Module 7: Biology of Cancer and Tumor Spread

Which of the following cell junctions allows small ions and other molecules to pass directly from the inside of one cell to the inside of another? A) Gap junctions B) Tight junctions C) Desmosomes D) Gating channels

A) Gap junctions

Which of the following organelles is (are) responsible for processing and packaging proteins into secretory vesicles for transportation to intracellular or extracellular destinations? A) Golgi apparatus B) Nucleolus C) Endoplasmic reticulum D) Mitochondria

A) Golgi apparatus

Which of the following alterations in metabolism is often present in people with cancer? A) Increased basic metabolic rate B) Decreased fat breakdown C) Increased anabolism D) Overproduction of protein

A) Increased basic metabolic rate

How does radiation therapy provide an effective means for treating some forms of cancer? A) Ionizing radiation damages the cancer cell's DNA. B) Heat generated by radiation is thermally toxic to cancer cells. C) The resulting inflammatory response destroys the tumor. D) High-energy waves cause cell membrane injury.

A) Ionizing radiation damages the cancer cell's DNA.

A proto-oncogene is best defined as: A) a normal gene. B) a frameshift mutation. C) an inactive gene. D) a tumor-suppressor gene.

A) a normal gene.

Normally, the tumor suppressor gene p53 induces: A) apoptosis. B) secretion of anti-growth factors. C) the formation of oncogenes. D) telomere activity.

A) apoptosis.

In order for a tumor cell to invade tissues, it must attach to laminin in the: A) basement membrane. B) endothelium. C) collagenous matrix. D) blood.

A) basement membrane.

The wasting syndrome associated with cancer and cancer treatment is called: A) cachexia. B) anemia. C) Cushing syndrome. D) anabolism.

A) cachexia.

Sarcomas are cancers that arise from: A) connective tissues. B) glandular tissues. C) epithelial tissues. D) germ cells.

A) connective tissues.

The most commonly reported symptom in individuals with cancer is: A) fatigue. B) anorexia. C) nausea. D) depression.

A) fatigue.

Anticipatory nausea related to cancer treatment is caused by: A) fear of impending chemotherapy treatment. B) central nervous system effects of chemotherapeutic drugs. C) gastrointestinal tract toxicity. D) constipation and diarrhea.

A) fear of impending chemotherapy treatment.

All of the following dietary substances are known carcinogens except: A) fiber. B) polyunsaturated fats. C) charbroiled beef. D) nitrates (nitrosamines).

A) fiber.

Cancers in the abdominopelvic cavity, such as ovarian and colorectal cancers, tend to first metastasize to the: A) liver. B) bladder. C) brain. D) axillary lymph nodes.

A) liver.

Referring to cancer, the term anaplasia means: A) loss of cellular differentiation. B) rapid growth of cells. C) independence from normal cellular controls. D) ectopic production of hormones.

A) loss of cellular differentiation.

Viruses are associated with all of the following cancers except: A) lung cancer. B) Kaposi sarcoma. C) lymphoma. D) liver cancer.

A) lung cancer.

Survival from breast cancer is directly correlated to the: A) number of involved lymph nodes. B) amount of seeding in the peritoneal cavity. C) amount of pain an individual incurs. D) degree of nausea and vomiting side effects from chemotherapy. ji

A) number of involved lymph nodes.

One way that a tumor suppressor gene can become inactivated in the absence of mutation or deletion is through gene: A) silencing. B) splicing. C) amplification. D) translocation.

A) silencing.

Oral ulcers caused by chemotherapy or radiation therapy is a condition known as: A) stomatitis. B) candidiasis. C) impetigo. D) decubitus ulceration.

A) stomatitis.

Which of the following statements about alcohol intake and cancer risk is true? A) Alcohol intake is linked to the development of liver cancer only. B) Alcohol intake increases the development of smoking-related cancers. C) Moderate amounts of alcohol intake protect against breast and colon cancer. D) Alcohol acts as an antioxidant, resulting in liver cancer.

B) Alcohol intake increases the development of smoking-related cancers.

Which of the following is a typical characteristic of benign tumors? A) Cells in the tumor are undifferentiated. B) Benign tumors are surrounded by a capsule. C) Benign tumors have a tendency to invade surrounding tissue. D) Cells in the tumor occasionally metastasize to lymph nodes.

B) Benign tumors are surrounded by a capsule.

Which of the following modes of treatment is not used to eradicate cancer? A) Immunotherapy B) Blood transfusions C) Hormone therapy D) Surgery

B) Blood transfusions

Which of the following factors is necessary for metastasis to occur? A) Decreased cellular motility B) Decreased cell adhesions C) Temporary cessation of cell division D) Proximity to body cavities

B) Decreased cell adhesions

Which of the following statements about cancer pain is false? A) Non-pharmacologic therapies such as meditation and relaxation are ineffective for cancer pain management. B) Most patients with cancer experience pain early in the disease process. C) Cancer pain management requires a multimodal and multidisciplinary approach. D) When first diagnosed with cancer, many individuals say that severe pain is their biggest fear.

