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135 Cards in this Set
- Front
- Back
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Main difference between benign and malignant
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malignant can metastasize
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what is the most common benign tumor of women, and in which organ of a female?
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leiomyomas (fibroid, tumor of smooth muscle) and located in the uterus
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most common benign tumor of a male?
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lipoma
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benign tumor of glands
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adenoma
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Benign tumors are of what tissue origin?
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epithelial or CT origin
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this class of tumor is derived from ectoderm, endoderm and mesoderm?
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teratoma
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This class of cancer derives from squamous, glandular or transitional epithelium?
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Carcinoma
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This class of cancer is derived from connective tissue (mesenchymal tissue)?
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sarcoma - e.g. osteogenic sarcoma (cod-mans triangle and sunburst
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This structure is a non-neoplastic overgrowth of tissue.
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Hamartoma
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benign tumor of glands is called?
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adenoma
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If this tumor was making cortisol what it cause?
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Cushing syndrome and cause atrophy of the zona fasciculata (cortisol) and reticularis (sex hormones) because it would suppress ACTH
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IF a tumor of the adrenals releases mineralcorticoids what will it do the adrenal gland?
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conns syndrome-causes atrophy of zona glomerulosa
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most common precursor lesion of colon cancer?
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Tubular adenoma
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Benign and maligant version of the skin cancer
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Nevus and melanoma (of neural crest origin)
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Little girl presents w/ mass of the vagina and they took a biopsy, it was vimetin and kertain negative and desmin positive, DX
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briano rhabomyosarcoma (striated muslce cancer) - most common sarcoma of little children, presents in the penis of boys
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This is a cancer of smooth muscle what is it called?
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Leiomyosarcoma
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Cancer of fat?
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liposarcoma (malignant of mesechymal tissue)
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VHY***
Most common cancer of the parotid gland? |
Mixed tumors - neoplastic cells have two different morphologic patterns but dervie from the same germ cell layer***
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6 yr old girl of right lower quadrant pain, X-ray shows calcifications of the pelvic area,DX?
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teretoma - also called germ cell tumors
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ON EVERY BOARDS
picture of hypersegmented neutrophils, DX other is a picture of auer rod in a myeloblast? |
B12 and folate deficeincy
M3 - for leukemia |
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malignancy of stem cells of the bone marrow and can metastasize out of it, hepatosplenomegaly and lymph nodes an
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Leukemia
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These malignancy arise in the lymph nodes and metastasize out of it, they may go to the bone?
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Lymphoma
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what is the most common site of a lymphoma not developing in a lymph node (extranodal lympoma) what can produce them?
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Stomach
H. PYlORI can produce them |
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what is the 2nd most common place that lymphoma can arise if not from a typical lymph node?
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pyers patches in the terminal ileum
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Most common of the lymphoma, what is the translocation
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follicualr cell lympohoma
14;18 transolocation causes the B cells to inactivate the apoptotic gene |
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THIS IS ON EVERY EXAM
PICTURE that looks like a cluster of grapes. A patient history like this...preeclampsia (HTN, protein uria), snow storm effect on ultrasound, DX |
hydatidform mole (benign tumor of chorionic villi)
complete mole (most likley to become choriocarcinoma) |
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what are the layers that oxygen diffuses through in the chorionic villi to get to the fetal circulation?
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synscotrophoblast
cytotrophoblst...then wortens jelli in the chorionic villus then little vessel in the middle of the vessel theat becomes the umbilical vein meschymal tisssue vascular endothelium |
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which of layers of the placenta makes hormones, what are the important ones?
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SYNCIOTROPHOBLAST
beta-hCG, Human placental lactogen (growth hormone of pregnancy) |
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Choriocarcinoma, are mestastatic cancers of what tissue, where do they metastisize to and what is the best treatment?
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Synscotrophblast and cytotrophoblast
LUNG RESPOND VERY WELL TO CHEMO W/ almost 100% remission. |
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hyperplatic polyps and peutz-Heghers polyp are considered what type of tissue growth
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hamartomas
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CHoristoma (heterotopic rest) is a, meckels diverticulum is a common example
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non-neoplstic normal tissue in a foreign location
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Signs of malignancy
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atypical mitotic spindles and anueploid (abnormal number of chromosomes)
longer cell cycle than what they came from. |
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how many doulbling times does it take to detect a tumor clinically
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30X
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malignant celles characteristics
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lack adhesion, simple anerobic metabolism, lots of enzymes (proteazes and collagenase to break through tissue)
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Three modes of metastasis?
