Path 300 Neoplasia

Front 1

What are the common metaplastic sites of
1. Lung cancer (5)
2. Colorectal (2)
3. Breast (3)
4. Prostate (4)
5. Melanoma (2)

Back 1

1. upper vertebral (NOT distal), liver, brain, adrenal gland, bone
2. Liver (via portal), lungs,
3. Skull and ribs (bone), liver, lungs.
4. lower vertebra+pelvic plexus (bone), liver lungs.
5. Gall bladder and spleen

Front 2

Which cancers (3) do you need to look at a ten yr remission instead of a 5 yr.

Back 2

Breast
Prostate
Melanoma

Front 3

What cancer has risk maintained even after smoking cessation ?

Back 3

Colorectal cancer

Front 4

What does neoplasia mean?
Dysplasia?
Anaplasia?
Metaplasia?

Back 4

new growth = cancer
dysplasia = cells tart to look abnormal, diff shapes and sizes.
anaplasia = cancer
switch cell type from one differentiated cell to another

Front 5

Which is more dangerous:
differentiated vs undifferentiated cancer?

Back 5

undifferentiated is more dangerous

Front 6

What are the three most common types of cancer in
women
men
What are the rates of death for these three
women
men

Back 6

breast, lung, colorectal
prostate, lung, colorectal

lung, breast, colorectal
lung, prostate, colorectal

Front 7

What percentage of cancers cause by genetics

Back 7

5%

Front 8

What (7) criterias can you compare benign cancers to malignant cancers

Back 8

1. threat to life
2. how fast it grows
3. ability to metastasize
4. mitosis rate and normality
5. differentiation
6. resemblance to parent.
7. type of cells (heterogeneous vs non)

Front 9

Name the cancer that grows from squamous epithelial cells
1. benign
2. malignant

Back 9

1. squamus cell papilloma
2. squamous cell carcinoma

Front 10

Name the cancer that grows from epithelial cells (general)
1. benign
2. malignant

Back 10

1. papilloma
2. carcinoma

Front 11

Name the cancer that grows from glandular tissues (secretiting)
1. benign
2. malignant

Back 11

1. adenoma
2. adenocarcinoma

Front 12

Name the cancer that grows from connective tissues
1. benign
2. malignant

Back 12

1. -"oma"
2. -"sarcoma"

Front 13

What is a teratoma

Back 13

Cancer that has all kinds of different things / diff tissues and cell growing.

Front 14

What (7) can tumours affect host and cause death?

Back 14

1. destroy tissue affect vital function
2. eroding into tissue, and causing hemorrhage
3. erosion of blood vessels vs continual bleeding
4. causing infection distal to an obstruction, abcess
5. metastasis (biggest one)
6. cardiac failure
7. if glandular cancer, can secrete abnormal things

Front 15

What are (3) effects of malignant tumours (in general)

Back 15

1. cachexia
2. paraneoplastic syndromes
3. immunosupression

Front 16

What is carcinoma in situ

Back 16

Severe dysplasia that has not yet penetrated the BM, can be cured 100%

Front 17

What substances do tumours secrete in order to penetrate the BM and grow? (5)
What do these do

Back 17

1. laminin - allows tumour cell to anchor to the collagen in the BM
2. collagenase - dissolve the BM
3. autocrine motility factors - allows cells to move away from the site of the primary tumour
4. enzymes to destroy the fibronectin
5. TAF tumour angiogenesis factors like VEGF

Front 18

What is retrograde venous spread

Back 18

as lymphatics growth of tumor within vein may cause reversal of blood flow .

Front 19

Do cancers invade veins or arteries more? Why?

Back 19

Veins
because arteries are resistant to cancer cell invasion. they have thick walls

Front 20

What two factors affect metastasis

Back 20

1. direction of blood flow
2. affinity for cancer cells

Front 21

What are two ways to stage a tumour? (2)
what do low number in each way mean?

Back 21

1. TNM - primary tumour, lymph nodes, metastasis
2. histology - level of differentiation. low numbers mean differentiated.

Front 22

ER+ breast cancer
better or worse prognosis

Back 22

better

Front 23

Name the four types of LUNG cancer

Back 23

1. squamous cell
2. adenocarcinoma
3. large cell
4. small cell (oat cell)

Front 24

Put the four type of lung cancer in order of increase fatality

Which one grows the fastest

Back 24

NSCLC < SCLC
squamous cell < adenomcarcinoma < undiff large cell < undiff small cell

SCLC grows the fastes

Front 25

Which lung cancer are centrally located (2)
Which lung cancer are undifferentiated (2)

Back 25

Central: small cell and squamous cell
Small cell and large cell.

