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• Answer 50 questions in 15 minutes.
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• Match each statement with the correct term.
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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. Causes: Hyperuricemia due to excess nucleic acid (e.g. - cytotoxic therapy) Effect: Gout - urate nephropathy What neoplasm would create this paraneoplastic effect?
Leukemias and lymphomas
C - kit
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.
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.


2. Necrosis morphologies
Incidence: Prostate (32%) Lung (16%) Colon and rectum (12%) Mortality: Lung (33%) Prostate (13%)
Mononuclear cell mediated: Characterized by persistent destruction and repair. Associated w/ blood vessel proliferation - fibrosis. Granuloma -- nodular collections of epithelioid macrophages and giant cells.
L - myc
Coagulative (heart - liver - kidney) Liquefactive (brain) Caseous (tuberculosis) Fat (pancreas) Fibrinoid (blood vessels) Gangrenous (limbs - GI tract)


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

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4. Chemical carcinogens: Alkylating agents What is the affected organ?
NF2
Gastric adenocarcinoma
Blood (leukemia)
'HCG' H ydatidiform moles C horiocarcinomas G estational trophoblastic tumors


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

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6. Cervical carcinoma (types 16 - 18) Penile/anal carcinoma What is the assocciated oncogenic virus?
Melanoma - neural tumors - astrocytomas.
Sarcoma
HPV
Carcinoma = epithelial origin Sarcoma = mesenchymal origin (blood vessels - muscle - bone - fat - etc.) Both imply malignancy


7. Type of amyloid protein: Senile cardiac Protein? Derived from...?
Benign: Rhabdomyoma Malignant: Rhabdomyosarcoma
Protein = transthyretin Derived from AF (AF = old F ogies)
IL-8 C5a Leukotriene B4 Kallikrein
Squamous cell lung carcinoma - renal cell carcinoma - and breast carcinoma


8. Neoplasm: Astrocytoma - angiomyolipoma - and cardiac rhabdomyoma With what dz is this associated?
Larynx (squamous cell carcinoma) Lung (squamous cell and small cell carcinomas) Kidney (renal cell carcinoma) Bladder (transitional cell carcinoma)
BRCA2
Tuberous sclerosis (facial angiofibroma - seizures - mental retardation)
NF1


9. Tumor nomenclature: Epithelium What do you call a benign tumor of this tissue? .. a malignant one?
Abnormal growth w/ loss of cellular orientation - shape - and size in comparizon to normal tissue maturation; commonly preneoplastic. Reversible.
Colon carcinoma
Assoc: Melanoma ('MelaN oma is N ine')
Benign: Adenoma - papilloma Malignant: Adenocarcinoma - papillary carcinoma


10. TNM staging system
T = size of T umor N = N ode involvement M = M etastases
Assoc: Neurofibromatosis 2 ('Type 2 = 22')
P 53
Plummer - Vinson syndrome (atrophic gastritis - esophageal webs - anemia; all due to iron deficiency)


11. Adult T- cell leukemia What is the assocciated oncogenic virus?
HTLV-1
Normal cells w/ basal --< apical differentiation <img src='220a.JPG' />
Rubor (redness) Dolor (pain) Calor (heat) Tumor (swelling) Functio laesa (loss of fxn)
Occurs during embryogenesis - hormone induction (menstruation) - immune cell - mediated death - injurious stimuli (e.g. - radiation - hypoxia) - atrophy (e.g. - endometrial lining during menopause)


12. Tumor nomenclature: Bone What do you call a benign tumor of this tissue? .. a malignant one?
C - myc
Benign: Osteoma Malignant: osteosarcoma
Amylin protein Derived from AE (AE = E ndocrine)
Chronic atrophic gastritis - pernicious anemia - postsurgical gastric remnants


13. Neoplasm: Squamous cell carcinoma of the skin With what dz is this associated?
'HCG' H ydatidiform moles C horiocarcinomas G estational trophoblastic tumors
Actinic keratosis
Usually well - differentiated - slow growing - well - demarcated - no metastasis.
Causes: Ab's against presynaptic Ca2+ channels at NMJ Effect: Lambert - Eaton syndrome (muscle weakness)


14. Dz: AIDS What is the associated neoplasm?

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15. Chronic inflammation
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' />
Mononuclear cell mediated: Characterized by persistent destruction and repair. Associated w/ blood vessel proliferation - fibrosis. Granuloma -- nodular collections of epithelioid macrophages and giant cells.
Plasma membrane damage Lysosomal rupture Ca2+ influx --< oxidative phosphorylation Nuclear pyknosis - karyolysis - karyorrhexis Mitochondrial permeability
Visceral malignancy (stomach - lung - breast - uterus)


16. Dz: Xeroderma pigmentosum - albinism What is the associated neoplasm?
Follicular and undifferentiated lymphomas (inhibits apoptosis)
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.
Melanoma - basal cell carcinoma - and esp. squamous cell carcinomas of the skin
Metastatic bone tumors are far more common than primary bone tumors. L ung = lytic Prostate = blastic B reast = B oth lytic and blastic.


