AP9: T Flashcards by S F

______ is defined as an autonomous abnormal growth of cells that persists in the absence of the initiating stimulus

Neoplasia

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All tumours are composed of which two essential components Options A Neoplastic cells parenchyma B Necrotic core C Reactive stroma D Encapsulated lipids

Answer A and C Neoplastic cells parenchyma and Reactive stroma

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When parenchymal cells stimulate the formation of an abundant collagenous stroma the process is referred to as ______

Desmoplasia

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What is the general rule for naming benign mesenchymal tumours Options A Suffix sarcoma B Suffix carcinoma C Suffix oma D Prefix Adeno

Answer C Suffix oma

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Which of the following are examples of benign epithelial tumours Options A Adenoma B Papilloma C Fibroma D Squamous cell papilloma

Answer A B and D

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A malignant neoplasm arising from solid mesenchymal tissue such as fat or bone is specifically called a Options A Carcinoma B Adenoma C Sarcoma D Blastoma

Answer C Sarcoma

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Define the term Adenocarcinoma and distinguish it from Squamous cell carcinoma

Adenocarcinoma is a malignant epithelial tumour with glandular pattern while squamous cell carcinoma is composed of squamous cells

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Tumours that arise from germ layers and show multiple lines of differentiation are known as Options A Hamartomas B Teratomas C Mixed tumours D Embryonal tumours

Answer B Teratomas

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Which of the following are considered primitive embryonal tumours blastomas Options A Neuroblastoma B Nephroblastoma C Hepatoblastoma D Chondroma

Answer A B and C

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Which three features are primarily used to distinguish between benign and malignant tumours Options A Differentiation and anaplasia B Local invasion C Colour of parenchyma D Metastasis

Answer A B and D

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Malignant tumours often undergo central ______ because their rapid growth causes them to outgrow their blood supply

Necrosis

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Compare the growth rate and nuclear morphology of benign versus malignant tumours

Benign tumours grow slowly with near normal nuclei while malignant tumours grow rapidly with enlarged hyperchromatic pleomorphic nuclei

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What is the preferred route of metastasis for most Sarcomas Options A Lymphatic system B Bloodstream haematogenous C Direct seeding D Nerve sheaths

Answer B Bloodstream haematogenous

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Which age group is most commonly affected by Carcinomas Options A Children under 10 B Teenagers C Adults under 50 D Adults over 50

Answer D Adults over 50

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Differentiate between a Hamartoma and a Choristoma

Hamartoma is disorganized mature tissue native to site while choristoma is ectopic normal tissue

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The Epstein Barr virus EBV is most strongly associated with which type of cancer Options A Cervical carcinoma B Burkitt lymphoma C Hepatocellular carcinoma D Kaposi sarcoma

Answer B Burkitt lymphoma

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Which inherited disorders predispose an individual to colorectal adenomas or carcinomas Options A Familial adenomatous polyposis coli B Lynch syndrome C Li Fraumeni syndrome D Xeroderma pigmentosum

Answer A and B

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The process of transforming a normal cell into a neoplastic cell through cumulative mutational events is called ______

Carcinogenesis

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Explain the Hit and Run concept in autonomous neoplastic growth

Tumour continues growing even after carcinogen is removed once transformation is complete

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What is the primary mechanism by which UVB radiation causes DNA damage leading to skin cancer Options A DNA double strand breaks B Formation of pyrimidine dimers C Promoter hypermethylation D Chromosomal translocation

Answer B Formation of pyrimidine dimers

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Which tissues are particularly sensitive to ionizing radiation Options A Thyroid B Breast C Bone D Skeletal muscle

Answer A B and C

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Inhalation of asbestos fibres is associated with which lesions Options A Malignant mesothelioma B Adenocarcinoma breast C Carcinoma lung D Pleural plaques

Answer A C and D

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Contrast initiation and promotion in carcinogenesis

Initiation is genetic mutation while promotion is clonal proliferation of mutated cells

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How do neoplastic cells achieve immortality Options A Inactivation of oncogenes B Expression of telomerase C Activation of TP53 D Histone deacetylation

Answer B Expression of telomerase

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Which genes are classified as Gatekeepers Options A TP53 B RB1 C BRCA1 D RAS

Answer A and B

Normal genes responsible for proliferation that become oncogenes are called ______

Proto oncogenes

HER2 is classified as what type of oncogene Options A Growth factor B Growth factor receptor C Nuclear transcription factor D Cell cycle regulator

Answer B Growth factor receptor

Which are epigenetic events contributing to carcinogenesis Options A Hypermethylation B Histone modification C microRNA interference D Point mutation RAS

Answer A B and C

In the adenoma carcinoma sequence mutation of which gene is an early event

APC

Which are hallmarks of cancer Options A Angiogenesis B Resisting cell death C Evading growth suppressors D Sustained proliferation

Answer A B C and D

Describe the role of caretaker genes

Caretaker genes repair DNA and maintain genomic stability

Which syndrome is caused by TP53 mutation Options A Lynch B VHL C Li Fraumeni D Fanconi anaemia