Front 26

Which cancer is initially the most response to radiotherapy and drugs

Back 26

SCLC

Front 27

What are symptoms of lung cancer (2)
local effects (3)
distal effects (7)
general symptoms (5)

Back 27

1. persistent cough w blood
2. infection
local : 1. shedding seen in sputum, bleed, block bronchi
distal: 1. secrete abnormal compounds 2. metastasis 3. finger clubbing, 4. increase ACTH, 5. increased ADH, 6. wt loss, 7. cachexia
general: 1. chest pain 2. chest infection 3. malaise 4. shortness of breath 5. hoarseness

Front 28

T of F
Lung cancer goes to distal extremeties

Back 28

No, FALSE

Front 29

Name (3) enviro causes of Lung cancer

Back 29

1. smoking
2. radon
3. asbestos

Front 30

What does asbestos lead to.

Back 30

mesothelioma - cancer of pleural coverings

Front 31

What is a benign adenomatous polyp

Back 31

between cancer and normal cells. benign growth that will lead to colorectal cancer.

Front 32

What is carcinoma embyronic antigen?
Which cancer is it found in?

Back 32

Marker for Colorectal cancer. Can be used to see if surgery worked

Front 33

What is tenesmus

Back 33

difficulty defecating

Front 34

If tumour is in descending colon where is the pain felt?
Ascending colon?

Back 34

below the umbilicus
above the umbelicus

Front 35

What are symptoms of colorectal cancer (3)

Back 35

1. pain, location will tell you where tumour is.
2. bleeding causing anemia
3. tesnesmus

Front 36

Name the treatment of colorectal cancer

Back 36

Surgery

Front 37

Name (2) genetic causes of colorectal cancer

Back 37

1. FAP
2. HNPCC

Front 38

What is FAP stand for?
What does it do?

Back 38

Familial adenomatous polyposis
hundred of adenomas polyps growing and only a matter of time before some of these to become malignant

Front 39

Risk factors for colon cancer

Back 39

1. diet (visceral fat), high fat low fiber
2. cigarette smoking
3 inflammatory bowel disease

Front 40

What is the difference between a sigmoidoscopy and a colonoscopy

Back 40

sigmoidoscopy (distal colon and rectum)
colonoscopy (entire colon)

Front 41

Name (4) other GI cancers, and which one is the worst

Back 41

1. esophageal 9% survival
2. liver 6%
3. stomach 18%
4. pancreatic cancer 3% worst but rare

Front 42

Esophageal cancer is caused by what two modifiable risks:

Back 42

1. drinking
2. smoking
156x higher

Front 43

Paraneoplasmic syndromes, what are they?

Back 43

remote effet of tumour due to release of mediators, like cytokines, and other things, because the blood vessles supplying tumours are leaky. lots of things are released.

Front 44

During paraneoplasmic syndrome, what is the protein called that dendritic cells pick up ?
What happens next?

Back 44

cdr2
dendritic cell active T cells --> cause problems in the brain

Front 45

Cachexia definition?
Caused by?
Treat?
Contrast w starvation

Back 45

body wasting, progressiv weakness, anorexia and wt loss, no appetitie
due to cytokine release by tumour
only way is to treat tumour
BMR increasas! energy expenditure increases. and metabolism increases.

Front 46

Name the commonalities between breast and prostate cancer (8)

Back 46

1. both common but not fatal
2. homrone dep
3. metastasize to bone, liver and lungs
4. radiotherapy and chemotherapy are effective
5. asymptomatic in older patients
6. surgically treated and better now (prostate not as much)
7. late metastasis, 10 yr survival looked at instead of 5yr
8. lifestyle risk factors similar

Front 47

What is the age of onset of breast cancer and prostate cancer

Back 47

around 70 + for breast cancer
around 75-85 + for prostate

Front 48

What is the most common place where breast cancer comes from?

Back 48

ducts

Front 49

If you have HER2neu you have worse prognosis? T or F?
Why?

Back 49

T, worse prognosis because oncogene

Front 50

Where are most of breast cancer lumps found

Back 50

upper outer quadrant

Front 51

What is the surgery used to treat breast cancer nowadays called

Back 51

lumpectomies

Front 52

Risk factors (5) for breast cancer

Back 52

1. fat and wt gain
2. lack regular exercise
3. excess alcohol
4. increased BMI
5. HRT (small increase)

Front 53

What are heritable examples of breast cancer

Back 53

BRCA1 and 2 mutations are defects in DNA repair genes

Front 54

What is a diverticulum (prostate cancer)

Back 54

pouch portruding from bladder wall --> in BPH and in prostate cancer.

Front 55

What is TURP?
What does it treat?

