Mmmmm, Neoplasia 4

Front 1

What is carcinoid syndrome?

Back 1

endocrinopathy caused by serotonin, bradykinin that can lead to bronchial carcinoid, pancreatic carcinoma, gastric carcinoma

Front 2

What is polycythemia?

Back 2

endocrinopathy caused by erythropoietin that can lead to renal carcinoma, hepatocellular carcinoma, cerebellar hemangioma

Front 3

What is myasthenia gravis?

Back 3

autoimmune nerve and muscle syndrome caused by antibody against acetylcholine receptor that causes thymic hyperplasia and loss of functional AChRs at neuromuscular junction

Front 4

How does MG present?

Back 4

weakness in muscle that begins with extraocular muscles and then generalizes, symptoms respond to administraction of anticholinesterases and mortality is due to respiratory compromise

Front 5

What is acanthosis nigricans?

Back 5

skin disorder that produces gray black velveity patches in axilla and other skin folds. malignant in 20% of pts caused by secretion of epidermal growth factor

Front 6

What is hypertrophic osteoarthropathy?

Back 6

associated with carcinoma of the bronchus and distinct clinical features include digital clubbing, new bone formation on digits, arthritis of adjacent joints

Front 7

What about venous thrombosis is related to CA?

Back 7

tumor products from pancreatic CA, bronchogenic CA release clotting proteins that can lead to venous thrombosis

Front 8

What is CA graded?

Back 8

degree of differentiation of corresponding normal tissue
low grade - well differentiated - resemble normal tissue
high grade - poor differentiated - do not resemble normal tissue

Front 9

What is cancer staging?

Back 9

extent of cancer relative to size of primary tumor, lymph node involvement, existence of distant metastasis
higher the stage, more extensive CA, worse prognosis

Front 10

What four methods of cancer dx are most often employed?

Back 10

1. excision
2. biopsy
3. fine needle aspiration followed by smear and staining
4. cytologic smear (like a pap smear)

Front 11

What intermediate filament is used to detect what kind of tumors in all epithelial cells?

Back 11

keratin to detect carcinomas

Front 12

What intermediate filament is used to detect what kind of tumors in all mesenchymal cells?

Back 12

vimentin to detect sarcomas

Front 13

What intermediate filament is used to detect what kind of tumors in all muscle cells?

Back 13

desmin to detect leiomyoma and rhabdomyosarcoma

Front 14

What intermediate filament is used to detect what kind of tumors in all CNS & PNS neurons and neural crest cells?

Back 14

neurofilament to detect pheochromocytoma and neuroblastoma

Front 15

What intermediate filament is used to detect what kind of tumors in all glial cells?

Back 15

glial fibrillary acidic protein to detect astrocytomas and ependymomas

Front 16

What are serum tumor markers?

Back 16

cell components that are indicative of CA presence

Front 17

what is AFP used for?

Back 17

serum tumor marker that is related to hepatocellular CA and nonseminomatous testicular germ cell tumors

Front 18

what is cacitonin used for?

Back 18

serum tumor marker related to medullary thryoid CA

Front 19

what is CEA used for?

Back 19

colon cancer

Front 20

what is CA-125 used for?

Back 20

serum tumor marker related to ovarian CA

Front 21

what is CA 19-9 used for?

Back 21

serum tumor marker related to pancreatic and colon cancer

Front 22

what is CA15-3 used for?

Back 22

serum tumor marker related to breast CA

Front 23

What epidermal cell types are relevant to CA?

Back 23

1. keratinocytes
2. melanocytes
3. langerhans cells
4. merkel cells

Front 24

What is the predominant epidermal cell type and what is it responsible for?

Back 24

keratinocyte produces keratin. keratinocytes begin as basal cells, migrate toward the skin surface and are sloughed off every 30 days.

Front 25

What cells produce melanin and what is the purpose of melanin?