17. tumor: CML What is the associated oncogene?
Bladder (transitional cell carcinoma)
Breast - ovarian - and gastric carcinomas
Benign: Adenoma - papilloma Malignant: Adenocarcinoma - papillary carcinoma
Abl


18. 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)
High - output failure; high mixed venous pressure. Findings: hot pt - dilated arterioles - decr TPR.
Usually stage < grade
Protein = transthyretin Derived from AF (AF = old F ogies)


19. Tumor suppressor gene: WT1 chromosome? Associated tumor?

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20. Dz: Cirrhosis (alcoholic - hepatitis B or C) What is the associated neoplasm?
Carcinoembryonic Ag. Very nonspecific - but produced by ~70% of colorectal and pancreatic cancers; also produced by gastric and breast carcinomas.
Hepatocellular carcinoma
Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome
Beta - pleated sheet demonstrable by apple - green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.


21. Retinoblastoma - osteosarcoma What is the tumor suppressor gene?
HBV - HCV
Rb
Small cell lung carcinoma and intracranial neoplasms
Membrane lipid peroxidation Protein modification DNA Breakage


22. Dz: Paget's dz of bone What is the associated neoplasm?
Secondary osteosarcoma and fibrosarcoma
Enzymatic degradation of a cell resulting from exogenous injury.
Enzymatic digestion and protein denaturation - with release of intracellular components. Inflammatory.
Squamous cell carcinoma of esophagus


23. Tumor suppressor gene: DPC chromosome? Associated tumor?

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24. Causes: Erythropoietin Effect: Polycythemia What neoplasm would create this paraneoplastic effect?
Usually stage < grade
Tartrate - resistant acid phosphatase. Hairy cell leukemia -- a B- cell neoplasm. 'TRAP the hairy animal.'
Typically multiple well - circumscribed tumors at grety- white border. Overall - approximately 50% of brain tumors are from metastases.
Renal cell carcinoma - hemangioblastoma


25. Dz: Acanthosis nigricans (hyperpigmentation and epidermal thickening) What is the associated neoplasm?
C - myc
Assoc: Melanoma ('MelaN oma is N ine')
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.
Visceral malignancy (stomach - lung - breast - uterus)


26. Type of amyloid protein: Medullary carcinoma of thyroid Protein? Derived from...?
Skin (squamous cell carcinoma) Liver (angiosarcoma)
Radiation exposure
A- CAL protein Derived from calcitonin (A- CAL = CAL citonin)
NF1


27. Type of amyloid protein: Dialysis - associated Protein? Derived from...?
Beta -2 microglobulin Derived from MHC class I proteins.
Cellular swelling Nuclear chromatin clumping Decr ATP synthesis Ribosomal detachment Glycogen depletion Fatty change
Renal cell carcinoma - hemangioblastoma
A- CAL protein Derived from calcitonin (A- CAL = CAL citonin)


28. [aka Kaposi's sarcoma - associated herpesvirus] Kaposi's sarcoma Body cavity fluid B- cell lymphoma What is the assocciated oncogenic virus?
HHV-8
Membrane lipid peroxidation Protein modification DNA Breakage
Loss of fxn --< cancer; both allels must be lost for expression of dz.
Usually well - differentiated - slow growing - well - demarcated - no metastasis.


29. Tumor markers: Bombesin
Autoimmune dz's (e.g. - Hashimoto's thyroiditis - myasthenia gravis)
Neuorblastoma - lung - and gastric cancer.
C - kit
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.


30. Oncogene: c - kit Associated tumor?
Assoc.: Retinoblastoma - osteosarcoma
WT1
Causes: ACTH or ACTH- like peptide Effect: Cushing's syndrome
Gastrointestinal stromal tumor (GIST)


31. Free radical injury induces cell injury thru...?
Benign: Adenoma - papilloma Malignant: Adenocarcinoma - papillary carcinoma
Membrane lipid peroxidation Protein modification DNA Breakage
Neutrophil - eosinophil - and Ab - mediated. Rapid onset (seconds - minutes) - lasts minutes - days.
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.


32. Primary tumors that metastasize to brain
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.
C olon < S tomach < P ancreas < B reast < L ung 'C ancer S ometimes P enetrates B enign L iver.'
NF2
L ung B reast S kin (melanoma) K idney (renal cell carcinoma) G I L ots of B ad S tuff K ills G lia.


33. Chemical carcinogens: Naphthalene (aniline) dyes What is the affected organ?
Incidence: Breast (32%) Lung (13%) Colon and rectum (13%) Mortality: Lung (23%) Breast (18%)
Assoc: Neurofibromatosis type 1
Bladder (transitional cell carcinoma)
Metastases to bone - obstructive biliary dz - Paget's dz of bone.


