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161 Cards in this Set

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Tumor Marker = AFP

Associated Cancer?
hepatocellular carcinoma,
yolk sac tumor (endodermal sinus tumor) of ovary or testis
Tumor Marker = Bence Jones protein

Associated Cancer?
multiple myeloma,
Waldenstrom's macroglobulinemia (represent light chains in urine)
Tumor Marker = CA 15-3

Associated Cancer?
breast carcinoma
Tumor Marker = CA 19-9

Associated Cancer?
pancreatic, colorectal carcinomas
Tumor Marker = CA 125
surface-derived ovarian cancer (e.g. serous cystadenocarcinoma; helpful in distinguishing benign from malignant tumors)
Tumor Marker = CEA

Associated Cancer?
colorectal and pancreatic carcinomas (monitor for recurrences **not** good for screening)
Tumor Marker = LDH

Associated Cancer?
malignant lymphoma (prognostic factor for response to standard therapy)
Tumor Marker = PSA

Associated Cancer?
prostate carcinoma (**also increased in prostate hyperplasia)
Cushing syndrome - ectopic hormone?

**paraneoplastic syndrome endocrinopathies
ACTH
Cushing syndrome - associated cancer?

**paraneoplastic syndrome endocrinopathies
small cell carcinoma of lung, medullary carcinoma of thyroid
gynecomastia - associated cancer

**paraneoplastic syndrome endocrinopathies
choriocarcinoma (testes)
gynecomastia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
hCG
hypercalcemia - associated cancer

**paraneoplastic syndrome endocrinopathies
renal cell carcinoma, primary squamous cell carcinoma of lung, breast carcinoma

malignant lymphomas (contain 1alpha-hydroxylase)
hypercalcemia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
PTH-related protein

calcitrol (vit D)
hypocalcemia - associated cancer

**paraneoplastic syndrome endocrinopathies
medullary carcinoma of thyroid
hypocalcemia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
calcitonin
hypoglycemia - associated cancer

**paraneoplastic syndrome endocrinopathies
hepatocellular carcinoma
hypoglycemia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
insulin-like factor
hyponatremia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
ADH
hyponatremia - associated cancer

**paraneoplastic syndrome endocrinopathies
small cell carcinoma
secondary polycythemia - associated cancer

**paraneoplastic syndrome endocrinopathies
renal cell and hepatocellular
secondary polycythemia - ectopic hormone

**paraneoplastic syndrome endocrinopathies
erythropoietin
acanthosis nigricans - associated cancer
stomach carcinoma
acanthosis nigricans - appearance
black, verrucoid-appearing lesions
Eaton-Lambert syndrome - associated cancer
small cell carcinoma of lung
hypertrophic osteoarthropathy - associated cancer
bronchogenic carcinoma
What is hypertrophic osteoarthropathy?
periosteal reaction of distal phalanx (often associated with clubbing of nail)
nonbacterial thrombotic endocarditis - associated cancer
mucus-secreting pancreatic and colorectal carcinomas
What is nonbacterial thrombotic endocarditis?
sterile vegetations on mitral valve
seborrheic keratosis - associated cancer
stomach cancer
Leser-Trelat sign
sudden appearance of numerous pigmented seborrheic keratoses --> stomach carcinoma
superficial migratory thrombophlebitis - associated cancer
pancreatic carcinoma
superficial migratory thrombophlebitis - cause?
release of procoagulants (Trousseau's sign)
nephrotic syndrome - associated cancer
lung, breast, stomach carcinomas
nephrotic syndrome - cause?
diffuse membranous glomerulopathy
HCV - oncogenic mechanism
produces postnecrotic cirrhosis
HCV - associated cancer
hepatocellular carcinoma
HVC - RNA or DNA?
RNA
HTLV-1 - RNA or DNA?
RNA
HTLV-1 - oncogenic mechanism
activates TAX gene, stimulates polyclonal T-cell proliferation, inhibits TP53 suppressor gene
HTLV-1 - associated cancer
T-cell leukemia and lymphoma
Oncogenic RNA viruses