Back 25

melanocytes produce this dark pigment which absorbs UV radiation. number and size of melanocytes produces skin tone

Front 26

What is a langerhans cell?

Back 26

dendritic immune cells that resemble melanocytes but are not pigmented. these are very susceptible to UV damage

Front 27

What are merkel cells?

Back 27

dendritic cells in the epidermal basal layer and they act as mechanoreceptors in areas of high tactile sensitivity

Front 28

What three major cell types are in the dermis?

Back 28

arrector pili muscle cells, fibrocytes, mast cells

Front 29

What is the difference between the papillary dermis and the reticular dermis?

Back 29

papillary dermis interdigitates with epidermis. reticular dermis provides most strength of dermal layer and is deeper than papillary dermis

Front 30

What are the four main skin appendages?

Back 30

1. eccrine glands
2. apocrine glands (ears, axilla, anogenital, eyelids)
3. sebaceous blands
4. hair follicles

Front 31

What is a macule and a patch?

Back 31

macule - color change that is flat and < 1 cm
patch - color change that is flat and > 1 cm

Front 32

What is a papule, plaque, and nodule?

Back 32

papule - elevated dome or flat-top < 1 cm
plaque - bigger papule, not taller
nodule - elevated and wider papule, dome top

Front 33

What is a vesicle, pustule, and bulla?

Back 33

vesicle - clear fluid filled blister < 1 cm diameter
pustule - cloudy fluid vesicle
bulla - bigger vesicle

Front 34

What is an erosion and an ulceration?

Back 34

erosion - loss of part or all epidermis due to trauma

ulceration - loss of all of epidermis and part of the dermis

Front 35

What are the two common skin malignant neoplasms?

Back 35

1. basal cell carcinoma
2. squamous cell carcinoma

Front 36

What is the most common skin cell carcinoma

Back 36

basal cell carcinoma derived from basal cells of lower epidermis, presents as a papule, nodule, or plaque. May ulcerate, but will rarely metastasize. generally excellent prognosis

Front 37

What are the three common subtypes of basal cell carcinoma?

Back 37

1. nodular - most common, pink, red, or gray nodule
2. superficial - scaly flat lesion with distinct borders
3. morpheic - flat, sometimes depressed, white plaque with adjacent erythema

Front 38

What are risk factors for basal cell carcinoma?

Back 38

decreased melanin
male
ionizing radiation
xeroderma pidmentosum

Front 39

How is basal cell carcinoma treated?

Back 39

1. excision
2. moh micrographic surgery (excise small border of normal tissue to examine)
3. radiation therapy
4. electrodesication
5. topical imiquimod
6. cryosurgery
7. topical 5-FU

Front 40

What is the second most common skin cell carcinoma?

Back 40

squamous cell carcinoma is derived from keratinocytes and presents as a papule, nodule, or plaque it may feel rough and be pink or red. the full thickness of the epidermis is involved, there is a dermal invasive variety as well as an in-situ, non-dermis variety. prognosis is usually very good.

Front 41

What are the risk factors for squamous cell carcinoma?

Back 41

male
decreased melanin
xeroderma pigmentosum
ionizing radiation
HPV
chronic ulcers
industrial carcinogens
actinin keratoses

Front 42

What is the tx for squamous cell carcinoma?

Back 42

surgical excision
mohs micrographic surgery
radiation therapy

Front 43

how does a melanoma present?

Back 43

macule, patch, papule, nodule red, brown, black, blue, gray. follows the ABCD symptom pattern. caused by atypical melanocytes clustering and enlarging and moving from dermal mitoses upward through the epidermis. stage-dependent prognosis.

Front 44

What is the ABCD symptom pattern present in melanomas?

Back 44

A - asymmetry
B - border irregularity
C - color variation
D - diameter larger than 6mm (pencil eraser)

Front 45

whats is the tx for melanomas?

Back 45

1. wide local excision
2. sentinel lymph node biopsy to detect stage
3. chemotherapy and radiation