GU Patho Exam 1 (2)

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GU Patho Exam 1 (2)
2015-09-10 19:36:18
GU Patho
GU Patho modules 2-3
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  1. What are stromal cells?
    support cells in the tissue (CT, BV, etc)
  2. What are parenchymal cells?
    • uniquely adapted to perform the fxn of an organ 
    • Ex: parenchymal cells of heart are cardiomyocytes; of liver are hepatocytes
  3. What are mesenchymal cells?
    cells of mesodermal or neural crest origin that give rise to CT, blood, and muscle
  4. What is an oma?
    benign tumor
  5. What is a carcinoma?
    malignant tumor of epithelial origin
  6. What is a sarcoma?
    malignant tumor of mesenchymal origin
  7. What is the cancer stage is M=1?
    every cancer is stage IV if M=1
  8. T0
    • no penetration of basement membrane by the tumor 
    • Ex: polyp growing but has not grown into basement membrane
  9. T1
    tumor  has grown through basement membrane, but is still local
  10. T1
    invasion of tumor into other organs/neighboring tissue
  11. Four ways cancer can spread.
    • Direct (right out of local site)
    • Thru lymph nodes
    • Thru blood
    • Thru incisions (biopsy, surgery)
  12. What is leiomyoma? leiomyosarcoma?
    • beinign tumor of smooth muscle
    • malignant tumor of smooth muscle
  13. What does well-differentiated mean?
    • In a benign tumor, for example, it looks like the cells from which it came.
    • Myoma looks like myocytes; melanoma looks like melanocytes
  14. Six things ("super powers") that a cell needs to become cancerous.
    • Self-sufficiency in growth signals (accelerator)
    • Insensitivity to anti-growth signals (brake)
    • Evade apoptosis (ignore the signal)
    • Sustained angiogenesis
    • Limitless replicative potential (turns on telomerase)
    • Tissue invasion and metastasis
  15. What is a proto-oncogene?
    • normal gene w/ normal function
    • a protein whose normal cellular gene can be converted into a cancer-promoting oncogene by mutation
  16. How many mutations are needed in a proto-oncogene to make it cancerous?
  17. Examples of proto-oncogene mutations.
    • bcl-2: B-cell Lymphoma
    • HER2/neu (erbB-2): Breast or ovarian cancer & others (epidermal growth factor Receptor)
    • N-myc: Neuroblastoma
    • C-myc: Burkitt lymphoma, others
    • **Ras - various, 20-30% of ALL cancers**
  18. Two things that can happen with chromosomal translocations.
    • Too much protein
    • Synthesis of a Novel Fusion protein (a new protein is produced that did not exist, or did exist and causes cancer)
  19. Examples of Tumor Suppressor Genes.
    • p53: various
    • BRCA1, BRCA2: breast and ovarian (BReast CAncer)
    • APC: colorectal (Adenomatous Polyposis Coli)
    • RB1: various (RetinoBlastoma)
    • MSH2: colorectal, endometrial, gastric
    • NF1, NF2: neuroblastoma, etc. (neurofibromin)
  20. What is a germline mutation?
    A baby is born with one already mutated tumor suppressor gene
  21. Proto-oncogenes _____ a function and need _____ how many mutations to do this?
    • GAIN
    • ONE
  22. Tumor Suppressor Genes _____  function and need how many mutations to do this?
    • LOSE
    • TWO
  23. What can happen when cancer gets into the blood?
    It can travel through the blood and land on a distant organ, colonize it, and cause a secondary cancer site
  24. How can cancer spread through surgery?
    The scalpel can drag cancer cells into neighboring tissue
  25. How does a cancer cell develop limitless replicative potential?
    turns on telomerase, which keeps the telomeres from getting too short and signaling the cell to stop growing
  26. bcl-2 mutation
    B-cell Lymphoma proto-oncogene mutation
  27. HER2/neu   (erbB-2) mutation
    Breast or Ovarian cancer proto-oncogene mutation
  28. N-myc mutation
    Neuroblastoma proto-oncogene mutation
  29. C-myc mutation
    Burkitt Lymphoma proto-oncogene mutation
  30. RAS mutation
    • proto-oncogene mutation
    • 20-30% of ALL cancers
  31. p53 mutation
    Tumor Suppressor Gene mutation for various cancers
  32. BRCA1, BRCA2 mutation
    • Tumor Suppressor Gene mutation for BReast and ovarian CAncers
    • BRCA1 is the DNA repair molecule
  33. APC mutation
    Tumor Suppressor Gene mutation for colorectal cancer (Adenomatous Polyposis Coli)
  34. MSH-2 mutation
    Tumor Suppressor Gene mutation for colorectal, endometrial, & gastric cancers
  35. NF-1, NF-2 mutation
    Tumor Suppressor Gene mutation for Neuroblastoma (neurofibromin)
  36. _____ is one of several targets of the activated RAS pathway.
