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Neoplasia

FA review Round 1 2020

QuestionAnswer
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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