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hematogenous
seeding lymphatics |
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cacinomas first metastasize by what route?
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lymphatics frist
can also go by hematogenous spread |
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sarcomas spread by what route
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Hematogenous - thats why lung and bone so common.
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what is seeding?
what type of cancer frequently spreads by this route? |
when malignant cells exfoliate from a sruface and immplant and invade tissue in a body cavity
cancers that are in cavities (like ovarian cancers (cyst/serousadenocarcinoma), most are surface derived, so its easy for them to send out malignant seeds like to the omentum) |
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VHY***
what you feel on a Rectal in a women is analagous to what structure in men? why is this an important area in women? |
most dependent part of a women, were endometrial implants, blood pools and seeding goes from cancer
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Most common priamry maligancy of the brain, how does it spread?
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Glioblastoma multiforme commonly seeds the cerrebrospinal fluid...causing spread to the brain in
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when asking about cancer to an organ think is primary or metastasize most common to this area: lung, kidney, bone, batson system
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LUNG MC- mets from the breast
kidney - MC is a primary renal cell carcinoma Bone - MC is mets from the breast to the vertebral column |
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What is responsible for transporting malignancies to the vertebral column?
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Batson system (venous network)
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1st and 2nd most common bones to be effectd by malignancy?
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vertebral column
2nd - head of the femur |
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most common organ to lymphasize too?
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lymph node
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what is the most common cancer to metasatize to the liver?
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lung
2nd most common is colon |
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where does testicular cancer metastasize to?
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para-aortic lymph nodes-because they originate to there during development
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left supraclavicular node (virchow), most common primary caner?
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mets from the stomach (weight loss and epigstric distress)
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what cancer causes lytic bone lesions? why, what blood chemistry will be elevated?
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Multiple myeloma
all malignant plasma cells have IL-1, (osteoclast activating factor), Calcium from breaking down bone |
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what cancer causes bastic change to bone,what enzyme will be elevated?
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prostate cancer - alkaline phosphatase
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80 yr old man w/ lower lumbar pain and point tenderness, what is your frist step in managment?
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DRE - its the cheapest and the easiest
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what do you do to look for mets in spine?
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radionucleotide bone scan
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most common cancer of brain?
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mets from the lung
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most common cancer of the lung?
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mets from the breast is most common
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steps of oncogenesis
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1. Mutation
2. Make multiple copies, dividing 3. Progression/subspecialiation (different cancer cells have different functions all the purpose to kill you: invasion, spread, resistance...) |
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what are the two big sets of genes involved in cancer?
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1. Proto-oncogenes - involved in normal growth receptors, those that send messanges and repair
2. Suppressor genes (anti-oncogenes)-protect from unregulated cell grwoth 3. Anti-apoptosis genes (BCL2) 4.Apoptosis (BAX gene) |
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In which way are RAS and TP53 mutated?
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point mutations
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what are the differnt types of mutations
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translocation
amplification point mutations |
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**ON EVER BOARD**
acute progranulocytic lukemia occured as a result of what type of mutation in its genes. What is the treatment for this cancer? |
t(15;17)
retinoic acid - causes the blasts to mature |
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B cell lymphoma involves what type of mutation
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t(14;18)
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the cancer chronic myelogenous leukemia, involves what type of proto-oncogene and mutation?
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ABL proto-oncogene w/ a mutation being a traslocation of 9;22 the chromosome is 22 the philadelphia chromosome
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what is the oncogenesis of brukitts lymphoma?
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8; 14 translocation of the proto-oncogene MYC
Has a strong correlation w/ Epstein Barr-virus - it hooks into CD21 receptor and causes bell cells to become plasma cells (multiple division result in a mutation) |
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what is the important anti-oncogenes (suppresor genes) that when mutated causes leukemia, lung, colon and pancreatic cancer?
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RAS - when it has a point mutation it no longer protects against un-regulated growth
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what is the antioncogene associated w/ familial polyposis (colorectal cancer)?
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APC
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what is the anti-oncogene associated w/ breast, ovary, and prostate cancers?