B) Most patients with cancer experience pain early in the disease process.

Local tissue invasion by a tumor is accomplished by which of the following mechanisms? A) Release of cytokines by the tumor cells, which kills surrounding cells B) Release of lytic enzymes by the tumor cells, which causes tissue degradation C) Release of antibodies by the tumor cells, which enhances phagocytosis of surrounding tissue D) Release of free radicals by the tumor cells, which damages surrounding tissue

B) Release of lytic enzymes by the tumor cells, which causes tissue degradation

Which of the following cancers arise from connective tissue? A) Lymphoma B) Sarcoma C) Glioma D) Adenoma

B) Sarcoma

A tumor that has regional lymph node involvement only is classified as: A) Stage I. B) Stage II. C) Stage III. D) Stage IV.

B) Stage II.

Free radicals cause tissue injury by all of the following mechanisms except: A) DNA fragmentation. B) activation of lysosomal enzymes. C) lipid peroxidation. D) mitochondrial damage.

B) activation of lysosomal enzymes.

Hair loss from chemotherapy treatment is condition known as: A) folliculitis. B) alopecia. C) erythema. D) sterility.

B) alopecia.

Cancer cells stimulate blood vessel growth toward the tumor by releasing: A) autocrine growth factors. B) angiogenic factors. C) lysosomal enzymes. D) telomerase.

B) angiogenic factors.

Pharmacologic therapies for pain management include all of the following except: A) local anesthesia. B) beta receptor blockers. C) anti-inflammatory agents. D) opioids.

B) beta receptor blockers.

Cervical carcinoma in situ: A) usually progresses to cervical cancer even after treatment. B) contains cancer cells that have not invaded the surrounding tissue. C) refers to cervical cancer that has metastasized to the liver. D) cannot be detected using available medical tests.

B) contains cancer cells that have not invaded the surrounding tissue.

The normal function of tumor suppressor genes in an individual without cancer is to: A) prevent apoptosis. B) control production of anti-growth signals. C) stimulate cell replication. D) prevent cancer-causing mutations.

B) control production of anti-growth signals.

Chronic infection of the cervix by the human papilloma virus results in cervical: A) atrophy. B) dysplasia. C) metaplasia. D) hormonal hyperplasia.

B) dysplasia.

The less differentiated a cancer cell is, the more: A) benign it will be. B) embryonic it will appear. C) similar it will appear to its tissue of origin. D) all of the above.

B) embryonic it will appear.

Cell surface markers are composed of: A) phospholipids. B) glycoproteins. C) lactose molecules. D) cholesterol.

B) glycoproteins.

Cytokines are: A) adhesion molecules. B) growth factors. C) cell junctions. D) sequences of DNA.

B) growth factors.

Cancer-causing mutations of a proto-oncogene result in: A) apoptosis. B) increased cell division. C) production of monoclonal antibodies. D) decreased cell responsiveness to growth factors.

B) increased cell division.

Cancer-causing mutations to proto-oncogenes result in: A) apoptosis. B) increased cell division. C) production of monoclonal antibodies. D) decreased cell responsiveness to growth factors.

B) increased cell division.

As a tumor grows, it exerts mechanical pressure on surrounding tissues, which results in: A) cellular swelling. B) ischemia. C) metastasis. D) extravasation.

B) ischemia.

Obesity is an important risk factor for all of the following cancers except: A) breast cancer. B) leukemia. C) colon cancer. D) esophageal cancer.

B) leukemia.

Free radical injury can be caused by: A) tissue damage by antioxidants. B) radiation injury. C) excess amounts of vitamin C and E. D) the presence of edema.

B) radiation injury.

The primary function of the nucleus is to: A) control molecular movement into and out of the cell. B) regulate cell division and control genetic information. C) release enzymes that detoxify harmful substances. D) form the skeletal framework for the cell.

B) regulate cell division and control genetic information.

Seeding involves the spread of cancer cells to: A) blood vessels. B) serous membranes of body cavities. C) fascia surrounding muscles and bones. D) dermis and subcutaneum of the skin.

B) serous membranes of body cavities.

Determining the size of the tumor, the degree of node involvement, and the extent of distant metastasis is called: A) categorization. B) staging. C) factoring. D) processing.

B) staging.

Tumor grading is performed to determine: A) the type of cancer-causing gene. B) the degree of differentiation in the tumor cells. C) the level of autonomy a cancer has. D) the extent of metastasis present.

B) the degree of differentiation in the tumor cells.

