Gen Path Exam III

All statements about telomeres in cancer are true EXCEPT: Telomeres have a very high rate of genetic mutations In most cancers there is upregulation of telomerases that rebuild shortened telomeres Telomere maintenance is seen in virtually all types of cancers Some cancer cells may activate telomerases after chromosomal damage and recombination

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Invasion of the surrounding tissue by cancer cells (CCs) is described by all of the following EXCEPT: CCs overexpress type IV collagenase to penetrate basal lamina CCS penetrate through ECM by avoiding most fibers attachment and breaking most of their crosslinks Degradation of ECM by matrix metalloproteases and cathepsins releases stored growth factors Tumor associated fibroblasts are stimulated to remodel the ECM and to increase its stiffness

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Select multiple correct statements about cancer cells metabolism (MACA) There is a shift of mitochondrial metabolism to use ROS as a source of electrons for the electron transport chain There is a high production of intermediary metabolites for the synthesis of cellular components There is a high levels of lipids uptake and conversion into ATP through mitochondrial beta-oxidation → shunts pathway There is a high levels of glucose uptake and increased glycolytic pathway

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Select multiple correct statements about growth signals involved in cancer (MACA) Cancer cells growth-transmission-signal may become activated even in the absence of normal growth-promoting signals, like with a mutated RAS protein Cancer cells may stimulate regulators factors like cyclin-dependent kinases inhibitors (CDKIs) which normally prevent cycle progression Cancer cells inhibit nearby stromal cells production of growth factors Cancer cells growth factor receptors may be mutated to stay active longer

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Antitumor activity is mediated mostly through which mechanisms? (MACA) Activated macrophages by IFN secreted by T cells and NK cells CD8+ T-Cell mediated cytotoxicity, especially against virus-associated neoplasms CD8+ T-suppressor cells T-Cell mediated cytotoxicity against tumor antigen in the presence of Damage Associated Molecules (DAMP) Polymorphonuclear Cells Natural killer cell cytotoxicity preferentially against cells that possess low levels of MHC class I molecules

Activated macrophages by IFN secreted by T cells and NK cells CD8+ T-Cell mediated cytotoxicity, especially against virus-associated neoplasms T-Cell mediated cytotoxicity against tumor antigen in the presence of Damage Associated Molecules (DAMP) Natural killer cell cytotoxicity preferentially against cells that possess low levels of MHC class I molecules

Genetic changes involved in carcinogenesis include all EXCEPT Activation of the proto-oncogens Silencing of tumor suppressor genes Inhibition of genes that produce apoptosis Activation of DNA repairing genes

Activation of DNA repairing genes

An example of a malignant tumor of the thyroid gland is Carcinosarcoma Adenocarcinoma Sarcoma Adenoma

Adenocarcinoma

What is the leading known and most preventable cause of mental retardation and birth defects affecting as many as 1 in 100 live births? Alcohol Thalidomide Cigarette smoke

Alcohol

Tumor suppressor genes like retinoblastoma gene (RB) or TP53 gene: Are overexpressed or hyperactive in many lines of cancers Are mutated or inhibited in many lines of cancers Are mutated or inhibited in NK cells that have to prevent cells growth Are overexpressed or hyperactive in T regulator cells

Are mutated or inhibited in many lines of cancers

What is the most common cancer by incidence in females? Lung cancer Breast cancer Colon cancer Uterine cancer

Breast cancer

Edema of the scalp caused by passage of head through the birth canal is known as ______________. Intracranial hemorrhage Caput succedaneum Skull fracture Cephalohematoma

Caput succedaneum

Paraneoplastic syndromes may include: (MACA) Cerebral and cerebellar degeneration through autoantibodies Rheumatoid Arthritis Bacterial thrombotic endocarditis Hypercalcemia Cushing's syndrome through ACTH like substances Venous thrombosis (Trousseau's sign)

Cerebral and cerebellar degeneration through autoantibodies Hypercalcemia Cushing's syndrome through ACTH like substances Venous thrombosis (Trousseau's sign)

A malignant tumor is described as a grade 3. What does this refer to? Degree of local invasion within the patient Whether lymphatic metastases are present within the patient Degree of differentiation of the tumor cells Whether hematogenous metastases are present within the patient

Degree of differentiation of the tumor cells

What disease is caused by abnormality of formation of cervical arches that produces abnormalities of both the parathyroids and the thymus? Phenylketouria DiGeorge's syndrome Neurofibromatosis 1 Huntington disease

DiGeorge's syndrome

It is hypothesized that cancer stem cells have a high intrinsic resistance to conventional therapies By inducing expression of protection factors like multiple drug resistance-1 (MDR1) in the surrounding cells It is an old hypothesis that was rejected after modern discovery that stem cells are only seen in embryos and placenta By having the highest rate of mitosis to compensate for damaged cells Due to low rate of cell division and expression of protection factors like multiple drug resistance-1 (MDR1)

