The document discusses tumor immunology and clinical aspects of neoplasia. It describes how the immune system can recognize tumor cells as foreign and attempt to destroy them. It discusses different types of tumor antigens that can be recognized by the immune system, including tumor-specific antigens only found on tumor cells and tumor-associated antigens also found on some normal cells. The document also summarizes various mechanisms the immune system uses to fight tumors, including cytotoxic T lymphocytes, natural killer cells, and macrophages. Finally, it outlines several ways tumors can clinically affect the host, such as local effects, systemic manifestations like cancer cachexia and fever, tumor lysis syndrome, and paraneoplastic syndromes.
IMMUNE RESPONSE TO TUMORS-Humoral immunity
-Cellular Immunity- Failure of Host Defenses
- Evasion of Immune Responses by Tumors
- Cancer Immunosurveillance vs Immunoediting- Immunotherapy
IMMUNE RESPONSE TO TUMORS-Humoral immunity
-Cellular Immunity- Failure of Host Defenses
- Evasion of Immune Responses by Tumors
- Cancer Immunosurveillance vs Immunoediting- Immunotherapy
The presentation outlines aspects of immunity against cancer, evasion strategies by cells, immunotherapy in cancer, cancer vaccines etc. Download and view the slideshow for better experience.
Prepared in Sept 2014
Patients are beginning to benefit from antibody based, cellular and vaccine approaches that are effective against genetically diverse and therapy-resistance cancers.
The presentation outlines aspects of immunity against cancer, evasion strategies by cells, immunotherapy in cancer, cancer vaccines etc. Download and view the slideshow for better experience.
Prepared in Sept 2014
Patients are beginning to benefit from antibody based, cellular and vaccine approaches that are effective against genetically diverse and therapy-resistance cancers.
a short presentation about the types of treatments used in cancer therapy, including traditional chemotherapy, targeted therapy, immunotherapy and hormonal therapy. also a short talk about side effects and administration of the CTX drugs.
A presentation descripes tumors,pathogensis,devlopment,antigenes and genes.
how host responds to them and how tumors evade immunity with latest lines of therapy and prevention.
facaulity of pharmacy.Damascus university.master of libaratory diagnossis. immunology.
Baraa ALomar and feras deban
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TUMOUR IMMUNOLOGY, CLINICAL ASPECTS OF NEOPLASIA & Clinical Features of Tumors
1. NEOPLASIA - 8
TUMOUR IMMUNOLOGY,
CLINICAL ASPECTS OF NEOPLASIA,
Clinical Features of Tumors
Dr. Roopam Jain
Professor & Head, Pathology
2. HOST RESPONSE AGAINST TUMOUR
(TUMOUR IMMUNOLOGY)
Body’s immune system can recognise tumour
cells as ‘non-self’ and they attempt to destroy
them & limit the spread of cancer
1. Antitumour immune responses
2. Tumour antigens
3 Immunotherapy.
3. Host Defense Against Tumor
(Tumor Immunity)
Definition
coordinated biologic process designed to
recognize tumor cells and their products
and to kill or damage them
Cancer immuno-editing - effect of immune
system in preventing tumor formation &
select tumor cells that escape immune
elimination
4. Host Defense Against Tumor
Tumor Immunity
Tumor Specific Antigens (TSA)
Present only on tumor cells and not on any
normal cells and can be recognized by cytotoxic
T-lymphocytes.
Tumor Associated Antigens (TAA)
Not unique to tumors and are also present on
normal cells.
5. Tumor Antigens
Tumor Specific Antigens (TSA)
Present only on tumor cells and not on any normal
cells & can be recognized by cytotoxic T-lymphocytes.
Cancer testis antigen
Viral antigen
Mucin
Oncofetal antigens
Antigens resulting from mutational in protein
B catenin, RAS, P53,CDK4
6. Tumor Antigens
Tumor Associated Antigens(TAA)
present on tumour cells as well as on some normal
cells from where the tumour originated.
