What is an average size of a red blood cell (with its unit)? 1
Diameter 7,7 µm Thickness 2 µm
What are the names of the 3 cotyledons in mammals? 3
Mesoderm
Ectoderm
Endoderm
Name 5 different cell types. 5
Nervous cell
Epithelial cell
Stem cells
Blood cells (Erythrocyte, monocyte, platelet)
Fat cells
Sperm cells
What is the difference between euchromatin and heterochromatin? 2
Euchromatin: Active Areas- loosely coiled
Heterochromatin: Inactive areas - tightly coiled
Which processes take place in the rough endoplasmic reticulum? 4
→ Protein biosynthesis + folding → Membrane production (Integral membrane protein, luminal proteins)
Name 5 characteristics of a malignant tumor. 5
Grows into surrounding tissue and destroys it
Grows fast
Metastases occur frequently
Tumor often recurs
Malignant usually have no or only incomplete capsula
How does a tumor spread throughout the body? 3
Malignant tumors often spread along nerves or in lymphatic and blood vessels. The tumor cells can penetrate into the vessels and are dragged away with the bloodstream.
Then, in other parts of the body, they migrate from the blood vessel into the tissues, multiply there and grow into another tumor.
These secondary tumors are called metastases. Malignant tumors, after they have been removed, can recur after a certain time (recurrence).
What do you call a tumor that has arisen from pigment cells of the skin? 2
Benign: Melanocyte nervus
Malignant: Malignant melanoma
What do you call a tumor that has arisen from lymphoid cells? 2
Leukemia
What do you call a tumor that has arisen from embryonic cells? 2
Teratoma
What do you call a tumor that has arisen from striated muscle cells? 2
Benign: Rhabdomyoma
Malignant: Rhabdomyosarcoma
What does a stage 3 tumor mean according to UICC? 2
Tumors of any size with 1-4 lymph node metastases focally without distant metastases
According to which systems a tumor is classified? 2
They are classified according to their origin and different stages of the development
Union internationale contre le cancre UICC stages and TNM classification
What does a tumor T1, N0, M0 mean? 2
T= Size and extent of tumor - t1= smaller than 2 centimeters
N= Number and location of affected lymph nodes - N0= No infestation of adjacent lymph nodes
M= Presence of metastases - M0= Absense of metastases
What does a tumor T3, N1, M1 mean? 2
t3= Primary tumor is larger than 5 cm
N1= Metastases in lymphnodes of the armpit
M1= remote metastases detectable
Name 3 risk factors for the development of tumors. 3
External: Smoking, Excessive sun exposure, Dangerous chemicals
Which example of bacterial tumorigenesis do you know? 1
Helicobacter pylori
Which example of viral tumorigenesis do you know? 1
Human papillomavirus
Epstein-Barr virus
Hepatitis viruses
How does a tumour lead to complications? 3
Tumours can squeeze surrounding tissue → Compressing hollow organs, blood vessel → No sufficient supply can even lead to necrosis
Urine can not drain → various complications of kidneys
What does B symptomatology mean? 2
Set of symptoms (fever, night sweats, unintended weight loss (more than 10%in 6 months)) that can be associated with cancer
Name 8 therapeutic methods against solid tumours? 4
Surgery
Radiotherapy
Chemotherapy
Gene therapy
Targeted therapies
Bone marrow and stem cell therapy
Complementary& alternative methods
Hormone therapy
Immunotherapies
What are the individual options to minimize the risk of a tumour disease? 4
Quit smoking
Get physically active
Use sunscreen
Reduce alcohol intake
Proper diet
What does hazard ratio mean? 2
It’s the ratio of two hazards → If greater than 1 the probability of the event is greater than in comparison group vice versa
Name four risks for prostate cancer. 4
higher age
Family history of protate cancer
African ethnity
Gene changes
Name 3 common genomic alterations in prostate cancer. 4
BRCA Gene 1 → DNA damage repair
BRCA Gene 2 → DNA damage repair
HOXB13 → DNA damage repair
Name 4 signs of prostate cancer. 4
Frequent urination
Blood in urine/semen
Shortness of breath, feeling tired
Sudden urge to urinate
What does PSA mean? 1
Prostata specific antigen → Protein
What is the most common type of primary prostate cancer? 1
Adenocarcinoma of the prostate
Name 4 sites of metastases of prostate cancer. 4
Bone (90)
Lung (45)
Liver (25)
Pleura (20)
What is the most common promotor for prostate cancer? 1
RASSF1
How are non melanoma skin tumors sub-divided? 2
