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Disease and Defense > Test 3 > Flashcards

Test 3 Flashcards

1
Q

localized and amenable to surgical removal; patient usually survives

A

benign

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2
Q

invasive tumor capable of destroying structures and spread to distant sites (metastasis); may result in early death of the patient

A

malignant

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3
Q

benign tumor of fibrous tissue

A

fibroma

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4
Q

benign tumor of fat

A

lipoma

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5
Q

benign glandular tumor

A

adenoma

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6
Q

benign cartilaginous tumor

A

chondroma

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7
Q

benign squamous epithelial tumor

A

papilloma

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8
Q

What are sarcomas?

A

malignant tumors of mesenchymal derivation (connective tissues); Examples– fibrosarcoma, chondrosarcoma

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9
Q

What are carcinomas?

A

malignant tumors of epithelial derivation; 80% of all malignancies
examples— adenocarcinoma, squamous cell carcinoma

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10
Q

tumors with more than one neoplastic cell type (epithelial and mesenchymal)

A

mixed tumors

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11
Q

tumors with more than one neoplastic cell type and derived form more than one germ layer

A

compound tumors

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12
Q

Which type of neoplasms are said to be differentiated (resemble tissue of origin)?

A

benign neoplasms

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13
Q

How can benign tumors cause problems?

A

1) secreting a substance (hormone, etc) in abundance
2) compressing vital organs
3) a few benign tumors may transform into malignant tumors

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14
Q

What are the hallmarks of malignancy?

A

invasion and metastases

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15
Q

What are the 2 steps involved in chemical carcinogenesis?

A

Tumor initiation and tumor promotion

INITIATION ALONE IS NOT SUFFICIENT FOR TUMOR FORMATION

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16
Q

Describe tumor initiation (In regards to chemical carcinogenesis).

A

an IRREVERSIBLE process involving the single application of a chemical or physical agent

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17
Q

Describe tumor promotion (In regards to chemical carcinogenesis).

A

a reversible process involving multiple applications of a promoting agent. Promoters cause cell proliferation.

Promoters are not carcinogenic.

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18
Q

Describe direct acting carcinogens.

A

They do not require metabolic activation to have their effect

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19
Q

Describe indirect acting carcinogens (procarcinogens)

A

require metabolism to produce ultimate carcinogen; generally performed by the cyt P-450 mono-oxygenate system

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20
Q

What is the primary target of chemical carcinogens?

A

DNA

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21
Q

How is ionizing radiation carcinogenic?

A

it causes strand breaks in the DNA

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22
Q

How is UV radiation carcinogenic?

A

it causes the formation of pyrimidine dimers in DNA; these are very hard to repair

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23
Q

Which UV rays are given credit for the observed increases in skin cancer?

A

UVB (280-320nm)

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24
Q

What are the common high risk strains of HPV that cause cancer?

A

Types 16, 18, and 31

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25
Q

The oncogenic potential of HPV can be related to products of two early viral genes:

A

E6 and E7

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26
Q

What are the cancers associated with Epstein-Barr Virus?

A

Burkitt lymphoma, B cell lymphomas, Hodgkin lymphoma, and nasopharyngeal carcinomas

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27
Q

What are the cancers associated with HPV?

A

cervical and penile/anal carcinoma

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28
Q

What are the cancers associated with HBV and HCV?

A

hepatocellular carcinoma

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29
Q

What are the cancers associated with HHV-8 (Kaposi sarcoma-assocatied herpesvirus)

A

Kaposi sarcoma and body cavity fluid B cell lymphoma

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30
Q

What are the cancers associated with helicobacter pylori?

A

gastric lymphomas and gastric carcinomas, MALT lymphoma (B cell lymphoma of stomach)

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31
Q

What are the cancers associated with HTLV-1?

A

adult T cell leukemia

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32
Q

2-naphthylamine is linked to what cancer?

A

urinary bladder cancer

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33
Q

4-aminobiphenyl is linked to what cancer?

A

urinary bladder cancer

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34
Q

Vinyl chloride is linked to what cancer?

A

angiosarcoma, liver cancer

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35
Q

Asbestos is linked to what cancer?

A

cancers of the pleura, peritoneum, and lungs

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36
Q

Chromium compounds are linked to what cancer?

A

lung cancer

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37
Q

Benzene is linked to what cancer?

A

cancer of lymphoid tissue

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38
Q

What are the hormones released in small cell carcinoma of the lungs?

A

ACTH, ADH-like, PTHrP

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39
Q

What are the hormones released in sarcoma?

