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Neoplasia
FA review Round 1 2020
| Question | Answer |
|---|---|
| What is the goal of primary disease prevention? | Prevent onset of disease |
| What is the goal of secondary disease prevention? | Early detection of disease before clinical manifestations of disease |
| What is the goal of tertiary disase prevention? | Decrease morbidity and mortality of a disease already present |
| Examples of common Primary disease prevention actions: | Vaccinations, Prophylactic mastectomy |
| Example of secondary disease prevention | Mammongraph |
| Chemotherapy is a ___________ disease prevention. | Tertiary |
| Why is self breast exam not considered a secondary measure of disease prevention? | It has not proven to decrease mortality due to breast cancer |
| What is the highest associated risk factor of Squamous Cell carcinoma of the lung? | Cigarette smoking |
| Where is SQCC of lung located? | Centrally located as a mass with cavitation |
| A centrally located mass in the lung with signs of cavitation. Dx? | Squamous cell carcinoma of the lung |
| What is the common Paraneoplastic syndrome (hormone) associated with SQCC of lung? | PTHrP |
| What does the elevated PTHrP in SQCC of lung causes? | 1. Hypercalcemia and symptoms of Nephrolithiasis 2. Hypercalciuria 3. Constipation, Weakness, and Depression |
| Histological description or features of Squamous cell Carcinoma of the lung | Keratin pearls and intercellular bridges |
| Which lung cancer is often characterized histologically with Keratin pearls? | Squamous cell carcinoma of the lung |
| Antimetabolite precursor of 6-MP | Azathioprine |
| What is the MOA of Azathioprine? | Interfere with Purine nucleotide synthesis |
| What is the common use for Azathioprine and/or 6-MP? | Long-term immunosuppressive therapy |
| Common long-term immunosuppressive | Azathioprine and 6-MP |
| Which drug, if given at same time, increases toxicity of 6-MP? | Allopurinol |
| Which condition should raise a flag when oncologist is about to start 6-MP therapy? | Gout |
| What enzyme degenerates 6-MP? | XO |
| What is a common antitumor antibody that works of G2 phase of cell cycle? | Bleomycin |
| What is the mode of action of Bleomycin? | Generation of free radicals, which lead to single DNA strand breaks |
| What is the most significant adverse effect of Bleomycin? | Pulmonary fibrosis |
| Which cancers are treated with Bleomycin? | 1. Testicular cancer 2. Hodgkin lymphoma |
| What is prevented with Paclitaxel? | Microtubule disassembly |
| Paclitaxel or Vincristine/Vinblastine. Prevent microtubule disassembly. | Paclitaxel |
| What is the MOA of Paclitaxel? | Hyperstabilize polymerized microtubules in M-phase , so that the mitotic spindle cannot break down |
| Which cancer drug works by preventing the break down of the mitotic spindle? | Paclitaxel |
| What is treated with Paclitaxel? | Ovarian and Brest cancers |
| What is the common side effect of Paclitaxel? | Neuropathy |
| What is inhibited (overall) with Vincristine/Vinblastine? | Microtubule polymerization |
| What is the MOA of Vincristine and Vinblastine? | Bind to B-tubulin and inhibit polymerization of microtubules, preventing the mitotic spindle to form |
| Pacliaxel or Vincrinite/Vinblatine. Prevent formation of mitotic spindle? | Vincristine and Vinblastine |
| Which drugs are known to work in the M-phase by binding to B-tubulin? | Vincristine and Vinblastine |
| To which protein does Vinca alkaloids bind to? | B-tubulin |
| What are the common anticancer uses for Vinblastine and Vincristine? | 1. Solid tumors 2. Leukemias 3. Hodgkin and Non-Hodgkin lymphomas |
| What is the SE of Vincristine? | Neurotoxicity |
| What is the SE of Vinblastine? | Bone marrow suppression |
| Vinblastine or Vincristine, present with Bone marrow suppression? | Vinblastine |
| What area of the Prostate is where Prostatic cancer arisis? | Peripheral |
| BPH or Prostate cancer. Develops in the Transitional zone? | BPH |
| What is the old treatment regimen for Hodgkin lymphoma? | MOPP: Mechlorethamine Oncovin (Vinblastine) Procarbazine Prednisone |
| Which is a common corticosteroid to be biologically metabolized into its active from? | Prednisone, it is converted into Prednisolone |
| What is the active form of Prednisone? | Prednisolone |
| Vinblastine or Vincristine is part of the old regimen for Hodgkin lymphoma treatment? | Vinblastine |
| The ABVD regimen is used to treat what condition? | Hodgkin lymphoma |
| What is the newer regimen treatment for Hodgkin lymphoma? | ABVD |
| What are ABVD regimen medications? | A-Adriamycin (Doxorubicin) B- Bleomycin V- Vinblastine D- Dacarbazine |
| What area of the brain is often affected by Chemotherapy? | Cerebellum |
