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Pathology
FA12 with erratta corrections 244-256
73
Biology
Graduate
02/11/2013

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Cards

Term
Which of the following is NOT true of Apoptosis

1) ATP required
2) Involve caspase activation
3) Significant inflammation
4) Cell shrinkage, with nuclear shrinkage
5) Nuclear fragmentation
Definition
3- Necrosis generates inflammation

Apoptosis has 2 paths, both of which require ATP and end in caspase activation.

Signs of apoptosis include nuclear shrinkage and basophilia (Pyknosis) and nuclear fragmentation (Karyohexis), and well as nuclear fading (Karyolysis) and formation of aptoptotic bodies
Term
Describe the intrinsic pathway of apoptosis. When is it active?
Definition
ATP-mediated programmed cell death with nuclear shrinkage, fragmentation and fading, but no inflammation.

Intrinsic occurs during embryogenesis, hormone induction (menstruation), atrophy (endometrial lining during menopause) and toxic injury (radiation, toxins, hypoxia)

1) Pro-apoptotic factors (Bax) increase and anti-apoptotic factors (Bcl-2) decrease in response to p53, leading to increased mitochondrial permeability and cytochrome C release.

2) Released Cytochrome C activates caspases, leading to cellular breakdown
Term
Describe the extrinsic pathway of apoptosis. When is it active?
Definition
Extrinsic pathway has 2 pathways

1) Ligand receptor interactions (Fas ligand binds CD95 in membrane, leading to caspase activation

- activates caspase 8, which activates caspase 3,6 and 7, and ultimately 9.

2) Immune cell-mediated
- CD8 T cells release perforin and granzyme B, which poke holes in the membrane and induced apoptosis
Term
What type of necrosis occurs in each of the following organ systems?

1) Heart
2) Systemic fungi
3) Pancreas
4) Kidney
5) Blood vessels
Definition
1) Coagulative (kidney and liver)
2) Caseous (TB and systemic fungi)
3) Fatty (saponification)
4) Coagulative (liver and heart)
5) Fibrinoid
Term
Necrosis involves inflammation from enzymatic degradation and protein denaturation of a cell resulting from exogenous injury and leading to extravasation of intracellular components.

Which tissues suffer each of the following types of necrosis?

1) Coagulative
2) Liquefactive
3) Caseous
4) Fatty
5) Fibrinoid
6) Gangrenous
Definition
1) Heart, liver, kidney (solid organs)

2) Brain, bacterial abscess and pleural effusion

3) TB and systemic fungus

4) Pancreas (saponification)

5) Blood vessels

6) Dry (ischemic coagulative) or Wet (bacteria); common in limbs and GI tract
Term
Somtimes cellular injury due to hypoxia can be reversible. Which of the following characteristics of cell injury is NOT reversible with O2?

1) Cellular swelling
2) Caspase activation
3) Low glycogen stores
4) Fatty change
5) Ribisomal detachment
Definition
2- This means apoptosis is activated.

Decreased ATP leads to impaired Na/K pump activity, producing cellular swelling and low glycogen levels (all of which are reversible). Without ATP, ribosomes can detach and fatty change can take place.

Once you see nuclear changes (karyohexis, lysis and pyknosis), it is IRREVERSIBLE.
Term
What areas of each of the following organs are most vulnerable to hypoxia?

1) Heart
2) Kidney
3) Liver
4) CNS
Definition
Neurons and Watershed areas (Splenic flexure, ACA/MCA) are very susceptible

1) Sub-endocardial tissue

2) Proximal tubule (cortex) and thick ascending limb (medulla)

3) Central vein

4) Neurons
Term
What is the difference between a "red" and a "pale" infarct?
Definition
1) Red (hemorrhagic) infarcts occur in loose tissues with collateral
- liver, lungs, intestine, or following re-perfusion (free radical damage).

2) Pale infarcts occur in solid tissues with single blood supplies
- Heart, Kidney and Spleen
Term
What types of heart failure occur in hypovolemic/cardiogenic vs. septic shock?