Over expressed Antigens
e.g HER-2 (neu) in 30 % Breast cancer
( present in normal breast & ovary)
Differentiation- Specific Antigens
e.g CD10& PSA
Expressed in normal B cells & Prostate
Used as a marker for tumors arise from these cells
7.
8. VARIOUS GROUPS OF
TUMOUR ANTIGENS
i) Oncoproteins from mutated oncogenes
ii) Protein products of tumour suppressor genes
iii) Overexpressed cellular proteins
iv) Abnormally expressed cellular proteins
v) Tumour antigens from viral oncoproteins
vi) Tumour antigens from randomly mutated genes
vii) Cell specific differentiation antigens
viii) Oncofoetal antigens
ix) Abnormal cell surface molecules
9. (1) Products of mutated oncogenes
(2) & tumor suppressor genes
-Synthesized in cytoplasm of tumor cells
-Recognized by CD+8 &CD4+ T cells
-p53,RAS, BCR-ABL
10. (3) Over expressed cellular proteins
- example : in melanoma the tumour antigen is
structurally normal melanocyte specific protein,
tyrosinase, which is over expressed compared
with normal cells.
- Similarly, HER2/ neu protein is over expressed
in many cases of breast cancer.
11. (4) Abnormally expressed cellular proteins
Sometimes, a cellular protein is present in some
normal cells but is abnormally expressed on the
surface of tumour cells of some cancers.
The classic example is - presence of MAGE gene
silent in normal adult tissues - but MAGE genes are
expressed on surface of many tumours such as
melanoma
Other examples - GAGE (G antigen), BAGE (B
melanoma antigen) and RAGE (renal tumour
antigen).
12. (5) Tumor antigens produced by
oncogenic viruses
-produced by DNA viruses- HPV & EBV
-Immune system recognize and kill virus infected
cells
e.g. viral oncoproteins of HPV (E6, E7) in
cervical cancer and EBNA proteins of EBV
in Burkitt’s lymphoma
13. (6) Products of other mutated genes
-Various other carcinogens such as chemicals
and radiation induce random mutations in
the target cells
14. (7) Cell specific differentiation
antigens
-normally present on cells of origin
-CD10(CALLA) & CD20- B cell derived tumors
15. (8) Onco-fetal antigens
expressed high levels in cancer cells & in fetus
but not adult tissue
Alpha fetoprotein(AFP) in hepatocellular carcinoma
& nonseminomatous testicular tumors
Carcinoembryonic antigen(CEA) in carcinomas of
colon, pancreas, lung, stomach & heart
16. (9) Abnormal cell surface molecules
In some cancers, there is - Altered cell-surface Glycolipids
and Glycoproteins, Gangliosides, blood group antigens
& mucins
-as diagnostic markers & targets for therapy
-Glycolipids- e.g. Gangliosides Gm2,GD2 & GD3 in
melanoma
-Mucins –high mol. wt. Glycoproteins
e.g. CA-125 & CA-19 in ovarian carcinoma
MUC-1 in breast carcinoma
18. Mechanisms of Immunity to
Tumors
Cytotoxic T lymphocytes (CTL) - that are
sensitized to tumor specific antigens and kill tumor
cells. Play a role in virus induced malignancy
Natural Killer (NK) cells - can attack tumor
cells directly without antibody coating or by
Antibody Dependent Cell Cytotoxicity (ADCC)
utilizing the Fc receptor on the NK cells, effective
against cells with reduced MHC expression
19. Mechanisms of Immunity
to Tumors
Killer Macrophages - activated by IFN-g
elaborated by Helper T lymphocytes. Participate
in ADCC and can kill tumor cells through
release of TNF-Alpha.
20.
21. Evidence for Immune Response to Tumors
1) Infiltrate of lymphocytes and macrophages associated
with better prognosis in many tumors.
2) Peripheral blood NK activity correlates with survival.
3) Peripheral blood lymphocytes counts fall as cancer
overwhelms host; patients develop anergy to skin tests.
4) Non-specific vaccines can stimulate macrophages and
improve prognosis. IFN-g and IL-2 can stimulate NK
cells and improve outcome.
