Download HSCI 305 Exam 1 Questions with 100% complete answers. NEW UPDATE!! and more Exams Nursing in PDF only on Docsity!
HSCI 305 Exam 1 Questions with 100%
complete answers. NEW UPDATE!!
Cancer - CORRECT ANSWER -What is the second leading cause of death?
Heart disease - CORRECT ANSWER -What is the first leading cause of death?
Unintentional injuries - CORRECT ANSWER -What is a high cause of death of
males?
- What caused it?
- What is it?
- Options?
4) Will my family get it too? - CORRECT ANSWER -Important questions for
family/patients
- Diagnostic test?
- Other diagnoses to rule out?
- stage/ grade and local or metastatic?
- therapeutic approach?
5) How often and how long to follow patient? - CORRECT ANSWER -Important
questions for physicians
- Possible causes?
- Mechanism?
- preventative measures
- Certain people more likely to get it?
5) Can we use unique features of tumors to devise treatments? - CORRECT
ANSWER -Important questions for researchers
hyperplasia - CORRECT ANSWER -increased number of cells
dysplasia - CORRECT ANSWER -cells look abnormal (unusually
undifferentiated)
neoplasia - CORRECT ANSWER -new (abnormal) proliferation
tumor - CORRECT ANSWER -mass of cells
cancer - CORRECT ANSWER -malignant neoplasia
cancer - CORRECT ANSWER -an abnormal growth of cells caused by multiple
changes in gene expression leading to a dysregulated balance of cell proliferation and cell death and evolving into a population of cells that can invade tissues and metastasize to distant sites causing death if untreated
- ability to invade and metastasize
- benign tumors contain cancerous cells too - CORRECT ANSWER -What differentiates benign from malignant cancer?
- set of unique diseases
- inevitable consequence of multicellularity
- a genetic syndrome - CORRECT ANSWER -What are the three ways of looking at cancer?
- histological
- molecular - CORRECT ANSWER -What are the two ways to classify cancers?
histological - CORRECT ANSWER -organ and tissue cell of origin
appearance under microscope tumor organization (level of invasion)
molecular - CORRECT ANSWER -mutational profile
amount of mutation (mutational load)
risk factors - CORRECT ANSWER -______ ___________ indicate the likelihood
of acquiring the disease
prognostic factors - CORRECT ANSWER -indicate how the disease will behave
independent of therapy (cancer by itself no treatment)
predictive factors - CORRECT ANSWER -indicate how the disease will behave in
the presence of a particular therapy
therapeutic approach - CORRECT ANSWER -Clinical goal is to determine the
best _______________ ____________.
carcinoma - CORRECT ANSWER -80-90% of all cancers epithelial origin
sarcoma - CORRECT ANSWER -mesenchymal origin connective tissue
chronic myeloid leukemia - CORRECT ANSWER -type of leukemia in a mutation
of BCR-ABL gene
Hodgkins and Non-Hodgkins - CORRECT ANSWER -two types of lymphoma
lymphoma - CORRECT ANSWER -starts in the lymphoid system in the
lymphatics
sarcomas and leukemia - CORRECT ANSWER -Most childhood cancers are.......
carcinomas - CORRECT ANSWER -Most adult cancers are.......
molecular classification - CORRECT ANSWER -Which classification is a better
predictor to targeted therapy?
predictive factor most commonly - CORRECT ANSWER -What factor does
molecular classification use?
HER2 mutated gene (breast cancer) - CORRECT ANSWER -Example of a
molecular classification
Keytruda (pembrolizumab) - CORRECT ANSWER -What is the name of the drug
based on molecular classification only?
anatomical pathology - CORRECT ANSWER -microscopic analysis of samples to
help diagnose and understand disease
histology - CORRECT ANSWER -focus on tissue architecture and organization
- heterogenous mass
- irregular shape
- edges might not be obvious
- discoloration
- increased blood vessels and hemorrhage
- mass effect - CORRECT ANSWER -factors of a primary tumor (6)
mass effect - CORRECT ANSWER -where normal tissue gets pushed and
shifted causing loss of symmetry
- multiple modules
- rare to see large nodules
- edges?