What are the other differences between the two?
Definition
1) Hypovolemic/Cardiogenic (Cold and Clammy)
- Low output failure
- Increased TPR, low CO

2) Septic (Hot)
- High output failure
- Low TPR with dilated arterioles and high venous return
Term
Which of the following is NOT a cause of cellular atrophy? Of those that are, provide an example of each.

1) Low hormones
2) Low innervation
3) Low BF
4) Low nutrients
5) Low pressure
6) Duct occlusion
Definition
5- HIGH pressure (nephrolithiasis) would cause atrophy.

1) Uterus/Vagina
2) Motor neuron damage
3) Ischemia
4) Kwashiorker
6) CF
Term
What is responsible for each of the following features of inflammation?

1) Rubor
2) Dolor
3) Calor
4) Tumor
5) Functio laesa
Definition
Starts with endothelial injury, progresses to fluid exudation and fibrosis and is then resolved.

1) Redness- Histamine from mast cells produces arteriole vasodilation

2) Pain- Bradykinin system (F XI/XII intrinsic pathway-mediated)

3) Heat- Histamine from mast cells produces arteriole vasodilation

4) Fluid- Histamine from mast cells produces increased venule permeability

5) Loss of function from the above 4
Term
Following endothelial injury, tissue can respond in a number of ways.

What do each of the following mean?

1) Granulation tissue
2) Abscess
3) Fistula
4) Scar
Definition
1) Highly vascularized , fibrotic (Collagen III) tissue that is laid down under site of injury to restore tissue structure.

2) Fibrosis surrounding pus (Staph and Pseudo)

3) Abnormal communication

4) Collagen deposition resulting in altered structure and function
Term
What are the major cell types involved in acute vs. chronic inflammation?
Definition
1) Acute
- PMNs (bacterial), Eosinophils (hypersensitivity 1) and Antibodies

- Rapid and lasts minutes to days

2) Chronic
- Mononuclear cell mediated: persistent destruction and repair

- Blood vessel proliferation and fibrosis, with granuloma formation (dead multi-nucleated giant cells)
Term
What are the 4 major steps of leukocyte extravasation during an acute inflammatory response?

What molecules (cell and vasculature) mediate each step?
Definition
1) Rolling
- Vessel (E-selectin, P-selectin)
- Leukocyte (Sialyl Lewis)

2) Tight binding
- Vessel (ICAM-1)
- Leukocyte (LFA-1- integrin)

3) Diapedesis
- Vessel (PECAM-1)
- Leukocyte (PECAM-1)

4) Migration
- Bacterial products (C5a, IL-8, LTB4, Kallikrien)

5) Phagocytosis
Term
Which of the following molecules does NOT mediate neutrophil migration during acute inflammation?

1) PECAM-1
2) C5a
3) IL-8
4) LTB4
5) Kallikrein
Definition
1) This molecule is expressed on leukocytes and vasculature for Diapedesis

CILK is for migration
Term
How can free radicals be eliminated?
Definition
1) Enzymes
- SOD, Catalase (bacteria), Glutathione peroxidase

2) Antioxidants (A, C, E)
Term
What major pathologies are mediated by free radical damage?
Definition
1) Retinopathy of prematurity
2) Bronchopulmonary displasia
3) CCl4 leading to liver necrosis
4) Acetaminoophen
5) Iron overload
6) Re-perfusion after anoxia (O2-), especially after thrombolytic therapy
Term
Wound healing has Inflammatory, proliferative and remodeling stages.

What are the primary mediators and timeframes of each stage?
Definition
1) Inflammatory (immediate): Clot formation (platelet), increased vessel permeability (histamine) and PMN migration. Macrophages clear debris 2 days later

2) Proliferative (2-3 days later): Deposition of granulation tissue and collagen (fibroblasts), angiogenesis (endothelial cells), epithelial proliferation (keritinocytes) and clot dissolution, with wound contraction (myofibroblasts)

3) Remodeling (1 week after wound)
- Fibroblasts replace type III collagen with type I collagen, increasing tensile strength of tissue.
Term
Which of the following does NOT cause granulomatous disease?

