Patho. Evolve Chapters 12, 13, 14

Which is the most common solid tumor in children? a. Central nervous system (CNS) tumors b. Ewing sarcoma c. Kidney d. Soft tissue

a. Central nervous system (CNS) tumors CNS tumors are the most common types of solid tumors in children and account for 21% of all childhood cancers and 10% of adolescent cancers. Not all brain tumors are malignant by histologic study; however, even a benign tumor can have devastating effects, depending on its anatomic location.

Which statement characterizes radiation therapy? a. Radiation is used to kill cancer cells while minimizing damage to normal structures. b. Effective killing of cancer cells using radiation requires poor local delivery of oxygen. c. Radiation blocks the normal growth pathways in cells. d. Radiation can cause reversible changes in normal tissues.

a. Radiation is used to kill cancer cells while minimizing damage to normal structures. Radiation is used to kill cancer cells while minimizing damage to normal structures. Effective cell killing using radiation also requires good local delivery of oxygen. Radiation produces slow changes in most cancers and irreversible changes in normal tissues as well. Antimetabolite chemotherapy blocks normal growth pathways in cells.

What is the term for cancers originating in connective tissue? a. Sarcoma b. Leukemia c. Lymphoma d. Carcinoma

a. Sarcoma Cancers arising from connective tissue usually have the suffix sarcoma. Cancers of lymphatic tissue are called lymphomas, whereas cancers of blood-forming cells are called leukemias. Carcinoma is a cancer of epithelial tissue.

Physical activity reduces the risk of which types of cancer? (Select all that apply.) a. Breast b. Oral c. Liver d. Colon

a. breast c. liver d. colon

Air pollution is associated with cancer. Which statements pertaining to this association are true? (Select all that apply.) a. Ground level ozone is the major component of smog b. Radon exposure can occur in underground mines and homes c. Evidence suggests that air pollution is associated with cancers other than lung and childhood cancers d. Indoor air pollution is considered worse than outdoor air pollution

a. Ground level ozone is the major component of smog b. Radon exposure can occur in underground mines and homes d. Indoor air pollution is considered worse than outdoor air pollution

Which statements are true regarding melanoma? (Select all that apply.) a. Melanoma is the most lethal form of skin cancer b. Individuals with fair skin and hair color are at risk for melanoma c. Individuals with a history of sunburns are at risk for melanoma d. Melanoma is typically underdiagnosed

a. Melanoma is the most lethal form of skin cancer b. Individuals with fair skin and hair color are at risk for melanoma c. Individuals with a history of sunburns are at risk for melanoma

Which statement is true concerning the prognosis of childhood cancers? a. Nearly 85% of childhood cancers are cured. b. Survival rates for children of all ages have remained static. c. Combination chemotherapy and multimodal treatments have not been effective in children with cancer. d. Young children are not as likely to develop the long-term sequelae of cancer therapy as adults.

a. Nearly 85% of childhood cancers are cured

Which statement is true regarding ultraviolet (UV) light? a. UV light causes basal cell carcinoma and squamous cell carcinoma b. The degree of damage is not affected by wavelength c. UV light can cause the formation of sarcomas d. The principal source of ultraviolet radiation (UVR) is tanning beds

a. UV light causes basal cell carcinoma and squamous cell carcinoma Skin exposure to UVR and ionizing radiation (IR) produces reactive oxygen species (ROS) in large quantities, which can lead to oxidative stress, tissue injury, and direct DNA damage. The duration, intensity, and wavelength content affect exposure. UV light can cause the formation of basal cell and squamous cell carcinomas. The principal source of UVR is sunlight.

Which statement is true regarding caretaker genes? (Select all that apply.) a. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA). b. Loss of function results in increased mutation rates. c. Loss of function can cause increased rates of cancer. d. Mutations that disrupt caretaker genes are not inherited. e. Loss of function causes chromosome instability.

a., b., c. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA); Loss of function results in increased mutation rates; Loss of function can cause increased rates of cancer. Caretaker genes are repair mechanisms responsible for maintenance of the genetic code. Loss of function of caretaker genes leads to increased overall mutation rates and is responsible for the increase in rates of cancer. Inherited mutations can disrupt the caretaker genes that protect the integrity of the genome. The underlying mechanism of chromosome instability is not clear but may be caused by malfunctions in the cellular machinery that regulates chromosome segregation at mitosis.

Obesity results in a higher risk of death from which cancers? (Select all that apply.) a. Esophageal b. Kidney c. Colorectal d. Brain

a., b., c. esophageal, kidney, colorectal

A person drinks alcohol in excessive quantities. Which areas are likely to develop cancer related to alcohol consumption? (Select all that apply.) a. Oral cavity b. Larynx c. Pharynx d. Spleen e. Liver

a., b., c., e. oral cavity, larynx, pharynx, liver

Which statement is true regarding obesity? (Select all that apply.) a. It has been increasing rapidly over the past 20 years b. BMI is one of several globally accepted criteria for overweightness c. Obesity is linked to an increased risk of developing many cancers. d. Childhood obesity occurs only in low socioeconomic groups

a., c. it has been increasing rapidly over the past 20 years, obesity is linked to an increased risk of developing many cancers

Which drug and environmental exposures are linked to the risk of developing childhood cancers? (Select all that apply.) a. Ionizing radiation b. Antibiotic use c. Pesticide exposure d. Anabolic adrenergic steroids

a., c., d. ionizing radiation, pesticide exposure, anabolic adrenergic steroids Ionizing radiation, pesticide exposure, and anabolic adrenergic steroids have been associated with childhood cancer risk.