- not as vascularized as primary tumors - CORRECT ANSWER -factors of a metastasis
hematoxylin - CORRECT ANSWER -stains nuclei blue/purple is basophilic and
positive charge
eosin - CORRECT ANSWER -stains cytoplasm pink is eosinophilic and negative
charge
More purple because more nuclei because increased number of cells - CORRECT
ANSWER -if there is a lot of hyperplasia what type of stain would you see more?
- normal duct
- ductal hyperplasia
- atypical hyperplasia displasia BENIGN (above) MALIGNANT (below)
- ductal carcinoma in situ
5) invasive ductal carcinoma (metastasis) - CORRECT ANSWER -What are the
5 stages for breast cancer development?
- 15-20 lobes and each lobe has 20-40 lobules, small ducts are attached to the lobules about 10 duct systems
- cancer can be either ductal or glandular (ductal more common) - CORRECT
ANSWER -Describe typical structure of breast
hyperplasia benign - CORRECT ANSWER -stage in breast cancer with more
than one layer of epithelial cells in duct
atypical hyperplasia - CORRECT ANSWER -stage in breast cancer with more
than one layer of epithelial cells and they are irregular in shape
ductal carcinoma in situ - CORRECT ANSWER -stage in breast cancer with
lowest malignant grade and not invasive and may not have symptoms
invasive ductal carcinoma (low grade) - CORRECT ANSWER -stage in breast
cancer where it escapes normal structure and invades surrounding tissue and symptoms should be evident
necrosis (outside cells do not care about inside cells) - CORRECT ANSWER -
when a tumor outgrows its blood supply what happens?
lymph nodes - CORRECT ANSWER -Whats the first metastatic site?
- intravasation
- circulation
- microvessels of many organs
- extravasation
7) metastasis - CORRECT ANSWER -What is the invasion metastasis cascade?
mesenchymal or blood cells - CORRECT ANSWER -Which cells are normally
motile? epithelial cells they have a basement membrane (non motile cells grow attached to
other cells) - CORRECT ANSWER -Which cells are anchored?
metastasis - CORRECT ANSWER -_____________ requires detached motile
cells
mesenchymal invasion - CORRECT ANSWER -this invasion is carried out by
single cells that go from epithelial to mesenchymal often times in a single file line and extracellular matrix is realigned to allow them out and once metastasis occurs the cells reverse back to epithelial
amoeboid invasion - CORRECT ANSWER -this invasion single cells detach from
tumor and behave like blood cells and invading cells squeeze through gaps in the extracellular matrix, but inability to create new paths
collective invasion - CORRECT ANSWER -this invasion is epithelial like in cell to
cell adhesion. Motile cells at front generate a path by re shaping extracellular matrix and these cells pull the cells that are connected to them through the path
coordinate and cohort invasion - CORRECT ANSWER -What are the two types
of collective invasion methods?
coordinated invasion - CORRECT ANSWER -this invasion is attached to primary
and migrate as a sheet
cohort invasion - CORRECT ANSWER -this invasion is separate from primary
the migration is a cluster of cells
epithelial cells - CORRECT ANSWER -What cell type is more likely to use
collective invasion?
sarcomas, lymphomas, and leukemia's - CORRECT ANSWER -What cell types
are more likely to use individual invasion like amoeboid or mesenchymal?
plasticity - CORRECT ANSWER -cancer cell types of invasion can change as the
cancer grows what is this called?
intravasation - CORRECT ANSWER -for the cancer to metastasize it must enter
the blood vessels paracellular- between cells
transcellular- through cells - CORRECT ANSWER -2 types of intravasation and
definitions
lymphangiogenesis - CORRECT ANSWER -Newer research has shown that
tumors induce ____________________ and is correlated with metastasis
regional lymph vessels and then into subclavian veins - CORRECT ANSWER -
Where do lymph vessels first drain to and them where do they drain after that? Yes. There are multiple companies looking for blood tests to run to determine if DNA in
blood stream or which cells of cancer are in blood - CORRECT ANSWER -True
or False: Do circulating cancer cells mean metastasis?
circulating tumor DNA (ctDNA) - CORRECT ANSWER -cells naturally release
DNA fragments to surrounding fluids and have a short half life of about 3 hours these are great for evaluating disease progression and found in other fluids as long as tumor interacts with it
recurrence - CORRECT ANSWER -tumor has come back after therapy
local recurrence - CORRECT ANSWER -recurrence at primary site
recurrence out of field - CORRECT ANSWER -recurrence at primary site but
outside of local treatment area
regional recurrence - CORRECT ANSWER -recurrence at draining lymph node
distal recurrence - CORRECT ANSWER -recurrence at secondary site
Paget's Seed and Soil Hypothesis - CORRECT ANSWER -tumor cells like seeds
are carried in all directions but can only grow in areas with congenial soil (nutrients) some cancer types have sites of metastases that normally occur with that type of cancer
- CORRECT ANSWER -what is a preferential metastatic site?