A

insulin like hormone

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40
Q

What are the hormones released in ovarian teratoma?

A

thyroid hormones

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41
Q

What are the hormones released in Bronchial carcinoid?

A

serotonin

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42
Q

If a patient comes in with Acanthosis Nigricans, what cancers might you suspect them of having?

A

gastric, lung, uterine cancer

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43
Q

If a patient comes in with Dermatomyositis, what cancers might you suspect them of having?

A

breast, bronchogenic cancer

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44
Q

If a patient comes in with Hypertrophic osteoarthropathy & clubbing of the fingers, what cancers might you suspect them of having?

A

lung cancer

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45
Q

What is cachexia?

A

Progressive body weight loss
Body fat & lean body mass
Different from starvation

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46
Q

What causes cancer cachexia?

A

Production of cytokines and other soluble factors

TNF-a, IL-1, INF-g

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47
Q

What composes the staging system for tumors?

A 
T= tumor size
N= node involvement
M= metasteses
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48
Q

A small local invasive tumor would be categorized as _____.

A

Stage 1

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49
Q

A large local invasive tumor would be categorized as ____.

A

stage 2

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50
Q

A tumor that has spread beyond the limits of operation would be categorized as ____.

A

Stage 4

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51
Q

A tumor with metastases in the lymph nodes would be categorized as _____.

A

stage 3

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52
Q

a needed component of the daily diet is missing or present in inadequate quantities

A

primary malnutrition

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53
Q

diet is adequate, but factors such as malabsorption, excess loss, an impairment in the ability to store or utilize, or an increase in the requirements results in malnutrition (GI diseases, chronic illness).

A

secondary malnutrition

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54
Q

protein in skeletal muscle - loss can be identified by a reduced circumference of the midarm

A

somatic compartment

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55
Q
  • protein in liver - loss can be identified by decreased levels of albumin and transferrin in the blood
A

visceral component

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56
Q

Is the result of a diet deficient in both protein and carbohydrates

A

marasmus

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57
Q

Is the result of a diet where the majority of the calories consumed consist of carbohydrates, but protein intake is inadequate

A

Kwashiorkor

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58
Q

Have loss of protein within the visceral compartment (liver)

Subcutaneous fat and skeletal muscle mass are relatively preserved

A

Kwashiorkor

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59
Q

Patients have a loss of muscle mass and of subcutaneous fat

The proteins within the visceral component are not as depleted, so serum levels of albumin and transferrin are normal or slightly reduced

A

marasmus

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60
Q

What are some major complications of Bulimia ?

A

Major complications are due to repeated vomiting and laxative use
Pulmonary aspiration of gastric contents
Esophageal rupture
Electrolyte imbalances, such as hypokalemia, which cause cardiac arrhythmias

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61
Q

What are some major complications of anorexia?

A

Endocrine system effects are prominent
Decreased gonadotropin-releasing hormone causes decreased LH and FSH, resulting in amenorrhea.
Decreased thyroid hormone release causes bradycardia, constipation, and cold intolerance
Decreased estrogen levels cause a decrease in osteoblast activity and an increase in osteoclastic activity, resulting in osteoporosis

Body hair is fine and pale in appearance (lanugo)

Hypokalemia can result in cardiac arrhythmias and sudden death

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62
Q

What are the fat soluble vitamins

A

A, D, K, E

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63
Q

What are some of the functions of vitamin A?

A

Maintains normal vision when in reduced light
–Retinal is a component of rhodopsin in the rod cells in the retina

Helps in the differentiation of specialized epithelial cells, especially mucin-secreting cells

Stimulates the immune system

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64
Q

What are the roles of vitamin D?

A

Maintains plasma calcium & phosphorous concentrations; Supports cellular processes, neuromuscular function, & bone ossification; Enhances calcium & phosphorous absorption from small intestine & mobilization from bone

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65
Q

What are the water soluble vitamins?

A

B and C

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66
Q

What happens when you have too much vitamin D?

A

hypercalcemia which can lead to permanent brain damagE; And kidney stones

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67
Q

What is one of the earliest signs of vitamin A deficiency?

A

nigh blindness

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68
Q

What is the purpose of vitamin E?

A

serves as an antioxidant

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69
Q

What’s the role of vitamin K?

A

carboxylation of glutamate residues for the coagulation process

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70
Q

Describe vitamin D metabolism.

A

Vitamin D from the skin and diet are converted to 25-hydroxyvitamin D in the liver
25-hydroxyvitamin D is converted to 1,25-dihydroxyvitamin D (the active form of vitamin D) in the kidney

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71
Q

What do you see with vitamin D deficiencies ?