Due to low rate of cell division and expression of protection factors like multiple drug resistance-1 (MDR1)

A T3 breast cancer (in TNM staging) has grown to about 2 cm (20 mm) in largest diameter True False

False

A baby who is born at forty weeks of pregnancy and weighs 4 lbs at birth is said to be AGA (Appropriate for Gestational Age). True False

False

A benign tumor can be poorly differentiated. True False

False

A benign tumor is a tumor that is capable of metastasizing and causing death. True False

False

A malignant tumor is in general encapsulated and can be surgically removed True False

False

A ratio of lecithin/sphingomyelin of less than 2:1 in the amniotic fluid means that a baby should not experience Neonatal Respiratory Distress Syndrome after birth. True False

False

Although the meningocele form of spina bifida has just osseous defects it has severe sensory and motor loss True False

False

Amniotic Alpha-fetoprotein (AFP) level may be use for screening for TORCH diseases True False

False

An immature teratoma contains tissue from all three germ layer and is benign True False

False

Benign tumor may eventually outgrow there blood supply and become necrotic and produce hemorrhage True False

False

Combining hyperthermia with innate immunity stimulation through Toll-like receptors was proven to be a false hope in treatment of cancer True False

False

Major Principle that "Interference with transmission in the body is always directly or indirectly due to subluxations in the spinal column" was supported during Dr Parker's times by new scientific discoveries including PET CT and DNA sequencing showing that tumor cells chromosomes were altered in areas innervated by pinched spinal nerves True False

False

PET scanning using 18-FluoroDeoxyGlucose is a modern low dose imaging for detection of small tumors True False

False

The leading cause of death for infants in the United States is malnutrition and infectious diseases. True False

False

A tumor like seminoma of the testis is due to malignant transformation of what type of cells? Placenta Germ cell Embryo Yolk sac

Germ cell

An apical non-small-cell lung carcinoma known as Pancoast tumor may compress any of the following structures EXCEPT Sympathetic stellate ganglion Recurrent laryngeal nerve Vagus nerve Glossopharyngeal nerve Phrenic nerve

Glossopharyngeal nerve

Cell proteins that when presented on the cancer cells surface may become tumor antigens and help in cancer control are all the following EXCEPT: Aberrantly expressed proteins, Hormones responsible for paraneoplasic syndrome Products of mutated genes, Tumor antigens produced by oncogenic viruses.

Hormones responsible for paraneoplasic syndrome

Metastasis usually happens In the bone marrow of vertebral bodies As a result of mechanical breaks of the tumors by movement during exercising, gravity, or chiropractic adjustments In the first extended capillary bed they encounter, mostly lung and liver In the spleen and paraaortic lymph nodes

In the first extended capillary bed they encounter, mostly lung and liver

Angiogenesis in cancer is supported by all of the following mechanisms EXCEPT Increased production of angiostatins and endostatins Angiogenic factors produced by endothelial cells themselves Increased angiogenic factors produced by inflammatory cells or other tumor associated stromal cells Increased proteases activity to release growth factors stored in the ECM

Increased production of angiostatins and endostatins

Loss of contact inhibition in cancer: Is a disruption of the normal mechanism of interaction between E-cadherin and β-catenin as seen in wound healing Is the initial process that triggers the uncontrolled growth of cells Is the cooperation of mechanoreceptors and β-catenins to prevent Cytotoxic T Lymphocyte (T) to attach to cancer cells Is the ability of cancer cells to squeeze between ECM fibers to initiate metastasis

Is a disruption of the normal mechanism of interaction between E-cadherin and β-catenin as seen in wound healing

A benign tumor of uterine smooth muscle is what? Angioma Lymphoma Rhabdomyoma Leiomyoma

Leiomyoma

What are characteristics of a benign tumor? (MACA) Local compression Anaplastic Metastasize hematological Encapsulation Fibroma and papilloma are typical examples Slow growing

Local compression Encapsulation Fibroma and papilloma are typical examples Slow growing

What are the steps involved in tissue invasion by cancer cells? (MACA) Loosening of cell-cell junctions for example by cadherins alterations ECM alterations that increases its stiffness Basement membranes and ECM degradation by metalloproteases Reduced expression of histocompatibility molecules Contraction of leading cells to advance through ECM Cell dormancy to evade damaging by ROS

Loosening of cell-cell junctions for example by cadherins alterations ECM alterations that increases its stiffness Basement membranes and ECM degradation by metalloproteases Contraction of leading cells to advance through ECM

A baby born at 40 week of pregnancy and weighing 3 pounds is described as what? (Give the one best answer.) Low birth weight and small for gestational age Low birth weight premature Small for gestational age and premature appropriate for gestational age small for gestational age low birth weight and premature

