Instructions:

• Answer 50 questions in 15 minutes.
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• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Neoplasm: Gastric adenocarcinoma With what dz is this associated?
Emigration (rolling - tight binding - diapedesis); chemotaxis (bacterial products - complement - cytokines); phagocytosis and killing.
Chronic atrophic gastritis - pernicious anemia - postsurgical gastric remnants
Low - output failure. Findings: cold - clammy pt; low cardiac output; Increase TPR.
Protein = transthyretin Derived from AF (AF = old F ogies)


2. 5 Characteristic signs of inflammation
Melanoma - neural tumors - astrocytomas.
Liver (centrilobular necrosis - fatty change)
Assoc: Colorectal cancer (assoc w/ FAP)
Rubor (redness) Dolor (pain) Calor (heat) Tumor (swelling) Functio laesa (loss of fxn)


3. Tumor markers: S-100
Melanoma - neural tumors - astrocytomas.
High - output failure; high mixed venous pressure. Findings: hot pt - dilated arterioles - decr TPR.
Malignant melanoma
Beta -2 microglobulin Derived from MHC class I proteins.


4. Resolution of inflammation
Small cell lung carcinoma and intracranial neoplasms
Restoration of normal structure. Granulation tissue -- highly vascularized - fibrotic. Abscess -- fibrosis surrounding pus. Fistula -- abnormal communication. Scarring -- collagen deposition resulting in altered structure and fxn.
Leukemias and lymphomas
Autoimmune dz's (e.g. - Hashimoto's thyroiditis - myasthenia gravis)


5. Neoplasm: Astrocytoma - angiomyolipoma - and cardiac rhabdomyoma With what dz is this associated?
T = size of T umor N = N ode involvement M = M etastases
C - myc
Pancreatic adenocarcinoma
Tuberous sclerosis (facial angiofibroma - seizures - mental retardation)


6. Type of amyloid protein: DM2 Protein? Derived from...?
Radiation exposure Metabolism of drugs (phase I) Redox rxtn Nitric oxide Transition metals Leukocyte oxidative burst *Reperfusion after anoxia induces free radical production (e.g. - superoxide) and is a major cause of injury after thrombolytic thera
Amylin protein Derived from AE (AE = E ndocrine)
P 16
Metastasis = Spread to distant organ Must survive immune attack. 'Seed and soil' theory of metastasis: Seed = tumor embolus Soil = target organ -- liver - lungs - bone - brain... Angiogenesis allows for tumor survival Decr cadherin - Increase laminin


7. Neoplasm: Hepatocellular carcinoma With what dz is this associated?
Cirrhosis (alcoholic - hepatitis B or C)
Squamous cell carcinoma of esophagus
WT1
Benign: Osteoma Malignant: osteosarcoma


8. Leukocyte extravasation

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9. Neoplasm: Benign and malignant lymphomas With what dz is this associated?

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10. Breast and ovarian cancer What is the tumor suppressor gene?
Assoc: Melanoma ('MelaN oma is N ine')
Neoplastic cells hae not invaded basement membrane. High nuclear/cytoplasmic ratio and clumped chromatin Neoplastic cells encompass entire thickness Tumor cells are monoclonal <img src='220c.JPG' />
Ret
BRCA1


11. Oncogene: L - myc Associated tumor?
Squamous cell lung carcinoma - renal cell carcinoma - and breast carcinoma
Assoc: breast cancer
L ung tumor
Benign: Osteoma Malignant: osteosarcoma


12. Characteristics of irreversible cell injury
Thymoma - small cell lung carcinoma
Plasma membrane damage Lysosomal rupture Ca2+ influx --< oxidative phosphorylation Nuclear pyknosis - karyolysis - karyorrhexis Mitochondrial permeability
Benign: mature teratoma (women) Malignant: immature teratoma and mature teratoma (men)
Down syndrome


13. Which usually has more prognostic value - tumor stage or grade?
Esophageal adenocarcinoma
Usually stage < grade
Beta -2 microglobulin Derived from MHC class I proteins.
Liver (centrilobular necrosis - fatty change)


14. Neoplastic progression: step 2 In situ carcinoma

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15. Chemical carcinogens: Arsenic What is the affected organ?
Skin (squamous cell carcinoma) Liver (angiosarcoma)
Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert - Eaton syndrome (muscle weakness)
Benign: Rhabdomyoma Malignant: Rhabdomyosarcoma
Degree of localization/spread based on site and size of 1' lesion - spread to regional LNs - presence of metastases; spread of tumor in a specific pt. S tage = S pread


16. Oncogene: abl Associated tumor?
CML
Assoc: Colon cancer [DCC = D eleted in C olon C ancer]
Larynx (squamous cell carcinoma) Lung (squamous cell and small cell carcinomas) Kidney (renal cell carcinoma) Bladder (transitional cell carcinoma)
Enzymatic degradation of a cell resulting from exogenous injury.


