Test 1

Question 1

Three characteristics of neoplasia

Answer 1

Monoclonal, autonomous, irreversible

Question 2

What is a teratoma?

Answer 2

Tumor containing cells from more than one germ layer

Question 3

Difference between teratoma vs mixed tumor?

Answer 3

Teratoma - multiple germ layers (usu. gonads - req. completely naive pluripotent stem cell?)
Mixed tumor - one germ layer, more than one cell type (ex. salivary tumor with epithelial and myoepithelial cells). All teratomas are mixed tumors but not all mixed tumors are teratomas

Question 4

Pathways of tumor dissemination (metastasis)

Answer 4

(1) Seeding within body cavities (think abdominal - ovarian)
(2) Lymphatic spread (think carcinoma)
(3) Hematogenous spread (think sarcoma)

Question 5

“Big 3” (well, 4) most common and deadly cancers, epidemiologically speaking

Answer 5

Lung/bronchial ; breast ; prostate ; colorectal

Question 6

PCB exposure is a risk factor for what CA?

Answer 6

Lung

Question 7

Asbestos exposure is a risk factor for what CA?

Answer 7

Mesothelioma, bronchogenic carcinoma

Question 8

Aromatic amines and azo dye exposure are risk factors for what CA?

Answer 8

Bladder

Question 9

Most common adult cancer

Answer 9

Carcinoma

Question 10

Most common peds cancers (2)

Answer 10

Leukemia ; CNS (brain)

Question 11

Name two autosomal dominant cancer syndromes

Answer 11

Familial adenomatous polyps of colon (fapc)

Retinoblastoma

Question 12

Name “the” autosomal recessive defective DNA repair syndrome often associated with CA

Answer 12

Xeroderma pigmentosum

Question 13

Name the four classes of regulatory genes that are key targets of cell damage

Answer 13

Proto-oncogenes
Tumor suppressor genes
Genes regulating apoptosis
Genes involved in DNA repair

Question 14

Are proto-oncogene mutations dominant or recessive?

Answer 14

Dominant (only requires one for altered activity)

Question 15

Are tumor-suppresor mutations dominant or recessive?

Answer 15

Recessive (requires 2 for altered activity)

Question 16

Differentiate between BAX/BAK/BCL-2/BCL-XL

Answer 16

These are all proteins/gene products in the BCL family. BAX/BAK are pro-apoptotic and BCL-2/BCL-XL are anti-apoptotic.

Question 17

Name six hallmarks of cancer

Answer 17

(1) evade apoptosis
(2) lose reliance on extracellular growth signals
(3) lose sensitivity to anti-growth signals
(4) invade and metastasize
(5) replicate without limit
(6) initiate and sustain angiogenesis

Question 18

Vinyl chloride is a risk factor for what CA?

Answer 18

Angiosarcoma of liver

Question 19

Nitrosamine (smoked foods) is a risk factor for what CA?

Answer 19

Gastric CA

Question 20

Arsenic is a risk factor for what CA?

Answer 20

Squamous cell carcinoma (skin)

Question 21

Napthalene (aniline) dye is a risk factor for what CA?

Answer 21

Urothelial carcinoma

Question 22

Aflatoxin B

Answer 22

Hepatocellular carcinoma

Question 23

Mechanism of carcinogenesis and associated CA:

ionizing radiation

Answer 23

chromosome breakage, point mutations, translocations

associated with papillary carcinoma of the thyroid

Question 24

Mechanism of carcinogenesis and associated CA:

UV light

Answer 24

formation of pyrimidine dimers (normally repaired by nucleotide excision pathway)
squamous cell, basal cell carcinoma (skin); melanoma

Question 25

Characteristics of radiation carcinogenesis (3)

Answer 25

Long latent period
Damage is additive
Damage is irreversible

Question 26

Human T Cell Lymphotrophic Virus (HTLV-1) is a risk factor for what CA?

Answer 26

T cell leukemia/lymphoma (T cell proliferation [polyclonal] by autocrine and paracrine pathways mediated by TAX gene. TAX also neutralizes p53 and p16 genes to decrease growth inhibitory signals. Then, all it takes is another couple mutations of one of the cell lines

Question 27

Human papilloma virus (HPV) is a risk factor for what CA?

Answer 27

Cervical CA (also benign warts)

Question 28

Epstein Barr Virus (EBV) is a risk factor for what CA?

Answer 28

Burkitt lymphoma, nasopharyngeal carcinoma

Question 29

Hep B/C is a risk factor for what CA?

Answer 29

Hepatocellular carcinoma

Question 30

H. pylori is a risk factor for what CA?

Answer 30

Gastric adenocarcinoma, MALT lymphoma

Question 31

What is the major immune cell of CA defense?

Answer 31

Cytotoxic (CD8) T cells

Question 32

Describe the potential dual role of macrophages in the tumor milieu

Answer 32

May attack the tumor under the right circumstances, but also may secrete growth factors that stimulate tumor growth

Question 33

Name a couple common paraneoplastic syndromes

Answer 33

Cushing’s syndrome with small cell lung cancer
PTH like hormone (hypercalcemia?) with breast CA
Acanthosis nigrans in gastric, lung, uterine carcinoma

Question 34

Differentiate between grading and staging of cancer

Answer 34

Grading attempts to estimate the aggressiveness of the tumor based on cytologic differentiation; really only “important” in prostate CA and chondrosarcoma. Staging attempts to do the same based on more global characteristics of the lesion and is generally more clinically helpful.

Question 35

What is staging of CA based on?

Answer 35

Size, extent of spread to lymph nodes, and metastasis

Question 36

What is the primary utility of detecting tumor associated markers (and give two examples)?

Answer 36

Detecting recurrence
Alpha-fetoprotein [Liver carcinoma, gonadal tumors, tumors of yolk sac remnanats]
Carcinoembryonic antigen [Colon, pancreas, lung, breast, stomach]