Basal Cell carcinoma
Squamous cell Carcinoma
Define the term incidence. 1
Frequency of new cases of disease in a population within a certain period of time
Define the term prevalence. 1
Proportion of sick people in a population
Name 3 main layers of the skin. 3
Epidermis
Subcutis
Dermis
What is a Basal Cell Carcinoma? 4
Skin cancer that often developes on areas of skin exposed to the sun
Its growing slowly and metastases are rare
Its most common of all types
What is a Squamous cell carcinoma (Plattenepithelcarcinom)? 4
Second most common skin cancer
Sunexposed areas (body, face, ears, hands)
Grows faster than basal cell carcinoma
People with darker skin are more at risk
What is a Melanoma? 4
Most dangerous and aggressive form of skin cancer
highest rates of metastases
Can occur on skin which has not exposed to sun
Can develop anywhere on ones body
How does prostate cancer spread? 3
Through
Tissue
Lymph system
Blood
How can you prevent skin cancer? 4
Using sunscreen / minimize direct sun exposure
Wearing protective clothes
getting skin checked regularly
Being aware of sun sesitizing medications
Name a major driver mutation in malignant melanoma. 2
Somatic mutations MAPK and PI3K/AKT
What are TILs? 1
Tumor infiltrating lymphocytes
What does ABCDE diagnostics in dermatology mean? 5
a= Asymmetry
b= Border
c=colour
d= Diameter
e= Evolving
Name 6 possible symptoms of ovarian cancer.
Abdominal Pain
Loss of appetite
Loss of weight
Disruption of bowel movement
increase in abdominal circumference
Disruption of menstrual period
Name 6 risk factors for Ovarial cancer. 3
Older than 50 yrs
Childlessness
Close relatives with previous disease of breast, uterine or colon ca
Severe obesity
Hormone treatment to relieve menopausal symptoms
Close realtives with ovarian cancer
What mutations can lead to Ovarial cancer? 2
Familial ovarian cancer. Gene alteration:
BRCA1
BRCA2
What is the special feature of ovarian cancer in terms of surgery?
It is part of the diagnosis and first step in therapy at the same time
What is the disadvantage of minimally invasive surgery for ovarian cancer? 1
Risk of overlooking tumor foci
carrying over cancer cells in the body
What does FIGO II mean for ovarian cancer? 1
System for classifying gynecological tumors
Tumor spread to adjacent tissue → Tumor spreading in pelvis
Name the 2 major histological types of lung cancer. 2
Non small cell lung cancer, small cell lung cancer
What is the median age at diagnosis for lung cancer? 1
70
Which lung cancer has the higher 5-year survival rate? 1
Non small cell lung cancer
Which ethnicities are mostly affected by lung cancer. 2
African American and white
Name 4 risk factors for lung cancer. 4
Tobacco smoking
Inherited mutation
Air polution
Occupational Exposures (Asbestos, nickel..)
Name 4 signs and symptoms of Lung Cancer. 4
Dyspneau
Chest pain
Drumstick fingers
Cough
What does driver mutation mean? 2
Mutations that influence the course of a tumor disease e.g. tyrosine kinases
Name 4 common driver gene mutation for NSCLC. 4
Epidermal Growth Factor Receptor (EGFR) Mutations
Kirsten Rat Sarcoma (KRAS) Mutations
Anaplastic Lymphoma Kinase (ALK) Rearrangements
ROS1 Gene Rearrangements
How is non small-cell lung cancer (NSCLC) subdivided? 3
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
What is tyrosine kinase? 5
Group of enzymes, two types: receptor TK and cytoplasmic TK
Play important role in signal transduction
They have the function of an on-off switch for many cell processes
reversible transfer of phosphate group to hydroxy group of amino acid tyrosine of another protein
Where do we use Cytokeratin 5/6 antibodies? 2
Cancer diagnosis
Lung Cancer → help differentiate between non small cell carcinoma and small cell carcinoma
Breast Cancer
Prostate Cancer
Where do we find therapeutic significance for targeted therapy of tyrosine kinases? 6
Cancer treatment: NSCLC- EGFR inhibitors, CML- targetting BCR ABL fusion protein, Breast Cancer - Inhibit HER2/neu tyrosine kinase activity
Name 3 important Driver Gene Mutations sites in Non-Small Cell Lung 3 Cancer (NSCLC) Adenocarcinoma.
HER2
MEKI
BRAF
What is the idea behind Immuno-checkpoint inhibitor therapy? 4
Immune system to fight cancer by targeting specific proteins known as immune checkpoints
Immune checkpoints are molecules on immune cells and cancer cells that regulate the immune system
However, cancer cells can exploit these checkpoints to evade the immune system.
