Module 7 CS

  1. Third most common gynecologic cancer diagnosis in the US
    Cervical cancer
  2. 80% of cervical cancer cases are classified as
    squamous cell
  3. is the second most common subtype and counts for 15% of cases; (gynecologically)
  4. central to the development of both aforementioned subtypes(cervical cancer amd adenocarcinoma)
  5. Incidence is highest among(cervical cancer)
    Mortality highest in (cervical cancer)
    • Hispanic females
    • African american women
  6. Average age of diagnosis of cervical cancer
    48 years
  7. Risk factors closely linked with an increased risk for acquiring HPV
    • Early onset sex
    • history of STIs
    • immunosuppression
    • two or more sexual partners
    • duration of oral contraceptive use >5 yrs
  8. Four major steps in the development of cervical cancer:
    • Oncogenic HPV infection at junction of vaginal portion of cervix and cervical canal
    • HPV infection
    • Progression to precancer
    • carcinoma and invasion into membrane
  9. subtypes responsible for over 70% of cervical carcinomas
    subtypes 16 and 18
  10. subtypes also commonly linked to cervical carcinomas
    31, 33, 35
  11. the time from initial hpv infection to development of invasive cervical cancer takes an average of
    15 years
  12. Advanced cervical carcinoma spreads by primarily to
    • direct extension
    • bladder, ureters, rectum, vagina
  13. what is first symptom of cervical cancer as disease progresses; including other symptoms of painful intercourse, pelvic pain, and vaginal
    abnormal vaginal bleeding
  14. what immunization covers 9 HPV strains
  15. subclass of benign epithelial lesions that are not associated with increased risk of breast cancer is known as
    Fibrocystic changes
  16. fibrocytis changes occur in women between ages of
    15-50 years
  17. Incidence of breast cancer in US how many times higher than other countries
    4-7 times
  18. Breast cancer that occurs due to the inheritance of susceptibility gene or genes is known
    familial breast cancer
  19. Major susceptibility geneswith breast cancer
    BRCA1, BRCA2, TP53, and CHEK2
  20. what gene mutations are responsible for 80% to 90% of “single gene” familial breast cancers
    Mutations in BRCA1 and BRCA2
  21. Breast cancer caused by hormone exposure
    sporadic breast cancer
  22. Factors related to hormone exposure causing breast cancer include
    gender, age at menarche and menopause, reproductive history, breastfeeding, and exogenous estrogen
  23. Researchers believe that breast cancer begins to form when
    the cells in the milk-producing ducts grow uncontrollably and rapidly
  24. What causes fibrocystic changes in breast
    changes during puberty allow stromal and ductal components to deviate from their normal development
  25. What age does involution occur (breast cancer)
    35 years
  26. involutional changes occur which involves (breasts)
    the replacement of loose hormone receptive connective tissue with denser connective tissue in the stroma
  27. Invasive ductal carcinoma – three major genetic pathways
    • ER-positive and HER2-negative
    • HER2-positive
    • ER-negative and HER2 negative
  28. Germline mutation in TP53 that causes HER2 amplification leads to
    atypical apocrine adenosis which is known as a putative precursor lesion
  29. HER2-positive Strongly associated with strengthening of
    HER2 gene on chromosome 17q
  30. Lesions can progress to ductal carcinoma in situ caused by
    angiogenesis and tumor-associated inflammation
  31. Fibrocystic changes – principal variations include
    cysts, fibrosis, adenosis, and mild ductal and lobular hyperplasia
  32. Cysts in breasts form due to
    dilation of lobules, may be small but can come together and form larger cysts
  33. Palpable nodules of the breast are due to
  34. Increased acini per lobule
  35. Invasive ductal carcinoma – will appear in cells that
    line milk duct and spread to nearby tissue
  36. what gives breast tumor a streak chalky-white appearance
    Desmoplastic stroma and foci calcification
  37. breast lumps, swelling, and tenderness or pain; exacerbate just before new menstrual cycle and change throughout r/t?