1) M. leprae
2) Bartonella henselae (Cat scratch)
3) Staph aureus
4) Histoplasmosis
5) Treponema pallidum
6) Berylliosis (chronic lung disease in response to berilleum exposure)
Definition
3- Coagulase +, catalase + gram positive cocci

Th1 cells secrete IFN-y, activating macrophages, which produce TNF-a and induce granuloma formation.

**giving Inflixumab might break up granuloma and cause disseminated disease**
Term
What bacteria are known to produce granulomatous infections?
Definition
IFN from Th1 cells activates macrophages to produce TNF-a and macrophage-inhibitory factor, leading to granuloma formation/maintenence.

1) B. hensliae (cat scratch)
2) T. pallidum (syphilus)
3) TB and M. leprae

**also fungal infections (histo), toxins (beryllium), CD and Sarcoid**
Term
What is the difference between a Transudate and an Exudate?
Definition
1) Transudate (hydrostatic pressure or decreased oncotic pressure, as well as Na+ retention)

- Hypocellular and Protein poor (SG <1.012)

2) Exudate (Lymphatic obstruction +/- inflammation)

- Cellular and protein rich (SG > 1.020)
Term
What is the basis for the ESR and what are causes of increased/decreased ESR?
Definition
Products of inflammation (fibrinogen and IgM) coat RBCs and cause aggregation, causing a faster rate of RBC falling in spinning tube.

1) Increased
- Infection
- Inflammation (temporal arteritis)
- Cancer
- Pregnancy
- SLE

2) Decreased
- Sickle cell (altered shape)
- Polycythemia (too many)
- CHF (unknown)
Term
Iron poisoning is a leading cause of toxicologic fatalities in children.

What is the mechanism of this and what are the acute/chronic symptoms?
Definition
1) Mechanism
- Peroxidation or lipid membranes (ROS) with cell death

2) Acute- gastric bleeding
Chronic- Metabolic acidosis and scarring with GI obstruction
Term
There are multiple forms of protein in amyloidosiss. What disease is associated with each of the following and where is it derived from?

1) AL
2) AA
3) Transthyretin
4) Amylin
5) A-CAL
6) Beta amyloid
7) B2-microglobulin
Definition
1) Bence Jones derived from Ig light chains in multiple myeloma

2) Secondary amyloidosis derived from serum amyloid-associated (SAA) protein in chronic inflammatory disease

3) Senile cardiac amyloidosis derived from AF (old fogies)

4) DM-2, derived from AE (E= endocrine)

5) A-CAL in medullary carcinoma of thyroid, derived from Calcitonin

6) Alzheimer's derived from APP

7) Dialysis-associated, derived from MHC class 1 proteins.
Term
Which of the following is NOT associated with forms of amyloidosis?

1) Medullary thyroid cancer
2) Multiple myeloma
3) Type 1 diabetes mellitus
4) Senile heart disease
5) Dialysis
6) Chronic inflammatory conditions
Definition
3- Amylin (derived from AE) is associated with Type II DM

1) A-CAL (derived from calcitonin) in MEN 2A/2B
2) AL (light chain derived)
4) Transthyretin (AF derived)
5) B2 microglobulin (MHC-1 derived)
6) Secondary (derived from AA)
Term
What are the 5 stages of neoplastic progression?
Definition
1) Normal- Epithelial cell layer and basement membrane (apical-basal differentiation)

2) Hyperplasia- Increased number
- When they lose size/shape/orientation, they become "dysplastic

3) Carcinoma in situ- Neoplastic cells that have not invaded BM (high N:C ratio and clumped chromatin)

4) Invasive carcinoma- Cells invaded BM using collagenase and hydrolase (MMP)

5) Metastasis
- Spread to distant organ
Term
Which neoplastic stages are reversible, and which are irreversible?
Definition
1) Reversible
- Hyperplasia
- Metaplasia
- Dysplasia

