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131 Cards in this Set
- Front
- Back
The intrinsic pathway of apoptosis involves Bax which is ___-apoptotic and Bcl-2 which is ____-apoptotic. Changes in proportions of anti- and pro-apoptotic facts lead to increased mitochondria permeability and cytochrome c release
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Bax- pro, Bcl-2 = anti
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The brain, bacterial abscess, and pleural effusions are considered ____ necrosis
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liquefactive
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TB and systemic fungi infections cause ____ necrosis
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caseous
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The pancreas via saponification goes through ____ necrosis
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fatty
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Blood vessel go through ____ necrosis
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fibrinoid
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This type of necrosis is common in the limbs and GI tract
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gangrenous necrosis
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Is cell injury caused by fatty change reversible?
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Yes
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Is cell injury that results in nuclear pyknosis, karyolysis (nuclear fading) and karyorrhexis (nuclear fragmentation) reversible or irreversible?
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irreversible
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Is plasma membrane damage to the cell, lysosomal rupture and mitochondrial permeability reversible or irreversible modes of cell injury?
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irreversible
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What are some organs that are susceptible to hypoxia?
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heart (subendocardial tissue), kidney, neurons, liver (area around central vein), watershed areas (splenic flexure, ACA/MCA)
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Infarctions of the lung, liver or intestine are red or white infarctions?
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red
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Reperfusion injury is due to damage by ____
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free radicals
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The heart, kidney, and spleen undergo red or white infarction?
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white
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Is Hypovolemic/cardiogenic shock high or low output failure? What happens to the TPR? Is the patient hot or cold and clammy?
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low output failure, increase in TPR, cold/clammy pt
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Is septic shock high or low output failure? What happens to the TPR? Is the patient hot or cold and clammy?
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high output failure, decrease in TPR, hot patient due to dilated arterioles, high venous return
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Increased pressure such as nephrolithiasis can lead to reduction in the size or number of cells. This is known as ____
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atrophy
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Granulation tissue is highly vascularized and ____
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fibrotic
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Scarring is ____ deposition resulting in altered structure and function
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collagen
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____ inflammation is mediated by neutrophils, eosinophils, and antibody mediated
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Acute
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_____ inflammation is mononuclear cell mediated. Associated with blood vessel proliferation, fibrosis. Granuloma: nodular collections of epitheliod macrophages or giant cels
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Chronic
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Neutrophils exit from blood vessels at sites of tissue injury via what 4 steps?
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rolling, tight binding, diapedesis, and migration
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E-selectin and P-selectin is expressed on the vasculature/stroma and is responsible for what stage of leukocyte extravasation?
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rolling
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ICAM-1 expressed on the vasculature/stroma and LFA-1 expressed on the leukocyte is responsible for what stage of leukocyte extravasation?
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tight binding
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PECAM1 is responsible for what stage of leukocyte extravasation?
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diapedesis--> leukocyte travels between endothelial cells and exits blood vessel
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What bacterial products mediate neutrophil chemotaxis? Name 4
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C5a, IL-8, LTB4, Kallikrein
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Free radicals can be eliminated by the enzymes catalase, superoxide dismutase, glutathione peroxidase, spontaneous decay, or antioxidants (vitamins __, ___ and, ___)
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A,C,E
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CCl4 can cause free radical injury of the _____ leading to necrosis and _____
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liver, fatty change
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Reperfusion after anoxia, especially after thrombolytic therapy can lead to free radical injury. The free radical injury is mostly mediated by _____
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superoxide
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What are the three stages of wound healing?
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inflammatory, proliferative, remodeling
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Fibroblasts, myofibroblasts, endothelial cells, and keratinocytes mediate what phase of wound healing?
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Proliferative (2-3 days after wound)
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This stage of wound healing is characterized by deposition of granulation tissue and collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contraction
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Proliferative phase
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This stage of wound healing is mediated by fibroblasts and is characterized by Type III collagen being replaced by Type I collagen--> leads to increased tensile strength of tissue
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Remodeling
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This cytokine produced by macrophages induce and maintain granuloma formation.
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TNF-alpha, anti-TNF drugs can break down granulomas, leading to disseminated disease
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Name some granulomatous disease?
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TB, histoplasmosis, syphilis, sarcoidosis, Crohn's disease, leprosy, cat scratch disease (Bartonella Henselae), Berylliosis
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Is Transudate or exudate hypocellular and protein poor?
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transudate
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Transudate is caused by a ____ in hydrostatic pressure and a ____ in oncotic pressure
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increase, decrease
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Exudate usually occurs due to what two conditions?
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lymphatic obstruction or inflammation
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Does inflammation and infection cause RBCs to fall at a slower or faster rate within a test tube?
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faster
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Infections, inflammation, Cancer, Pregnancy, and SLE cause the ESR to go up or down?
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up ESR
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Sickle cell, polycythemia and CHF cause the ESR to go up or down?
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down ESR
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What is one of the leading causes of fatality from toxicologic agents in children?