Back 55

transurethral prostatectomy (TURP),
prostate removed by going through the urethra.
treats BPH and prostate cancer

Front 56

What are symptoms of prostate cancer

Back 56

1. trouble urinating

Front 57

What is therapy for prostate cancer (7)

Back 57

1. TURP
2. surgery
3. hormone therapy
4. chemo
5. radiotherapy
6. brachytherapy
7 waitful watching

Front 58

What is brachytherapy

Back 58

radioactive implants

Front 59

what is a the marker called for prostate cancer?
is is full-proof?
What is it controlled by?

Back 59

PSA - prostate specific antigen, higher means prostate cancer in men > 10ng/ml is bad.
Not full-proof
DHT controls it

Front 60

What is the age group for testicular cancer?
Is it a lethal cancer

Back 60

20-40
No, 90% survival

Front 61

name three things cancer cells have (3)
(not the malignant tumour characteristic list)

Back 61

1. lose contact inhibition
2. abnormal jcts
3. abnormal surface antigens

Front 62

What kind of immune cells are able to kill some tumor cels

Back 62

1. natural killer
2. CD8
3.Cyt T cells

Front 63

Name the three steps in dev cancer

Back 63

1. initiation
2. promotion
3. progression

Front 64

Malignant tumour 6 main characteristics!!

Back 64

1. evade apoptosis
2. self sufficient in growth signals
3. insensitive to anti-growth signals
4. sustain angiogenesis
5. have limitless replicative potential
6. invade and metastasize

Front 65

Name three ways a proto-oncogene can become an oncogene. and what happens in each

Back 65

1. point mutation, del, insert, --> hyperactive
2. gene amplification --> overexpression
3. chr rearrange --> abnormal expression of abnormal or normal protein.

Front 66

Give two examples of chr rearrangment and the chrs involved

Back 66

1. philadelphia - 9 and 22 --> bcr-able
2. Burkitt Lymphoma - 8 and 14 --> increase in transcription of oncogene c-myc

Front 67

Name three oncogenes and their functions (3)

Back 67

1. Ras - ccell cycle progression via myc
2. myc - cell cycle progression
3. bacl2 block apoptosis

Front 68

How many mutations does it take to make an oncogene?
To get rid of a TSG

Back 68

oncogene 1
TSG 1

Front 69

Name three TSGs

Back 69

1. Rb controls and block E2F which blocks at the G1 to S phase
2. APC - regulate beta catenin by blocking it
3. p53 - cell cycle arrest + apoptosis

Front 70

What is Li-Fraumeni syndrome

Back 70

born with a germline mutation in p53 --> one of the two p53 genes are mutated

Front 71

DNA repair genes name one

Back 71

BRCA

Front 72

Epigenetic changes in cancer (3)

Back 72

omg too easy
1. hypomethylation of oncogene
2. hypermehtlation of TSH
3. histone mods

Front 73

What is the difference between genotoxic and nongenotxc mech of dna damage

Back 73

genotoxic - affects genome
nongenotoxic - affects signalling pathways

Front 74

HPV inactivates what? (2)

Back 74

1. Rb
2. p53

Front 75

Name the 7 cancer virus and the cancer they cause

Back 75

1. EBV --> Burkitt
2. HPV --> Cervical
3. Hep B, C --> liver
4. human T-cell lymphotrophic virus ->adult T cell leukemia
5. kaposi sarcoma ass herpes virus --> kaposi sarcoma
merkel cell polyomavirus --> merkel cell carcinoma

Front 76

Chronic inflammation is linked to cancer via what mech?

Back 76

ROS

Front 77

What are the 4 general therapies for cancer

Back 77

1. surgery
2. chemo
3. radiotherapy
4. hormone therapy

Front 78

New drugs (5) targets for cancer therapy

Back 78

1. gleevec
2. mAb against feature of tumour cell
3. anti-angiogenesis
4. metastatic drugs.
5. inject highly toxid drugs directly into the tumor be used to embolize the blood supply to the tumor

Front 79

What is the mech of the TSG APC?

Back 79

APC normally destroys the beta catenin from wnt signaling. which keep cells from proliferating. without APC you get proliferations

Front 80

What is the (2) mech of p53

Back 80

1. prevent cell from moving into the cell cycle by transcribing p21
2. also transcribe BAX --> promote apoptosis

Front 81

What is the mech of Rb TSG

Back 81

1. Rb protein, non-functional Rb causes retinoblastoma. there is a difference between sporadic and hereditary forms of retinoblastoma
If Rb is hyper-phosphorylated by cyclinc/dck --> it permit the transcription of G1 to S by releasing the usually sequestered E2F

Front 82

What can radiation cause?

Back 82

1. single or double strand breaks.