DNA repair genes - CORRECT ANSWER -promote repair of mutations that occur
during the cell cycle. Loss of these results in accumulation of many mutations within a cell
- Sustaining proliferative signaling
- Evading growth suppressors
- Activating invasion and metastasis
- Enabling replicative immortality
- Inducing angiogenesis
6. Resisting cell death - CORRECT ANSWER -What are the 6 original hallmarks
of cancer?
proliferation - CORRECT ANSWER -The major defining feature of cancer is
increased ____________________. focus is on cancer cell at expense of tissue level changes or organization -
CORRECT ANSWER -What is a criticism of hallmark as a whole?
growth factors (increase in these is cancer) - CORRECT ANSWER -sustaining
proliferative signalling includes
growth factor independent signalling - CORRECT ANSWER -An altered structure
can lead to .........
overexpression - CORRECT ANSWER -An increase in sensitivity to growth
factor signalling
Autocrine signaling - CORRECT ANSWER -Where the growth factor receptor is
intact, increased growth signalling can be induced by the cancer cell itself
EGF (overexpression) - CORRECT ANSWER -What is an example of a growth
factor?
- proliferation in cancer
- angiogenesis
- invasion
- growth at metastatic site
- therapeutic resistance - CORRECT ANSWER -What are some roles of growth factors in cancer?
VEGF (vascular endothelial growth factor) - CORRECT ANSWER -What is the
main growth factor involved in angiogenesis?
fibroblasts - CORRECT ANSWER -What secretes VEGF?
Existing vessels are pruned and new vessels are made. They have to balance each
other to work - CORRECT ANSWER -What does balancing of angiogenic
signalling mean?
tumor suppressors - CORRECT ANSWER -genes/proteins whose normal
function protects a cell from becoming cancerous, they are inactivated in cancer
mutations - CORRECT ANSWER -Most familial and hereditary cancers are from
tumor suppressor ________________
the cell cycle and checkpoints - CORRECT ANSWER -evading growth
suppressors includes........
- G1/S checkpoint
- S phase checkpoint
- G2/M checkpoint
4) Mitotic checkpoint - CORRECT ANSWER -What are the four types of cell
cycle checkpoints? adequate nutrition, DNA damage sensor
- restriction point
- pRb keeps E2F in check
- if not combined correctly leads to arrest of cells - CORRECT ANSWER -What happens at G1/S checkpoint?
DNA damage - CORRECT ANSWER -S phase checkpoint?
Give time for cells to repair and even commit suicide if damaged
- double stranded breaks studied
- apoptosis - CORRECT ANSWER -G2/M checkpoint? Chromosome aligned on metaphase plate only slows down and stops mitosis if error -
CORRECT ANSWER -Mitotic checkpoint??????
Rb or pRb - CORRECT ANSWER -What is the protein for retinoblastoma?
Parent inherits one mutated copy from parent and a new mutation occurs in the second copy of the gene and leads to loss of function this leads to the retinoblastoma (loss of
heterozygosity) - CORRECT ANSWER -Explain retinoblastoma family
connection
insertion/deletion - CORRECT ANSWER -mutations can lead to frameshift
changes that drastically change the protein product, copy number variation is associated with it
aneuploidy - CORRECT ANSWER -different number of chromosomes
chromosomal translocations - CORRECT ANSWER -formation of abnormal
chromosomes
oncogene activation - CORRECT ANSWER -This can be caused from deletion or
point mutation, gene amplification, or chromosome rearrangement
point mutation - CORRECT ANSWER -lead to more subtle changes in either
binding sites or regulatory domains
oncogenic mutations - CORRECT ANSWER -most often lead to constituvely
activated proteins that can signal in the absence of regulating factors
tumor suppressor mutations - CORRECT ANSWER -most often lead to
inactivation of the protein
driver mutations - CORRECT ANSWER -relevant mutations to cancer growth
and progression
passenger mutations - CORRECT ANSWER -irrelevant to cancer growth and
progression
base excision, single and double strand breaks, nucleotide excision - CORRECT
ANSWER -What are some pathways for DNA repair?