Low birth weight and small for gestational age

What is the most common cause of cancer death in the Male population in the US? Prostate Cancer Pancreatic Cancer Lung Cancer Breast Cancer

Lung Cancer

What is the second most common cancer in both males and females by incidence? Prostate cancer Breast cancer Lung cancer Colon cancer

Lung cancer

Select multiple correct statements about TP53 gene in cancer (MACA) The coded protein normally clear the cell of certain viral proteins like E6 protein of HPV More than 70% of human cancers have a defect in this gene If mutated or inhibited the coded protein can't repair the DNA The coded protein normally induce a temporary cell cycle arrest to allow for DNA repair

More than 70% of human cancers have a defect in this gene The coded protein normally induce a temporary cell cycle arrest to allow for DNA repair

Cancer cells are avoiding apoptosis mainly by: Overexpressing the anti-apoptotic BCL2 type protein Upregulating telomerases to rebuild damaged mitochondrial DNA Upregulating signals about ECM alterations or DNA damage Overexpressing Toll like receptor (TLR) family members

Overexpressing the anti-apoptotic BCL2 type protein

A patient in the late stage of pregnancy presents with sudden weight gain, ankle swelling and protein in the urine. What is this most likely a description of? Renal disease Gestational diabetes Eclampsia Pre-eclampsia

Pre-eclampsia

What is the most common cancer in males by incidence? Leukemia Prostate cancer Colon cancer Lung cancer

Prostate cancer

Histological methods of diagnosing cancer are all of the following EXCEPT Fine needle aspiration and microscopic examination. Cytological sample like in Papanicolaou smear Prostate specific antigen from blood sample Quick-frozen section analysis during surgery

Prostate specific antigen from blood sample

Neo-angiogenesis in cancer: Is the new way of cancer cells generating oxygen in acid environment Is the initial process that triggers the uncontrolled growth of cells Is the formation of new 1-2 mm length angled fibers that surrounds the tumor and confer its resistance Provides cancer cells with new blood vessels that are abnormal and leaky

Provides cancer cells with new blood vessels that are abnormal and leaky

What type of physical agents are known causes of cancer? (MACA) Hyperthermia Radioactive iodine Far infrared radiation X-ray Ultraviolet (UV) Nuclear gamma radiation

Radioactive iodine X-ray Ultraviolet (UV) Nuclear gamma radiation

Cancer may avoid immune system through: (MACA) Expressing high number of CD4 molecules to avoid Cytotoxic T Lymphocytes activation Reducing but not losing expression of histocompatibility molecules Recruiting B cell to produce autoantibody against NK cells Selective outgrowth of antigen-negative variants

Reducing but not losing expression of histocompatibility molecules Recruiting B cell to produce autoantibody against NK cells

An example of a tumor of pluripotent, analage cells? Dysgerminoma Retinoblastoma Choriocarcinoma Adenocarcinoma

Retinoblastoma

What is a tumor that is usually found at mass in the sacral region or the buttocks of female infants? Hemangiomas Lymphangiomas Sacrococcygeal teratomas Hamartomas

Sacrococcygeal teratomas

What are characteristics of a malignant tumor? (MACA) Sarcoma is a typical examples Anaplastic Local invasion Encapsulation Slow growing Metastasize hematological or lymphatic

Sarcoma is a typical examples Anaplastic Local invasion Metastasize hematological or lymphatic

An infant is born with congenital syphilis. What stage of syphilis are they born with? Secondary syphilis Primary syphilis Tertiary syphilis

Secondary syphilis

Cancer may avoid immune system through: (MACA) Recruiting B cell to produce autoantibody against NK cells Secreting TGF-β to inactivate Macrophages and B cells Producing decoy molecules that bind to NK receptors Mutating TP53 gene to avoid apoptosis induced by immune cells

Secreting TGF-β to inactivate Macrophages and B cells Producing decoy molecules that bind to NK receptors

Chronic inflammation contributes to cancer progression through (MACA) Secretion by the leukocytes of proteases that degrade ECM Secretion by the leukocytes of cytokines that promote angiogenesis, fibroblast proliferation, and collagen deposition Limiting the local availability of oxygen, thus inducing higher rate of mutations Secretion by the leukocytes of onco-proteins that protect tumor cells against apoptosis

Secretion by the leukocytes of proteases that degrade ECM Secretion by the leukocytes of cytokines that promote angiogenesis, fibroblast proliferation, and collagen deposition

Chronic inflammation contributes to cancer progression through (MACA) Secretion by the leukocytes of proteases that degrade ECM Secretion by the leukocytes of cytokines that promote angiogenesis, fibroblast proliferation, and collagen deposition Secretion by the leukocytes of oncoproteins that protect tumor cells against apoptosis Secretion by the leukocytes of growth factors that also stimulate tumor growth

