Pathology Module - content based on learning objective - very good for exam

What is cancer fundamentally characterized by?

Uncontrolled cell growth, cell division, and the ability to spread (metastasise).

How many new cancer cases and deaths occur annually in the UK?

Approximately 385,000 new cases and 167,000 cancer deaths.

Which cancers account for over 53% of new diagnoses in the UK?

Breast, prostate, lung, and bowel cancers.

What is a major environmental factor in the aetiology of cancer?

Cancer arises in actively dividing tissues exposed to environmental damage.

By what percentage have cancer incidence rates among people under 50 risen over the last two decades?

24%.

What percentage of cancers are estimated to be preventable through lifestyle modifications?

38%.

What are the core phases of the cell cycle?

G0 (resting), G1 (preparation), S (DNA synthesis), G2 (checking), and M (Mitosis).

What regulates the cell cycle?

Proteins called cyclins and Cyclin-Dependent Kinases (CDKs).

What happens at the G1 to S checkpoint?

It assesses cell size, nutrients, and DNA damage; if damage is detected, CDK inhibitors halt the cycle.

What does the 'Multiple Hit' hypothesis propose?

A cell must accumulate an average of four to seven mutations to become malignant.

What are oncogenes characterized as?

Genes that promote cell growth and division; when mutated, they become activated and promote excessive cell division.

What are tumor-suppressor genes?

Genes that inhibit cell division and induce apoptosis if a cell is damaged.

What happens when tumor-suppressor genes are mutated?

They become inactivated, removing safety brakes on cell division.

What is the role of DNA repair genes in cancer?

They fix spontaneous DNA damage; mutations in these genes lead to an accumulation of mutations.

What is telomerase and its function in cancer cells?

An enzyme that, when overexpressed, extends the telomeres of chromosomes, granting cancer cells immortality.

What is angiogenesis in the context of cancer?

The process by which tumors attract new blood vessels to secure nutrients and oxygen for growth.

What is the Warburg Effect?

Cancer cells' preference for metabolic pathways that lead to high glucose uptake and lactate production, even in the presence of oxygen.

What do Matrix Metalloproteinases (MMPs) do in cancer invasion?

They degrade the extracellular matrix to facilitate local invasion of cancer cells.

What is the sequence of metastasis in cancer spread?

Intravasation, circulation, extravasation, and colonization.

What role do cancer cells play in immune system evasion?

They mask themselves by downregulating surface proteins and producing inhibitory proteins.

What imaging techniques are used for cancer detection?

X-rays, CT scans, MRI, Ultrasound, and PET scans.

What are biomarkers in cancer diagnosis?

Molecular indicators in the blood, such as PSA, CA-125, and AFP.

What is a carcinoma?

A cancer that arises from epithelial cells, which is the most common type globally.

What is an adenocarcinoma?

A subtype of carcinoma arising from glandular epithelial tissue.

What is a sarcoma?

A cancer arising from connective tissues, such as bones and muscles.

What is metastatic organotropism?

The tendency of circulating cancer cells to preferentially colonize specific distant organs.

What are the RECIST Criteria?

Standards used to measure if a solid tumor is shrinking in response to therapy.

How is lung cancer primarily classified?

Into Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC).

What is the most common type of lung cancer found in non-smokers?

Adenocarcinoma.

What is a significant risk factor for lung cancer?

Smoking, which accounts for approximately 72% of cases.

What genetic mutations are frequently associated with lung cancer?

Mutations in oncogenes like EGFR and KRAS, along with loss-of-function mutations in tumor suppressors like p53.

What is the prognosis for lung cancer?

Poor, with less than 10% of patients surviving beyond 10 years.

What is the Philadelphia Chromosome associated with?

A chromosomal translocation that creates an oncogene driving the development of Chronic Myeloid Leukemia (CML).

What are the hallmarks of cancer?

Immortality, angiogenesis, adaptation to the tumor microenvironment, invasion and metastasis, and immune system evasion.

What role does the immune microenvironment play in cancer?

Cancer can recruit fibroblasts and macrophages to remodel the extracellular matrix and suppress the immune response.

What are the primary treatment modalities for cancer?

Surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

What is the purpose of immunotherapy in cancer treatment?

To recruit the patient's immune system to recognize and destroy hidden cancer cells.

How does HPV primarily relate to cervical cancer?

Persistent infection with high-risk strains of HPV (like HPV 16 and 18) causes cervical cancer.

What changes do E6 and E7 oncoproteins induce in cervical cells?

E6 degrades p53 and E7 degrades pRb, leading to unchecked cell cycle progression and evasion of apoptosis.

