3 Neoplasia Iv

Front 1

location of neoplasm
critical effect:
obstruction:

Back 1

critical: pituitary adenoma
obstruction: benign/malignant neoplasm of gut

Front 2

endocrine neoplasm
def and ex:

Back 2

produce manifestations by elaboration of hormones
ie. pancreatic - secrete insulin - hypoglycemia

Front 3

erosive and destructive growth

Back 3

benign and malignant neoplasms - ulceration, infection and bleeding

Front 4

what is Cancer Cachexia?

Back 4

wasting syndrome - loss of body fat, lean body mass, weakness, anorexia, anemia

Front 5

mechanism of cancer cachexia

Back 5

Loss of appetite and alteration in fat metabolism (TNF-α), produced by macrophages and tumor cells
Cytokines (IL-1 and IFN-γ) synergize with TNF

Front 6

def of paraneoplastic syndrome

Back 6

Hormonal, neurological, hematological, and other clinical and biochemical disturbances associated with malignant neoplasms but not directly related to invasion by the primary tumor or its metastases.

Front 7

Cushing syndrome
paraneoplastic syn assoc w/:
mechanism?

Back 7

small cell ca of lung, pancreatic ca, neural tumors
mech: excessive production of ACTH or ACTH like peptides

Front 8

Syndrome Inappropriate ADH Secretion (SIADH)
assoc w/:

Back 8

small cell ca of lung, intracranial neoplasm

Front 9

hypercalcemia
assoc w/:
mechanism?

Back 9

squamous cell ca of lung, (breast, renal, ovarian, adult T cell leuk/lymp)
mech: PTHRP, IL-1, TNF-α, TGF-α

Front 10

carcinoid syndrome
assoc w/:
mechanism?

Back 10

Bronchial carcinoid, Pancreatic & gastric ca
Mech: secretion of serotonin, bradykinin

Front 11

nerve and muscle syndromes

Back 11

myasthenia gravis
disorders of central/periph nervous system
eton-lambert syndrome (gets better w/ exercise)

Front 12

dermatologic disorders

Back 12

acanthosis nigricans [gastric, lung, uterine]
dermatomyositis [bronchogenic, breast ca]

Front 13

osseous, articular, soft tissue changes

Back 13

Hypertrophic osteoarthropathy and clubbing of fingers - bronchogenic ca

Front 14

Vascular and Hematologic changes

Back 14

Venous thrombosis (Trousseau’s phenomenon) noted in deep seated cancers e.g. Pancreatic; Non bacterial thrombotic endocarditis (advanced ca), Anemia

Front 15

renal dysfunction

Back 15

nephrotic syndrome - increased proteinuria, edema

Front 16

what can mimic carcinoma?

Back 16

radiation changes

Front 17

what can mimic osteosarcoma?

Back 17

bone healing at fracture site

Front 18

ways of procuring specimen

Back 18

biopsy or excision of lesion
fine needle aspiration cytology
exfloliative cytology

Front 19

ways of preserving the specimen

Back 19

frozen section: fresh or in saline
light microscopy: 10% neutral buffered formalin
immunofluoro: saline or Michel's fixative
molecular studies: RPMI
EM: glutaraldehyde

Front 20

tissue biopsy stains?

Back 20

H&E: routine biopsies
trichrome: fibrous tissue
periodic acid schiff (PAS): glycogen and fungi
gomori methamine silver (GMS): fungi
oil red o: fat
iron stain: hemosiderin

Front 21

what is the concept of fine needle aspiration cytology?

Back 21

cells from a mass are dislodged with a needle, smeared on slide, and read

Front 22

superficial needle aspiration
what organs?
done by?

Back 22

breast, thyroid, lymph node, salivary gland masses, skin tumors
pathologist or clinician

Front 23

deep needle aspiration
what organs?
done by?

Back 23

liver, lung, kidney, pancreas, lymph nodes
radiologist

Front 24

fine needle aspiration
advantages/disadvantages?

Back 24

advant: rapid interpretation, cost effective
disadvan: req's specially trained pathologists

Front 25

exfoliative cytology
concept?

Back 25

cancer cells have lower cohesiveness, exfoliate into body cavities

Front 26

An accuracy approaching 100% can be reached in the interpretation of cytologic smears e.g?

Back 26

cervical, sputum and urine, body fluids (pleural and peritoneal), bronchial brushings and washings

Front 27

immunohistochemistry (IHC)
definition?

Back 27

using tissue markers for diagnostic and research purposes

Front 28

immunohistochemistry (IHC)
mechanism?

Back 28

diluted Ab solution applied to tissue section, Ag-Ab rxn detected by fluoro-probe (immunofluoro) or enzymatic system (immunoperoxidase). presence/absence of antigen impacts dx

Front 29

immunofluoresence: biopsies from certain sites is performed on ___

Back 29

fresh frozen tissue
(kidney, skin, lung)

Front 30

immunoperoxidse staining
advantages?

Back 30

more sensitive, permanent preparation, can be performed on paraffin embedded tissue

Front 31

specific uses of immunoperoxidase?