| What are common signs and symptoms Chemotherapy-induced cerebellar degeneration? | Ataxia, dysmetria, dysarthria, and nystagmus |
| What are the functions of the cerebellum? | 1. Modulates movement 2. Aid in coordination and movement |
| What are Frontal Cortex functions? | Motor functioning, planning movements, thinking, feeling, imaging, and decision making |
| Generation of free radicals that cause single double-stranded DNA breaks. | Mechanism of action of Bleomycin |
| What type of cancer is treated with BEP? | Testicular cancer |
| What medications compose the BEP regimen? | Bleomycin Etoposide cisPlatin |
| What does the P in "BEP" regimen? | Cisplatin |
| What are common monoclonal antibodies on VEGF? | Ranibizumab and Bevacizumab |
| What is the common use for Ranizumab? | Exudative (wet) age-related macular degeneration |
| What precancerous process is inhibited by the use of monoclonal antibodies on VEGF? | Angiogenesis |
| Bevacizumab is a : | Monoclonal antibody drug on VEGF |
| What type of cancers are often treated with monoclonal antibodies on VEGF? | Colon, Lung,and Breast cancers |
| What is the mode of action of Mesna? | Binding to Acrolein, an urotoxic metabolite of cyclophosphamide |
| Mesna is used to prevent: | Cyclophosphamide-mediated hemorrhagic cystitis |
| What is the main condition associated with ALL? | Down syndrome (trisomy 21) |
| What is shown in the PBS of ALL sample? | Lymphoblasts with an increased nuclear; cytoplasmic ratio |
| What is the translocation seen with ALL? | t(12;21) |
| t(12;21). Dx? | ALL |
| What are the common spread places of ALL? | CNS and Testes |
| What is the typical T-cell ALL presentation? | Mediastinal mass, which can present as SVC-like syndrome |
| What are Leiomyosarcomas? | Malignant neoplasms of the smooth muscle of the uterus |
| What are the histological features of Leiomyosarcomas? | Atypia and high degree of mitosis |
| What is the classical vignette presentation of Leiomyosarcomas? | Vaginal bleeding of postmenopausal women |
| What are the common features of NF type 1? | Cutaneous neurofibromas, cafe-au-lait spots, and Lisch nodules. |
| Which chromosome is affected in NF type 1? | Chromosome 17 |
| Which AD conditions is characterized with a modified Ras signaling? | Neurofibromatosis type 1 |
| Modified Ras signaling due to mutation chromosome 17. Dx? | Neurofibromatosis type 1 |
| What is a severe and common complication fo chemotherapy for lymphomas and leukemias? | Tumor Lysis syndrome |
| What medication is used to prevent Tumor Lysis syndrome? | Allopurinol |
| A patient of prophylactic Allopurinol, is probably undergoing what procedure? | Chemotherapy for Lymphoma or leukemia |
| What is the mode of action of Allopurinol? | Blocks uric acid formation by inhibiting xanthine oxidase (XO) |
| What causes a Retinoblastoma? | Mutation of RB, tumor suppressor gene on chromosome 13 |
| Which chromosome is affected in Retinoblastoma? | Chromosome 13 |
| How many alleles need to be affected in cancer due to a tumor suppressor gene ? | Both alleles (2) |
| What is the most logical form in which the two alleles involved in a tumor suppressor gene are generated? | 1. One inherited gene 2. One sporadic mutated gene |
| What is Essential thrombocytopenia? | Overproduction of platelets by megakaryocytes that causes obstruction capillaries and arterioles |
| What are the common symptoms of Essential thrombocytopenia? | Epistaxis, thrombosis, bruising, bleeding, mild splenomegaly, erythromelalgia, and transient ischemic attacks |
| What is the most common treatment option for Essential Thrombocytopenia? | Hydroxyurea |
| What condition is commonly treated with Hydroxyurea? | Essential Thrombocytopenia |
| What is a key cytologic feature of CML? | Neutrophilic Leukocytosis |
| What agent is used to treat CML? | Imatinib mesylate |
| How does Imatinib work? | Inhibits the Tyrosine kinase encoded by the BCR-ALB fusion protein of CML |
| Which hematologic and oncologic condition is associated with the formation of the BCR-ALB fusion protein? | CML |
| The BCR-ALB fusion protein work as: | Active Tyrosine kinase receptor |
| Common way to downregulate MHC I molecule? | By cancer cells in an attempt to evade destruction by CD8+ cytotoxic T cells |
| Which immunologic cells become the primary defense against cancer in cases that the MHC I molecules are downregulated? | Natural Killer cells |
| What cells downregulate MHC I in order to avoid destruction by CD8+ T cells? | Cancer cells |
| Which MHC structure is downregulated by cancer cell in order to avoid destruction by cytotoxic T cells, MHC I or MHC II? | MHC I |
| Recombinant anti-CD20 antibody | Rituximab |
| What is Rituximab? | Recombinant anti-CD20 antibody agent |
| Rituximab is against with CD? | CD 20 |