    Fibrocystic changes
  38. generally, lumps that are painless, hard, and have irregular edges are cancerous are caused by what disease
    Invasive ductal carcinoma
  39. nephrotic syndrome dx at what age
    individuals under 17
  40. primary cause of NS is
    a lesion to the kidney
  41. most common of primary lesions in NS are
    minimal-change disease, membranous glomerulopathy, and focal segmented glomerulosclerosis
  42. most common cause of NS in children and may occur in adults associated with NSAID use or as a paraneoplastic effect of malignancy
    Benign disorder characterized by diffuse effacement of foot processes of visceral epithelial cells called podocytes
    minimal change disease
  43. most common primary lesion that accounts for nephrotic syndrome in adults
  44. NS Can present as idiopathic syndrome, referred to as
    primary FSGS
  45. NS may be associated with
    HIV, reflux nephropathy, healed previous glomerular injury, or morbid obesity
  46. most common causes of primary nephrotic syndrome in adults
    Membranous nephropathy
  47. is underlying mechanism of proteinuria in NS
    Podocyte dysfunction
  48. one of the classic clinical manifestations of nephrotic syndrome
  49. NS caused by imbalance in...resulting in
    • glomerular capillary walls
    • increased permeability to plasma proteins
  50. Damaged glomeruli allow more than...of protein to leak into the urine
  51. principle urinary protein that is excreted in NS
  52. Increased amounts of protein in the urine diminishes...resulting in
    • serum albumin levels faster than the liver can compensate for
    • hypoalbuminemia causing edema
  53. dense deposits of immune complexes such as Ig in NS is a characteristic finding of
    membranous nephropathy
  54. As nephrotic syndrome advances in severity, glomeruli may become
    totally sclerosed.
  55. Sclerosed segments of glomeruli causes
    collapse of capillary loops leads to an increase in matrix and segmental accumulation of plasma proteins along the capillary wall, also known as hyallosis
  56. NS key manifestations are
    proteinuria, hypoalbuminemia, generalized edema, hyperlipidemia, and lipiduria; pleural effusions and ascites may be noted in severe cases; NS causes a hypercoagulable state
  57. most common gynecologic cancer and fourth most common female malignancy;
    Endometrial carcinoma
  58. endometrial cancer hyperplasia is caused by
    unopposed estrogen and lack of progesterone
  59. continuous estrogen stimulation unopposed by progesterone is caused by inactivation of the
    tumor suppressor gene PTEN
  60. what percent of cases of endometrial cancer uses atypical hyperplasia state caused by mutations in KRAS gene
  61. rarely progress to adenocarcinoma but may turn into cystic atrophy when estrogen is withdrawn
    Non-atypical hyperplasia
  62. at times cannot be discerned from well-differentiated endometrioid adenocarcinoma until a hysterectomy is complete
    Atypical hyperplasia
  63. estrogen dependent, less aggressive; squamous cell characteristics; can metastasize to proximal lymph nodes and synthesize tumors in the liver, bones, lungs, and other organs
    Endo. Carcinoma -Type I
  64. clear cell, serous carcinoma; non-estrogen dependent, no precursor state, more aggressive; bulkier tumor in appearance; early mutation of TP53
    Endo Carcinome Type II
  65. abnormal vaginal bleeding, abnormal vaginal discharge, pap smear showing glandular abnormalities, associated conditions include excessive ovarian cortical function, functioning granulosa cell tumors or the ovary
    Endo Hyperplasia
  66. more similar to ovarian cancer symptoms including bloating, bowel abnormalities, pelvic pressure
    Endo Carcinoma Type II
  67. postmenopausal bleeding r/t what endometrium cancer type
    type 1
  68. Prevalence of EH vs cancer
    8% and 1% (premenopause), 12.1% and 3% (postmenopause)
