Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• 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. Oncogene: erb - B2 Associated tumor?
Prostate carcinoma.
Breast - ovarian - and gastric carcinomas
Amylin protein Derived from AE (AE = E ndocrine)
Acanthosis nigricans (hyperpigmentation and epidermal thickening)


2. Dz: Cirrhosis (alcoholic - hepatitis B or C) What is the associated neoplasm?
HHV-8
AA protein Derived from serum amyloid - associated (SAA) protein (chronic inflammatory dz) (AA = A cute - phase reactant)
Hepatocellular carcinoma
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels - muscle - bone - fat - etc.) Both imply malignancy


3. Chemical carcinogens: Alkylating agents What is the affected organ?
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.
Blood (leukemia)
Enzymatic degradation of a cell resulting from exogenous injury.
Metastatic bone tumors are far more common than primary bone tumors. L ung = lytic Prostate = blastic B reast = B oth lytic and blastic.


4. Paraneoplastic effects of tumors: Small cell lung carcinoma and intracranial neoplasms Causes...? Effect?
Ras
Causes: ADH Effect: SIADH
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).
Colonic adenocarcinoma


5. Oncogene: ret Associated tumor?
Chr. 11p Assoc: Wilms' tumor
Multiple endocrine neoplasia (MEN) types II and III
Beta - amyloid Derived from amyloid precursor protein (APP)
Esophagus - stomach


6. tumor: N euroblastoma What is the associated oncogene?
APC
NF1
N - myc
Small cell lung carcinoma


7. [aka Kaposi's sarcoma - associated herpesvirus] Kaposi's sarcoma Body cavity fluid B- cell lymphoma What is the assocciated oncogenic virus?
TB (caseating) Syphilis Listeria monocytogenes Wegener's granulomatosis Leprosy Bartonella Some fungal pneumonias Sarcoidosis Crohn's dz *Granuloma formation is IL-2 - interferon - gamma mediated.
Esophageal adenocarcinoma
HHV-8
BRCA1


8. Neoplastic progression: normal state - before anything goes wrong

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9. Septic shock
May be poorlly differentiated - erratic growth - locally invasive/diffuse - may metastasize.
Colon carcinoma
High - output failure; high mixed venous pressure. Findings: hot pt - dilated arterioles - decr TPR.
Assoc.: Breast and ovarian cancer


10. Chemical carcinogens: Aflatoxins (produced by Aspergillus) What is the affected organ?
Thymoma - small cell lung carcinoma
Ovarian - malignant epithelial tumors
Liver (hepatocellular carcinoma)
High - output failure; high mixed venous pressure. Findings: hot pt - dilated arterioles - decr TPR.


11. Oncogenic viruses: HHV-8 What is the associated cancer?

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12. tumor: Multiple endocrine neoplasia (MEN) types II and III What is the associated oncogene?
Assoc: Colon cancer [DCC = D eleted in C olon C ancer]
Usually well - differentiated - slow growing - well - demarcated - no metastasis.
The liver and lung are the most common sites of metastasis after regional LN's. Metastasis << primary liver tumors.
Ret


13. Metastasis to liver

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14. Tumor nomenclature: Blood vessels What do you call a benign tumor of this tissue? .. a malignant one?
Benign: hemangioma Malignant: Angiosarcoma
Blood (leukemia)
Assoc.: Retinoblastoma - osteosarcoma
EBV


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

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16. Melanoma - What is the tumor suppressor gene?
P 16
Increase vascular permeability - vasodilation - endothelial injury.
Enzymatic degradation of a cell resulting from exogenous injury.
Emigration (rolling - tight binding - diapedesis); chemotaxis (bacterial products - complement - cytokines); phagocytosis and killing.


