What cancers appeared first and second after hiroshima?

Answer 13

Leukaemia first, skin and lung cancer second

Question 14

What oncogene is of relevance in the development of thryoid cancers following exposure to radiation
?

Answer 14

Ret oncogene (tyrosine kinase receptor) promotes cell proliferation when activated

Question 15

What occured as a result of irridation of the spines of men with ankylosing spondylitis?

Answer 15

Leukaemia

Question 16

What are two explanations for the high incidence of cancer in areas surrounding power stations other than the power station itself?

Answer 16

Radion gas

Familial clustering

Question 17

What is the most important fact in determinng the prognosis of a melanoma?

Answer 17

Size of melanoma, deeper means more luymphatic drainage and spread

Question 18

What are the 6 things to look for when assesing a mole?

Answer 18

Assymetry
Border irregularity
Colour change
Ddepth
Elevation

Question 19

What was the agent in soot which was responsible for the development in scrotal cancer in chimney sweeps?

Answer 19

Polycyclic aromatic hydrocarbons

Question 20

Give another occupational cause of cancer

Answer 20

Textile workers and aromatic amins

Question 21

What are the two main carcinogenic substances in cigarette smoke?

Answer 21

Polycylcic aromatic hydrocarbons and benzopyrene

Question 22

What is the mechanism by which polycyclic aromatic hydrocarbons have effect?

Answer 22

P450 hydroxylates it, making it soluble and more reactive

Damage DNA, playing a key role in mutagenesis

Question 23

What effect does smoking have on bronchial epithelium?

Answer 23

Hyperplasia and metaplasia.

Ciliated columnar epithelial cells –> Squamous cell

Question 24

What other tumurs are associated with cigarette smoking?

Answer 24

Breast, bladder and stomach

Question 25

What are the clinical and pathological features of familial adenomatous polyposis?

Answer 25

Thousands of polyps on bowel wall

Higher risk of bowel cancer

Question 26

What gene is involved in familial adenomatous polyposis?

Answer 26

Mutations in APC gene, autosomal dominant

Question 27

What other genetic alterations have to occur for carcinoma to form?

Answer 27

Alterations in both tumour supressor genes and a proto-oncogene

Question 28

How does hereditary non-polyposis colorectal cancer differ from familial adenomatous polyposis?

Answer 28

No polyps form, other cancers form other than colorectal

ovarian|, stomach|, pancreas|, pancreas

Question 29

What kinds of cancers can be found in the testicles?

Answer 29

Germ cell tumours

Lymphomas

Question 30

What tumour marker would be reaised in testicular canceR?

Answer 30

HCG

Raised in non-seminomatous testicular tumours

Question 31

How can tumour markers be helpful in assessing treatment?

Answer 31

Measure before and after surgical treatment to compare levels and assess if reccurence is occurin’

Question 32

What type of cells are found in the lymph nodes in hodgkins lymphoma?

Answer 32

Eosinophils

Reed stennenberg cells

Question 33

What are B symptoms in cancer?

Answer 33

Fever
Night sweats
Weight loss

Question 34

What three clinical signs are useful in the staging of breast cancer?

Answer 34

Size of tyumour, metastasis, lymph node involvement

Question 35

How does tamoxifen work?

Answer 35

Competitively inhibits osetrogen receptors, reducing oestrogen dependent proliferation

Question 36

What are the side effects of tamoxifen?

Answer 36

Can have an effect on endometrium causing bleeding

Question 37

Give three causes of colorectal bleeding

Answer 37

Cancer
Haemrrhoids
Ulcerative colitis

Question 38

Give three factors which help assess the differentiaition of a lesion

Answer 38

Pleomorphism
Number of mitoses
Gland formation

Question 39

Describe dukes staging for the assesment of colorectal cancer

Answer 39

A - Invasion into but not through bowel
B - Invasion through bowel wall
C - Involves lymph nodes
D - Dustabt metastases

Question 40

Give four factors which can cause raised PSA

Answer 40

Prostate

• Neoplasia
• inflammation
• benign enlargement

Question 41

What is the value of cervical screening?

Answer 41

Can see dysplasia before symptoms occura nd treat or take preventative measures