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HSC2008 Pathology & Pharmacology > Week 4 > Flashcards

Week 4 Flashcards

1
Q

carcinogenesis

A

accumulates mutations leads to abnormal appearance & behavior

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2
Q

carcinoma-in-situ (stage 0 / pre-cancer)

A

carcinoma that has not invaded basement membrane

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3
Q

3 germ layers

A

ectoderm (outer), mesoderm (middle), endoderm (inner)

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4
Q

what are ectoderms

A

epithelium, nervous tissue

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5
Q

what are mesoderms

A

epithelium, connective, muscle tissues

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6
Q

what are endoderms

A

epithelium

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7
Q

where do most cancers develop in

A

epithelial cells

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8
Q

exceptions to benign tumors

A

melanoma, mesothelioma

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9
Q

asbestos leads to

A

mesothelioma

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10
Q

alcohol leads to

A

head, neck, liver, oesophageal cx

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11
Q

diet leads to

A

stomach, colorectal cx

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12
Q

hepatitis B/C leads to

A

liver cx

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13
Q

liver fluke leads to

A

cholangiocarcinoma

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14
Q

HPV leads to

A

head, neck, cervical cx

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15
Q

UV leads to

A

skin cx, melanoma

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16
Q

BRCA1/2 mutation leads to

A

breast cx

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17
Q

RB1 mutation leads to

A

retinoblastoma

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18
Q

APC mutation leads to

A

colorectal cx

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19
Q

NF1 mutation leads to

A

neurofibromatosis

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20
Q

implications of carcinoma-in-situ

A

histological diagnosis, screening, insurance

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21
Q

mechanism of metastasis

A
  1. detaching from neighbouring cells
  2. invaded other tissue layers
  3. penetrate blood / lymphatic vessels
  4. escape from vessels
  5. establish & growth at new site
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22
Q

mechanism of metastasis sites

A

first-pass organ, favored sites,
vascular organs

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23
Q

common sites of metastasis

A

lungs, liver, brain, bones, adrenals, left supraclavicular lymph nodes

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24
Q

colorectal cx leads to

A

liver cx

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25
Q

prostate cx leads to

A

bone cx

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26
Q

patterns of metastases

A

orderly (colorectal, cervical)

random (breast & lung)

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27
Q

general symptoms of cx

A

pain, bleeding, obstruction / compression fracture

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28
Q

symptoms of breast cx

A

hard lump, nipple discharge, bleeding, skin ulceration

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29
Q

skin ulceration of breast cx is indicative of __

A

late stage

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30
Q

symptoms of lung cx

A

cough, SOB, hemoptysis

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31
Q

symptoms of colorectal cx

A

rectal bleeding, change in bowel habits, constipation, diarrhoea

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32
Q

mass screening

A

breast, cervical, colorectal cx

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33
Q

high risk screening

A

breast, colorectal, liver cx

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34
Q

wilson’s criteria for screening includes

A

disease
- must be latent & important health problem

test
- available, cheap, reliable

treatment
- available, cheaper if detected earlier

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35
Q

breast cx screening

A

mammogram

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36
Q

colorectal cx screening

A

FOBT, colonoscopy

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37
Q

liver cx screening

A

alpha-fetoprotein (AFP), US liver

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38
Q

cervix cx screening

A

Pap smear

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39
Q

rationale of staging

A

prognosis, treatment intent & modality

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40
Q

colorectal type of staging

A

Duke’s

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41
Q

thymoma type of staging

A

masaoka

42
Q

testicular cx type of staging

A

Marsden

43
Q

SCLC type of staging

A

limited & extensive staging

44
Q

what is the gold standard of investigation diagnosis

A

histology

45
Q

clinical investigation for diagnosis

A

CT, MRI, PET

46
Q

tumor markers for investigation

A

CEA, CA19-9, alpha-FP, CA125, CA15-3

47
Q

types of biopsy

A

core biopsy, fine needle aspirate (FNA)

48
Q

conditions when treatment is initiated without histological confirmation

A

emergency, difficult to access / patient not fit, germ cell tumor markers, hepatocellular carcinoma

49
Q

elevated germ cell tumor markers

A

beta-hCG, alpha-FP, LDH

50
Q

hepatocellular carcinoma is indicative of __

A

underlying liver cirrhosis

51
Q

what germ cell tumor marker indicates hepatocellular carcinoma

A

alpha-FP

52
Q

what tumor marker indicates prostate cx

A

PSA

53
Q

most common CT-PET scan

A

FDG-PET

54
Q

radioactive tracer in CT-PET is tagged to __

A

glucose; increased uptake in metabolically active tissues

55
Q

CT-PET scan has lower sensitivity for __

A

brain, liver, urinary tract

56
Q

MRI allows for greater visualization of ___

A

brain, CNS, liver, pelvic organs, joints

57
Q

examples of pelvic organs

A

prostate, rectum, uterus/cervix

58
Q

downsides of MRI scan

A

longer scan time, noisy, expensive, claustrophobic, issues with implants & pacemakers