2) Irreversible
- Anaplasia (abnormal cells lacking differentiation- little resemblance to normal tissue)

- Neoplasia (clonal proliferation of cells that is uncontrolled and excessive)

- Desmoplasia (fibrous tissue formation in response to neoplasia)
Term
What is the difference between a tumor "stage" and a "grade"?
Definition
1) TMN Stage is more prognostic and indicates Spread

- localization/spread based on site and size of primary lesion, spread to regional lymph nodes, presence of metastasis

2) Grade based on cellular differentiation based upon histological appearance of individual tumor.

- 1-4 based on differentiation and number of mitoses per high-power field
Term
Which neoplastic stages are reversible, and which are irreversible?
Definition
1) Reversible
- Hyperplasia
- Metaplasia
- Dysplasia

2) Irreversible
- Anaplasia (abnormal cells lacking differentiation- little resemblance to normal tissue)

- Neoplasia (clonal proliferation of cells that is uncontrolled and excessive)

- Desmoplasia (fibrous tissue formation in response to neoplasia)
Term
What is a benign tumor called in each of the following locations?

1) Blood vessels
2) Smooth muscle
3) Skeletal muscle
4) Connective tissue
5) Bone
6) Fat
7) > 1 cell type
Definition
Adenomas and Papillomas are benign

1) Hemangioma
2) Leiomyoma
3) Rhabdomyoma
4) Fibroma
5) Osteoma
6) Lipoma
7) Mature teratoma (women)
Term
What is a malignant tumor called in each of the following locations?

1) Blood vessels
2) Smooth muscle
3) Skeletal muscle
4) Connective tissue
5) Bone
6) Fat
7) > 1 cell type
8) Blood cells
Definition
Adenocarcinomas and Papillary carcinomas

1) Angiosarcoma
2) Leiomyosarcoma
3) Rhabdomyosarcoma
4) Fibrosarcoma
5) Osteosarcoma
6) Liposarcoma
7) Immature teratoma and mature teratoma (Men)
8) Leukemia, lymphoma
Term
What is the difference between a "sarcoma" and a "carcinoma"?
Definition
Carcinoma= epithelial origin (adenocarcinoma)

Sarcoma= Mesenchymal origin (osteosarcoma)
Term
What is cachexia and what are the primary factors involved?
Definition
Loss of weight, muscle atrophy and fatigue in chronic disease (AIDS, cancer, TB and heart failure)

1) TNF-a (cachectin)
2) IFN-y
3) IL-6
Term
A wide variety of diseases are associated with particular forms of neoplasms.

For each of the following, provide the associated neoplasm.

1) Down syndrome
2) Xeroderma pigmentosium
3) Actinic keratosis
4) Barrett's esophagus (chronic GI reflux)
5) Plummer-vinson syndrome
Definition
1) Trisomy 21
- ALL (we ALL fall DOWN), AML

2) AR genetic disorder of DNA repair where ability to repair damage caused by ultraviolet (UV) light is deficient - basal cell carcinoma and especially Squamous cell carcinoma of skin

3) Thick, scaly, or crusty patches of skin
- Squamous cell cancer of skin

4) esophageal adenocarcinoma in distal esophagus

5) Iron deficiency: anemia, esophageal webs and atrophic glossitis
- Squamous cancer of esophagus (middle 1/3)
Term
A wide variety of diseases are associated with particular forms of neoplasms.

For each of the following, provide the associated neoplasm.

1) Paget's disease on bone
2) Autoimmune disease (Hashimoto's and Myasthenia gravis)
3) Dysplatic nevus
4) Radiation exposure
5) Acanthosis nigricans
Definition
1) Localized, excessive breakdown (osteoclast) and formation (osteoblast) of bone
- Secondary osteosarcoma and fibrosarcoma

2) Lymphoma

3) Large, with irregular borders and color variation
- Malignant melanoma

4) Sarcoma, papillary thyroid cancer, breast and leukemia

5) Hyper-pigmentation and epidermal thickening
- Visceral malignancies (stomach, lung and uterus)
Term
A wide variety of diseases are associated with particular forms of neoplasms.