Secretion by the leukocytes of proteases that degrade ECM Secretion by the leukocytes of cytokines that promote angiogenesis, fibroblast proliferation, and collagen deposition Secretion by the leukocytes of growth factors that also stimulate tumor growth

What viral infections are known causes of cancer? (MACA) Hepatitis A virus Some strains of HPV (human papiloma virus) EBV (Epstein-Barr virus) KSV (Kaposi's sarcoma virus, or HHV8) HTLV - 1 (Human T cell Leukemia Virus)

Some strains of HPV (human papiloma virus) EBV (Epstein-Barr virus) KSV (Kaposi's sarcoma virus, or HHV8) HTLV - 1 (Human T cell Leukemia Virus)

Tumors arising from the protective layer of epithelial cells are known as _____. Squamous cell carcinomas Adenocarcinomas Sarcomas Leiomyomas

Squamous cell carcinomas

Cancer may avoid immune system through: (MACA) Switching macrophages to M2 Mutating TP53 gene to avoid apoptosis induced by immune cells Induction of immunosuppressive regulatory T cells Releasing viral antigens as decoys for Cytotoxic T Lymphocytes

Switching macrophages to M2 Induction of immunosuppressive regulatory T cells

What produced Phocomelia (undeveloped extremities) and was a drug that was used to prevent nausea in women in the first trimester of pregnancy? Thalidomide Diethylstilbestrol (DES) Cigarette smoke Alcohol

Thalidomide

It is considered that cancer cells have altered mitochondria: That are switched from high ATP production to production of more intermediate metabolites and ROS That are blocked to prevent apoptosis That are overstimulated to produce protection factors like multiple drug resistance-1 (MDR1) That are switched to ignore ATP and ROS feedback to ensure energy for growth and ROS to evade nearby immune cells

That are switched from high ATP production to production of more intermediate metabolites and ROS

A malignant tumor is described as a T3 Nx M1. What does this refer to? That the tumor and lymphatic nodes were not evaluated and there is one metastasis That the tumor has three lobes, there are ten lymphatic nodes that were invaded, and there is one metastasis That the tumor has grown considerably, the lymphatic nodes were not evaluated, and there are metastasis That the tumor is 3 mm in size, the lymphatic nodes were not evaluated, and there are metastasis

That the tumor has grown considerably, the lymphatic nodes were not evaluated, and there are metastasis

A malignant tumor is described as a T1 N2 M0. What does this refer to? That the tumor is 1 mm and lymphatic nodes are 2 mm in size, and there are no metastasis The tumor is small, lymphatic nodes are 2 mm in size, and metastasis were not evaluated. That the tumor is small, lymphatic nodes were invaded past the local ones, and there are no metastases. That the tumor is small, two lymphatic nodes were invaded, and metastasis were not evaluated.

That the tumor is small, lymphatic nodes were invaded past the local ones, and there are no metastases.

A stage IV malignant tumor has generaly metastasized to a distant organ True False

True

Although not known during DD's or Dr Parker's time, mechano-receptors may be an epigenetic factor that influence tumor biology and offer a foundation for preventive therapies in addition to nutritional and mental support. True False

True

DNA analysis of mutated TP53 gene in certain cancers is also possible from stool, sputum, or urine samples True False

True

Dr Parker's principle "I will anticipate the good - even during the bad" may be of support not only when studying about cancer but also when encountering it, since spontaneous remissions are possible and were documented scientifically. True False

True

Epidemiology helps to highlight associations between diseases that help to inform science research. True False

True

In the black population the majority of babies who are born with a low birth weight are small for their gestational age rather than being premature. True False

True

In the worst case rhesus incompatibility can produce erythroblastosis fetalis. True False

True

Maternal Alpha-fetoprotein (AFP) Serum level may be used for screening for neural tube defects, Down syndrome, and other chromosomal abnormalities True False

True

MicroRNAs are investigated for blocking oncogene expression since they are a form of RNA that can reduce mRNA translation True False

True

Mortality of cancer of the pancreas is higher than the incidence because the treatment is not effective. True False

True

Neonatal respiratory distress syndrome (NRDS) is caused by a lack of surfactant due to immaturity of the lungs True False

True

Neoplasms of pluripotent cells are highly malignant and manifest in young children. True False

True

Recent studies on mouse embryos show that even normal light affects the embryological development True False

True

Studies on the effect of blocking mechanoreceptors showed that they may promote as well as block tumor progression True False

True

Tumor heterogeneity is the concept that even though all cancer cells are daughter cells of single transformed cell, by picking up additional mutations many cancer cells have varying characteristics. True False

True

A baby who weighs 1.5 lbs is a ___________________. Low birth weight Very low birth weight Normal birth weight None of the above apply

Very low birth weight