17. Wilms' tumor What is the tumor suppressor gene?
Ulcerative colitis
Hepatocellular carcinoma
APC
WT1


18. Neoplastic progression: step 1 Hyperplasia/dysplasia

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19. Neoplasm: Visceral malignancy (stomach - lung - breast - uterus) With what dz is this associated?
Enzymatic digestion and protein denaturation - with release of intracellular components. Inflammatory.
Acanthosis nigricans (hyperpigmentation and epidermal thickening)
Colonic adenocarcinoma
EBV


20. Cervical carcinoma (types 16 - 18) Penile/anal carcinoma What is the assocciated oncogenic virus?
Assoc: Melanoma ('MelaN oma is N ine')
L ung tumor
HPV
Squamous cell carcinoma of the skin


21. Neoplasm: Squamous cell carcinoma of esophagus With what dz is this associated?
Plummer - Vinson syndrome (atrophic gastritis - esophageal webs - anemia; all due to iron deficiency)
Produced thru enzymes (catalase - superoxide dismutase - glutathioe peroxidase) - spontaneous decay - antioxidants (Vitamins A - C - E).
CML
Incidence: Breast (32%) Lung (13%) Colon and rectum (13%) Mortality: Lung (23%) Breast (18%)


22. Paraneoplastic effects of tumors: Thymoma - small cell lung carcinoma Causes...? Effect?

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23. Tumor nomenclature: Fat What do you call a benign tumor of this tissue? .. a malignant one?
IL-8 C5a Leukotriene B4 Kallikrein
Thymoma - small cell lung carcinoma
Benign: lipoma Malignant: liposarcoma
Laminated - concentric - calcific spherules seen in: 1.) Papillary adenocarcinoma of thyroid 2.) Serous papillary cystadenocarcinoma of ovary 3.) Meningioma 4.) Malignant mesothelioma PS aMM oma: P apillary (thyroid) S erous (ovary) M eningioma M eso


24. Female cancer epidemiology (incidence - mortality)
Incidence: Breast (32%) Lung (13%) Colon and rectum (13%) Mortality: Lung (23%) Breast (18%)
Plasma membrane damage Lysosomal rupture Ca2+ influx --< oxidative phosphorylation Nuclear pyknosis - karyolysis - karyorrhexis Mitochondrial permeability
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.
Colon carcinoma


25. Resolution of inflammation
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.
Squamous cell carcinoma of the skin
Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome
Breast - ovarian - and gastric carcinomas


26. Tumor markers: Alkaline phosphatase

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27. Oncogenic viruses: HPV What is the associated cancer?
Beta - pleated sheet demonstrable by apple - green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.
Cervical carcinoma (types 16 - 18) Penile/anal carcinoma
Thymoma - small cell lung carcinoma
C - kit


28. Free radical degradation
P 16
WT1
Breast - ovarian - and gastric carcinomas
Produced thru enzymes (catalase - superoxide dismutase - glutathioe peroxidase) - spontaneous decay - antioxidants (Vitamins A - C - E).


29. Tumor suppressor gene: p 53 chromosome? Associated tumor?
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.
Follicular and undifferentiated lymphomas (inhibits apoptosis)
Assoc: most human cancers (crap!) - Li - Fraumeni syndrome
Assoc.: Retinoblastoma - osteosarcoma


30. Neoplastic progression: step 3 Invasive carcinoma

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31. Dz: Ulcerative colitis What is the associated neoplasm?
Sarcoma
Colonic adenocarcinoma
Esophagus - stomach
Benign and malignant lymphomas


32. Tumor markers: Prostatic acid phospatase
Paget's dz of bone
Gain of fxn --< cancer. Need damage to only 1 allele.
Prostate carcinoma.
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.


33. Neurofibromatosis type 1 What is the tumor suppressor gene?
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.
NF1
Leukocyte travels btw endothelial cells and exits blood vessel; PECAM-1 is involved. <img src='218a.JPG' />
Benign: Adenoma - papilloma Malignant: Adenocarcinoma - papillary carcinoma


34. Dz: Down syndrome What is the associated neoplasm?
Tuberous sclerosis (facial angiofibroma - seizures - mental retardation)
All (we All fall Down ) AML
IL-8 C5a Leukotriene B4 Kallikrein
[DCC = D eleted in C olon C ancer] What is the tumor suppressor gene? DCC


35. Chemical carcinogens: Vinyl chloride What is the affected organ?
HHV-8
L - myc
Liver (angiosarcoma)
Benign: lipoma Malignant: liposarcoma


36. Oncogene: abl Associated tumor?
Autoimmune dz's (e.g. - Hashimoto's thyroiditis - myasthenia gravis)
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
CML
All (we All fall Down ) AML