  69. 90% of kidney cancer is
  70. RC affects what gender more?
  71. may have association with VHL gene; deletion or defect of chromosome 3
    renal cancer
  72. renal cancer most common subtype (95%)
    clear cell carcinoma
  73. RCC known for early metastases to
    lungs, bones, and lymph nodes
  74. renal cancer classic triad
    costovertebral angle pain or tenderness, palpable mass on exam, and hematuria (reliable sign seen in 90% of pts);
  75. tumor less than 10 cm in kidneys pt may (not over 10cm)
    malaise, fever, and weight loss
  76. ovarian tumor risk factors include
    age (time of menopause), nulliparity or preg after 35, family hx of breast or ovarian cancer, BRCA1 and BRCA2 mutations increase ovarian cancer risk by 35-70% and 10-30%, lifestyle factors such as diet, obesity and smoking
  77. most common ovarian tumors develop from
    epithelial cells and divided histologically into serous, mucicnous, and endometrioid tumors
  78. BRCA1 and BRCA2 mutations increase ovarian cancer risk by
    • 35-70%
    • 10-30%
  79. the most common ovarian malignant tumor, that divides into low grade, well differentiated and high grade is
    Serous tumors
  80. ovarian tumors will flourish in the because
    peritoneum due to the microorganisms and lead to a decreased response for chemotherapy
  81. what % of ovarian cancers are detected early
  82. ovarian tumor s/s
    • SOB r/t pleural effusions and severe N/V and constipation r/t bowel obstruction; some pt present with VTE due to hypercoagulable state; adnexal mass, bloating, abd. Distention, pain, discomfort, and urinary urgency or frequency
    • Late stage manifestations – progressive weakness, weight loss, cachexia, and massive ascites
  83. ovarian cancer Grade 3 and higher stage are associated with what prognosis
    5 year survival rate of just 17%
  84. 5 year survival rate for grade 1 ovarian cancer
  85. Gestational Trophoblastic Disease encompasses a spectrum of conditions including
    hydatidiform mole, invasive mole, choriocarcinoma, and placental site trophoblastic tumor
  86. arises from abnormal proliferation of trophoblastic tissues in the placenta
    Gestational Trophoblastic Disease
  87. Gestational trophoblastic neoplasia (more aggressive GTD) includes...  and may arise following...
    • invasive mole, choriocarcinoma, and PSTT
    • preterm pregnancy, abortion, or ectopic pregnancy
  88. mole characterized by swelling of the chorionic villi and trophoblast proliferation, hydropic villi metastasize to other organs
    hydatidiform moles
  89. mole caused by the fertilization of an egg that has lost female chromosomes
    complete mole
  90. mole in which genetic material becomes only paternal and undergoes duplication of the chromosomes of a single sperm
    homozygous complete mole with 46,XX karyotype
  91. Abnormal vaginal bleeding early in pregnancy is the most common presentation of a......along with large uterus for gestational date, pain, vaginal passage of grapelike vesicles, and exaggerated pregnancy symptoms such as hyperemesis; continuous persistent elevation of HCG
    molar pregnancy
  92. presence of more than 3 RBCs per high power field in a properly collected specimen known as
    Asymptomatic Hematuria
  93. asymptomatic hematuria is attributable to 3 diseases
    IgA nephropathy, thin basement membrane nephropathy, and hereditary nephritis
  94. asymptomatic hematuria frequently found in pts with
    glomerular disease
  95. most common type of glomerulonephritis worldwide
  96. result of glomerular injury attributable to the body’s own inflammatory response; promotes deposition of IgA 1 into the mesangial cells of the glomerulus and formation of immune complexes in the circulation; IgG autoantibodies are directed against the defective IgA 1 molecules leading to the formation of immune complexes
    Asymptomatic Hematuria
  97. Asymptomatic hematuria can only be determined by
    kidney biopsy
  98. hallmark characteristic of IgA nephropathy is
    deposition of IgA, primarily in mesangial regions; deposits can occur alone but often appear in conjunction with C3, IgG, or IgM
  99. kidney biopsy taken in more advanced cases of asymptomatic hematuria show symptoms of
    chronic disease such as tubulointerstitial inflammation, tubular atrophy, interstitial fibrosis, and glomerulosclerosis
  100. what tumors cause about 10% of all testicular cancer deaths
    germ cell tumors
  101. risk factors of testicular cancer include
    cryptorchidism, family hx, HIV, tall stature, white males, carcinoma in situ
  102. patho (genetic) of testicular cancer
    genetic change of the short arm of chromosome 12
  103. Which model of testicular cancer includes abnormal cells develop in fetal stage; development of spermatogonia is blocked and cell division cannot take place leading to possible abnormal cell growth
    Model 1
  104. Which model of testicular cancer includes abnormal cell development to occur as germ cells develop; crossing over of chromatid does not occur appropriately; apoptosis may not occur leading to overexpression of 12p genes
    Model 2
  105. Seminomas contain
    isochromosome 12p and express OCT3/4 and NANOG
  106. is a precursor lesion that most testicular germ cell tumors develop from
    intratubular germ cell neoplasia
  107. classic seminomas can be...the size of normal testis; clear cytoplasm and sheets of uniform polygonal cells
  108. s/s of testicular cancer
    painless swelling or nodule in one testicle; elevated AFP and HCG levels
  109. Testicular germ cell tumors occur in men aged, most commonly present between ages
    • 15-34 years
    • 28-36 y/o
Card Set
Module 7 CS