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38 Cards in this Set
- Front
- Back
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How is anti-tumor activity predominantly mediated? |
Cell-mediated mechanisms Tumor Ags are presented on the cell surface by MHC Class I and are recognized by CD8+ CTLs |
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What is the difference between tumor-specific antigens and tumor-associated antigens? |
Tumor-specific are only present on tumor cells Tumor-associated are present on tumor cells and some normal cells |
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What is HER-2 an example of? |
Product of mutated oncogenes and tumor suppressor genes (tumor-specific Ag) |
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T cells from patients with what kind of cancer recognize peptides derived from tyrosinase? |
Melanoma |
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Why can't CD20 be used to monitor regrowth of B cell tumors after treatment with rituximab? |
Rituximab targets CD20, so any regrowth would be made up of a subclone of cells that lack this cell surface marker |
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What receptor on B cells does EBV use to attach and infect? |
CD21 |
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What are 3 primary ways that tumors evade immune surveillance? |
1. Failure to produce tumor antigen 2. Mutations in MHC genes or genes needed for antigen processing 3. Production of immunosuppressive proteins (ex. TGF-beta) |
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Do immunosuppressed patients have an increased risk for developing cancer? |
You best believe it |
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What do vacuolizations in the bone marrow indicate? |
Burkitt's Lymphoma |
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What are 5 of the major problems that tumors can cause? |
1. Impingement on adjacent structures 2. Interference with functional activity such as hormone synthesis or the development of paraneoplastic syndromes 3. Bleeding and infections when the tumor ulcerates through adjacent surfaces 4. Symptoms that result from rupture or infarction 5. Cachexia or wasting |
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What is superior vena cava syndrome (SVCS)? |
Occurs when a person's SVC is partially blocked or compressed. Ex. Pancoast tumor |
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What are the 3 most common paraneoplastic syndromes? |
1. Hypercalcemia (most common) 2. Cushing Syndrome 3. Nonbacterial thrombotic endocarditis |
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What leads to hypercalcemia in the case of paraneoplastic syndromes? |
Tumor cells release PTH-like proteins that can act on the kidneys to increase calcium levels Squamous cell carcinoma of the lung is a big player here |
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What is the most common fundamental cause of Cushing's syndrome? |
Something that increases secretion of ACTH |
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What is the primary danger of nonbacterial thrombotic endocarditis? |
Potential for systemic embolization |
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What is Kassabach-Merrit syndrome? |
Spontaneous or traumatic rupture with hemoperitoneum, intra-tumoral bleeding, and consumptive coagulopathy (patients use up all of their clotting factors) Usually due to a vascular tumor |
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Why can tumors cause cachexia or wasting? |
A lot of it is due to systemic inflammation. Tumors release inflammatory factors like TNF-alpha, IL-1, and IL-6. These inflammatory cytokines can affect the brain, muscles, hepatic function, fat deposition, and brown fat breakdown, all leading to wasting. |
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What is the difference between grading and staging? |
Grading: cell differentiation and rate of growth of the tumor (low grade means well-differentiated, high grade means poorly differentiated) Staging: progression or spread in the body You grade a tumor; you stage a patient. |
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What are examples of tumors that are graded purely on the basis of their diagnosis? |
Grade I: pilocytic astrocytoma (benign cytological features) Grade II: low-grade astrocytoma (moderate cellularity with no anaplasia or mitotic activity) Grade III: anaplastic astrocytoma (cellularity, anaplasia, mitoses) Grade IV: glioblastoma (same as grade III plus microvascular proliferation and necrosis) |
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Why is staging important? |
For determining treatment and prognosis |
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If you see reddish-purple hues on a histological stain of a tumor, what should you think? |
Vascular tumor ex. angiosarcoma |
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How are thyroid tumor biopsies typically taken? |
Fine needle aspiration |
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Name the tumors with which the following tumor markers are associated |
Leggo |
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Human chorionic gonadotropin |
Trophoblastic tumors Nonseminomatous testicular tumors |
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Calcitonin |
Medullary carcinoma of thyroid |
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Catecholamine & metabolites |
Pheochromocytoma and related tumors Neuroblastoma (in urine) |
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alpha-Fetoprotein |
Liver cell cancer Nonseminomatous germ cell tumors of testis |
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Carcinoembryonic antigen |
Carcinomas of the colon, pancreas, lung, stomach, and heart |
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Prostatic acid phosphatase |
Prostate cancer |
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Neuron-specific enolase |
Small-cell cancer of lung Neuroblastoma |
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Immunoglobulins |
Multiple myeloma and other gammopathies |
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Prostate-specific Ag (PSA) and prostate-specific membrane antigen |
Prostate cancer |
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CA-125 |
Ovarian cancer |
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CA-19-9 |
Colon cancer Pancreatic cancer |
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CA-15-3 |
Breast cancer |
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What are the uses of molecular markers? |
1. Diagnosis 2. Prognosis 3. Detection of minimal residual disease 4. Diagnosis of hereditary predisposition 5. Determination of viable therapies |
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How does vemurafenib work? |
It inhibits a mutant form of BRAF (BRAF V600E) which has been shown to be a key driving mutation in several cancers |
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What is the biggest issue with using whole genome sequencing? |
Bioinformatics (huge amount of data to get through) |