37. Tumor nomenclature: Bone What do you call a benign tumor of this tissue? .. a malignant one?
Ovarian - malignant epithelial tumors
Membrane lipid peroxidation Protein modification DNA Breakage
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.
Benign: Osteoma Malignant: osteosarcoma


38. Tumor nomenclature: Blood cells What do you call a benign tumor of this tissue? .. a malignant one?
Laminated - concentric - calcific spherules seen in: 1.) Papillary adenocarcinoma of thyroid 2.) Serous papillary cystadenocarcinoma of ovary 3.) Meningioma 4.) Malignant mesothelioma PS aMM oma: P apillary (thyroid) S erous (ovary) M eningioma M eso
Hypocellular Protein - poor Specific gravity > 1.012 Due to: Increase hydrostatic pressure Decr oncotic pressure Na+ retention
Benign: -- Malignant: Leukemia - lymphoma
Assoc: Neurofibromatosis type 1


39. Fluid exudation in inflammation
Increase vascular permeability - vasodilation - endothelial injury.
Benign and malignant lymphomas
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.
Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome


40. Adult T- cell leukemia What is the assocciated oncogenic virus?
HTLV-1
Thymoma - small cell lung carcinoma
Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome
TB (caseating) Syphilis Listeria monocytogenes Wegener's granulomatosis Leprosy Bartonella Some fungal pneumonias Sarcoidosis Crohn's dz *Granuloma formation is IL-2 - interferon - gamma mediated.


41. Characteristics of irreversible cell injury
Plasma membrane damage Lysosomal rupture Ca2+ influx --< oxidative phosphorylation Nuclear pyknosis - karyolysis - karyorrhexis Mitochondrial permeability
Chr. 11p Assoc: Wilms' tumor
Follicular and undifferentiated lymphomas (inhibits apoptosis)
Metastatic bone tumors are far more common than primary bone tumors. L ung = lytic Prostate = blastic B reast = B oth lytic and blastic.


42. Oncogene: c - kit Associated tumor?
Metastatic bone tumors are far more common than primary bone tumors. L ung = lytic Prostate = blastic B reast = B oth lytic and blastic.
Increase vascular permeability - vasodilation - endothelial injury.
Gastrointestinal stromal tumor (GIST)
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change


43. Characteristics of reversible cell injury
AL protein Derived from Ig L ight chains (multiple myeloma) (AL = L ight chains)
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change
CML
Amylin protein Derived from AE (AE = E ndocrine)


44. Neoplasm: All (we All fall Down ) AML With what dz is this associated?
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.
Colonic adenocarcinoma
Down syndrome
Benign: Adenoma - papilloma Malignant: Adenocarcinoma - papillary carcinoma


45. Neoplasm: Colonic adenocarcinoma With what dz is this associated?
Ulcerative colitis
C - kit
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
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels - muscle - bone - fat - etc.) Both imply malignancy


46. Oncogene: bcl -2 Associated tumor?
Follicular and undifferentiated lymphomas (inhibits apoptosis)
Produced thru enzymes (catalase - superoxide dismutase - glutathioe peroxidase) - spontaneous decay - antioxidants (Vitamins A - C - E).
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.
Pancreatic adenocarcinoma


47. Acute inflammation
Causes: ADH Effect: SIADH
Metastases to bone - obstructive biliary dz - Paget's dz of bone.
Ulcerative colitis
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.


48. Tumor markers: CA-125
C - myc
Bladder (transitional cell carcinoma)
Ovarian - malignant epithelial tumors
Liver (angiosarcoma)


49. Chemical carcinogens: Arsenic What is the affected organ?
Skin (squamous cell carcinoma) Liver (angiosarcoma)
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels - muscle - bone - fat - etc.) Both imply malignancy
Coagulative (heart - liver - kidney) Liquefactive (brain) Caseous (tuberculosis) Fat (pancreas) Fibrinoid (blood vessels) Gangrenous (limbs - GI tract)
Rubor (redness) Dolor (pain) Calor (heat) Tumor (swelling) Functio laesa (loss of fxn)


50. Neoplasm: Gastric adenocarcinoma With what dz is this associated?
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change
Chronic atrophic gastritis - pernicious anemia - postsurgical gastric remnants
Squamous cell lung carcinoma - renal cell carcinoma - and breast carcinoma