5) High incidence of some tumors in immunosuppressed
individuals.
24. Clinical Features of Tumors
Tumors are essentially parasites with some
only causing mischief while others are
catastrophic
ALL tumors, even benign ones, can cause
morbidity and mortality
25. Clinical Features of Tumors
The following will be discussed under this
heading:
1) the effects of a tumor on the host
2) the grading and clinical staging of cancer
3) the laboratory diagnosis of tumors
27. Effects of Tumor on Host
Certainly cancers are far more threatening than
benign tumors but both types can cause problems
because of:
1) location and impingement on adjacent structures
2) functional activity such as hormone synthesis
3) bleeding and secondary infections when they
ulcerate
28. Effects of Tumor on Host (Conti……)
4) initiation of acute symptoms caused by either
rupture or infarction
5) Neoplasms arising in endocrine glands may
produce manifestations by elaboration of hormones
6) The erosive destructive growth of cancers or the
expansile pressure of a benign tumor on any
surface may cause ulcerations, secondary infections
and bleeding
29. A. LOCAL EFFECTS
i) Compression - e.g. pituitary adenoma may lead to
serious endocrinopathy; a small benign tumour in ampulla of
Vater may lead to biliary obstruction.
ii) Mechanical obstruction - Benign and malignant
tumours in the gut may produce intestinal obstruction.
iii) Tissue destruction Malignant tumours, both
primary and metastatic, infiltrate and destroy the vital
structures.
iv) Infarction, ulceration, haemorrhage -
infarction, surface ulceration, haemorrhage , torsion and
produce infarction and haemorrhage.
30. B. SYSTEMIC MANIFESTATIONS
1. CANCER CACHEXIA
2. FEVER
3. TUMOUR LYSIS SYNDROME
4. PARANEOPLASTIC SYNDROMES
31. 31
Clinical manifestations of Cancer
Cachexia – wasting
anorexia
early satiety
weight loss
anemia
marked weakness
taste alterations
altered metabolism
32. 32
Clinical manifestations of Cancer
Anemia
chronic bleeding
malnutrition
medical therapies
malignancy in blood forming organs
Administer erythropoietin
33. Effects of Tumor on Host:
Cancer Cachexia .
Cancer patients commonly suffer progressive
loss of body fat and lean body mass
accompanied by profound weakness,
anorexia and anemia. This wasting
syndrome is termed CACHEXIA
The causes of cachexia are obscure but
cachexia is NOT caused by the nutritional
demands of the neoplasm
34. Cancer Cachexia .
Current evidence indicates that cachexia results from the
action of soluble factors such as cytokines (TNF-alpha
and IL-1) either produced by the tumor or the host
Reduced food intake alone is not sufficient to explain the
cachexia of malignancy
Various other causes of cancer cachexia include
necrosis, ulceration, haemorrhage, infection,
malabsorption, anxiety, pain, insomnia,
hypermetabolism and pyrexia.
36. 3. TUMOUR LYSIS SYNDROME .
caused by extensive destruction of a large number of
rapidly proliferating tumour cells.
lymphomas and leukaemias, chemotherapy,
administration of glucocorticoids or certain hormonal
agents (e.g. tamoxifen).
It is characterized by hyperuricaemia, hyperkalaemia,
hyperphosphataemia and hypocalcaemia, all of which
may result in acidosis and renal failure.
37. 4. Paraneoplastic Syndromes .
group of conditions developing in patients with
advanced cancer,
either by the local or distant spread of the tumor
or by the elaboration of hormones indigenous to
the tissue from which the tumor arose, are known
as PARANEOPLASTIC SYNDROMES
About 10 to 15% of the patients with advanced
cancer develop
38. Paraneoplastic Syndromes
Paraneoplastic syndromes are important for three
reasons:
1) they may represent the earliest manifestation of
an occult tumor
2) they may represent significant clinical
problems and may even be lethal
3) they may mimic metastatic disease and
therefore confound treatment
39. Paraneoplastic Syndromes
(Endocrinopathies)
Cushing Syndrome Small cell
carcinoma-lung;
pancreatic
carcinoma; neural
tumors
ACTH or ACTH-
like substance
Syndrome of
inappropriate ADH
secretion
Small cell
carcinoma-lung;
intracranial
neoplasms
ADH or Atrial
natriuretic
hormones
42. Paraneoplastic Syndromes
(Nerve and Muscle Syndromes)
Myasthenia Bronchogenic
carcinoma,
Thymoma
Immunologic
Disorders of the
central and
peripheral nervous
systems
Breast,
Carcinoma Lung
(small cell Ca),
Immunologic
49. 32 A 49-year-old man experiences an episode of hemoptysis.