What neoplasms are associated with each of the following?

1) AIDS
2) Immunodeficiency
3) Tuberous sclerosis
4) Ulcerative colitis
5) Cirrhosis
6) Pernicious anemia
Definition
1) Aggressive malignant lymphomas (non-hodgkins) and Kaposis (HHV-8)

2) Malignant lymphoma

3) Facial angiofibromas, seizures and mental retardation
- Astrocytoma, angiomyolipoma, cardiac rhabdomyoma

4) Autoimmune, continuous small bowel disease including rectum.
- Colonic adenocarcinoma (CD is not cancer risk)

5) HCC

6) Gastric adenocarcinoma (also from chronic atrophic gastritis and post-surgical gastric remnants)
Term
A wide variety of diseases are associated with particular forms of neoplasms.

Which condition(s) is/are associated with the following neoplasms?

1) ALL

2) Astrocytoma and cardiac rhabdomyoma

3) Visceral malignancies (stomach, lung and uterus)

4) Papillary thyroid cancer

5) Squamous cell carcinoma of Esophagus

6) Squamous cell carcinoma of skin
Definition
1) Down's syndrome (also AML)

2) Tuberous sclerosis (Also angiomyolipoma)
- Facial angiofibromas, seizures and mental retardation)

3) Acanthosis nigricans
- Black/brown skin discoloration patches

4) Radiation exposures (also sarcomas, breast cancer and leukemias)

5) Plummer-vinson syndrome (vs. Barret's for adenocarcinoma)
- Iron deficiency: esophageal webs, atrophic glossitis and anemia

6) Xeroderma pigmentosium (DNA repair), Albinism, Actinic Keratosis
Term
What are the primary etiologies of gastric adenocarcinoma?
Definition
1) Chronic atrophic gastritis
2) Pernicious anemia
3) Post-surgical adhesions in the stomach
Term
Which syndrome commonly presents with cardiac rhabdomyomas, astrocytomas and angiomyolipomas?
Definition
Tuberous Sclerosis: With seizures, mental retardation and facial angiofibromas
Term
Which cancers are associated with the following skin lesions?

1) Dysplastic nevus
2) Acanthosis nigricans
3) Albinism
4) Xeroderma pigmentosum
5) Actinic keratosis
Definition
1) Malignant melanoma
2) Visceral malignancy (lung, stomach, uterus)
3) Squamous (**), Basal cell and Melanoma
4) Squamous (**), Basal cell and Melanoma
5) Squamous cell carcinoma of skin
Term
Numerous gain of function mutations in particular genes can cause cancers.

Some of these only need damage to 1 allele?

What type of genes are these (what do they code for) and what cancer is associated with each of the following?

1) abl
2) c-myc
3) bcl-2
4) erb-B2
5) RAS
Definition
Oncogenes

1) Tyrosine kinase: CML (use Imitinab)
2) Transcription factor: Burkitt's lymphoma t(8:14)
3) Anti-apotosis: Follicular lymphoma t(14;18)
4) Tyrosine kinase: Breast, ovarian and gastric
5) GTPase: Colon carcinoma
Term
Numerous gain of function mutations in particular genes can cause cancers.

Some of these only need damage to 1 allele?

What type of genes are these (what do they code for) and what cancer is associated with each of the following?

1) L-myc
2) N-myc
3) ret
4) c-kit
5) abl
Definition
1) Transcription factor: Lung tumor
2) Transcription factor: Neuroblastoma
3) Tyrosine kinase: MEN2A/2B
- MEN2A (pheo, hyperaldosteronism, medullary thyroid cancer)
- MEN2B (pheo, medullary thyroid cancer, neuroma)

4) Cytokine receptor: GI stromal tumor (GIST)

5) Tyrosine kinase: CML
Term
Rapid Review: Name that oncogene.