Answer C Li Fraumeni

Which are histological features of malignant nuclei Options A Small uniform B Hyperchromatic C Irregular D Multiple nucleoli

Answer B C and D

A benign epithelial neoplasm forming finger like projections is called Options A Adenoma B Papilloma C Polyp D Cyst

Answer B Papilloma

Carcinomas growing in squamous pattern are called ______

Squamous cell carcinomas

What is the significance of reactive stroma in tumour growth

Supports tumour growth spread and can form desmoplasia making tumour firm

Which environmental risk factors are linked to hepatocellular carcinoma Options A Hepatitis B C B Aflatoxin B C HPV D Alcohol

Answer A B and D

Which oncogene is an intracellular signalling mediator Options A MYC B Cyclins C RAS D BCL2

Answer C RAS

UV damage is repaired by ______ excision repair

Nucleotide

Which are macroscopic ways to classify tumours Options A Site B Appearance C Mutation type D Histogenic origin

Answer A and B

Collagenous stroma around a malignant tumour is referred to as ______

Desmoplasia

A carcinoma of glandular epithelium is called an ______

Adenocarcinoma

The preferred route of metastasis of carcinomas is via the ______

Lymphatics

A congenital anomaly of heterotopic tissue is a ______

Choristoma

Match the alteration to the consequence Telomerase expression Inactivation of tumour suppressor genes Oncogene activation

Immortalisation Removal of growth inhibition Autocrine growth stimulation

Complete the differences Origin Carcinoma = ? Sarcoma = ? Route Carcinoma = ? Sarcoma = ? In situ phase Carcinoma = ? Sarcoma = ?

Epithelium Connective tissue Lymph Blood Yes No

Double minute chromatin bodies are indicative of which of the following Gene amplification

Gene amplification

Breast cancer susceptibility associated with a mutant BRCA1 allele is inherited as what trait

Autosomal dominant

Which statement regarding viral carcinogenesis is FALSE Ebstein Barr virus is associated with basal cell carcinoma of the skin

False statement EBV is associated with Burkitt lymphoma and nasopharyngeal carcinoma

Which of the following is NOT a class of oncogenes Cyclin dependent kinase inhibitor p16

Tumour suppressor gene not oncogene

Due to rapid growth malignant tumours can outgrow blood supply and undergo necrosis True or False

True

Benign tumours can invade and destroy adjacent tissue True or False

False

A 62 year old male with a hard fixed submandibular mass biopsy shows malignant glandular cells with dense collagen stroma What is this called A Anaplasia B Desmoplasia C Metaplasia D Hyperplasia

B Desmoplasia

Which step in metastasis involves survival after loss of attachment A Intravasation B Evasion of host defense C Transport D ECM invasion

B Evasion of host defense

In the adenoma carcinoma sequence which gene mutation is the first hit A KRAS B TP53 C APC D HER2

C APC

A hit and run carcinogen must be continuously present for tumour growth True or False

False

Teratomas are always benign True or False

False

UVB radiation causes cancer by forming ______ ______ in DNA

Pyrimidine dimers

Tumours resembling embryonic tissue stages are called ______ tumours

Embryonal or Blastomas

Match the agents HPV Aflatoxin B HHV8 H pylori to cancers Kaposi sarcoma Gastric carcinoma Cervical carcinoma Hepatocellular carcinoma

HPV Cervical carcinoma Aflatoxin B Hepatocellular carcinoma HHV8 Kaposi sarcoma H pylori Gastric carcinoma

Why can carcinoma in situ not metastasize

Because cells have not breached the basement membrane

Define neoplasia

Autonomous abnormal growth that persists without stimulus

What are the two components of tumours

Neoplastic parenchyma and reactive stroma

What is desmoplasia

Formation of abundant collagenous stroma by tumour cells

Suffix for benign mesenchymal tumours

-oma

What is a malignant mesenchymal tumour called

Sarcoma

What is a malignant epithelial tumour called

Carcinoma

Define adenocarcinoma

Carcinoma with glandular pattern

What is a teratoma

Tumour from multiple germ layers with diverse tissues

Example of mixed tumour

Fibroadenoma or pleomorphic adenoma

Three features distinguishing benign vs malignant tumours

Differentiation invasion metastasis

Common benign epithelial growth pattern

Exophytic polypoid

Why malignant tumours show central necrosis

Rapid growth outgrows blood supply

Difference between hamartoma and neoplasm

Disorganized native tissue vs true tumour

What is a choristoma

Ectopic normal tissue

Virus associated with Burkitt lymphoma

Epstein Barr virus

Agent associated with gastric carcinoma

Helicobacter pylori

Define initiation in carcinogenesis

Permanent nonlethal genetic mutation

Define promotion in carcinogenesis

Clonal proliferation of mutated cells

Mechanism of tumour immortality

Telomerase activation

Function of gatekeeper tumour suppressor genes

Control proliferation and apoptosis

Function of caretaker tumour suppressor genes

DNA repair and genomic stability

Light chain in AL amyloidosis

Lambda

Preferred metastasis route for sarcomas

Blood

Preferred metastasis route for carcinomas

Lymphatics

T in TNM staging

Tumour size or extent

N in TNM staging

Node involvement

M in TNM staging

Metastasis

Mechanism of UVB carcinogenesis

Pyrimidine dimers

Syndrome from TP53 mutation

Li Fraumeni syndrome

What is immunoediting

Elimination equilibrium escape

Tumour marker for prostate cancer

PSA

Define anaplasia

Loss of differentiation

A 55 year old smoker has a lung mass biopsy shows pleomorphic cells hyperchromatic nuclei and abnormal mitoses what feature is this