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Iron poisoining
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____ poisoning leads to cell death due to peroxidation of membrane lipids. Its symptoms can be acute such as gastric bleeding or chronic such as metabolic acidosis, scarring leading to GI obstruction
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Iron
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____ demonstrated via b-pleated sheets and apple-green birefringence of Congo red stain under polarized light
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Amyloidosis
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Amylodosis can be caused by A___, an acute phase reactant
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AA
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Transthyretin is derived from A___ and is seen amyloidosis seen in senile cardiac disease
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AF
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Amylin is a protein derived from A___ and is an amyloidosis seen in diabetes mellitus type 2
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AE
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Medullary carcinoma of the thyroid will produce A-CAL, which is derived from _____, and can cause amyloidosis
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calcitonin
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What is the amyloid protein associated with Alzheimer's disease?
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beta-amyloid derived from amyloid precursor protein
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What is the amyloid protein that is dialysis associated?
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B2-microglobulin
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Abnormal proliferation of cells with loss of size, shape and orientation is termed ___
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dysplasia
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This describes neoplastic cells that have not invaded the basement membrane. There is high nuclear/cytoplasmic ratio and clumped chromatin. Neoplastic cells encompass the entire thickness
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Carcinoma in situ
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____plasia is irreversible and describes abnormal cells lacking differentiation, resemble primitive cells of same tissue, often equated with undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin
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anaplasia
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____plasia is fibrous tissue formation in response to neoplasm
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desmoplasia
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Is grade or stage the degree of cellular differentiation based on histologic appearance of tumor? Usually graded 1-4 based on degree of differentiation and number of mitoses per high power field; character of tumor itself
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Grade
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Does stage or grade have more prognostic value usually?
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stage
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Is grade or stage the degree of localization/spread based on site and size of primary lesion, spread to regional lymph nodes, presence of metastases; spread of tumor in a specific patient
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stage
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A rhabdomyosarcoma is malignant transformation of ____ muscle
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skeletal
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A _____ is malignant transformation of connective tissue
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fibrosarcoma
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Is a mature teratoma benign or malignant in a male?
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malignant
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The term _____ implies epithelial origin, whereas the term ____ denotes mesenchymal origin. Both terms imply malignancy
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carcinoma, sarcoma
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Cachexia is usually mediated by what cytokine?
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TNF-alpha, IFN-Y, and IL-6
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Down's syndrome is associated with what neoplasm?
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ALL, AML
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Xeroderma pigmentosum and albinism are associated with what neoplasms?
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melanoma, basal cell carcinoma, and especially squamous cell carcinomas of skin
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Chronic atrophic gastritis, pernicious anemia, and postsurgical gastric remnants are associated with what neoplasms?
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Gastric adenocarcinoma
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Tuberous sclerosis (facial angiofibroma, seizures, and mental retardation) is associated with what neoplasms?
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astrocytoma, angiomyolipoma, and cardiac rhabdomyoma
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Actinic keratosis is associated with what neoplasm?
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squamous cell carcinoma of skin
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Barrett's esophagus is associated with what neoplasm?
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Esophageal adenocarcinoma
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Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, anemia; all due to iron deficiency) is associated with what neoplasm?
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squamous cell carcinoma of esophagus
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Cirrhosis (alcoholic, hepatitis B or C) is associated with what neoplasm?
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hepatocellular carcinoma
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The condition ulcerative colitis is associated with what neoplasm?
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colonic adenocarcinoma
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Paget's disease of the bone is associated with what neoplasm?
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secondary osteosarcoma and fibrosarcoma
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Immunodeficiency states predisposed the person to develop what neoplasm?
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malignant lymphomas
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AIDS predisposes a person to develop what neoplasms?
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aggressive malignant lymphomas (non-Hodgkin's) and Kaposi's sarcoma
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Autoimmune diseases (Hashimoto's thyroiditis and myasthenia gravis) is associated with what neoplasm?
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lymphoma
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Acanthosis nigricans (hyperpigmentation and epidermal thickening) is associated with what neoplasm?
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visceral malignancy (stomach, lung, uterus)
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Dysplastic nevus is associated with what neoplasm?
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malignant melanoma
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Radiation exposure is associated with what neoplasms?
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Sarcomas, papillary thyroid cancer, leukemia
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The oncogene abl is associated with what tumor and has what gene product?
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CML, tyrosine kinase
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The oncogene c-myc is associated with what tumor and has what gene product?
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Burkitt's lymphoma and the gene product is a transcription factor
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The oncogene bcl-2 is associated with what tumor and has what gene product?
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follicular lymphoma, it is anti-apoptotic
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The oncogene erb-B2 is associated with what tumor and has what gene product?
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breast, ovarian, and gastric carcinomas and associated with tyrosine kinase
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The oncogene ras is associated with what tumor and has what gene product?
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colon carcinoma, GTPase
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The oncogene L-myc is associated with what neoplasm and has what gene product?
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lung tumor, transcription factor
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The oncogene n-myc is associated with what neoplasm and has what gene product?
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neuroblastoma, transcription factor
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The oncogene ret is associated with what neoplasm and has what gene product?
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multiple endocrine neoplasia (MEN) types IIA and IIB, tyrosine kinase
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The oncogene "c-kit" is associated with what neoplasm and has what gene product?
