Path-Ew-logy Test 2 L3

lunalovegood's version from 2015-10-14 00:51

Section 1

Question Answer
What kills the most ppl in US? Next? cardiovascular disease, cancer (31% and 23%)
Which cancer KILLS the most? Leading cancer site in men? In women?lung, prostate, breast (lung 14% M and 12% F, prostate 29% and breast 30%
Neoplasm - the cells undergo ____ changes. (reversible, irreversible)IRREVERSIBLE
A mass of abnormal cellular growth, cells undergo irreversible changes with loss of normal genetic control of cell cycle neoplasm (unrestricted, uncoordinated, autonomous)
Is hyperplasia a true neoplasia?NO (growth stops with elimination of stimulus)
Excess growth of benign/normal tissue, develops secondary to mechanical stimulation and growth stops with removal of stimulushyperplasia
Is metaplasia reversible?YES
A benign, reversible adaptive change of one type of tissue into another due to exposure to an irritant.Metaplasia
_____ esophagus - lower esophageal squamous epithelium changes to the columnar gastric epithelium due to chronic acid regurgitationBarrette's esophagus
Barrette's esophagus develops in about 10% of people with ___.GERD
Could Barrette's esophagus turn into esophageal adenocarcinoma? yes (but only in minority of untreated cases)q
Abnormal cellular organization reflecting IRREVERSIBLE changes in surface/ling epithelium - partial progression towards cancer.dysplasia
Is dyspalia reversible?NO (precancerous changes)
A leukoplakia on the tongue is a type of epithelial _____.dysplasia
Are neoplasms benign, malignant or either?either
T/F - Metastasis possible pathway - epithelial dysplasia --> carcinoma --> invasion of local tissue --> intravasation --> embolization --> extravasation --> colonization T
T/F - Some carcinomas, sarcomas, and melanomas frequently metastasize. Others, like basal cell carcinoma, rarely do. T
Name the 3 pathways that metastasis may occur.Direct extension, lymphatic spread, hematogenous spread
Most common metastatic tumors in adults are ___.carcinomas
_____ metastasis is uncommon, usually seen in children.sarcoma
What are the 4 determinants of a specific neoplasm?primary anatomic site, histologic type, histologic grade and clincical stage
Determines possible removal/management, clinical detection and possibility of spread.primary anatomic site
Determines the type of cancer, clinical behavior and prognosis.histologic type
"Degree of morphologic similarity of neoplastic cells to the native tissue of origin"histologic grade
Histologic grade - Do you want high grade or low grade?low grade (well-differentiated, better prognosis, I wish the same applied to this exam)
Clinical stage - implies ___ of spread of cancer.extent
Grade + stage will give you the overall...prognosis of the patient
Progressive loss of body fat and lean body mass - associated with anorexia, anemia and general weakness.Cachexia of malignancy (paraneoplastic syndrome)
A syndrome that is a consequence of cancer in the body, but not due to local presence of cancer cells.paraneoplastic syndrome
Dermatomyositis is a ____ syndrome.paraneoplastic
Cushing syndrome is a paraneoplastic syndrome of ___ cancer.lung cancer


Question Answer
T0, N0, M0healthy - no tumors, no palpable node, no evidence of metastasis
Tumor 2cm or lessT1
Tumor 2-4cmT2
Tumor > 4cmT3
Tumor >4 and invades adjacent structuresT4
Node palpable, ipsilateralN1
Node palpable, bilateralN2
Node palpable, bilateral, large and fixedN3
Clinical/radiographic metastasisM1
5 year - T1 N0 M0>85% - STAGE 1
5 year - T2 N0 M066% - STAGE 2
5 year - T3 N0 M041% - STAGE 3
5 year - (T1, T2, T3) with N1 and M041% - STAGE 3
5 year - any N2, any N39% - STAGE 4
5 year - any M19% - STAGE 4


Target organs of Metastasis
Question Answer
Oral carcinomas?lymph nodes
Intestinal adenocarcinomas?liver
Various cancers?lungs
T/F - Other target organs include the brain skeletal system and adrenal glands.T


Tumors are Classy
Question Answer
B or M? - squamous papillomabenign
B or M? - adenomabenign
B or M? - squamous cell carcinomamalignant
B or M? - adenocarcinomamalignant
B or M? - fibromabenign
B or M? - lipomabenign
B or M? - chondrosarcomamalignant
B or M? - osteosarcomamalignant
B or M? - hemangiomabenign
B or M? - lymphangiomabenign
B or M? - angiosarcomamalignant
B or M? - lymphangiosarcomamalignant
B or M? - leiomyomabenign
B or M? - rhabdomyomabenign
B or M? - leiomyosarcomamalignant
B or M? - rhadomyosarcomamalignant
B or M? - Schwannomabenign
B or M? - neuorfibromabenign
B or M? - neurfibrosarcomamalignant
B or M? - leukemiamalignant
B or M? - multiple myelomamalignant
B or M? - lymphomamalignant
Squamous cell carcinoma, osteosarcoma, rhabdomyosarcoma, leukemia, multiple myeloma, lymphoma.malignant


Tumors are Classy Part 2
Question Answer
Squamous cell carcinomaepithelial (stratified squamous epithelium)
Adenoma, Adenocarcinomaepithelial (glandular)
Squamous Papillomaepitheilal (stratified squamous epithelium)
Fibrosarcoma, liposarcoma, chondrosarcoma, osteosarcomaconnective tissue
Hemangiomavascular (blood vessels)
Angiosarcomavascular (blood vessels
Lymphangiomavascular (lymph vessels)
Lymphangiosarcomavascular (lymph vessels)
Leiomyoma, Leiomyosarcomamuscle tissue (smooth
Rhabdomyoma, Rhabdomyosarcomamuscle tissue (skeletal, cardiac)
Leukemiahematopoeitic tissue
Multiple myelomahematopoeitic tissue