17. Tumor grade
Squamous cell carcinoma of the skin
Esophageal adenocarcinoma
P rostate - T hyroid - T estes - B reast - L ung - K idney 'P.T. B arnum L oves K ids' Metastases from breast and prostate are mosot common.
Degree of cellular differentiation based on histologic appearance of tumor. Usually graded I- IV based on degree of differentiation and number of mitoses per high - power field; character of tumor itself.


18. Tumor nomenclature: Skeletal muscle What do you call a benign tumor of this tissue? .. a malignant one?
Benign: Rhabdomyoma Malignant: Rhabdomyosarcoma
Astrocytoma - angiomyolipoma - and cardiac rhabdomyoma
Assoc: Neurofibromatosis 2 ('Type 2 = 22')
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels - muscle - bone - fat - etc.) Both imply malignancy


19. Tight binding (step 2 of leukocyte extravasation)

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20. Characteristics of reversible cell injury
Benign: Leiomyoma Malignant: Leiomyosarcoma
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change
Membrane lipid peroxidation Protein modification DNA Breakage
Bcl -2


21. tumor: N euroblastoma What is the associated oncogene?
Increase vascular permeability - vasodilation - endothelial injury.
Assoc: Neurofibromatosis type 1
'HCG' H ydatidiform moles C horiocarcinomas G estational trophoblastic tumors
N - myc


22. Hyperplasia
Benign: lipoma Malignant: liposarcoma
Cirrhosis (alcoholic - hepatitis B or C)
Degree of localization/spread based on site and size of 1' lesion - spread to regional LNs - presence of metastases; spread of tumor in a specific pt. S tage = S pread
Increase in # of cells. Reversible.


23. Adult T- cell leukemia What is the assocciated oncogenic virus?
Benign: hemangioma Malignant: Angiosarcoma
HTLV-1
Assoc: Melanoma ('MelaN oma is N ine')
Squamous cell carcinoma of esophagus


24. tumor: Breast - ovarian - and gastric carcinomas What is the associated oncogene?
Erb - B2
L - myc
Astrocytoma - angiomyolipoma - and cardiac rhabdomyoma
Carcinoembryonic Ag. Very nonspecific - but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric and breast carcinomas.


25. Primary tumors that metasize to bone

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26. Burkitt's lymphoma nasopharyngeal carcinoma What is the assocciated oncogenic virus?
Rb
EBV
Increase vascular permeability - vasodilation - endothelial injury.
All (we All fall Down ) AML


27. Neurofibromatosis 2 ('Type 2 = 22') What is the tumor suppressor gene?
Usually stage < grade
NF2
Increase in # of cells. Reversible.
Adult T- cell leukemia


28. Oncogene: ret Associated tumor?
Liver (centrilobular necrosis - fatty change)
Abnormal cells lacking differentiation; like primitive cells of the same tissue - often equated w/ undifferentiated malignant neoplasms. Little or no resemblance to tissue of origin. Irreversible.
Aggressive malignant lymphomas (non - Hodgkin's) and Kaposi's sarcoma
Multiple endocrine neoplasia (MEN) types II and III


29. Diapedesis (step 3 in leukocyte extravasation)

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30. Oncogene: N - myc Associated tumor?
HTLV-1
Melanoma - neural tumors - astrocytomas.
Small cell lung carcinoma and intracranial neoplasms
N euroblastoma


31. Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome What neoplasm would create this paraneoplastic effect?
Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert - Eaton syndrome (muscle weakness)
Small cell lung carcinoma
Lung cancer deaths have plateaued in males - but continue to Increase in females. Cancer is the 2nd leading cause of death in the USA (heart dz is 1st).
Membrane lipid peroxidation Protein modification DNA Breakage


32. Dz: Chronic atrophic gastritis - pernicious anemia - postsurgical gastric remnants What is the associated neoplasm?
Normally made by fetus. Hepatocellular carcinomas. Nonseminomatous germ cell tumors of the testis (e.g. - yolk sac tumor)
Skin (squamous cell carcinoma) Liver (angiosarcoma)
Gastric adenocarcinoma
Benign: mature teratoma (women) Malignant: immature teratoma and mature teratoma (men)