Name 2 immune checkpoints we can control. 2
PD-1/PD-L1 Pathway Inhibition
CTLA-4 Pathway Inhibition
What are characteristics of ROS1-Fusion-positive patients? 4
bis zu 36% ZNS metastasen bei Erstdiagnose
Häufiger Frauen (2/3)
Adenokarzinom bis zu 100%
Bis zu 920 Neuerkrankungen pro Jahr in Deutschland
Why does malignant melanoma lead to anemia? 4
Inhibits growth of healthy blood forming cells in bone morrow
Which progenitor cells for blood cells exist? 3
Common myeloid Progenitor CMP
Common Lymphoid Progenitor (CLP)
Name the solid blood particles (0,5 pts each). 3
Leukozyten → Neutrophile Eosinophle, basophiler, Lymphozyten, Monocyten
Erythrozyten
Thrombozyten
Where does hematopoiesis take place in adults? (0,5 pts. each) . 4
Red Bonemorrow → Bones
vertebrae, ribs, sternum, pelvic bones, end of long bones
What is a CFU baso? 1
CFU-Baso is a colony forming unit that gives rise to basophils
What is the function of eosinophilic granulocytes? 3
involved in defense against parasites
involved in allergies → react to histamine
involved in autoimmune reactions
What is the function of neutrophils? 2
defense against pathogens (bacteria/viruses) → release of antimicrobial substances
Phagocytosis
What are the most common white blood cells in healthy people? 1
Neutrophil granulocytes (50-65%)
What does "shift to the left" mean? 2
Increasing proportion of immature neutrophils
In which cells do monocytes transform? 1
Makrophages
What are the 2 types of lymphocytes? 2
B and T lymphocytes
Which cells produce antibodies? 2
B Lymphocytes -> Plasmazelle
Name 5 growth factors? 5
Erythropoetin
Stem cell factor
GM-CSF
G-CSF
MCSF
Who coined the term leucaemia? 1
Rudolf Virchow
Name 6 symptoms of leukemia. 6
swollen lymphnodes
Tiredness
loss of appetite
Severe Infection
enlargement of spleen or liver
Epitaxis
fever
Name 4 types of leukemias. 4
acute lymphocytic leukemia
acute myelogenous leukemia
chronic lymphocytic leukemia
chronic myelogenous leukemia
Name the top 3 types of lymphoma. 6
indolent
aggressive non hodkin lymphoma
Morbus hodking
What is CHOP? 4
Combination therapy of following 4 drugs
Cyclophosphammide
Hydroxydaunorubicin
Oncovin
Prednisone
What are the main symptoms of MDS? Myelodysplastische Syndrom 2
anemia
fatigue
Frequent infections
Pale skin
What is multiple myeloma? 2
its a malignant degeneration of plasma cells. Proliferation of cells in bone marrow gets out of control
Against which diseases thalidomide (formerly Contergan) is still used today? 2
treatment for multiple myeloma and plasmacytoma
Name 5 risk factors for leukemia. 5
Ionizing radiation
Family backround
Chemicals and toxit substances
Health status
Genetics
What does CD mean in tumor biology? 3
Cluster of differentiation
CD molecules are markers of cell surface helpful in identifying leukocytes
Specific to type/stage of development of cells
What is karyotyping? 4
Examines chromosomes inside of cells
looking for abnormal changes in chromosomes
determining treatment options ad prognosis, prediction for response to treatment
bone marrow or blood sample
What is minimal residual disease? 4
some leukemia cells may remain in bone marrow
increased ris of disease relapse
intensified therapies → allogenic stem cell transplantation
identification by nex generation sequenzing
What is a CAR T-cell therapy? 3
Chimeric antigen receptor T cell therapy
Patients own immunecells are engineered to recognize and attack cancer cells
Against CD19 with help of a lentiviral vector
What is immunotherapy? 2
Therapies that work by activation of the patient's immune system to attack tumor cells → elevant for allogeneic stem cell transplantation
Which gender has a higher risk for gastric cancer? 1
male sex
Name 4 risk factors for gastric cancer. 4
herdeditary
blood type a
Peutz jeghers syndrom
Helicobacter pylori infection
Define “Paraneoplastic syndrome” and give an example. 4
Symptoms that are caused by a tumor but do not express locqally - sweats, fever , anorexia
How does a paraneoplastic syndrome develop? 2
Yet unclear but likely to be secondary substances secreted by a tumor or as result of antibody formation against tumor cells - cross reaction with other tissues
What is a Wilms Tumor 3
Quickly growing tumor that forms metastatses at early stage especially lungs, liver, brain
good prognosis with early therapy
What is renal involvement with renal cell carcinoma in a patient usually like? 1
only one kidney is affected
most patients do not have problems with urinary tract
How is a renal cell carcinoma discovered? 2
Ultrasound
during other examination with ultrasound
Where do metastases of a renal cell carcinoma occur? 3
Lungs
skeletal system
lymph nodes
What is the meaning of TNM?