Reversible or Irreversible?
Question Answer
Dysplasia?irreversible (wikipedia has different thoughts than the slides........)
Benign or Malignant?
Question Answer
Well-defined marginbenign (defined, sharp)
Infiltrative marginmalignant
NO metastasisbenign
OFTEN metastasismalignant
Mostly slow growth ratebenign
Slow to fast growth rate malignant
Good cell differentiationbenign
Well-poor cell differentiationmalignant
Nuclear morphology close to normalbenign
Nuclear morphology abnormalmalignant
Uniform nuclear shapebenign
Variable nuclear shapemalignant (pleomorphic)
Small nuclear sizebenign
Enlarged nuclear sizemalignant (greater ratio of nucleus to cytoplasm)
Normal nuclear stainingbenign
Hyperchromatic nuclear stainingmalignant
Rare to no mitosisbenign
Many, abnormal cell divisionsmalignant
Regular cellular morphologybenign
Irregular, pleomorphic cellular morphologymalignant


Molecular Basis
Question Answer
Genes for DNA repair. Growth promoting genes ______. Growth inhibiting genes _____. Genes for programmed cell death ____.proto-oncogenes, tumor suppressor genes, apoptosis
1. Growth factor to receptor on cell membrane (EGF, FGF etc.) 2. Signal transducing proteins intracellularly 3. Transduction of signal to nucleus (2nd messenger) 4. DNA transcription 5. Cell division 6. Growth inhibiting genes stop cell cycle.normal cell cycle
BCL-2 inhibits...apoptosis
RAS is a...signal transducer (with GTP and GDP)
Name a very very important cell cycle and apoptosis regulator.p53
RB is a cell cycle ___.inhibitor
EGF, PDGF, FGF, TGF-a are growth factors. TGF-B is a growth ____.inhibitor
Cyclin D, CDK4, CDK6, MYC, MYB, JUN and FOS are all...nuclear transcription factors
BRCA-1 and BRCA-2 function in ...DNA repair
ERBB1 and HER2 are ...growth factor receptors (for EGF)
RB, p53, APC, NF1 and BRCA1 BRCA2 are all..tumor suppressor genes
APC suppresses ____ cancer.colon (specifically adenoma polyposis coli
NF1 suppresses...neurofibromatosis 1
What does HPV16 disable?p53 and RB genes (HPV16 - E6 E7)
HPV can be high risk and cause ___.oro-pharyngeal carcinoma
HPV _________ is most frequent.16 (over 92% of cases)
T/F - HPV for SCC in oro-pharyngeal carcinoma is still in the minority at <10% of cases, but it is increasing.T
Nodules/lesions in tonsillar regions or base of tongue, non-keratinizing carcinoma, most patients <40 years of age.HPV driven oro-pharyngeal carcinoma
What is the prognosis for HPV-driven oro-pharyngeal carcinoma?5 year survival >80%
___ million Americans are HPV positive.20 million (AHHHHHHHH! EVERYBODY GO GET THE VACCINE NOW! I already have mine. Still concerned.)
More than ___ million new infections of HPV occur each year.6 million
More than half of sexually-active young people are ___ infected.HPV
T/F - Over 33,000 men and women will develop HPV-related malignancy each year, with 12,000 of those being head and neck squamous cell carcinoma.T
T/F - 20% of head and neck SCC are caused by HPV and more than half of oro-pharyngeal SCCs.T
HPV-related HNSCC - Oropharynx _________%, Sinonasal _________%, Larynx 3%, Oral cavity <3%80, 30
Overall survival of patients with HPV- ______ (associated, negative) carcinoma is higher.associated
CD95 (Fas), FasL, APAF-1, and TP53 are all ...proapoptosis
Which proapoptosis gene is regulated by Bcl-2?APAF-1
Most cancers are caused by an accumulation of gene mutations, with an average of ___ mutations - in some cancers like breast and colon.90
Burkitt's lymphoma is caused by ___ ___ between 8 and 14.chromosome translocation
Familial RB, FAP, HNPCC, Neurofibromatosis 1 and 2, MEN 1 and 2 are all...inherited cancer syndromes (AUTOSOMAL DOMINANT)
Direct-acting agents are highly reactive _____.electrophiles (electron loving, DNA is very negative)
Indirect-acting agents require ___ conversion before they become active carcinogens.metabolic
Roentgen measures...exposure to X-rays
Roentgen can cancer
Name 3 cancers UV light can cause.basal cell carcinoma, SCC, melanoma
Watch dialers are exposed to ...radium
What virus causes hepatocellular carcinoma?Hep B
___ is associated with Burkitt lymphoma, nasopharyngeal carcinoma, and immunoblastic lymphoma.EBV
____ is associated with Kaposi sarcoma.HHV-8
____ is associated with leukemia.HTLV-1
T/F - Helicobacter pylori is associated with gastric carcinoma and lymphoma.T


Direct or Indirect Carcinogens
Question Answer
Alkylating agentdirect
Anticancer drugsdirect
cyclophosphamide, chlorambucil, nitrosoureasdirect
Acylating agentsdirect
Polycyclic hydrocarbonsindirect
Benzopyrene, Benzanthraceneindirect
Aromatic amines, amides, azo dyesindirect
2-Naphthylamine, Beta-naphthylamineindirect
Natural plant and microbial products - Aflatoxin B1, Grisofulavin, betel nutsindirect
Nitrosamines, amides, insecticides, fungicides, arsenic, asbestosindirect


Ionizing yes or no?
Question Answer
UV lightno (whoooooooooa girl say what?)
Gamma raysyes
Alpha rays. Beta rays.yes
Cosmic Rays.background radiation