1) CML
2) Burkitt's lymphoma
3) Follicular and undifferentiated lymphomas
4) Breast, ovarian and gastric cancer
5) Colon cancer
6) Lung tumor
7) Neuroblastoma
8) MEN2A/2B
9) GI stromal tumor (GIST)
Definition
1) abl: Tyrosine kinase
2) c-MYC: transcription factor
3) bcl-2: anti-apoptosis gene
4) erb-B2: tyrosine kinase
5) RAS: GTPase
6) L-MYC: transcription factor
7) N-MYC: transcription factor
8) RET: tyrosine kinase
9) c-kit: cytokine receptor
Term
MYC is an oncogene that had a number of forms and cancer associations. What are they?
Definition
1) C-MYC- Burkitt's lymphoma
2) L-MYC- Lung tumor
3) N-MYC- Neuroblastoma
Term
Numerous loss of function mutations in particular genes can cause cancers.

Which cancer is associated with each of the following?

1) Rb
2) p53
3) BRCA1
4) BRCA2
5) p16
Definition
Tumor suppressor genes require loss of BOTH alleles

1) Retinoblastoma, osteosarcoma
- blocks G1-S transition

2) Most human cancers, Li-Fraumeni syndrome
- Blocks G1-S transition

3) Breast and ovarian cancer: DNA repair problem

4) Breast cancer: DNA repair problem

5) Melanoma
Term
What is Li-Fraumeni syndrome? What is the associated gene?
Definition
Extremely rare AD syndrome associated with germline mutations in p53, which is responsble for blocking the G1:S transition in the cell cycle.

Also called "Sarcoma, breast, leukaemia and adrenal gland (SBLA) syndrome"
Term
Numerous loss of function mutations in particular genes can cause cancers.

Which cancer is associated with each of the following?

1) APC
2) WT1
3) NF1
4) NF2
5) DPC
6) DCC
Definition
Tumor suppressor genes don't get cancer unless BOTH alleles are lost.

1) FAP colorectal cancer (chromosomal instability pathway with beta catenin signalling)

2) Wilm's tumor (pediatric kidney): gene involved in early gonadal development to produce bi-potential stage.

3) Neurofibroma, Aggressiveness, Cafe-au-lait, Optic glioma

4) Bilateral Acoustic neuromas

5) Pancreatic cancer

6) Colon cancer
Term
Which tumor suppressor genes block the cell cycle transition between G1:S1? What cancers are associated with loss of expression of both alleles?
Definition
1) Rb- Retinoblastoma- Osteosarcoma

2) p53- All human cancers and Li-Fraumeni (Sarcoma, Breast, Leukemia, Adrenal)
Term
Many tumor markers can help in diagnosis and prognostic determination in cancer.

How are each of the following used?

1) PSA
2) Prostatic acid phosphatase
3) CEA
4) AFP
5) b-hCG
Definition
Useful to confirm diagnosis, monitor recurrence and monitor response to therapy (NOT primary diagnostic tool)

1) Prostate carcinoma screening (level at diagnosis is prognostic, along with stage and Gleason grade)
- Also elevated in BPH and prostatitis

2) Prostate carcinoma

3) Carcinoembryonic antigen
- Very non-specific, but produced by 70% of colorectal and pancreatic cancers, as well as gastric, breast and thyroid medullary carcinomas.

4) Non-seminomatous germ cell tumors (Yolk Sac) or HCC

5) Hyatidiform moles, Choriocarcinomas and Gestational trophoblastic tumors (HCG)
Term
True or False:

Tumor markers are a useful primary tool for cancer diagnosis due to their cost effectiveness and sensitivity
Definition
False!

Used to confirm, predict recurrence and measure response to therapy (NOT primary)
Term
Many tumor markers can help in diagnosis and prognostic determination in cancer.

How are each of the following used?