33. Tumor suppressor gene: p 16 chromosome? Associated tumor?

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34. [aka Kaposi's sarcoma - associated herpesvirus] Kaposi's sarcoma Body cavity fluid B- cell lymphoma What is the assocciated oncogenic virus?
Multiple endocrine neoplasia (MEN) types II and III
Increase in # of cells. Reversible.
HHV-8
Neutrophils exit from blood vessels at sites of injury and inflammation in 4 steps: 1.) Rolling 2.) Tight binding 3.) Diapedesis 4.) Migration <img src='218a.JPG' />


35. Tumor suppressor gene: BRCA1 chromosome? Associated tumor?
Down syndrome
Assoc.: Breast and ovarian cancer
Esophageal adenocarcinoma
Metastases to bone - obstructive biliary dz - Paget's dz of bone.


36. tumor: Gastrointestinal stromal tumor (GIST) What is the associated oncogene?
[aka Kaposi's sarcoma - associated herpesvirus] Kaposi's sarcoma Body cavity fluid B- cell lymphoma
Benign: lipoma Malignant: liposarcoma
Secondary osteosarcoma and fibrosarcoma
C - kit


37. Type of amyloid protein: Medullary carcinoma of thyroid Protein? Derived from...?
A- CAL protein Derived from calcitonin (A- CAL = CAL citonin)
CML
Ulcerative colitis
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.


38. Tumor suppressor gene: NF1 chromosome? Associated tumor?
Assoc: Colon cancer [DCC = D eleted in C olon C ancer]
Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert - Eaton syndrome (muscle weakness)
Assoc: Neurofibromatosis type 1
Immunodeficiency states


39. Tumor markers: Bombesin
Neuorblastoma - lung - and gastric cancer.
Erb - B2
Enzymatic digestion and protein denaturation - with release of intracellular components. Inflammatory.
Breast - ovarian - and gastric carcinomas


40. Pancreatic cancer

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41. Chemical carcinogens: Naphthalene (aniline) dyes What is the affected organ?
C - kit
CML
Bladder (transitional cell carcinoma)
Adult T- cell leukemia


42. Characteristics of trans udate
Radiation exposure
Programmed cell death; ATP required. Mediated by caspases.
Hypocellular Protein - poor Specific gravity > 1.012 Due to: Increase hydrostatic pressure Decr oncotic pressure Na+ retention
Chr. 11p Assoc: Wilms' tumor


43. Tumor markers: TRAP

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44. Tumor suppressor genes
Tumor markers should not be used as the primary tool for cancer Dx. They may be used to confirm Dx - to monitor for tumor recurrence - and to monitor response to therapy.
Radiation exposure Metabolism of drugs (phase I) Redox rxtn Nitric oxide Transition metals Leukocyte oxidative burst *Reperfusion after anoxia induces free radical production (e.g. - superoxide) and is a major cause of injury after thrombolytic thera
Autoimmune dz's (e.g. - Hashimoto's thyroiditis - myasthenia gravis)
Loss of fxn --< cancer; both allels must be lost for expression of dz.


45. Neoplasm: All (we All fall Down ) AML With what dz is this associated?
Down syndrome
Malignant melanoma
Burkitt's lymphoma nasopharyngeal carcinoma
Incidence: Breast (32%) Lung (13%) Colon and rectum (13%) Mortality: Lung (23%) Breast (18%)


46. Oncogene: c - kit Associated tumor?
Gastrointestinal stromal tumor (GIST)
Beta - pleated sheet demonstrable by apple - green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.
Causes: PTH- related peptide - TGF- beat - TNF - IL-1 Effect: Hypercalcemia
Thymoma - small cell lung carcinoma


47. Tumor suppressor gene: NF2 chromosome? Associated tumor?

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48. Hypovolemic/cardiogenic shock
Amylin protein Derived from AE (AE = E ndocrine)
Low - output failure. Findings: cold - clammy pt; low cardiac output; Increase TPR.
Assoc.: Retinoblastoma - osteosarcoma
HHV-8


49. Tumor nomenclature: Fat What do you call a benign tumor of this tissue? .. a malignant one?
Benign: lipoma Malignant: liposarcoma
Autoimmune dz's (e.g. - Hashimoto's thyroiditis - myasthenia gravis)
Xeroderma pigmentosum - albinism
Colonic adenocarcinoma


50. Tumor markers: Alkaline phosphatase

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