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USMLE - Pathology Part 2

Microbiology41 CardsCreated about 2 months ago

A glycoprotein enzyme produced by prostate epithelial cells that liquefies semen. PSA levels are elevated in prostate carcinoma, BPH, and prostatitis. It is used mainly to monitor prostate cancer progression or recurrence, while its screening utility is controversial due to low specificity.

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PSA
Function
When is it elevated?
Screen utility?

Follow prostate carcinoma
Prostate carcinoma, BPH, Prostatitis
Questionable

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Key Terms

Term
Definition

PSA
Function
When is it elevated?
Screen utility?

Follow prostate carcinoma
Prostate carcinoma, BPH, Prostatitis
Questionable

Prostatic Acid Phosphatase maker for…

Prostate carcinoma

CEA marker
Name
Cancers associated with it?

CarcinoEmbryonic Antigen
Colorectal and Pancreatic Cancer
Gastric, Breast, and Medullary Thyroid Carcinoma

α-FetoProtein
Normally made by
Marker for what kind of cancers?

Normally made by fetus

| Hepatocellular carcinoma, NonSeminomatuous germ cell tumor (ovary, testis)

βhCG: Marker for what kind of tumors?

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease)

CA-125 marker for

Ovarian Cancer

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USMLE - Pathology Part 2
TermDefinition

PSA
Function
When is it elevated?
Screen utility?

Follow prostate carcinoma
Prostate carcinoma, BPH, Prostatitis
Questionable

Prostatic Acid Phosphatase maker for…

Prostate carcinoma

CEA marker
Name
Cancers associated with it?

CarcinoEmbryonic Antigen
Colorectal and Pancreatic Cancer
Gastric, Breast, and Medullary Thyroid Carcinoma

α-FetoProtein
Normally made by
Marker for what kind of cancers?

Normally made by fetus

| Hepatocellular carcinoma, NonSeminomatuous germ cell tumor (ovary, testis)

βhCG: Marker for what kind of tumors?

Hydatidiform moles and Choriocarcinomas (Gestational trophoblastic disease)

CA-125 marker for

Ovarian Cancer

S-100 marker for

Melanoma, Neural tumors, Schwannomas

ALP marker for

Metastases to bone, Liver, Paget's Disease of bone

Bombesin marker for…

Neuroblastoma, Lung, and Gastric Cancers

TRAP
Name
Marker for…

"Trap the Hair Animal"
Tartrate Resistant Acid Phosphatase
Hairy Cell Leukemia (B cell neoplasm)

CA-19-9 marker for

Pancreatic Adenocarcinoma

Calcitonin marker for

Medullary Thyroid Carcinoma

HTLV-1 leads to what cancer?

Adult T cell leukemia/lymphoma

HBV and HCV lead to what cancer?

Hepatocellular Carcinoma

EBV leads to what cancer?

Burkitt's Lymphoma, Hodgkin's Lymphoma, Nasopharyngeal Carcinoma, CNS lymphoma (in immunosuppressed pts)

HPV leads to what cancer?

Cervical carcinoma (16, 18)
Penile/anal carcinoma
Upper Respiratory SCC

HHV8 leads to what cancer?

Kaposi sarcoma, Body Cavity Fluid B cell lymphoma

H. pylori leads to what cancer?

Gastric Adenocarcinoma and Lymphoma

Liver Fluke (Clonorchis sinensis) leads to what cancer?

Cholangiocarcinoma

Aflatoxin
Made by what organism?
Organ affected?
Impact?

Aspergillus
Liver
Hepatocellular carcinoma

Vinyl Chloride
Organ affected?
Impact?

Liver

| Angiosarcoma

CCl4
Organ affected?
Impact?

Liver

| Centriolobular Necrosis and Fatty Change

Nitrosamines
Where are they from?
Organ affected?
Impact?

Smoked foods
Stomach
Gastric Cancer

Cigarette smoke
Organ affected?
Impact?

Larynx: Squamous Cell Carcinoma

Lung: Squamous and Small cell carcinoma

Kidney: Renal cell carcinoma

Bladder: Transitional cell carcinoma

Pancreas: Pancreatic adenocarcinoma

Asbestos
Organ affected?
Impact?

Lung

| Bronchogenic carcinoma > Mesothelioma

Arsenic
Organ affected?
Impact?

Skin: Squamous Cell Carcinoma
Liver: Angiosarcoma

Naphthalene (aniline)
Organ affected?
Impact?

Bladder

| Transitional Cell Carcinoma

Alkylating Agents
Organ affected?
Impact?

Blood

| Leukemia

Paraneoplastic ACTH
Made from…
Effect

Small cell carcinoma of the lung

| Cushing's syndrome

Paraneoplastic ADH
Made from…
Effect

Small cell carcinoma of the lung and intracranial neoplasms

| SIADH

Paraneoplastic PTHrP
Made from…
Effect

Small cell carcinoma of the lung, Renal cell carcinoma, Breast cancer
HyperCa

Paraneoplastic VitD
Made from…
Effect

Hodgkin's Lymphoma and some Non-Hodgkin's Lymphoma

| HyperCa

Paraneoplastic EPO
Made from…
Effect

Renal Cell Carcinoma, Hemangioblastoma, Hepatocellular carcinoma, Pheochromocytoma
Polycythemia

Paraneoplastic Abs against presynaptic Ca channels
Made from…
Effect

Small Cell Carcinoma of the Lung

| Lambert Eaton Syndrome

Psammoma Bodies
Appearance
Seen in what?

Laminated, Concentric, Calcific Spherules
"PSaMMoma"
Papillary Adenocarcinoma of the Thyroid
Serous Papillary cystadenocarcinoma of the ovary
Meningioma
Malignant Mesothelioma

Cancer epidemiology in Men
Incidence
Mortality

Prostate (32%), Lung (16%), Colon/Rectum (12%)

| Lung (33%), Prostate (13%)

Cancer epidemiology in Women
Incidence
Mortality

Breast (32%), Lung (13%), Colon/Rectum (13%)

| Lung (23%), Breast (18%)

Cancers that metastasize to Brain

Lung, Breast, GU, Osteosarcoma, Melanoma, GI

Cancers that metastasize to Liver

Colon, Stomach, Pancreas

Cancers that metastasize to Bone

| What bones are more common?

Prostate (blastic), Breast (lytic and blastic), Lung (lytic), Thyroid, Testes
Axial skeleton

Metastatic Brain tumors
Frequency
Location
Appearance

50% of brain tumors are metastatic
Gray/White Junction
Multiple well circumscribed tumors