1) CA-125
2) S-100
3) Alkaline phosphatase
4) Bombesin
5) TRAP
6) CA-19-9
7) Calcitonin
Definition
1) Ovarian, malignant epithelial tumors (superficial tumors)
2) Melanoma, Neural tumors, Schwanommas
3) Metastasis to bone, obstructive biliary diseases, Paget's
4) Neuroblastoma (Rb), lung (L-MYC) and gastric cancer
5) Hairy cell leukemia
6) Pancreatic adenocarcinoma
7) Thyroid medullary carcinoma (MEN 2A/2B)
Term
What tumors can be indicated by a CEA antigen?
Definition
Sensitive but NOT specific

1) Best for Colorectal and Pancreas (can also look at CA-19-9)

2) Can also be gastric, breast (BRCA or p53) and thyroid medullary (look at Calcitonin)
Term
There are many oncogenic microbes.

What cancer is associated with each of the following?

1) HTLV-1
2) HBV
3) HCV
4) EBV
5) HPV
Definition
1) Adult T-cell leukemia/lymphoma
2) HCC
3) HCC
4) Burkitt's lymphoma, Hodgkin's lymphoma, Nasopharyngeal carcinoma
5) 16 and 18 with Cervical. Penile and anal cancer (squamous)
Term
There are many oncogenic microbes.

What cancer is associated with each of the following?

1) HHV-8
2) HIV
3) H. pylori
4) Schistosoma haematobium
5) HBV
Definition
1) Kaposi's sarcoma, body cavity fluid B-cell lymphoma

2) Primary CNS lymphoma

3) Gastric adenocarcinoma and MALT lymphoma

4) Bladder cancer (squamous cell cancer of transitional cell epithelium)

5) HCC
Term
Rapid Review. Name that associated microbe

1) Squamous cell bladder cancer
2) HCC
3) Adult T-cell leukemia
4) Cervical carcinoma
5) Penile cancer
6) Body cavity fluid B-cell lymphoma
7) Primary CNS lymphoma
8) Nasopharyngeal carcinoma
9) Gastric adenocarcinoma
10) Hodgkin's lymphoma
Definition
1) Schistosoma haematobium
2) HBV and HCV
3) HTLV-1
4) HPV 16, 18
5) HPV
6) HHV-8 (also Kaposi's sarcoma)
7) AIDS
8) EBV (also Hodgkin's and Burkitt's)
9) H. pylori (also lymphoma)
10) EBV
Term
A number of chemicals are known to cause cancer.

What cancer is a worry with each of the following?

1) Aflatoxin from Aspergillus
2) Vinyl chloride
3) CCL4
4) Nitrosamine (smoked foods)
5) Cigarette smoke
Definition
1) HCC in the liver
2) Angiosarcoma in the liver
3) Centrilobular necrosis and fatty change of the liver
4) Gastric cancer
5) Squamous cell carcinoma and small cell carcinoma of lung and Squamous cell carcinoma of larynx
Term
A number of chemicals are known to cause cancer.

What cancer is a worry with each of the following?

1) Asbestos
2) Arsenic
3) Napthalene (aniline) dye
4) Alkylating agents
5) Cigarette smoke
Definition
1) Mesothelioma and bronchogenic carcinoma of lung

2) Squamous cell skin cancer and Angiosarcoma of liver (like Vinyl chloride)

3) Transitional cell bladder cancer (vs. Schisto for squamous)

4) Leukemia of blood

5) Small cell and Squamous cell in lung
Squamous cell in larynx
Term
What are the common causes of transitional cell carcinoma of the bladder? What about squamous cell?
Definition
1) Transition cell= Napthalene (analine) dyes
2) Squamous= Schistosoma haematobium
Term
What are the causes of Angiosarcoma of the liver?
Definition
Vinyl chloride and Arsenic (also causes squamous cell skin)

HBV, HCV and Aflatoxins cause HCC

CCl4 causes centrilobular necrosis and fatty change
Term
How do each of the following affect the liver?