(2)
HCV, HTLV-1
oncogenic DNA viruses

(4)
EBV, HBV, HHV-8, HPV (16+18)
EBV - oncogenic mechanism
promotes polyclonal B-cell proliferation, which increases risk for t(8;14) translocation
EBV - associated cancer
Burkitt's lymphoma, CNS lymphoma in AIDS, mixed cellularity Hodgkin's lymphoma, nasopharyngeal carcinomas
HBV - oncogenic mechanism
activates proto-oncogenes, inactivates TP53 suppressor gene
HBV - associated cancer
hepatocellular carcinoma
HHV-8 - associated cancer
Kaposi's sarcoma (AIDS-defining)
HHV-8 - oncogenic mechanism
acts via cytokines released from HIV and HSV
HPV (16/18) - associated cancer
squamous cell carcinoma of vulva, vagina, cervix, anus, larynx, oropharynx
HPV-16 - oncogenic mechanism
E6 gene product inhibits TP53 suppressor gene

(~50% of cancers)
HPV-18 - oncogenic mechanism
E7 gene product inhibits RB suppressor gene

(~10% of cancers)
Aflatoxin (from Aspergillus) - associated cancer
hepatocellular carcinoma in association with HBV
Alcohol - associated cancer
squamous cell carcinoma of oropharynx and upper/middle esophagus; pancreatic and hepatocellular carcinomas
Alklating agents - associated cancer
malignant lymphoma
Arsenic - associated cancer
squamous cell carcinoma of skin, lung cancer, liver angiosarcoma
Asbestos - associated cancer
bronchogenic carcinoma, pleural mesothelioma
Benzene - associated cancer
acute leukemia
Beryllium - associated cancer
bronchogenic carcinoma
Chromium - associated cancer
bronchogenic carcinoma
Cyclophosphamide - associated cancer
transitional cell carcinoma of urinary bladder
Diethylstilbestrol - associated cancer
clear cell carcinoma of vagina/cervix
Beta-Naphthylamine (aniline dyes) - associated cancer
transitional cell carcinoma of urinary bladder
Nickel - associated cancer
bronchogenic carcinoma
Oral contraceptives - associated cancer
breast, cervical carcinoma
Polycyclic hydrocarbons - associated cancer
squamous cell carcinoma: oral cavity, midesophagus, larynx, lung
adenocarcinoma: distal esophagus, pancreas, kidney
transitional cell carcinoma: urinary bladder, renal pelvis
Polyvinyl chloride - associated cancer
liver angiosarcoma
Silica - associated cancer
bronchogenic carcinoma
APC - function
prevents nuclear transcription (degrades catenin, an activator of nuclear transcription)
APC - associated cancers
familial polyposis (colorectal carcinoma)
BRCA1/BRCA2 - function
regulates DNA repair
BRCA1/BRCA2 - associated cancers
breast, ovary, prostate carcinoma
RB - function
inhibits G1 to S phase
RB - associated cancers
retinoblastoma, osteogenic sarcoma, breast carcinomas
TGF-Beta - function
inhibits G1 to S phase
TGF-Beta - associated cancers
pancreatic and colorectal carcinomas
TP53 - function
inhibits G1 to S phase
repairs DNA, activates BAX genes (initiates apoptosis)
TP53 - associated cancers
lung, colon, breast carcinomas
Li-Fraumeni syndrome: breast carcinoma, brain tumors, leukemia, sarcomas
VHL - function
regulates nuclear transcription
VHL - associated cancers
Von Hippel-Lindau syndrome: cerebellar hemangioblastoma, retinal angioma, renal cell carcinoma (bilateral), pheochromocytoma (bilateral)
WT1 - function
regulates nuclear transcription
WT1 - associated cancers
Wilms' tumor (nephroblastoma - kids)
ABL - function
nonreceptor tyrosine kinase activity
ABL - mutation
translocation t(9;22)
ABL - associated cancer
chronic myelogenous leukemia (chromosome 22 is Philidelphia chromosome)
HER (ERBB2) - function
receptor synthesis
HER (ERBB2) - mutation
amplification
HER (ERBB2) - associated cancer
breast carcinoma (marker of aggressiveness)
MYC - function
nuclear transcription
MYC - mutation
translocation t(8;14)
MYC - associated cancer
Burkitt's lymphoma
N-MYC - function
nuclear transcription
N-MYC - mutation
amplification
N-MYC - associated cancer
neuroblastoma
RAS - function
guanosine triphosphate signal transduction
RAS - mutation
point mutation
RAS - cancer
leukemia; lung, colon, pancreatic carcinomas
RET - function
receptor synthesis
RET - mutation
point mutation
RET - associated cancers
multiple endocrine neoplasia IIa/IIb syndromes
SIS - function
growth factor synthesis
SIS - mutation
overexpression
SIS - associated cancer
osteogenic sarcoma, astrocytoma
Actinic (solar) keratosis - precursor lesion for which cancer?
squamous cell carcinoma
Atypical hyperplasia of ductal epithelium of breast - precursor lesion for which cancer?
adenocarcinoma
Chronic irritation at sinus orifice, third-degree burn scars - precursor lesion for which cancer?
squamous cell carcinomas
Chronic ulcerative colitis - precursor lesion for which cancer?
adenocarcinoma
Complete hydatidiform mole - precursor lesion for which cancer?
choriocarcinoma
Dysplastic nevus - precursor lesion for which cancer?
malignant melanoma
Endometrial hyperplasia - precursor lesion for which cancer?
adenocarcinoma
Glandular metaplasia of esophagus (Barrett's esophagus) - precursor lesion for which cancer?
adenocarcinoma
Glandular metaplasia of stomach (H. pylori) - precursor lesion for which cancer?
adenocarcinoma
Myelodysplastic syndrome - precursor lesion for which cancer?
acute leukemia
Regenerative nodules in cirrhosis - precursor lesion for which cancer?
adenocarcinoma
Scar tissue in lung - precursor lesion for which cancer?
adenocarcinoma
Squamous dysplasia of oropharynx, larynx, bronchus, cervix - precursor lesion for which cancer?
squamous cell carcinoma
Tubular adenoma of colon - precursor lesion for which cancer?
adenocarcinoma
vaginal adenosis (diethylstilbestrol exposure) - precursor lesion for which cancer?
adenocarcinoma
Villous adenoma of rectum - precursor lesion for which cancer?
adenocarcinoma
____ derive from ectoderm, endoderm and mesoderm.
teratomas
____ derive from squamous, glandular, transitional epithelium.
carcinomas
____ derive from connective tissue.
sarcomas
def. hamartoma
non-neoplastic overgrowth of tissue
def. choristoma
normal tissue where it should not be
tumor parenchyma = ____ component
neoplastic
What is grading of cancers?
Determining if the cancer resembles its parent tissue or not.