oncogenic amplification - CORRECT ANSWER -having more copies of the
protein and leads to increased signaling and or increased sensitivity to signaling
myc - CORRECT ANSWER -this is a transcription factor that plays a role in cell
cycle progression. Normal not dividing cells myc levels are low, dividing cells myc levels intermediate, and oncogenic myc has his levels of myc
array CGH method - CORRECT ANSWER -the goal of this is to detect copy
number alterations using a gene chip. Probes are labelled to help detect chromosomes and several genomes can be compared
abberations - CORRECT ANSWER -these can be unique for each tumor and the
copy number variation can vary among tumors
chromosomal instablity - CORRECT ANSWER -a phenotype of most cancer cells
losses or gains of chromsomes result from errors in mitosis
karyotype - CORRECT ANSWER -describe the number of chromosomes and
what they look like under a light microscope (looks for physical differences)
G-banding - CORRECT ANSWER -stained with Giemsa following digestion of
chromosome with trypsin
R-banding - CORRECT ANSWER -the reverse of G-banding
chromsome rearrangement 1 (myc Burkitts lymphoma) - CORRECT ANSWER -
this rearrangement lead to altered regulation of a proto-oncogene, leads to significant alteration in gene expression
chromosome rearrangement 2 (bcr-abl) - CORRECT ANSWER -this
rearrangement can lead to production of new proteins via fusion genes the new protein either has a new function of altered function
FISH fluoresence in situ hybridization - CORRECT ANSWER -chromosomes are
labeled with fluorescent chromosome specific DNA probe
genetic subtyping of cancer - CORRECT ANSWER -Microarrays test for what?
molecular classification of tumors - CORRECT ANSWER -goal is to use changes
in mutations and expression as a biomarker helps with normal cancers but rare cancers are not as easy
predictive quality - CORRECT ANSWER -What is the primary goal of clinical
studies?
retrospective studies - CORRECT ANSWER -outcome is known, look backwards
in time descriptive studies (surveillance), case control, and nested case studies -
CORRECT ANSWER -What studies are retrospective studies?
prospective studies - CORRECT ANSWER -risk factors stratified at the start, look
forward in time
strength - CORRECT ANSWER -stronger associations are more likely to be
causal than weaker associations
consistency - CORRECT ANSWER -has this been reproduced by multiple
groups under different circumstances
specificity - CORRECT ANSWER -single cause to single effect
temporality - CORRECT ANSWER -cause must precede the effect
biological gradient - CORRECT ANSWER -clear dose-response curve
plausibility - CORRECT ANSWER -is there prior biological data to explain causal
relationship
coherence - CORRECT ANSWER -the cause effect relationship should not
contradict what we know about the disease
experimental evidence - CORRECT ANSWER -result from intervention studies or
pre clinical studies confirm the observational studies
analogy - CORRECT ANSWER -have we seen similar effects with exposures of
the same class
Developing countries - CORRECT ANSWER -what countries have higher cancer
rates
Asia for both - CORRECT ANSWER -What country has the highest incidence
and mortality rates?
prostate in developed, but lung cancer in Europe (cigars) - CORRECT
ANSWER -most common cancer (males)
mostly lung and some liver - CORRECT ANSWER -deadliest cancer in males?
Breast and some ovarian/cervical in developing countries - CORRECT
ANSWER -most common cancer females
US: lungs developing: breast
Africa: cervical cancer - CORRECT ANSWER -deadliest cancer in females
- prostate high incidence low mortality rate
- lung high incidence and high mortality rate
- lip/oral high incidence high mortality - CORRECT ANSWER -Males HDI stats
- Breast cancer high incidence, low mortality
- cervical cancer medium incidence and medium mortality more in developing countries
- CORRECT ANSWER -Female HDI stats
Cancer Facts and Figures 2020 - CORRECT ANSWER -a descriptive study with
stats about cancer in the USA and estimates based on modeling trends
75 and older - CORRECT ANSWER -What age has the highest cancer incidence
rate? Males: 40.1%
Females: 38.7% - CORRECT ANSWER -What is lifetime prob of developing
cancer for males? Females? breast cancer increased, lung cancer increased, and pancreas cancer increased -
CORRECT ANSWER -What are some trends in 5 year survival rates?