1) CCL4
2) Vinyl Chloride
3) Arsenic
4) HBV
5) Aflatoxin (aspergilliosis)
Definition
1) Centrilobular necrosis and fatty change
2) Angiosarcoma
3) Angiosarcoma
4) HCC
5) HCC
Term
What neoplasms are associated with the following conditions

1) ACTH or ACTH-like peptide production

2) Hyper-ADH

3) PTH-related peptide, TGF-b, TNF and IL-1

4) Ectopic EPO causing polycythemia

5) Lambert Eaton syndrome (muscle weakness)

6) Gout and urate nephropathy
Definition
1) Cushing's
- Small cell lung carcinoma

2) SIADH
- Small cell lung carcinoma and intracranial neoplasm

3) Hypercalcemia
- Squamous cell lung cancer, Breast cancer and Renal cell carcinoma

4) Renal cell carcinoma, hemangioblastoma, HCC, pheocromocytoma

5) Antibodies against presynpatic Ca2+ channels at neuromuscular junction
- Thymoma, small cell lung cancer

6) Leukemia and lymphoma (due to cytotoxic therapy)
Term
What paraneoplastic effects are associated with small cell lung cancers?
Definition
1) ACTH and ACTH-like peptide Cushings
2) SIADH (also intracranial neoplasm)
3) Lambert Eaton (also thymoma)
Term
What paraneoplastic effects are associated with squamous cell lung cancers?
Definition
PTH-releated peptide, TGF-beta, TNF and IL-1 mediated Hypercalcemia
Term
What paraneoplastic effects are associated with renal cell cancers?
Definition
1) PTH-related peptide, TGF-B, TNF and IL-1 related hypercalcemia

2) Ectopic EPO (polycythemia)
- Also HCC, hemangioblastoma and pheochromocytoma
Term
Why might a patient with a thymoma present with muscle weakness?
Definition
Paraneolastic Lamber-Eaton syndrome with anti-bodies against pre-synpatic calcium channels at NMJ

**Also associated with small cell lung cancer**
Term
What tumors can lead to hypercalcemia paraneoplastically via PTH-like peptide?
Definition
1) Squamous cell carcinoma of lung
2) Renal cell carcinoma
3) Breast cancer
Term
What are "Psammoma bodies" and what cancers are they associated with?
Definition
Laminated, conentric, calcified spherules seen in

PSaMMoma

1) Papillary thyroid cancer (radiation)
2) Serous (ovary) papillary cystadenocarcinoma
3) Meningioma
4) Malignant Mesothelioma (asbestos)
Term
What are the 3 most common causes of cancer and causes of cancer mortality in males and females?
Definition
Lung has dropped in men ONLY
cancer is 2nd leading cause of US death, behind heart disease

Males
1) Common- Prostate (32%) > Lung (16%)> colon/rectum (12%)
2) Mortality- Lung (33%)> Prostate (13%)

Females
1) Common- Breast (32%)>Lung (13%)>Colon/rectum (13%)

2) Mortality- Lung (23%) > Breast (18%)
Term
Where are the most common primary sites for the following metastases?

1) Brain
2) Liver
3) Bone
Definition
1) Lung > Breast > Kidney> Skin (melanoma)

2) Colon> Stomach> Pancreas

3) Prostate, Breast> Lung> thyroid/testes
Term
What % of brain tumors are metastasis and where are the most common primary sites?
Definition
50%! Typically are multiple well-circumscribed tumors at gray/white matter junctions

Lungs> Breast> Kidney >Melanoma
Term
What are the most common overall sites of metastasis?
Definition
regional lymph nodes, liver (colon> stomach> pancreas) and lung
Term
True or False:

Primary bone tumors are more common than metastatic lesions.
Definition
False! Prostate, Breast> Lung > Thyroid/testes
Term
What is the tumor appearance of each of the following primary tumor locations when they metastasize?

1) Lung
2) Prostate
3) Breast
Definition
1) Lytic (go to brain and liver)

2) Blastic (loves to go to bone)

3) Lytic and blastic (goes to Brain and Bone)
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