Which of the following genetic events is capable of activating oncogenes? A) Deletion B) Loss of heterozygosity C) Amplification D) All of the above

C) Amplification

Mechanisms that cause cancer pain include all of the following except: A) Pressure on tissues and nerve endings B) Metastases to bone C) Cancer cells residing in lymph nodes D) Release of pain-inducing chemicals

C) Cancer cells residing in lymph nodes

Which of the following mutational routes is necessary to cause cancer with a tumor suppressor gene mutation? A) Point deletion on one chromosome B) Chromosomal translocation C) Deletion of both copies of a tumor suppressor gene D) Gene amplification

C) Deletion of both copies of a tumor suppressor gene

Which of the following is an effective treatment for cancer-related or chemotherapy-related anemia? A) Exercise B) Chemotherapy C) Erythropoietin D) Calcium and magnesium supplements

C) Erythropoietin

Which of the following cancers always arises from an initial mutation in the blood-forming cells of the bone marrow? A) Lymphoma B) Carcinoma C) Leukemia D) Sarcoma

C) Leukemia

Which of the following cancers arise from bone marrow stem cells and always originate in the bone marrow? A) Glioma B) Lipoma C) Leukemia D) Lymphoma

C) Leukemia

Radon exposure increases an individual's risk for which of the following cancers? A) Pancreatic B) Esophageal C) Lung D) Skin

C) Lung

Which of the following is a typical characteristic of malignant tumors? A) Cells in the malignant tumor are well differentiated. B) Malignant tumors grow slowly. C) Malignant tumors have a tendency to invade surrounding tissue. D) Malignant tumors are surrounded by a capsule.

C) Malignant tumors have a tendency to invade surrounding tissue.

Which of the following statements about mutations is correct? A) Mutations always lead to genetic disease. B) Spontaneous mutations occur as a result of exposure to a mutagen. C) Mutations are alterations in normal DNA sequence. D) Mutations are always inherited.

C) Mutations are alterations in normal DNA sequence.

A tumor that has distant lymph node involvement but no evidence of distant metastasis to other tissues is classified as: A) Stage I. B) Stage II. C) Stage III. D) Stage IV.

C) Stage III.

Which of the following risk factors is associated with the development of lung, bladder, pancreatic, renal, laryngeal, pharyngeal, and esophageal cancer? A) Ultraviolet (UV) radiation B) Radon C) Tobacco use D) Asbestos

C) Tobacco use

The process of triggering new blood vessel formation in a tumor is called: A) erythropoiesis. B) atherosclerosis. C) angiogenesis. D) seeding.

C) angiogenesis.

Cachexia is a syndrome that includes all of the following symptoms except: A) anorexia. B) weight loss. C) dyspnea. D) weakness and fatigue.

C) dyspnea.

The term used to describe an aggregation of cancer cells that accumulates faster than its non-mutant neighbors is clonal: A) selection. B) stimulation. C) expansion. D) reunification.

C) expansion.

Anemia in individuals with cancer can be the result of all of the following except: A) decreased erythropoietin. B) chronic bleeding. C) fatigue. D) malignant cells in the bone marrow.

C) fatigue.

Helicobacter pylori infection is a bacterial cause of: A) lymphoma. B) colon cancer. C) gastric cancer. D) bladder cancer.

C) gastric cancer.

Major causes of fatigue related to cancer and cancer therapy listed by the National Cancer Institute include all of the following except: A) chronic stress. B) disordered sleep. C) immunosuppression. D) metabolic disturbances.

C) immunosuppression.

The process of cancer cells entering into blood vessels is called: A) tropism. B) embolism. C) intravasation. D) angiogenesis.

C) intravasation.

Plasma membrane receptors are available to bind to: A) carbon dioxide. B) ribosomes. C) ligands. D) cell adhesion molecules.

C) ligands.

Exposure to ionizing radiation is linked to all of the following cancers except: A) thyroid cancer. B) leukemia. C) melanoma. D) breast cancer.

C) melanoma.

The extension of cancer to distant tissues and organs is called: A) apoptosis. B) tropism. C) metastasis. D) malignancy.

C) metastasis.

Autotoxin release by cancer cells stimulates: A) cell division. B) apoptosis of normal cells. C) motility. D) release of lysosomal enzymes.

C) motility.

Immortality in cancer cells is obtained through the production of: A) growth factors. B) apoptosis signals. C) telomerase. D) tumor markers.

C) telomerase.

Apart from diminished physical energy, cancer-related fatigue can manifest in which of the following ways? A) Diminished intellectual performance B) Muscle weakness C) Mood changes D) All of the above

D) All of the above

Individual response to pain depends on which of the following factors? A) Cultural B) Psychologic C) Physiologic D) All of the above

D) All of the above

Which of the following factors plays a role in organ tropism? A) Preferential adherence to the surface of certain target cells B) Presence of certain growth factors or hormones C) Presence of chemotactic factors D) All of the above

D) All of the above

After cancer cells metastasize into lymphatic vessels, which of the following events occurs? A) Cancer cells are killed by immune cells in the lymph nodes. B) Cancer cells lodge in the lymph node and proliferate. C) Cancer cells continue past the lymph nodes to distant organ sites. D) All of the above can occur.