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BRCA1/BRCA2 (two is only associated w/ breast cancer)
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what is the anti-oncogene associated w/ wilms tumor
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WT1
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what is the role of TP53
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it inhibits G1 to S phase so that DNA can be repaired
if the DNA is damaged to bad then it activates BAX an apoptotic gene |
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Lung, colon, breast carcinomas, Li-Fraumeni syndrome (breast, brain, leukemias and sarcomas) are associated w/ this anti-oncogene?
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TP53
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Treating H. pylori reduces the risk of developing what two types of cancer?
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adenocarcinoma and lymphoma
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what is the most common type of mutation in cancer?
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point mutation
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what are teh carcinogenic agents and which is the most common?
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Chemical carcinogens (MC)
Microbes (viruses) Radiation |
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what is the most important way to decrease your risk of cancer
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stop smoking
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Cancers caused by smoking
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mouth, larynx, lungs, pancreas, bladder, colon, leukemias, and cervical...
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most common casuse of transitional cell carcinoma of the bladder?
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smoking
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patient working in the dye industry develops transitional cell carcinoma of the bladder what is the cause?
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Aniline dye
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VHY***
Patient is being treated for wegeners granulomatosis and they develop hematuria, on cytology you see abnormal cells what is the cause? |
cyclophosphamide - the drug that is being used to treat the wegeners
use mesna to prevent hemorrhagic cystitis |
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what are the lung cancer that are most most often associated w/ smoking and the mains stem bronchus?
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small cell and SCC
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non pruritic raised lesions what is cancer and the virus associated w/ this?
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kaposis sarcoma - herpes 8
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epstein barr virus is associated w/ what cancer in the chineese population?
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nasopharangeal carcinoma
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common cancer of southeast asia?
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hepatocellular carcinoma - aflatoxin B and cirrhosis are the cause
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The primary increase in primary CNS lymphoma is attributable to?
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HIV
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Human papilloma virus causes what 4 cancers
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Cervical, vaginal, vulvar and anal SCC of homosexulas...16 and 17 knock of TP53 (E6) and retinoblastoma (E7)
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most common cancer associated w/ radiation (ionizing radiation)
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leukemia-chronic myelogenous leukemia (MC)
t(9;22) ABL |
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patient had prior radiation, and presents w/ non-tender nodule in the neck is what DX?
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Papillary thryoid cancer
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which medical profession is most likley to get acute leukemia
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radioligist
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what is the most common caner associated w/ UV light?
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basal cell carcinoma from non-ionizing UVB radiation
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what heavy metal is associated w/ arsenic?
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skin cancer
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retinoblastoma cancer is found on what chromosome?
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chromosome 13 - RAS
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most common cause of white eye reflex?
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congenital cataracts
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This patient is pre-disposed to all types of skin cancer when they go out in the sun, DX? what is the problem they have?
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xeroderma pigmentosa- defect in repair enzymes
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wiscott aldrich, ataxia telangiectasias, and fanconis syndrome all have what as there underlying problem?
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defects in repairing DNA
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cancers of the upper lip vs the lower lip are usually? (GENERAL RULE)
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upper - basal cell carcinoma
lower - SCC |
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what is the only bacteria that can cause cancer? what are the two cancers it can cause
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H. Pylori
adenocarcinoma and low grade malignant lymphoma |
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what is the most common cause of death in cancer?
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Gram-negative sepsis
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what is the most common paraneoplastic syndrome (distant effects of a cancer that are unreleated to metastsis)?
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HYpercalcemia
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VHY***
what is the most effective host defense against cancer? |
Cytotoxic CD8 T cells
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what does grade mean?
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degree of differentiation (what it looks like)
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Staging system TNM system (goes from least to most important)
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T-size (how big it is)>2cm has a chance for metastazing
N-nodes M-metastasize (most important) |
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What is the more important in prognosis, the grade or the stage?
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STAGE
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patient had prostate cancer which has the worse prognosis, someone w/ mets to the lymph nodes, cancer spread to the seminal vesicles or someone w/ spread to the bone?
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BONE - remeber M is the worst of all
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what is the cause of cachexia?
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tumor necrosis factor alpha, it is irrevesible and TP
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most common anemia in cancer
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anemia of chronic disease
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VHY***
patient has painless jaundice, left supraclavicular node, light colored stools and peculiar lesions in the vein that jump from one part of the body to another, DX? (trouseas sign) |
superficial migratory thrombophlebitis of patient w/ pancreatic cancer of the head of the pancreas.