- leukemia high incidence high mortality
2) brain and CNS high incidence higher mortality - CORRECT ANSWER -What
are cancer incidence rates in peds?
descriptive studies - CORRECT ANSWER -are there particular subpopulations
that have higher rates of cancer? what study?
cohort studies - CORRECT ANSWER -separate groups based on an exposure
and then see which one has a higher risk
case control studies - CORRECT ANSWER -compare people that have cancer to
those that don't have cancer and see how they differ
Nurse's Health Study - CORRECT ANSWER -the cohort study on registered
nurses on contraceptives focused mostly on women due to the nurse profession (females mostly) -
CORRECT ANSWER -Issues with Nurses Health Study
pre-clinical studies - CORRECT ANSWER -cell culture and animal studies
conversion - CORRECT ANSWER -the step of benign to malignant
transformation
progression - CORRECT ANSWER -outright disease/ cancer step?
initiator- benzopyrene (irreversible)
promoter- croton oil (irritant)(reversible) - CORRECT ANSWER -mouse multi-
step theory of cancer experiment
chemical carinogen - CORRECT ANSWER -any discrete chemical compound
which has been shown to cause cancer in human or animal studies
initiation - CORRECT ANSWER -most known carcinogens, mutagens,
transforms normal cells into potential cancer cells
promotion - CORRECT ANSWER -induce cell proliferation cannot induce cancer
unless initiation has already occurred
complete carcinogen - CORRECT ANSWER -chemical capable of acting at every
step of cancer progression, mutagens and promoters EX: radiation
combining hits and steps - CORRECT ANSWER -Mutagens initiate
transformation from normal to cancer (1st hit), promoters repeatedly stimulate cell to divide so 2nd hit and 3rd hit. Cell eventually becomes unstable.
- epidemiological studies
- animal studies - CORRECT ANSWER -How is carcinogennicity determined?
Group 1 - CORRECT ANSWER -carginogen classification carcinogenic to
humans (worst) EX: alcohol, radiation, tobacco, asbestos
Group 2A - CORRECT ANSWER -carcinogen classification probably
carcinogenic to humans EX: DDT, steroids
Group 2B - CORRECT ANSWER -carcinogen classification probably
carcinogenic to humans EX: welding fumes, styrene, pickled veggies
Group 3 - CORRECT ANSWER -classification carcinogen not classifiable as its
carcinogenicity to humans (not sure) EX: coffee, tea, printing ink
Group 4 - CORRECT ANSWER -carcinogen classification probably not
carcinogenic to humans EX: caprolactam (not anymore moved to group 3)
- certainty
- risk
- mechanism - CORRECT ANSWER -How do you identify carcinogenicity? Obesity increases the risk of cancer but is reversible with good diet and exercise -
CORRECT ANSWER -How does diet affect cancer risk?
exposure is unlikely to be homogenous carcinogen can be more potent in stomach
rather than in liver etc. - CORRECT ANSWER -Carcinogenecity can be organ
specific lung: tobacco cervical: HPV melanoma: radiation stomach: h.pylori
liver: viral hepatitis, alcohol - CORRECT ANSWER -What is the known cause of
lung cancer, cervical cancer, melanoma, stomach, and liver cancer?
Lots of men and women stopped smoking due to the news - CORRECT
ANSWER -What happened in the surgeon generals warning?
cigarette use and death from lung cancer is about 20 years of a gap it is not immediate -
CORRECT ANSWER -Explain the delays between exposure and cancer
Still not as sure with cigarettes, but has a lot of the same qualities as smoking and
nicotine is addictive - CORRECT ANSWER -Is vaping carcinogenic?
still not much evidence, marijuana smoke has about 33 carcinogens in it, but THC is not carcinogenic, small studies but some show some increased risk (shown in animals) -
CORRECT ANSWER -Is marijuana carcinogenic?
oncovirus - CORRECT ANSWER -cancer causing virus