| What lymphoma is treated with Rituximab? | Large B-lymphocyte lymphoma |
| Why has Rituximab been added to the treatment regimen of Large B-lymphocyte lymphoma? | Due to increase survival outcomes |
| What are common adverse effects of Rituximab? | 1. Hypotension 2. Bronchospasm and Chills 3. Decrease in blood platelets, lymphocytes, and neutrophils |
| Form of non-Hodgkin lymphoma diagnosed by lymphoblastic proliferation in the bone marrow. | Lymphoblastic lymphoma |
| From where do most T-cell lymphomas arise form? | Mediastinum |
| Why do most T-cell lymphomas arise from the Mediastinum? | Thymic residence is necessary part of T-cell development |
| MOA of Etoposide | Antineoplastic agent, that acts by inhibiting action of Topoisomerase II |
| Which cell cycle phase is interrupted by Etoposide? | Transition form the S to the G2 phase of the cell cycle |
| What does the prevention of progression from S to G2-pashe by Etoposide ultimately cause? | Irreversible ds-DNA breaks |
| What are the two most common associated adverse effects of Etoposide? | Alopecia and mylopsupresin |
| Description of the shape of Kaposi sarcoma cells | Spindle-shaped tumor cells |
| Which virus is associated with Kaposi sarcoma? | Herpesvirus 8 |
| What type of patients are often associated with Kaposi sarcoma? | AIDS |
| What is the most common predisposing factor for Melanoma? | Extensie sunlight (UV) exposure |
| What are the most common places that Melanoma can metastasize to? | Lungs, bone, and brain |
| MOA of Cisplatin: | Cell-cycle independent chemotherapy agent that CROSSLINKS DNA |
| What is the most significant adverse effect of CIsplatin? | Nephrotoxicity |
| How is Cisplatin - induced nephrotoxicity prevented? | COadministration of Amifostine and Chloride diuresis |
| What are the associated adverse effects of Cisplatin? | Nephrotoxicity, Ototoxicity,and peripheral neuropathy |
| What cancers are often treated with Cisplatin? | Testicular, bladder, ovary, GI, and lung carcinomas |
| Which neoplasm is associated with the Philadelphia chromosome? | CML |
| What is the CML associated translocation? | t(9:22) |
| What is produced by the Philadelphia translocation in CML? | BCR-ALB fusion protein |
| How does the BCR-ALB fusion protein work in CML? | Functions as constitutively active Tyrosine kinase receptor that promotes proliferation of malignant cells |
| Burkitt lymphoma translocation | t(8:14) |
| t(8:14). Dx? | Burkitt lymphoma |
| What is the translocation of Mantle cell lymphoma? | t(11;14) |
| t(11;14). Dx? | Mantle Cell lymphoma |
| What is the associated translocation of Follicular lymphoma? | t(14;18) |
| t(14;18). Dx? | Follicular lymphoma |
| M3 type of AML translocation? | t(15;17) |
| t(15;17). Dx? | M3 type of AML |
| What is the Spindle apparatus? | Complex structure essential for mitosis and meiosis |
| What is the function of the Spindle apparatus? | Induces microtubule polymerization of opposing centrosomes and microtubule capture by kinetochores located on each chromosomes centromeres |
| Any drug or agent that affect the Spindle apparatus function or structure will cause a forced arrest in what phase of the mitosis? | Prophase |
| How are cells shown in Follicular lymphoma? | Nodular collections of lymphoma cells in a lymph node |
| What is the expressed protein in Follicular lymphoma? | BCL-2 |
| What causes the expression of BCL-2 in Follicular lymphoma? | Translocation of t(14;18) |
| What is the common presentation of Follicular lymphoma? | Painless lymphadenopathy |
| Which lymphoma is characterized ty painless lymphadenopathy? | Follicular lymphoma |
| How is CML manifested in lab measurements? | Left-shifted neutrophilia and low ALP activity |
| BCR-ALB fusion protein is the product of an oncogene or tumor suppressor gene? | Oncogene |
| What virus is associated with Burkitt lymphoma? | EBV |
| HIgler aggressive form of non-Hodgkin lymphoma associated with EBV. Dx? | Burkitt lymphoma |
| What is the histological view of Burkitt lymphoma? | Highly mitotic, basophilic lymphocytes surrounding clear zones of macrophages |
| Bx shows highly mitotic, basophilic lymphocytes surrounding clear zones of macrophages | Burkitt lymphoma |
| What is the main distinction between Busulfan and Bleomycin, in respect to adverse effects? | Busulfan toxicity may cause Pulmonary fibrosis and severe myelosuppression years after the treatment is completed, while Bleomycin takes weeks afer inititaing treatmetn |
| What is the most severe and most indicative adverse effect of Busulfan? | Severe myelosuppression |
| Anticancer drug that causes pulmonary fibrosis and severe myelosuppression years after treatment was completed. | Busulfan |
Created by:
rakomi
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