NOTE: most disseminanted cancers produce a hypercoagulable state |
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most common cuase of a fever in cancer patient?
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gram negative infection, most common cause of death in cancer patients
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Patient has mets to the bone causing lysis of bone and hypercalcemia. Another patient has lung cancer or renal cell cancer that produces Parathyroid like hormone and causes hypercalcemia which scernaria is a paraneoplastic syndrome?
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PTH-like hormone
The idea is to recognize theses so that you can prevent spread |
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Acanthosis nigracans and
seborrheic keratosis (leser-Trelat sign) that pops up over night is a sign for what? |
paraneoplastic marker for underlying gastric adenocarcinoma
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Hypertrophic osteoarthropathy (clubbing) is associated w/ what cancer?
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Bronchogenic carcinoma
results from periosteal reasction of distal phalynx |
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dermatomyositis high serum CK
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luekemias,
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Nonbacterial thrombotic endocarditis (sterile vegitations on the mitral valve) is associated w/ what cancer?
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Mucus-secreting pancreastic and coloretal cancers
They can embolize Tell the difference from rheumatic fever based on history |
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patient has myasthenia gravis-like symptoms (muscle weakness), what cancer is this associated w/?
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Small cell carcinoma of the lung (Eaton lambert syndrome)
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What is the associated cancer w/ the follwoing findings:
Ectopic ACTH/cushing syndrome or ADH (hyponatremia) |
small cell carcinoma of the lung
neural crest origin, see neural secretory granules on EM. |
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What is the associated cancer w/ the follwoing findings:
PTH-related protein/hypercalcemia or erythropoeitin |
Renal adenocarcinoma
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What is the associated cancer w/ the follwoing findings:
erythopoeitin or insulin-like factor (hypoglycemia)? |
Hepatocellular carcinoma
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What is the associated cancer w/ the follwoing findings:
Hypocalcemia or cushings, rare tumor where the tumor marker can be converted to amyloid? |
medullary carcinoma of the thyroid
calcitonin can be converted to amyloid |
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What two tumor markers do you always get when a male has a testicular cancer?
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alpha feta protein (AFP) - yolk sac tumor/endodermal sinus tumor
hCG |
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AFP is also elevated in what other syndromes
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hepatocellular and open nueral tube defects
AFP is decreased in down syndrome |
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when do you see bence Jones proteins? what is it?
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Multiple myeloma or Waldenstroms macroglubulinemia
Represents light chains in the urine |
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PSA is elevated in what cancer
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not specific for prostate cancer (because also elevated in hyperplasia) but it is sensetive
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CA 125 is elevated in what cancer?
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surface derived ovarian cancer
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CA 15-3 is elevated in what cancer?
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Breast cancer
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CEA (carcinoma embryonal antigen) is elevated in what cancer
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colon cancer
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CEA can be the antigen part of immune complex that deposits in the kideny, what does it cause?
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diffuse membranous glomerulonephritis (nephrotic syndrome)
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women who you think has a mole or trophoblastic tumor what lab would you check for?
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beta-hcG
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most common primary tumor of the brain in kids?
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cerebellar cystic astrocytoma
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most common primary cancer of the brain?
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medulloblastoma - arises from the cerebellum
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Most common childhood cancer
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leukemia - ALL
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Incidenc of women cancer?
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1. breast
2. lung 3. colon |
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Incidence of men cancer?
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1.prostate
2.lung 3.colon |
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Most common cancer killer in adults
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Lung
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Most common cancer killer of women
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1. lung
2. breast 3. colon |
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Most common cancer killer of men
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1. lung
2. prostate 3. colon |
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2nd most common cancer overall and cancer killer in men and women when you add them together?
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colon
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most common cause of positive guiac stool after 50?
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colon cancer
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most common gyn cancer
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1. endometrial
2. ovarian 3. cervix (least common because of pap smear) |
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most common cancer killers of women
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ovarian
cervix endometrial |
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VHY****
only tumor vaccine? |
hepatitis B - commonly transmitted by accidental needle stick
protected from Hep D because needs B to infect you hepatocellular carcinoma dosne't develop because of this vaccine because you don't get Hep B. |