T - Size of tumor
N- Involment of lymphnodes
M- Presence of metastases
Why has the mortality rate from breast cancer decreased in Germany
Early detection and screening programs
Personalized medicine
Advances in therapy and diagnosis
Improved Access to Healthcare
Public Health Education
Is there an ethnicity-dependent mortality rate for breast cancer? 1
Non hispanic whites and non hispanic blacks are amongst the most affected
What is a DCIS? 1
Ductal Carcinoma of the Breast in lactiforous duct
What is a LCIS? 1
Lobular Carcinoma in the mammary gland lobes
The occurrence of a Mamma-Ca evenly distributed over the female breast.
Where is the greatest probability? 1
Left upper quarter
Name causes and risk factors for breast cancer 4
Family history
Gene mutation
Late childbearing
Alcohol intake /tobacco
Age
What is BRCA 1 and 2? 2
Its the name of two tumor suppressor genes and the proteins they express against hereditary breast cancer. On chromosome 17
What does BRCA lead to? 2
BRCA1 plays an important role in the repair of double-strand breaks
loss of function or deletion increases likelihood of tumor formation
plays a key role in DNA repair and homologous recombination
Name 3 subtypes of breast cancer. 3
Luminal like
TNBC Triple-negative breast cance
HER2+
Which is the most common breast cancer subtype? 1
Luminal like (70-80%)
What is the most difficult breast cancer subtype to cure? 1
Triple-negative breast cancer
What are the characteristics of TNBC? 2
Lack of hormone receptor expression
Absence of Her 2+ Expression
What is KI 67? 2
Antigen KI-67 is a protein used to label dividing human cells. During interphase, the antigen is found inside the nucleus
What leads to a poorer survival probability in breast cancer (5 topics (among others)). 3
Lymph node involvement
Late stage of diagnosis
Distant metastasis
TNBC
Tumor Grade
Name 3 columns of breast cancer therapy. 3
Radiation
Systemic therapy
What are the building blocks of a systemic tumor therapy today? 3
Endocrine therapy
Targeted therapy
What is a sentinel lymph node? Why do we look at this? 2
removal during surgery → Examination for clarificaton of further procedure
What is the aim of breast tumor surgery? 2
• Surgery with tumor-free resection margins (R0), resection if necessary
Preservation if possible
What does neoadjuvant therapy mean? 2
refers to any treatment that is given for cancer before the main treatment, with the goal of making the main treatment more likely to be successful.
What are positive and negative effects of breast conserving surgery? 2
pos.
Preservation of Breast Tissue
Psychological and Emotional Benefits
neg.
Need for Radiation Therapy
Possibility of Further Surgery
What is a side effect of taxanes? 1
Taxanes can damage peripheral nerves, leading to peripheral neuropathy.
What is the AGO? 1
Arbeitsgemeinschaft Gynäkologische Onkologie
Define micrometastases. 1
Micrometastases are small clusters or individual cancer cells that have spread from the primary tumor but are not yet clinically detectable by conventional methods.
What is Her 2? 2
human epidermal growth factor receptor
Her is overexpressed in up to 20% of breast cancer patients
What are the components of an antibody drug conjugate? 3
Monoclonal antibody
Cytotoxic component
Thioether Bridge (linker molecule)
How does an antibody drug conjugate work? 2
They are disgned to deliver a potent anti cancer drug specifically to cancer cells while minimizing damage to healthy cells
What is the mode of action of an immune checkpoint inhibitor 3
works by enhancing the body's own immune system to recognize and attack cancer cells. Immune checkpoint inhibitors block inhibitory signals, interaction, unleashing the immune system to recognize and attack cancer cells.
What does a monoclonal Antibody consist of? 4
Made to mimmic the immune system - designed to target specific proteins
Variable regions (FAB) → recognizing and binding specific target
Constan Regions (FC) → effector funtions (interacting with immune cells)
What does the ingredient -xi mean in the name of a monoclonal antibody?? 2
Chimeric
What does the ingredient -zu in the name of a monoclonal antibody mean?? 2
humanized
What does the ingredient -tu mean in the name of a monoclonal antibody? 2
Tumors
Example: tuzumab, tumab
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