A

adults: osteomalacia
kids: rickets

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72
Q

What do you see in vitamin E deficiencies ?

A

Deficiency causes hemolytic anemia due to damage to the RBC membrane and peripheral neuropathy

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73
Q

What is the function of vitamin K?

A

Important in the formation of clotting factors II, VII, IX, and X, as well as Protein S and C

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74
Q

What is the function of vitamin C?

A

Hydroxylation of proline and lysine in collagen synthesis; also has antioxidant activity

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75
Q

What do you see in vitamin C deficiency?

A

scurvy

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76
Q

Vitamin B 1

A

thiamine

77
Q

What do you see in thiamine (B1) deficiency?

A

Early: anorexia, nausea, constipation; Later: depression, peripheral neuropathy, ataxia, opthaloplegia, dementia (Wernicke’s encephalopathy)

78
Q

What is the function of thiamine (B1)?

A

Is a cofactor in enzymatic reactions of ATP synthesis

79
Q

Vitamin B3

A

niacin

80
Q

What is the function of niacin (B3)?

A

act as cofactors in oxidation-reduction reactions

81
Q

What do you see in niacin (B3) deficiency?

A

pellagra

82
Q

What do you see in pellagra?

A

Pellagra - 3 D’s
Diarrhea
Dermatitis (hyperpigmentation of sun-exposed skin)
Dementia

83
Q

Vitamin B6

A

pyridoxine

84
Q

What is the function of pyridoxine (B6) ?

A

Manufacture of heme and synthesis of neurotransmitters

85
Q

What do you see in pyridoxine (B6) deficiency?

A

Causes sideroblastic anemia, convulsions, and peripheral neuropathy

86
Q

vitamin B 12

A

cobalamin

87
Q

What is the function of cobalamin (B12)?

A

DNA synthesis

88
Q

What do you see in cobalamin (B12) deficiency?

A

Megaloblastic anemia

Demyelination of the posterolateral tracts in the spinal cord

89
Q

Vitamin B9

A

folic acid

90
Q

What do you see in folic acid (B9) deficiency?

A

Causes megaloblastic anemia without neurologic symptoms

Increased risk of neural tube defects if present in pregnancy

91
Q

What is the function of folic acid (B 9) ?

A

DNA synthesis

92
Q

is produced by the stomach and results in increased appetite

A

ghrelin

93
Q

is produced by endocrine cells present in the ileum and colon and decreases appetite

A

PYY

94
Q

is secreted by adipocytes when adequate fat stores are present; results in decreased food intake, increased energy expenditure, and weight loss

A

leptin

95
Q

Traction wound of the skin
Usually involves the epidermis only
AKA “scrape”

A

abrasion

96
Q

Caused by blunt trauma
Damages deeper tissue, surface may be intact
Small vessel rupture with extravasation of blood
AKA “bruise”

A

contusion

97
Q

Cause by blunt trauma
Tearing & stretching injury
Irregular edges with tissue bridging
May involve internal organs

A

laceration

98
Q

A cutting wound made by a sharp instrument
Iatrogenic (scalpel) or accidental (glass)
Has clean edges and no tissue bridging

A

incision

99
Q 
Wound caused by a long narrow instrument
Penetrating wound (entrance only)
Perforating wound (entrance and exit)
A

puncture

100
Q

(little red dots) caused by gunpowder striking the skin at high speed

A

stippling

101
Q

What does stippling indicate?

A

gun shot was from a range of inches to about 3 feet

102
Q

What would you see in gunshot victims where the gun was pressed against the body surface?

A

soot accumulation without stippling

103
Q

What is damaged in first degree burns?

A

epidermis only

104
Q

What is damaged in second degree burns?

A

epidermis and superficial dermis

105
Q

What is damaged in third degree burns?

A

destroy skin. extend to subQ tissue

106
Q

What is damaged in fourth degree burns?

A

extends into muscle or bone

107
Q

3rd and 4th degree burns are characterized by what?

A

the lack of pain

108
Q

What is the leading cause of death in burn victims?

A

sepsis–>organ system failure

109
Q

What do you see in heat exhaustion cases?

A

hypovolemia due to water loss leads to cardiovascular collapse; CORE TEMP = NORMAL

110
Q

What do you see in heat stroke cases?

A

lack of sweating; CORE TEMP = INCREASED

111
Q

What is the most important mechanism in ionizing radiation injuries?

A

lysis of water to make free radicles

112
Q

What are the late effects of ionizing radiation?

