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Slackers Cancer Molecular Biology Fact Stack

Slackers Cancer Molecular Biology Fact Stack. Mike Ori. Disclaimer. These represent my understanding of the subject and have not been vetted or reviewed by faculty. Use at your own peril. I can’t type so below are common missing letters you may need to supply e r l

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Slackers Cancer Molecular Biology Fact Stack

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  1. Slackers Cancer Molecular Biology Fact Stack Mike Ori

  2. Disclaimer • These represent my understanding of the subject and have not been vetted or reviewed by faculty. Use at your own peril. • I can’t type so below are common missing letters you may need to supply • e r l • I didn’t use greek letters because they are a pain to cut and paste in.

  3. What are the key risk factors for colon cancer

  4. Age • Genetics • Chronic bowel inflammation • Crohns • UC • Diet

  5. What are the two types of intestinal polyps

  6. Hyperplastic • Smaller (< 5mm) • Better differentiation • Adenomatous • Larger (>5mm) • Size and dysplasia correlate with disease risk • Increased malignant potential.

  7. Outline the genetic steps required for the development of colon cancer

  8. Epigenetic changes • Loss of growth control • Loss of WNT signaling Pathway • APC is in WNT pathway • RAS mutations • Increases MAP kinase • Increases PI3 kinase • Loss of suppressors • TGF-B • P53 • APC/B-catenin • Genetic instability (?) • APC? • Loss of apoptosis (?) • P53/B-catenin

  9. What is the function of the WNT pathway

  10. The WNT pathway controls growth of epithelial cells via the APC and B-catenin proteins.

  11. Describe the interaction of APC and B-catenin

  12. APC binds free B-catenin to prevent B-catenin from initiating transcription in the nucleus. • B-catenin is a component of adherens junctions and may help to signal the completion of the epithelial layer. Presumably when B-catenin is present, the layer is incomplete and cell growth ensues to fill in the layer.

  13. Describe the frequency of mutation of wnt and apc in sporadic cancers

  14. Wnt pathway defective in 100% • APC defective in 70%

  15. Describe the role of RAS in tumor development

  16. RAS is a g-protein that leads to activation of downstream signaling pathways that lead proliferation

  17. Describe the role of TGF-B in tumorgenesis

  18. TGF-B normally halts the cell cycle in G1 to prevent proliferation and to activate differentiation or apoptosis. • Loss of TGF-B allows for uncontrolled growth

  19. What are the two forms of hereditary colon cancer

  20. Familial adenematouspolyposis (FAP) • Hereditary non-polyposis colorectal cancer (HNPCC)

  21. Why do molecular biologists make bad football coaches

  22. Because their “simplified” playbook looks like this

  23. What are the two types of genetic instability found in colon cancer

  24. Chromosomal instability • Microsatellite instability

  25. What is the failure of microsatellite instability

  26. MIN results from failure of the mismatch repair mechanism

  27. What is the failure in chromosomal instability

  28. CIN results from defects in chromosomal segregation.

  29. Relate FAP and HNPCC to MIN and CIN

  30. FAP • CIN • APC gene • HNPCC • MIN • MSH2, MLH1, PMS2 genes

  31. How many mutations are likely involved in the transformation to malignancy

  32. 5-6 mutations

  33. Draw a sample timeline and gene pathway leading to malignancy

  34. List the major types of diagnostic errors

  35. Differentiate retrospective vs prospective thinking

  36. Retrospective thinking such that used in CPC’s and by novice examiners relies on broad spectrum data collection with analysis performed late in the process. • Prospective thinking modifies the hypothesis during the data gathering process as a result of the collected data. This in turn modifies the data collection process.

  37. What is a heuristic

  38. Choose the correct answer • A statue of a bull commonly found in Minoan culture • A small fluid filled cyst that forms as a result of falling on the coccyx. • A problem solving technique that emphasizes experience

  39. What are common pitfalls of heuristics

  40. Availability • Ease of recall • Anchoring • Initial impressions • Framing effects • How the problem is framed affects the thinking process • Blind obedience • Remember authority figures are in charge, not all knowledgeable

  41. Why are mistakes by clinicians often unrecognized

  42. Happen in distant past • Not recognized as mistakes by provider • PT does not return to same provider

  43. What is the role of follow-up in clinical practice

  44. Provides space and time • Additional data collection (tests) • Research • Trial therapy results

  45. Who is responsible for test follow-up?

  46. You ordered it, you own it.

  47. What are the three stages of memory?

  48. Encoding • Attending to the event • Storage • Saving it for later • Recall • Getting it back out

  49. Describe the ability of the mind to process conceptual vs factual information

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