neoplasia II

question

is there a link between chronic inflammation and cancer? viruses?
answer

yes
question

what tumors are associated with h. pylori?
answer

stomach adenocarcinoma or B-cell lymphoma
question

what tumors are associated with EBV?
answer

hodgkin lymphoma, nasopharyngeal cancer, non-hodgkin lymphoma, primary CNS lymphoma and burkitt’s lymphoma
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what tumors are associated with HPV?
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cervical, analgenital and oropharyngeal carcinomas
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what tumors are associated with hepatitis B or C?
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hepatocellular carcinoma and NHL is associated only with hep C
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what tumors are associated with HIV/AIDS?
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non hodgkin lymphoma, kaposi sarcoma
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what are prenepoplastic disorders associated with endometrial carcinomas?
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hyperplasia or dysplasias
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what is a prenepoplastic disorder associated with gastric carcinomas?
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chronic atrophic gastritis
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what is a prenepoplastic disorder associated with colon carcinomas?
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ulcerative colitis
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what is a prenepoplastic disorder associated with squamous cell carcinomas?
answer

leukoplakia
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what is a prenepoplastic disorder associated with colon cancer?
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colonic adenomas
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what is a change in mucosa of esophagus called? what causes this?
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barrett’s esophagus which is a result of metaplasia (which is likely due to GERD)
question

what initially causes cancer?
answer

non-lethal genetic damage that kills most cells, but surviving cells can become neoplastic and whose clones can give rise to tumor cells. problems with protooncogenes, antioncogenes, apoptosis genes, and DNA repair genes can occur simlutaneously or independently of non-lethal genetic damage leading to carcinogenesis (a multistep process)
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what are three common gene types that when mutated, lead to cancer?
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activation of growth-promoting genes, alteration of apoptosis regulation genes, and inactivation of cancer suppressor genes
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what does heterogeneity mean in the context of a developing malignant tumor?
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when neoplasias develop heterogeneity, this means a whole population of cells with different abilities to divide, to multiply, to metastasize develop and many of which can be aggressive
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what are oncogenes?
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these encode oncoproteins which are devoid of regulatory elements, examples include: GFs, signal transduction proteins, nuclear regulatory proteins, cyclins
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what gene, if overexpressed, is associated with PDGF causing an astrocytoma?
answer

sis
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what gene, if overexpressed, is associated with FGF causing an osteosarcoma?
answer

hst-1
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what gene, if overexpressed, is associated with FGF causing stomach/bladder/breast carcinomas?
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Int-2
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what gene, if overexpressed, is associated with EGF receptors causing a glioma?
answer

erb B-1
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what gene, if amplified, is associated with EGF receptors causing breast/ovarian/gastric cancer?
answer

erb B-2
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what gene, if subject to a point mutation, is associated with medullary carcinomas of the thyroid?
answer

ret (a growth factor)
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what might point mutations in the gene for ras, a signal transduction protein associated with GTP binding lead to?
answer

various carcinomas
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what might translocation of the gene for abl, a tyrosine kinase signal transduction protein, lead to?
answer

leukemias (CML, ALL)
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what does the myc gene encode? what happens if there is a translocation involving it?
answer

myc encodes transcriptional activators and a translocation involving it can lead to burkitt’s lymphoma – which is linked to EBV and HIV. it is very fast growing; characterized by a “starry sky appearance” microscopically, w/ the sky being the lymphocytes – quickly proliferating lymphocytes, stars are macrophages which destroy dying and dead lymphocytes
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what cancers might result from amplification of N-myc, a gene that encodes transcriptional activators?
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neuroblastomas and small cell cancer of the lung
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if there is an amplification in the gene for cyclin D, what cancers may result?
answer

breast CA, esphageal CA, and some lymphomas
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mutations in rb (a cancer suppressor gene) can lead to what kinds of cancer?
answer