Which statement regarding tumors is true? a. All neoplasms are cancerous. b. Cancer refers to a malignant tumor. c. Benign growths are cancerous. d. Malignant tumors have slow growth.

b. Cancer refers to a malignant tumor. The term cancer refers to a malignant tumor with rapid growth, a loss of differentiation, and the absence of normal tissue organization. Neoplasm generally refers to new growth and may be benign or cancerous. Benign growths, which are not referred to as cancers, may retain some normal tissue structure and do not invade the capsules surrounding them or spread to regional lymph nodes or distant locations.

Which virus has been linked with the development of cancer? a. Measles b. Epstein-Barr c. Mumps d. Influenza

b. Epstein-Barr Epstein-Barr has been linked with the development of Burkitt lymphoma, nasopharyngeal carcinoma, and Hodgkin disease.

Which is associated with defects of the p53 tumor-suppressor gene? a. Retinoblastoma b. Li-Fraumeni syndrome (LFS) c. Down syndrome d. Neurofibromatosis

b. Li-Fraumeni syndrome (LFS) LFS is an autosomal dominant disorder involving the p53 tumor-suppressor gene that significantly increases the risk of developing cancer as a child or an adult. LFS often has a familial history. Retinoblastoma is a malignant embryonic tumor of the eye. Down syndrome is linked to the development of acute leukemia. Neurofibromatosis is associated with Wilms tumor.

Which statements regarding childhood cancer are true? (Select all that apply.) a. Tumor-suppressor genes are unaffected by cancer cells. b. MYCN is an oncogene associated with pediatric cancers. c. Wilms tumor is associated with tumor-suppressor genes. d. Mutated proto-oncogenes help turn normal cells into cancer cells.

b. MYCN is an oncogene associated with pediatric cancers. c. Wilms tumor is associated with tumor-suppressor genes. d. Mutated proto-oncogenes help turn normal cells into cancer cells. Some childhood and adolescent cancers identified with tumor-suppressor genes include osteosarcoma, leukemia, rhabdomyosarcoma, retinoblastoma, and Wilms tumor. If mutated, proto-oncogenes become oncogenes that help to turn normal cells into cancer cells. Tumor-suppressor genes are protective genes that normally suppress cancer cell proliferation but have lost their suppressor function. An example of an oncogene identified in pediatric cancer is MYCN, which is involved in neuroblastoma and glioblastoma.

Which statement is true regarding metastasis? a. Metastasis is a highly efficient process. b. Metastasis occurs through the vascular and lymphatic systems. c. Metastatic cancer cells suppress proteases. d. Most cancer cells are able to metastasize to new areas.

b. Metastasis occurs through the vascular and lymphatic systems. Two distinct mechanisms give rise to patterns of distant spread. First, cancer cells spread through vascular and lymphatic pathways, as well as natural tissue planes. Metastatic cells are very heterogeneous, and some of these cells have new abilities that can facilitate metastasis. Metastasis is highly inefficient; to metastasize, a cancer cell must surmount multiple physical and physiologic barriers. Many metastatic cells secrete proteases and protease activators to digest the extracellular matrix and basement membrane, enabling cells to move. Only rare cells in a cancer are able to metastasize.

When in its normal state, which gene negatively regulates proliferation? a. Oncogenes b. Tumor-suppressor genes c. Proto-oncogenes d. Telomeres

b. Tumor-suppressor genes Tumor-suppressor genes encode proteins that, when in their normal state, negatively regulate proliferation. Oncogenes are mutant genes that, when in their normal nonmutant state, direct the synthesis of protein that positively accelerate proliferation. A proto-oncogene is an oncogene in its nonmutant state. Telemeres are protective ends or caps on each chromosome.

It is true that embryonic tumors a. contain mature cells. b. are undifferentiated. c. may be diagnosed late in life. d. are often labeled with the term carcinoma.

b. are undifferentiated. Embryonic tumors contain immature cells and are not well differentiated, which means that they are unable to mature or differentiate into fully developed functional cells. They are diagnosed early in life and often contain the words, blast cell, in their names because of the immature nature of the cells.