D) All of the above can occur.

Which of the following factors plays a role in the development of cancer from viral and bacterial infections? A) Inflammatory chemicals cause damage to DNA. B) Growth factors are released during the resulting inflammation. C) Cells divide more frequently to replace damaged tissue. D) All of the above factors play a role.

D) All of the above factors play a role.

Which of the following cell populations do chemotherapeutic agents primarily target? A) All cells B) Cancer cells only C) Cells that are incapable of mitosis D) All rapidly dividing cells

D) All rapidly dividing cells

Which of the following cancers arise from epithelial tissue? A) Sarcoma B) Leukemia C) Glioma D) Carcinoma

D) Carcinoma

Which of the following is not a typical characteristic of cancer cells? A) Loss of cellular self-destruct mechanisms B) Unlimited replication C) Autocrine stimulation D) Decreased responsiveness to growth signals

D) Decreased responsiveness to growth signals

Which of the following mutational routes is necessary to cause cancer with a tumor suppressor gene mutation? A) Point deletion on one chromosome B) Chromosomal translocation C) Gene amplification D) Deletion of both copies of a tumor suppressor gene

D) Deletion of both copies of a tumor suppressor gene

Neuromuscular dysfunction and the release of inflammatory mediators such as tumor necrosis factor and interleukin-1 are thought to be responsible for which of the following manifestations of cancer? A) Cachexia B) Thrombocytopenia C) Metastasis D) Fatigue

D) Fatigue

In the cell cycle, RNA and protein synthesis takes place during the: A) S phase. B) M phase. C) G1 phase. D) G2 phase.

D) G2 phase.

Which of the following viruses has been implicated in the development of cervical cancer? A) Herpes virus B) HIV C) Epstein-Barr virus D) Human papilloma virus

D) Human papilloma virus

Chronic active hepatitis B infection is a risk factor for developing which of the following types of cancer? A) Lung B) Leukemia C) Pancreas D) Liver

D) Liver

Which of the following cellular structures is (are) involved in cellular communication and cell-to-cell interactions? A) Caveolae B) Lysosomes C) Ribosomes D) Plasma membrane

D) Plasma membrane

In autocrine signaling: A) a cell releases a hormone. B) a cell signals a neighboring cell. C) a neuron signals another neuron. D) a cell signals itself.

D) a cell signals itself.

Alterations in carbohydrate metabolism in people with cancer causes: A) hypoglycemia. B) depressed carbohydrate absorption. C) weight gain. D) a diabetes-like syndrome.

D) a diabetes-like syndrome.

Tumor cell markers can be used to: A) diagnose tumor type. B) screen individuals for cancer. C) follow the clinical course of tumor development. D) accomplish all of the above.

D) accomplish all of the above.

Malignant tumors have a tendency to: A) grow rapidly. B) metastasize to distant tissues. C) invade surrounding tissues. D) all of the above.

D) all of the above.

Mutations can result in: A) abnormal DNA. B) abnormal RNA. C) abnormal proteins. D) all of the above.

D) all of the above.

Pathologic hyperplasia can lead to: A) neoplasia (cancer). B) dysplasia. C) metaplasia. D) all of the above.

D) all of the above.

Tumor cell markers can be used to: A) screen individuals for cancer. B) diagnose tumor type. C) follow the clinical course of tumor development. D) all of the above.

D) all of the above.

Tumor markers can be found in: A) blood. B) cerebrospinal fluid. C) urine. D) all of the above.

D) all of the above.

Cancer cells ensure adequate supply of oxygen and nutrients by releasing: A) autocrine growth factors. B) lysosomal enzymes. C) telomerase. D) angiogenic factors.

D) angiogenic factors.

In normal cells, the glycoprotein fibronectin: A) is a self vs. non-self antigenic marker. B) acts as a receptor for growth factors. C) activates the conversion of fibrinogen to fibrin. D) helps adhere neighboring cells to each other.

D) helps adhere neighboring cells to each other.

Leukopenia from cancer or chemotherapy treatment increases an individual's risk for: A) allergic reactions. B) autoimmune disease. C) bleeding. D) infection.

D) infection.

Kwashiorkor is a form of malnutrition arising from a diet poor in: A) calories. B) fat. C) carbohydrate. D) protein.

D) protein.

Exposure to ionizing radiation is linked to all of the following cancers except: A) leukemia. B) thyroid cancer. C) breast cancer. D) skin cancer.

D) skin cancer.