A

cancer, fibrosis, and atrophy

113
Q

What is the most commonly altered oncogene?

A

Ras

114
Q

What are the mechanisms by which oncogenes can be activated?

A

1) point mutations (RAS)
2) chromosomal translocation (BCR, c-MYC)
3) gene amplification (ERBB2 [HER2])

115
Q

What cancers are associated with the oncogene HER2-neu (ERBB2)?

A

breast and ovarian cancers

116
Q

What cancers are associated with the oncogene RAS?

A

bladder, colon, pancreatic, others

117
Q

What cancers are associated with the oncogene ABL?

A

leukemias

118
Q

What cancers are associated with the oncogene BRAF?

A

melanoma, colon cancer, and thyroid cancer

119
Q

What cancers are associated with the oncogene c-MYC?

A

burkitt lymphoma

120
Q

What cancers are associated with the oncogene N-MYC?

A

neuroblastoma

121
Q

What cancers are associated with the oncogene cyclin D?

A

multiple myeloma; breast & liver cancers

122
Q

What cancers are associated with the tumor suppressor gene Rb?

A

Retinoblastoma, breast, bladder, small cell lung CA, osteosarcoma

123
Q

What cancers are associated with the tumor suppressor gene P53?

A

Colon, breast, bladder, lung, skin (~50% of all cancers)

124
Q

What cancers are associated with the tumor suppressor gene NF-1?

A

neurofibromatosis

125
Q

What cancers are associated with the tumor suppressor gene APC/ beta catenin?

A

Familial adenomatous polyposis, hepatocellular carcinomas

126
Q

What cancers are associated with the tumor suppressor gene WT-1?

A

Wilms tumor, leukemias

127
Q

What cancers are associated with the tumor suppressor gene VHL?

A

Renal Cancer, pheochromocytomas, CNS hemangioblastomas, others

128
Q

virus replicates, but the cell is not killed (measles virus)

A

persistent infection

129
Q

virus establishes a dormant infection (no active replication), but may reactivate later (herpesvirus)

A

latent infection

130
Q

virus does not kill cell, but rather induces tumors (papilloma virus, EBV)

A

transformation (oncogenesis)

131
Q

What is a limitation of serological techniques in diagnosing viral infections?

A

Limitations: Adaptive immune responses take time! Absence of specific Abs DOES NOT equal absence of infection!

132
Q

What cancers are associated with Polyomavirus?

A

merkel cell carcinoma

133
Q

What cancers are associated with cytomegalovirus?

A

glioblastoma

134
Q

HPV 16 is associated with _____.

A

squamous cell carcinoma

135
Q

HPV 18 is associated with ______.

A

cervical adenocarcinoma

136
Q

What is the co-factor for African (endemic) Burkitt’s lymphoma?

A

malaria

137
Q

In EBV, what does the gene EBNA2 do?

A

transactivates c-MYC

138
Q

In EBV, what does the gene LMP1 do?

A

mimics CD40 in B cell activation

139
Q

In Burkitt’s lymphoma, c-myc expression is induced by chromosomal translocation to Ig gene loci. Which Ig gene loci is the most common?

A

IgH

140
Q

What is one of the main mechanisms of immune evasion used by tumors? (associated with increased morbidity and mortality)

A

the induction of T-reg infiltration

141
Q

FDA approved antibody therapies target:

A

tumor antigens, angiogenesis, and immune checkpoint inhibitors

142
Q

List the common oncogenes that are activated via chromosomal translocation.

A

BCR/ABL I
c-MYC/IgH
IgH/BCL-2

143
Q

What are never sites of metastasis?

A

spleen and muscle

144
Q

Lung cancer often metastasizes to the _____.

A

brain

145
Q

GI cancers often metastasize to the _____.

A

liver

146
Q

Which of the chromosome structural aberrations typically have the most sever phenotypic effects?

A

deletions

147
Q

the inactivation of an X chromosome

A

lyonization

148
Q

How do you determine how many Barr bodies are present?

A

number of X chromosomes minus 1

149
Q

What is the most common form of congenital heart disease seen in down syndrome?

A

AV canal

150
Q

Trisomy 13

A

Patau syndrome

cleft lip, sever mental retardation, polydactyly

151
Q

Trisomy 18

A

Edward syndrome

clinched fist with overlapping finger; mental retardation and severe growth deficiency

152
Q

microcephaly, “greek warrior” faces, cleft lip/palate

A

Wolf Hirschhorn

153
Q

short stature, characteristic facies, cocktail party personality

A

Williams syndrome

154
Q

What is the heart condition associated with Williams syndrome?