less resemblance = higher grade
Malignant tumors have ____ nuclear/cytoplasmic ratio and ____ mitotic spindle fibers.
increased nuclear/cytoplasmic ratio and abnormal mitotic spindle fibers
Malignant tumors require ____ doubling times before they are detectable.
30 doubling times
Benign and malignant tumors are (monoclonal/polyclonal).
monoclonal
Malignant tumors have (upregulated/downregulated) telomerase activity.
upregulated
Basal cell carcinomas of the skin invade, but they do not ____.
metastasize
What is the second most important criterion for malignancy?
invasion
Name two tissues that resist invasion.
cartilage, elastic tissue
Loss of ____ ____ leads to cell invasion.
intercellular adherence
____ metastasis has greater prognostic significance than ____ metastasis.
extranodal > nodal
____ ____ are the first line of defense in carcinomas.
lymph nodes
Name three routes of metastasis.
1. lymphatic
2. hematogenous
3. seeding of body cavities
Seeding is common in surface-derived ____ cancers.
surface-derived ovarian cancers
Tx. for bone mets?
radiation
MC tissue metastasized to?
lymph nodes
What is the 2nd most common cause of death in the US?
cancer
Lifetime risk for cancer: men (><) women
men > women
MCC cancer in children
acute lymphoblastic leukemia
Cancer incidence in men, top 3.
1. prostate
2. lung
3. colon
Cancer incidence in women, top 3.
1. breast
2. lung
3. colon
Gynecological cancer incidence, top 3.
1. endometrium
2. ovary
3. cervical
MCC cancer death in adults?
lung cancer
Most rapidly increasing cancer?
malignant melanoma
Actinic (solar) keratosis -- precursor of ____ ____ carcinoma.
squamous cell carcinoma
What is the most important factor in decreasing risk for cancer?
smoking cessation
HBV immunization decreases risk for ____ carcinoma.
hepatocellular carcinoma
HPV immunization decreases risk for ____ cancer.
cervical
Is PSA more sensitive or more specific?
more sensitive
MC type of mutation in cancer.
point mutation
BCL2 gene family -- ____ genes
antiapoptosis genes
BAX gene = ____ gene
apoptosis
MC cancer due to ionizing radiation
leukemia
MC cancer due to excessive UV light exposure
basal cell carcinoma
Calcitonin is a hormone tumor marker for what cancer?
medullary carcinoma of the thyroid
MCC death in cancer
gram-negative sepsis
MC paraneoplastic syndrome
hypercalcemia