What is the purpose of cervical screening in cancer prevention?

To detect high-risk HPV infections early and prevent progression to cancer.

What is dysplasia?

Abnormal cellular growth and organization seen in tissue biopsies.

What is the LLETZ procedure?

A treatment method involving the use of an electric current to remove abnormal cervical cells.

What is the Gardasil 9 vaccine?

A vaccine that protects against multiple strains of HPV, given prophylactically to adolescents.

What are the key features of knee anatomy?

It consists of femur, tibia, fibula, patella, ligaments, menisci, and cartilage.

What is Osteoarthritis characterized by?

Cartilage degradation, bone changes, and inflammation in synovial joints.

What is subchondral sclerosis?

Pathological thickening of bone underneath the cartilage due to cartilage loss.

What are nociceptive Aδ fibres described as?

Thinly myelinated and fast-conducting fibres transmitting sharp pain signals.

What is allodynia?

Pain from a stimulus that normally does not provoke pain.

What is the purpose of the descending pathway in pain modulation?

To dampen pain signals using neurotransmitters like serotonin and noradrenaline.

What is neuropathic pain?

Pain arising from damage or dysfunction of the nervous system.

What are the primary drugs used in pain management for neuropathic pain?

Adjuvant analgesics like antidepressants (e.g., Amitriptyline) and anticonvulsants (e.g., Gabapentin).

What is rheumatoid arthritis?

An autoimmune inflammatory disease targeting the synovial joints.

How is rheumatoid arthritis distinguished clinically?

By symmetrical joint involvement, prolonged morning stiffness, and positive squeeze test.

What do the recent advancements in Alzheimer's treatment focus on?

Monoclonal antibodies targeting amyloid-beta to modify disease progression.

What is the importance of Power Spectral Density (PSD) analysis in diagnosing Alzheimer's?

It predicts conversion from Mild Cognitive Impairment to Alzheimer's with high specificity.

What factors contribute to the risk of developing Alzheimer's disease?

Genetic factors such as APOE ε4, age, and lifestyle/environmental factors.

What is the role of glial cells in neurodegeneration?

They become activated and release pro-inflammatory cytokines that damage neurons.

How does excitotoxicity relate to neurodegeneration?

Excess neurotransmitters like glutamate cause calcium overload in neurons, leading to death.

What is the typical progression of Alzheimer's disease?

Amyloid accumulation, tau pathology, brain atrophy, memory impairment, and functional decline.

How can advanced diagnostics enhance treatment outcomes in Alzheimer's?

By allowing early detection and targeting therapy to slow or modify the disease course.

What is the significance of synchronous neuronal oscillations?

They are crucial for cognitive function and are altered in neurodegenerative diseases.

What is the term for the abnormal intake of calcium due to glutamate toxicity?

Glutamate excitotoxicity.

What is the therapeutic approach to manage pain in cancer patients?

A multimodal approach, including standard analgesics and adjuvant medications.

What determines the response to cancer treatments?

The genetic and molecular profile of the tumor.

What is the clinical utility of neuroimaging in cancer?

To assess tumor size, location, and response to treatment.

What is the expected outcome of immunotherapies in cancer?

To enhance the immune system's ability to combat cancer.

Why is early detection critical in Alzheimer's disease management?

It maximizes the efficacy of emerging high-cost therapies.

What is the main therapeutic target in the treatment of Alzheimer's?

To target and clear amyloid-beta from the brain.

What does cognitive assessment entail in the context of dementia?

Evaluating memory, executive function, attention, and language abilitiy.

What role does patient history play in the diagnosis of neurodegenerative diseases?

It helps establish disease patterns and the presence of symptoms over time.

What is meant by 'terminally differentiated' in the context of neurons?

Neurons that have lost the ability to divide, meaning their death is permanent.

How are neurological function changes detected in advanced Alzheimer's research?

Through the analysis of EEG patterns and neuronal oscillations.

What is a key feature of Lewy Body Dementia?

Presence of Lewy bodies formed by misfolded alpha-synuclein.

What is the consequence of aging on drug metabolism?

Decreased renal and hepatic function leads to accumulation and toxicity of medications.

What defines the clinical management of patients with vascular dementia?

Addressing vascular risk factors to prevent further cognitive decline.

How is the effectiveness of cancer treatments typically assessed?

Using the RECIST criteria to evaluate tumor size changes.

What impact does lifestyle modification have on cancer prevention?

It can reduce the risk of developing certain types of cancers.

What is the overall goal in treating cancer using a combination of therapies?

To maximize effectiveness while minimizing side effects.