It is true that tobacco smoking a. is highest in people over 65 b. is more prevalent in men than women c. is dangerous only to lung tissue d. accounts for 4000-5000 deaths a year worldwide

b. is more prevalent in men than women

Which virus is linked to the development of cancer? (Select all that apply.) a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Epstein-Barr virus e. Human papillomavirus

b., c., d., e. Hep B, Hep C, EBV, HPV Hepatitis B and C have been linked to the development of liver cancer, which is usually caused by chronic inflammation. Epstein-Barr virus can lead to B-cell lymphomas in those individuals who are immunosuppressed. Human papillomavirus has been linked to cervical, anogenital, oral-pharyngeal, and penile cancers. Hepatitis A has not been linked to the development of cancer.

Which statement is true regarding the staging of cancer? a. Localized cancer is considered a high stage. b. Benign tumors are stage 4. c. Cancers that have spread regionally are stage 3. d. Stage 1 has the poorest prognosis.

c. Cancers that have spread regionally are stage 3. Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or prostate cancer spreading to bone, is stage 4. The prognosis generally worsens with increasing tumor size, lymph node involvement, and metastasis. Benign tumors do not spread to distant regions.

Which marker is used to evaluate a tumor of the adrenal gland? a. Prostate-specific antigen (PSA) b. Alpha-fetoprotein (AFP) c. Catecholamines d. Adrenocorticotropic hormone (ACTH)

c. Catecholamines Catecholamines are secreted by the adrenal medulla and are found in excess if a tumor exists. PSA levels are used to detect prostate cancer. AFP is used to detect liver and germ cell cancers. ACTH is the marker used to detect pituitary adenomas.

Which statement is true regarding childhood cancer? a. Embryonic tumors form after birth. b. Childhood cancer most commonly affects the brain. c. Childhood cancers originate from the mesodermal layer. d. The most common form of childhood cancer is lung cancer.

c. Childhood cancers originate from the mesodermal layer. Most childhood cancers originate from the mesodermal germ layer and give rise to connective tissue cancer. This type of cancer often involves the tissue, bone, cartilage, muscle, blood, blood vessels, gonads, kidneys, and lymphatic system. Embryonic tumors originate during intrauterine life.

Which statement best describes a multifactorial cause of cancer? a. Exposure to a chemical that causes leukemia should result in all children exposed to the chemical to develop cancer. b. The causes of cancer in children are well established. c. The interaction of many factors most likely produces cancer. d. Prenatal exposure to ionizing radiation has been linked to childhood cancers.

c. The interaction of many factors most likely produces cancer. A multifactorial cause or multiple causation concept suggests that the interaction of many factors most likely produces cancer. Not all children exposed to a chemical that causes leukemia will develop leukemia; other factors must interact with the chemical exposure to cause the disease. The causes of cancer in children are largely unknown. Prenatal exposure to ionizing radiation has been linked to childhood cancers.

Which statement is not true regarding the body's defense mechanisms against cell damage? a. The phase I activation enzyme is represented by cytochrome P-450 b. The enzymes that protect against cell damage are predominantly found in the liver. c. The two primary defense mechanisms are xenobiotics and the antioxidant system d. Most xenobiotics are transported in the blood by lipoproteins

c. the two primary defense mechanisms are xenobiotics and the antioxidant system Xenobiotics are a variety of compounds that can cause cellular damage and are transported by lipoproteins in the blood. The body has 2 primary defense systems to protect against xenobiotics that cause cell damage: 1. detoxification enzymes and 2. the antioxidant systems

Which are characteristics of cachexia? (Select all that apply.) a. Increased appetite b. Weight gain c. Early satiety d. Altered metabolism

c., d. early satiety, altered metabolism Cachexia includes anorexia, early satiety, weight loss, anemia, asthenia, taste alterations, and altered metabolism. Clinical manifestations of cancer include cachexia.

Which statement is true regarding basal cell carcinoma (BCC)? a. BCC is most commonly found on the trunk of the body b. BCC is commonly found on those with dark complexions c. Individuals with these tumors usually have a history of tanning, not burning d. BCC is most commonly found on the head and neck

d. BCC is most commonly found on the head and neck

Which is a characteristic of a malignant tumor? a. It is encapsulated. b. It does not invade local tissues. c. It is well differentiated. d. It is able to spread far from the tissue of origin.

d. It is able to spread far from the tissue of origin. Malignant tumors have no capsule, which allows them to spread readily. They have rapid growth rates and specific microscopic alterations. They are poorly differentiated and spread to distant tissues.

A man has worked with asbestos in his career for longer than 40 years. Which cancer is the most likely to develop? a. Bladder b. Leukemia c. Stomach d. Lung

d. lung

Which statement is true regarding childhood cancer? a. Childhood cancer commonly occurs. b. It is the leading cause of death in children. c. It has a long latency period. d. Leukemia is the most common malignancy in children.

d.Leukemia is the most common malignancy in children. Leukemia is the most common malignancy in children, with most cases occurring in children between 2 and 5 years of age. The most common type of leukemia is acute lymphoblastic leukemia (ALL), which represents approximately 75% of all childhood and 67% of all adolescent leukemia cases. The latency period is short in childhood cancer. Although cancer in children uncommonly occurs, it is the second leading cause of death in children.