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gastrointestinal stromal tumor (GIST) and gene product is cytokine receptor
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Li-Fraumeni syndrome is characterized by a mutation in what gene?
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p53
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Breast and ovarian cancer is associated with what gene mutation? Breast cancer alone is associated with what gene mutation?
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breast and ovarian - BRCA1, breast cancer alone -BRCA2
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A mutation in p16 is associated with what tumor?
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melanoma
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A mutation in APC is associated with what tumor?
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Colorectal cancer (associated with FAP)
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A mutation in WT1 is associated with what tumor?
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Wilm's tumor
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A mutation in NF1 is associated with what tumor?
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Neurofibromatosis Type 1
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A mutation in DPC is associated with what tumor?
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pancreatic cancer
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A mutation in DCC is associated with what tumor?
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colon cancer
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This is a carcinoembryonic antigen that is very nonspecific but is produced by 70% of colorectal and pancreatic cancers; also produced by gastric, breast, and thyroid medullary carcinomas
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CEA
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With hepatocellular carcinomas and nonseminomatous germ cell tumors (such as yolk sac tumors) this tumor marker is increased
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alpha-fetoprotein
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Beta-HCG is increased in what tumors?
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Hydatidiform moles, choriocarcinomas, and gestational trophoblastic tumors
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CA125 is increased in what types of tumors?
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ovarian, malignant epithelial tumors
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S100 is increased in what types of tumors?
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melanoma, neural tumor, schwannomas
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Alkaline phosphatase is increased in what type of tumors?
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metastases to bone, obstructive biliary disease, Paget's disease of the bone
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Bombesin is a tumor marker for what types of neoplasms?
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neuroblastoma, lung and gastric cancer
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TRAP is a tumor marker for what types of neoplasm?
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Hairy cell leukemia
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CA-19-9 is a tumor marker for what type of neoplasm?
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Pancreatic adenocarcinoma
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Calcitonin is a tumor marker for what type of neoplasm?
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thyroid medullary carcinoma
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EBV is associated with what cancers?
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Burkitt's lymphoma, Hodgkin's lymphoma, and nasopharyngeal carcinoma
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Cervical carcinoma (16,18) and penile/anal carcinomas are associated with what cancers?
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HPV
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Kaposi's sarcoma and body cavity fluid B-cell lymphoma is associated with what viral infection?
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HHV8
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Primary CNS lymphoma is associated with what viral infection?
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HIV
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H.pylori is associated with what cancer?
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gastric adenocarcinoma and lymphoma
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Schistosoma haematobium is associated with what cancer?
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squamous cell carcinoma of transitional epithelium, e.g. bladder
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Aflatoxins produced by ____ can lead to _____ carcinoma
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aspergillus, hepatocellular
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Vinyl chloride is a carcinogen that can lead to _____
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angiosarcoma of the liver
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CCL4 is a carcinogen and can impact what organ and cause what?
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liver, centrilobular necrosis, fatty change
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Nitrosamines (found in smoked foods) can impact what organ and cause what?
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stomach, gastric cancer
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Cigarette smoke can impact the larynx and cause ______, lung and cause _______, kidney and cause ______, bladder and cause _______
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squamous cell carcinoma; squamous cell and small cell carcinoma; renal cell carcinoma; transitional cell carcinoma
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Asbestos can impact what organ and cause what?
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lung, mesothelioma and bronchogenic carcinoma
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Arsenic can affect the skin and cause ______, or it can affect the liver and cause ______
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squamous cell carcinoma, angiosarcoma
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Naphthalene (aniline dyes) can impact what organ and cause what?
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bladder, transitional cell carcinoma
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Alkylating agents can impact what organ and cause what?
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blood, leukemia
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Small cell lung carcinoma can produce ectopic _____ which can lead to Cushings syndrome
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ACTH
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Small cell lung carcinoma and intracranial neoplasms can produce ectopic _____ which can lead to SIADH
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ADH
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Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma can produce ____ which can lead to hypercalcemia
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PTH related peptide
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Renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, and pheochromocytoma can produce ____ which can lead to polycythemia
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erythropoietin
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A thymoma and small cell lung carcinoma can produce effects such as antibodies against presynaptic calcium channels at neuromuscular junction. This can cause _____ syndrome
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Lambert-Eaton syndrome
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Leukemias and lymphomas can lead to hyperuricemia to excess nucleic acid turnover. This can lead to what effects?
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gout, urate nephropathy
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Psammoma bodies are laminated, concentric, ____ spherules seen in what 4 conditions?
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they are calcified and seen in papillary adenocarcinoma of thyroid, serous papaillary cystadenocarcinoma of ovary, meningioma, and malignant mesothelioma
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What is the leading cause of cancer death in both men and women?/
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lung
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What primary tumors like to metastasize to the brain?
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lung, breast, kidney, skin (melanoma)
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What primary tumors like to metastasize to the liver?
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colon, stomach, pancreas
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What primary tumors like to metastasize to the bone?
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prostate, breast, lung, thyroid, testes
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Does lung metastases cause osteolytic or osteoblastic lesions? What about prostate mestastases to bone?
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lung - lytic; prostate -blastic
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