A

supra-valvular aortic stenosis

155
Q

minor changes in lower face, hypoparathyroidism, thymic dysplasia, conotruncal heart anomalies

A

DiGeorge

156
Q

cleft palate, conotruncal defects, distinct facies, schizophrenia

A

Shprintzen syndrome (velo-cardio-facial syndrome)

157
Q

What cancers are associated with exposure to nitrosamine/ nitrate (smoked meats)?

A

stomach, bladder cancer

158
Q

What cancers are associated with exposure to afloxin

A

liver cancer

159
Q

Direct and indirect carcinogens are electron poor and ______ with electron rich compounds.

A

COVALENTLY BOND

160
Q

what is the direct action of ionizing radiation on a cell?

A

Direct action – radiation interacts with and breaks DNA double strands

161
Q

What is the indirect action of ionizing radiation on a cell?

A

Indirect action – radiation forms ROS that then damage the DNA

162
Q

What is a LOD score?

A

Method for estimating recombination frequency;

Compares the likelihood of obtaining the test results if the two loci are linked, to that of pure chance

163
Q

What LOD score are you looking for to confirm that ?

A

3 or greater (1 in 1000 the result was by chance)

164
Q

What are the assumptions for HW equilibrium?

A

1) Randomly mating population
2) Allele frequencies will remain constant from generation to generation provided none is under selection pressure (+ or -)
3) Large population size
4) Absence of gene flow (drift)

165
Q

purine to purine or pyrimidine to pyrimidine mutation

A

transition

166
Q

purine to pyrimidine and vice versa

A

tranversion

167
Q

What is polymorphism?

A

if there is a mutation that we see in over one percent of people, we call it polymorphism

168
Q

random fluctuations of allele frequencies from generation to generation that take place in small, isolated populations

A

genetic drift

169
Q

Allele frequencies established by chance in a population that is started by a small number of individuals

A

founder effects

170
Q

What is more informative than race?

A

ancestry

171
Q

Most common form of genetic variation in the human genome in which a single-base substitution has created 2 forms of DNA sequence that differ by a single nucleotide

A

Single-Nucleotide Polymorphisms (SNP)

172
Q

What will you see in an Array-comparative genomic hybridization (aCGH) when the patient’s DNA contains a deletion?

A

more red than green which results in an orange color

173
Q

What will you see in an Array-comparative genomic hybridization (aCGH) when the patient’s DNA contains a duplication?

A

more green than red

174
Q

How do SNP arrays differ form aCGH?

A

A SNP array does not use control DNA, rather it compares the ratio to a group of known specimens and normalizes the data

175
Q

Who invented the DNA fingerprint? When?

A

Alec Jeffreys; 1984

176
Q

Name two types of DNA repeats that can be used for human identity testing?

A

Short tandem repeats, Variable Number Tandem Repeats

177
Q

First DNA paternity test was when?

A

1983-1985

178
Q

What techniques were used for the first DNA parentage test?

A

Multilocus probe of 25 short tandem repeats (well, the 25 were common between mother & son)

179
Q

What DNA technique was used for DNA profiling in the Florida murder case?

A

single locus probes

180
Q

DNA techniques were used to convict murderers for the first time in Florida in what year?

A

1987

181
Q

What are FISH tests good for? What are they not good for?

A

Good for identifying duplication/deletions of specific loci.

Not good for detecting small changes, point mutations, etc.

182
Q

Higher levels of TGFbeta1 associated with _______.

A

A doubling of the risk of ‘bad’ pulmonary disease (more severe CF in our context)

183
Q

What is Robertsonian translocation?

A

fusion of two acrocentric chromosomes (acrocentric meaning they have their centromere near the end of the chromosome)

184
Q

What is most often the cause of Trisomy 18?

A

maternal nondisjunction

185
Q

When does the error that causes Trisomy 18 occur?

A

most frequently in Meiosis II

186
Q

Describe the mechanisms by which tumor cells invade normal tissue and metastasize to distant sites.

A

Detachment – E-cadherin down regulated

Degradation – MMP, collagenase, stromelysins, PAF, cathespsins, heparanase

Adhesion – integrins, laminin, CD44

Motility into ECM – autocrine stimulation

187
Q

When does the nondisjunction error that causes Klinefelters syndrome most frequently occur?

A

paternal meiosis I

188
Q

When does the nondisjunction error that causes Down syndrome most frequently occur?

A

maternal meiosis I

Disease and Defense (3 decks)

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