A anaplasia loss of differentiation hallmark of malignancy

Which of the following best distinguishes malignant from benign tumours A size B differentiation C metastasis D colour

C metastasis only malignant tumours metastasize

True or False all malignant tumours show poor differentiation

False some are well differentiated but still malignant

A tumour composed of mature tissues from multiple germ layers is called what

Teratoma may be benign or malignant

Which tumour spreads primarily via blood A carcinoma B sarcoma C lymphoma D adenoma

B sarcoma spreads hematogenously

Which tumour spreads via lymphatics A sarcoma B carcinoma C lipoma D fibroma

B carcinoma spreads via lymphatics

A tumour that resembles parent tissue closely is described as what

Well differentiated

What is the earliest genetic event in colon cancer A TP53 B KRAS C APC D HER2

C APC mutation gatekeeper event

True or False TP53 mutation is an early event in carcinogenesis

False it is a late event

A tumour induces dense fibrous stroma what is this called

Desmoplasia collagen deposition by fibroblasts

Double minute chromosomes indicate what

Gene amplification often oncogenes

Which virus is linked to cervical carcinoma

HPV causes oncogenic transformation

Which agent is linked to hepatocellular carcinoma

Aflatoxin B causes p53 mutation

Match tumour type carcinoma sarcoma lymphoma with origin

Carcinoma epithelium sarcoma mesenchyme lymphoma lymphoid tissue

True or False benign tumours can metastasize

False metastasis defines malignancy

A malignant tumour of glandular epithelium is called

Adenocarcinoma

Which feature indicates aggressive tumour behaviour A capsule B slow growth C invasion D uniform nuclei

C invasion into surrounding tissue

Why do malignant tumours undergo necrosis

Outgrow blood supply leading to ischemia

What is a hamartoma

Disorganized growth of native tissue not a true neoplasm

What is a choristoma

Normal tissue in abnormal location

Which tumour suppressor gene is called the guardian of the genome

TP53 regulates DNA repair and apoptosis

Function of BRCA1 gene

DNA repair caretaker gene

True or False oncogenes require both alleles to be mutated

False one activating mutation is sufficient

Tumour cells evade apoptosis by mutation in which gene

TP53 or BCL2 pathways

Which process allows tumour immortality

Telomerase activation preventing telomere shortening

Define metastasis

Spread of tumour cells to distant sites forming secondary tumours

Which step involves tumour cells entering circulation

Intravasation

Which step involves tumour cells exiting vessels

Extravasation

A tumour cell survives detachment from ECM this ability is called

Anoikis resistance

Which enzyme helps tumour invade ECM

Matrix metalloproteinases degrade basement membrane

True or False carcinoma in situ can metastasize

False basement membrane intact

Why is carcinoma in situ important

It is pre invasive stage with high cure potential

Which tumour marker is used in prostate cancer screening

PSA

Which syndrome is associated with TP53 mutation

Li Fraumeni syndrome

Which tumour is benign mesenchymal

Fibroma

Which tumour is malignant mesenchymal

Sarcoma

Which tumour is benign epithelial

Adenoma

True or False all adenomas progress to carcinoma

False only some undergo malignant transformation

Which gene promotes cell proliferation when activated

Oncogene eg RAS

Which gene inhibits proliferation when functional

Tumour suppressor gene eg RB TP53

Match gene type oncogene tumour suppressor caretaker with function

Oncogene promotes growth tumour suppressor inhibits growth caretaker repairs DNA

Which environmental factor causes pyrimidine dimers

UVB radiation

What is initiation in carcinogenesis

Irreversible genetic mutation

What is promotion in carcinogenesis

Clonal expansion of mutated cells

True or False promotion alone can cause cancer

False requires prior initiation

Which tumour shows both epithelial and stromal components

Fibroadenoma mixed tumour

Which tumour commonly shows desmoplasia

Carcinomas especially adenocarcinoma

Which pathway is most associated with lymph node spread

Carcinoma metastasis via lymphatics

Which pathway is most associated with lung metastases

Sarcoma via bloodstream

Why do tumours become heterogeneous

Accumulation of multiple genetic mutations

What is immunoediting

Elimination equilibrium escape of tumour from immune system

Which stage in TNM refers to lymph nodes

N node involvement

Which stage in TNM refers to metastasis

M distant spread

Which stage in TNM refers to tumour size

T primary tumour extent

Clinical case a patient has weight loss anemia and occult blood colonoscopy shows tumour mutation sequence APC KRAS TP53 what process is this

Adenoma carcinoma sequence classic colon cancer progression

AP9: T Flashcards

(148 cards)