increased frequency of retinoblastoma
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mutations in p53 (a cancer suppressor gene) can lead to what kinds of cancer?
answer

colon, breast, lung and some sarcomas
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mutations in WT (a cancer suppressor gene) can lead to what kind of tumor?
answer

wilm’s tumor
question

mutations in EWS (a cancer suppressor gene) can lead to what kind of tumor?
answer

ewing’s sarcoma
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mutations in brca-1 & 2 (a cancer suppressor gene) can lead to what kinds of cancer?
answer

breast cancer
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mutations in DCC (a cancer suppressor gene) can lead to what kinds of cancer?
answer

colon and gastric cancer
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mutations in NF1 (a cancer suppressor gene) can lead to what kinds of cancer?
answer

schwannoma, neurogenic sarcomas
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mutations in NF2 (a cancer suppressor gene) can lead to what kinds of cancer?
answer

schwannoma, meningiomas
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mutations in APC (a cancer suppressor gene) can lead to what kinds of cancer?
answer

colon, gastric, and pancreatic cancers
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what 2 genes regulate apoptosis?
answer

bcl-2 and p53
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what do mutations in bcl-2 lead to?
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overexpression of bcl-2 OVERprotects lymphomas from apoptosis, allowing them to survive longer than they are supposed to = follicular lymphomas
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what does p53 do?
answer

p53 triggers apoptosis
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can some chemotherapeutic agents induce apotosis in cancer cells?
answer

yes
question

what are 2 disorders associated with mutations in DNA repair genes?
answer

hereditary nonpolyposis colon carcinoma and xeroderma pigmentosum (increased skin CA risk)
question

what are 2 examples of balanced chromosomal translocations that result in specific cancers?
answer

CML results from 9->22 (philadelphia chromosome) and burkitt’s lymphoma results from 8->14 (associated with the myc protein, EBV and starry sky appearance)
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what kinds of tumors are more commonly caused by chromocomal deletions?
answer

nonhematopoietic (not arising from bone marrow elements) tumors such as retinoblastoma (chr 13)
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what kind of cancer is associated with overamplification?
answer

breast CA is associated with over amplification of Erb B-2
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what are some things that influnence cell growth?
answer

cell kinetics, angiogenesis, and tumor progression/heterogeneity
question

what are kinetics of tumor cell growth comprised of?
answer

the doubling time of tumor cells (tumor cells are triggered into the cell cycle more readily), the growth fraction (the proportion of cells in the replicative pool & can divide), and cell production & loss (how much cell production exceeds loss)
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what does bcl-2 do?
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induce cell accumulation
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what does bax do?
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produces apoptosis (bax can be upregulated by p53)
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what size can tumors not grow past w/out being vascularized?
answer

1-2 mm
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what growth factors powerfully stimulate tumor angiogenesis?
answer

FGF, VEGF
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can angiogenesis aid in tumor metastatis?
answer

yes
question

what are the steps of metastasis?
answer

invade ECM, detach from primary tumor, attach to matrix, degrade matrix, disseminate through vasculature, embolize w/WBC or travel solo
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what are direct and indirectly acting chemical carcinogens?
answer

direct-acting agents cause cancer and do not require metabolic conversion. indirect acting agents require conversion (aromatic hydrocarbons, cigarette smoke, aromatic amines/azodyes). both will result in gene mutations
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what are some examples of radiation carcinogenesis?
answer

UV rays can cause melanoma, BCC (not likely to metastasize), & SCC due to chromosome breakage, translocation and point mutations
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what are some examples of virus induced cancer?
answer

question

what cancers are associated with HSV?
answer

kaposi’s (HHV-8), primary effusion lymphoma
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what has RNA oncogenic virus been linked to?
answer

human T cell leukemia virus has been linked to leukemia…duh
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can cancer can be considered a STD by true definition?
answer

yes
question

exposure to what does malignant mesolelioma have a strong association with?
answer

asbestos exposure

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