59
Q

pre-treatment scans for potential disease complications

A

blood tests, heart scan, lung function, renal scan

60
Q

what is the treatment of most cancers

A

surgery

61
Q

what is the radical intent of treatment

A

to cure

62
Q

what is the palliative intent of treatment

A

relieve symptoms, delay complications, prolong life

63
Q

3 types of radical treatment

A

definitive, neoadjuvant, adjuvant

64
Q

definitive radical treatment

A

primary treatment without which cure is not possible

65
Q

neoadjuvant radical treatment

A

before definitive treatment to facilitate it

66
Q

adjuvant radical treatment

A

after definitive treatment to reduce risk of recurrence

67
Q

surgery is defined as __

A

complete resection of many solid tumors

68
Q

principle of oncological resection

A

resect all tumors including regional lymph nodes of adequate margins & en-bloc

69
Q

R0 resection

A

resect all tumors (gross & microscopic)

70
Q

R1 resection

A

incomplete resection (microscopic)

71
Q

R2 resection

A

incomplete resection (gross)

72
Q

second most effective cx treatment

A

radiotherapy

73
Q

principle of radiotherapy

A

irradiate tumors including regional lymph nodes within 1 field

74
Q

radiotherapy indications

A
  1. definitive treatment
  2. neoadjuvant & adjuvant settings
    - improve resectability
    - reduce risk of local occurence
  3. palliation
    - pain, bleeding, obstruction, impending #
75
Q

on electromagnetic spectrum, what has shortest wavelength

A

x-rays

76
Q

on electromagnetic spectrum, what has longest wavelength

A

radiowaves

77
Q

external beam radiotherapy involves use of __

A

photons, electrons, protons

78
Q

brachytherapy is a __ radioactive source

A

sealed

79
Q

radionuclides is a __ radioactive source

A

unsealed

80
Q

radiotherapy involves the use of __

A

ROS to damage DNA and cause mitotic cell death

81
Q

in early responding tissues, expression of damage appears __

A

early

82
Q

lag time of early & late side effects

A

early = from 2 weeks

late = >3 months after end of RT

83
Q

incidence of early & late side effects

A

early = most will experience

late = most will not experience

84
Q

outcome of early & late side effects

A

early = reversible

late = irreversible

85
Q

systemic therapy indications

A
  1. curable cx
  2. neoadjuvant/adjuvant setting
  3. palliative treatment in metastatic setting
86
Q

types of systemic therapy

A

cytotoxic chemotherapy, hormonal therapy, targeted therapy, immunotherapy

87
Q

common toxicities of cytotoxic chemotherapy

A

alopecia, nausea & vomitting, diarrhoea / constipation, bone marrow suppression

88
Q

what cx are hormonally driven

A

breast, prostate, uterine

89
Q

side effects of hormonal therapy

A

menopausal symptoms, CVS, osteoporosis

90
Q

targeted therapy includes __

A

1) structure = small molecules, monoclonal antibodies

2) target / action = tyrosine kinase inhibitors, anti-angiogenic, apoptosis-inducing

91
Q

benign tumors ends with __

A

-oma

92
Q

malignant tumors ends with __

A

-carcinoma

93
Q

tumor of connective tissue ends with __

A

-sarcoma

94
Q

metathesis

A

malignant cells do not adhere to each other & often break loose from the mass, infiltrating into adjacent tissue

95
Q

blood tests for cancer

A

low Hb & EPO count

96
Q

systemic effects of cx

A
  1. weight loss
  2. anemia
  3. severe fatigue
  4. effusions
  5. frequent infections
  6. paraneoplastic syndrome
97
Q

paraneoplastic syndrome

A

Tumour cells release
substances that affect neurological function or blood clotting, or may have hormonal effects

98
Q

tumor seeding

A

Spread of cancer cells in body fluid or along membranes, usually in body cavity

99
Q

tumor staging includes __

A

size of tumor, involvement of regional lymph nodes, spread of tumor

100
Q

radiotherapy is most effective in __

A

rapidly dividing radiosensitive cells

101
Q

chemotherapy involves the use of __

A

combo of 2-4 antineoplastic drugs
- antimitotics
- antimetabolites
- alkylating agents
- antibiotics

102
Q

glucocorticoids are used to __

A

reduce mitosis, inflammation, swelling

increase EPO count, appetite, well being

HSC2008 Pathology & Pharmacology (14 decks)

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