On physical examination, he has puffiness of the face, pedal
edema, and systolic hypertension. A chest radiograph shows a
5-cm mass of the right upper lobe of the lung. A fine-needle
aspiration biopsy of this mass yields cells consistent with
small-cell anaplastic carcinoma. A bone scan shows no
metastases. Immunohistochemical staining of the tumor cells
is most likely to be positive for which of the following?
□ (A) Parathyroid hormone–related peptide
□ (B) Erythropoietin
□ (C) Corticotropin
□ (D) Insulin
□ (E) Gastrin
50. 33 During a routine health maintenance
examination of a 40-year-old man, a stool guaiac
test result was positive. A followup
sigmoidoscopy showed a 1.5-cm, circumscribed,
pedunculated mass on a short stalk, located in
the upper rectum. Which of the following terms
best describes this lesion?
□ (A) Adenoma
□ (B) Hamartoma
□ (C) Sarcoma
□ (D) Choristoma
□ (E) Nevus
51. 36 A 23-year-old woman has noted a nodule on the skin
of her upper chest. She reports that the nodule has
been present for many years and has not changed in
size. On physical examination, there is a 0.5-cm, dark
red, nontender, raised nodule with a smooth surface.
Which of the following is the most likely diagnosis?
□ (A) Adenoma
□ (B) Fibroadenoma
□ (C) Hamartoma
□ (D) Hemangioma
□ (E) Leiomyoma
□ (F) Lipoma
□ (G) Melanoma
□ (H) Nevus
52. 37 A 63-year-old man sees the physician because of cough
and hemoptysis. He has a 65-pack-year history of smoking. A
chest CT scan shows a 5-cm right hilar mass. Bronchoscopy
is performed, and lung biopsy specimens show small-cell
anaplastic lung carcinoma. His family history shows three
first-degree maternal relatives who developed leukemia,
sarcoma, and carcinoma before age 40 years. Which of the
following genes is most likely to have undergone mutation to
produce these findings?
□ (A) APC (tumor suppressor gene)
□ (B) BCL2 (anti-apoptosis gene)
□ (C) ERBB2 (growth factor receptor gene)
□ (D) K-RAS (GTP-binding protein gene)
□ (E) NF1 (GTPase-activating protein)
□ (F) p53 (DNA damage response gene)
53. A 38-year-old woman has abdominal distention that has
been worsening for the past 6 weeks. An abdominal CT scan
shows bowel obstruction caused by a 6-cm mass in the
jejunum. At laparotomy, a portion of the small bowel is
resected. Microscopic examination shows that the mass is a
Burkitt lymphoma. Flow cytometry analysis of a portion of
the tumor shows a high S phase. Mutational activation of
which of the following nuclear oncogenes is most likely to
be present in this tumor?
□ (A) ERBB2
□ (B) p53
□ (C) RAS
□ (D) MYC
□ (E) APC
54. A 62-year-old man has had several episodes of hematuria in
the past week. On physical examination, there are no
abnormal findings. A urinalysis shows 4+ hematuria, and
cytologic examination of the urine shows that atypical cells
are present. The urologist performs a cystoscopy and
observes a 4-cm sessile mass with a nodular, ulcerated surface
in the dome of the bladder. Which of the following terms
best describes this lesion?
□ (A) Papilloma
□ (B) Carcinoma
□ (C) Adenoma
□ (D) Sarcoma
□ (E) Fibroma