Back 31

IHC demonstrates presence of antigens in tissue sections, making it possible to investigate functional aspect and histogenesis of many dz's

Front 32

types of immunoperoxidase staining

Back 32

identify cell of origin
tissue specific markers
oncofetal antigens
hormones, isozymes, specific proteins, mucins, other glycoproteins

Front 33

uses of IHC

Back 33

identify cell of origin of neoplasm
tissue specific markers

Front 34

carcinomas express

Back 34

intermediate filament cytokeratin (CK)

Front 35

lymphomas express

Back 35

LCA - leukocyte common Ag
CD45

Front 36

epithelial markers

Back 36

EMA - epithelial mem Ag
CK - cytokeratin

Front 37

mesenchymal markers

Back 37

vimentin

Front 38

muscle cell marker

Back 38

desmin

Front 39

skeletal muscle marker

Back 39

myoglobin

Front 40

endothelial cell

Back 40

Factor VIII
CD34

Front 41

histiocytic

Back 41

lysosome
CD68

Front 42

schwann cell

Back 42

S100

Front 43

melanocytic

Back 43

HMB 45
melan A

Front 44

neuroendocrine

Back 44

synaptophysin
chromogranin
CD56

Front 45

astrocytic and glial

Back 45

GFAP - glial fibrillary acid protein

Front 46

AFP - alpha fetal protein assoc w/ ?

Back 46

hepatocellular and germ cell ca

Front 47

CEA = carcinoembryonic Ag assoc w/

Back 47

colon, bronchogenic, gastric, pancreatic carcinomas

Front 48

pancreatic oncofetal antigen assoc w/

Back 48

pancreatic, colon, bronchogenic, gastric

Front 49

calcitonin assoc w/

Back 49

medullary ca of thyroid

Front 50

neuron specific enolase

Back 50

small cell ca of lung, neuroblastoma

Front 51

immunoglobulins (IHC)

Back 51

multiple myeloma

Front 52

PSA: prostate specific antigen

Back 52

prostate cancer

Front 53

CA 125 (IHC)

Back 53

ovarian carcinoma

Front 54

CA 19-9 (IHC)

Back 54

colon and pancreatic carcinoma

Front 55

CA 15-3 (IHC)

Back 55

breast carcinoma

Front 56

IHC in the management of malignant neoplasms

Back 56

Categorization of an undifferentiated neoplasms:
Categorization of lymphomas and leukemias
Determination of the site of origin of a metastatic tumor
Detection of molecules that have therapeutic or prognostic significance e.g. ERBB2

Front 57

molecular diagnosis can be used to distinguish benign ____ T&B cell prolif from malignant ___ proliferation

Back 57

benign: polyclonal
malignant: monoclonal

Front 58

molecular diagnosis can be used to determine prognosis of malignant neoplasms, ie?

Back 58

amplification of c-myc, del of 1p = poorer prognosis of pt w/ neuroblastoma

Front 59

molecular diagnosis can be used in detection of minimal residual disease, ie?

Back 59

bcr-abl by PCR = residual dz of CML
K-ras in stool = possible recurrence of colon ca

Front 60

molecular diagnosis can be used in diagnosis of hereditary predisposition to cancer, ie

Back 60

germ line mut in tumor suppressor genes
BRCA-1, BRCA-2, RET

Front 61

flow cytometry can be used as rapid and quantitative measure of several individual cell characteristics such as __ and __.

Back 61

membrane antigens and DNA content of tumor cells.

Front 62

identification of cell surface antigen can be used to classify

Back 62

leukemia and lymphomas

Front 63

specimens for flow cytometry

Back 63

fresh frozen tissue, fluids, bone marrow aspirates, irrigation of urinary bladder

Front 64

___ is assoc w/ poorer prognosis (in flow cytometry)

Back 64

aneuploidy

Front 65

Biochemical indicators of the presence of tumors ?

Back 65

cell surface antigens, cytoplasmic proteins, enzymes and hormones

Front 66

Molecules that can be detected in plasma or other body fluids are used to?

Back 66

as lab test to support dx of cancer

Front 67

tumor markers are used to determine

Back 67

response to therapy and indicate relapse in the follow up period

Front 68

Human chorionic gonadotropin (tumor marker)

Back 68

Trophoblastic tumors (choriocarcinoma), non seminomatous testicular tumors.

Front 69

calcitonin (tumor marker)

Back 69

medullary carcinoma of thyroid

Front 70

Catecholamine and metabolites Vanillylmandellic acid and Homovanillic Acid (tumor marker)

Back 70

Pheochromocytoma and related tumors

Front 71

Carcinoembryonic Antigen (CEA): (tumor marker)

Back 71

increased in colorectal ca, pancreatic ca, gastric, breast, lung ca. False(+) in cirrhosis, hepatitis, Crohn's dz, ulcerative colitis

Front 72

Alpha Fetoprotein (AFP): (tumor marker)

Back 72

increased in hepatocellular carcinoma, non seminomatous germ cell tumors of testis. False(+) in cirrhosis, heptitis, non-toxic liver injury and pregnancy

Front 73

prostatic acid phosphatase (PAP) elevated in

Back 73

benign prostatic hypertrophy
prostate adenocarcinoma
following digital rectal exam (blood should be drawn before or several days after DRE)

Front 74

neuron specific enolase

Back 74

small cell ca of lung, neuroblastoma

Front 75

serum amylase

Back 75

pancreas

Front 76

AP (alkaline phosphatase)

Back 76

non-specific

Front 77

immunoglobulins

Back 77

multiple myelomas
gammopathies

Front 78

5-Hydroxyindoleacetic Acid (5-HIAA)

Back 78

carcinoid tumor

Front 79

Des-gamma-carboxyprothrombin

Back 79

hepatocellular carcinoma

Front 80

Gamma-glutamyltransferase (GGT) and 5’-Nucleotidase

Back 80

elevated in metastatic carcinoma of the liver

Front 81

Terminal deoxynucleotidyl transferase:

Back 81

acute lymphoblastic leukemia

Front 82

Ferritin: (tumor marker)

Back 82

Head and Neck and hematologic malignancies