34. Fibrosis in inflammation
Xeroderma pigmentosum - albinism
Barrett's esophagus (chronic GI reflux)
Low - output failure. Findings: cold - clammy pt; low cardiac output; Increase TPR.
Fibroblast emigration and proliferation; deposition of ECM.


35. Paraneoplastic effects of tumors: Leukemias and lymphomas Causes...? Effect?
Causes: Hyperuricemia due to excess nucleic acid (e.g. - cytotoxic therapy) Effect: Gout - urate nephropathy
Neuorblastoma - lung - and gastric cancer.
Cellular Protein - rich Specific gravity < 1.020 Due to: Lymphatic obstruction Inflammation
Tartrate - resistant acid phosphatase. Hairy cell leukemia -- a B- cell neoplasm. 'TRAP the hairy animal.'


36. Dz: Tuberous sclerosis (facial angiofibroma - seizures - mental retardation) What is the associated neoplasm?
Melanoma - basal cell carcinoma - and esp. squamous cell carcinomas of the skin
Dysplastic nevus
Astrocytoma - angiomyolipoma - and cardiac rhabdomyoma
Erb - B2


37. Paraneoplastic effects of tumors: Renal cell carcinoma - hemangioblastoma Causes...? Effect?
Causes: Erythropoietin Effect: Polycythemia
Membrane lipid peroxidation Protein modification DNA Breakage
Aggressive malignant lymphomas (non - Hodgkin's) and Kaposi's sarcoma
IL-8 C5a Leukotriene B4 Kallikrein


38. Chemical carcinogens: Vinyl chloride What is the affected organ?
Benign: hemangioma Malignant: Angiosarcoma
Benign: mature teratoma (women) Malignant: immature teratoma and mature teratoma (men)
Liver (angiosarcoma)
Secondary osteosarcoma and fibrosarcoma


39. Dz: Chronic atrophic gastritis - pernicious anemia - postsurgical gastric remnants What is the associated neoplasm?
C - myc
Cells have increased in # (hyperplasia ) Abnormal proliferation of cells w/ loss of size - shape - and orientation (dysplasia ) <img src='220b.JPG' />
Abnormal growth w/ loss of cellular orientation - shape - and size in comparizon to normal tissue maturation; commonly preneoplastic. Reversible.
Gastric adenocarcinoma


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

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41. Hepatocellular carcinoma What is the assocciated oncogenic virus?
Fibrous tissue formation in response to a neoplasm. Irreversible.
HBV - HCV
Benign: hemangioma Malignant: Angiosarcoma
Cellular Protein - rich Specific gravity < 1.020 Due to: Lymphatic obstruction Inflammation


42. Neoplasm: All (we All fall Down ) AML With what dz is this associated?
Down syndrome
Chr. 11p Assoc: Wilms' tumor
Abnormal growth w/ loss of cellular orientation - shape - and size in comparizon to normal tissue maturation; commonly preneoplastic. Reversible.
A clonal proliferation of cells that is uncontrolled and excessive. Irreversible.


43. Migration (step 4 in leukocyte extravasation)

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44. Septic shock
Enzymatic digestion and protein denaturation - with release of intracellular components. Inflammatory.
Melanoma - basal cell carcinoma - and esp. squamous cell carcinomas of the skin
High - output failure; high mixed venous pressure. Findings: hot pt - dilated arterioles - decr TPR.
Fibroblast emigration and proliferation; deposition of ECM.


45. Colorectal cancer (assoc w/ FAP) What is the tumor suppressor gene?
Assoc: breast cancer
Increase in # of cells. Reversible.
APC
Enzymatic degradation of a cell resulting from exogenous injury.


46. tumor: N euroblastoma What is the associated oncogene?
Beta - amyloid Derived from amyloid precursor protein (APP)
N - myc
A- CAL protein Derived from calcitonin (A- CAL = CAL citonin)
Benign: Rhabdomyoma Malignant: Rhabdomyosarcoma


47. Type of amyloid protein: DM2 Protein? Derived from...?
Beta - pleated sheet demonstrable by apple - green birefringence of Congo red stain under polarized light; affected tissue has waxy appearance.
Amylin protein Derived from AE (AE = E ndocrine)
Abnormal growth w/ loss of cellular orientation - shape - and size in comparizon to normal tissue maturation; commonly preneoplastic. Reversible.
Chr. 11p Assoc: Wilms' tumor


48. tumor: L ung tumor What is the associated oncogene?
L - myc
AA protein Derived from serum amyloid - associated (SAA) protein (chronic inflammatory dz) (AA = A cute - phase reactant)
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.
Hepatocellular carcinoma


49. Neoplasm: Hepatocellular carcinoma With what dz is this associated?
Loss of fxn --< cancer; both allels must be lost for expression of dz.
Melanoma - basal cell carcinoma - and esp. squamous cell carcinomas of the skin
IL-8 C5a Leukotriene B4 Kallikrein
Cirrhosis (alcoholic - hepatitis B or C)


50. Metaplasia

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