  37. How does RB play a role in cancer?
    • RB (retinoblastoma gene) is a protein assoc with checkpt b/w G1 & S where DNA is REPLICATED.  
    • It sends anti-growth signals if it finds a bad cell. If BOTH RB genes are missing or bad, this checkpoint is lost.
    • Now the bad cell can continue to grow.
  38. What is the job of P53?
    • Tumor Suppressor Gene
    • activates processes to repair defective DNA
    • stops cell cycle until DNA is repaired 
    • if repair fails, apoptosis is triggered
  39. How does P53 play a role in cancer?
    • If BOTH P53 genes are bad, there is no checkpoint to stop bad DNA from continuing through the cell cycle
    • defective DNA can then become cancer
  40. What size tumor can cause death?
  41. How is sustained angiogenesis triggered?
    • Vascular Endothelial Growth Factor (VEGF)  is secreted by the tumor 
    • VEGF triggers BV to grow in tumor
  42. How is the limitless replicative potential turned on for a tumor?
    It turns on telomerase to prevent shortening of telomeres
  43. What are the steps a cancer cell takes to escape it's parent tissue and migrate?
    • Loosens junctions
    • breaks down collagenase to dissolve the basement membrane
    • attaches to something below the basement membrane (like fibronectin) & pulls itself away
    • migrates to CT below epithelial cells
  44. What are the main sites of metastatic tumors?
    • lungs (most popular)
    • liver (common w/ GI cancers)
    • bone
    • brain
    • adrenals
  45. What is the function of viral protein E7?
    disables the Rb protein, which means a checkpoint is lost; causes increased rate of mutated cell accumulation
  46. What is the function of viral protein 6?
    neutralizes P53, inhibiting a checkpoint; causes increased rate of mutated cell accumulation
  47. Other tissues affected by chemotherapy that contain rapidly dividing cells.
    • GI Tract (esp sm intestine)
    • Bone Marrow (anemia, neutropenia)
    • Hair follicles (mostly head)
    • Skin (thin skin, rashes)
    • FETUS
  48. What makes up plasma?
    • 90% water
    • 10% solutes.
    • Of the solutes: ~7% are plasma proteins made in the liver; ~3% are electrolytes, gases, nutrients, waste, & hormones
  49. Of what are the plasma proteins made? What are their fxns?
    albumin (60%): oncotic pressure, carrier molecule
  50. What is the function of alpha & beta globulins?
    carrier proteins for lipids & fat-soluble vitamins
  51. Where are gamma globulins/antibodies made?
    in lymph node or other lymph organs
  52. The 3 main plasma proteins.
    • albumin
    • globulins
    • fibrinogen
  53. What type of WBCs will be elevated with type I hypersensitivity rxns?
  54. Which types of RBCs are granulocytes?
    • neutrophils
    • eosinophils 
    • basophils
    • (also mast cells)
  55. Function of mast cells.
    cause vascular permeability & smooth muscle cell contraction
  56. What are granulocytes?
    • tiny membrane-bound granules filled with:
    •      digestive enzymes (kill microorganisms) &
    •      biochemical mediators (inflammation &     immunity)
  57. What is the main function of agranulocytes?
    create immunity (lymphocytes)
  58. WHich cells are agranulocytes?
    • lymphocytes (B-, T-, & NK-cells)
    • monocytes
  59. Function of NK-cells.
    provide immunity against virus-infected and tumor cells w/o prior exposure to antigens
  60. Additional stores of platelets are where?
    in the spleen
  61. Primary lymph organs.
    • Thymus
    • Bone Marrow
  62. Secondary lymph organs.
    • spleen
    • lymph nodes
    • tonsis
    • Peyer's Patches on sm intestine
  63. What happens in the white splenic pulp?
    lymphocytes illicit an immune response to blood-borne pathogens
  64. What happens in the red splenic pulp?
    • It is the primary filtration site
    • macrophages phagocytose old damaged RBCs
    • Heme (iron) is recycled
  65. What is differentiation when referring to hematopoiesis?
    maturation of blood cells
  66. Two types of tissue in BM.
    • Red (active) - hematopoietic tissue
    • Yellow (inactive) - adipose tissue
  67. Three ways hempatopoiesis is accelerated.
    • EPO causes increased amounts of active marrow (yellow to red)
    • increased rate of differetiation of daughter cells
    • increased rate of proliferation of blood cells
  68. What is GM-CSF?
    • Granulocyte Macrophage Colony Stimulating Factor:  released from:
    •      T-cells, endothelial cells, & fibroblasts
    • leads to formation of myeloid progenitor cells 
    • become either granulocyte OR macrophage