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PATHOPHYSIOLOGY
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Homework for Chapter 10, Part 1- Biology of Cancer and Tumor Spread
Instructions:
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Use your lecture notes and textbook to find the answers to these questions.
When finished, enter your answers on the electronic version of the homework posted on
Canvas.
You may do this up to three times until you are happy with your grade.
1. 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.
2. Malignant tumors have a tendency to:
A) grow rapidly.
B) metastasize to distant tissues.
C) invade surrounding tissues.
D) all of the above.
3. Sarcomas are cancers that arise from:
A) connective tissues.
B) glandular tissues.
C) epithelial tissues.
D) germ cells.
4. 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
5. A tumor that has regional 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.
6. 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.
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7. 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.
8. Tumor markers can be found in:
A) blood.
B) cerebrospinal fluid.
C) urine.
D) all of the above.
9. 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.
10. 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.
11. 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
12. The process of triggering new blood vessel formation in a tumor is called:
A) erythropoiesis.
B) atherosclerosis.
C) angiogenesis.
D) seeding.
13. Cancer cells ensure adequate supply of oxygen and nutrients by releasing:
A) autocrine growth factors.
B) lysosomal enzymes.
C) telomerase.
D) angiogenic factors.
14. Immortality in cancer cells is obtained through the production of:
A) growth factors.
B) apoptosis signals.
C) telomerase.
D) tumor markers.
15. A proto-oncogene is best defined as:
A) a normal gene.
B) a frameshift mutation.
C) an inactive gene.
D) a tumor-suppressor gene.
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16. 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.
17. The normal function of tumor suppressor genes in an individual without cancer is to:
A) prevent apoptosis.
B) limit cellular growth.
C) stimulate cell replication.
D) prevent cancer-causing mutations.
18. Normally, the tumor suppressor gene p53 induces:
A) apoptosis.
B) secretion of anti-growth factors.
C) the formation of oncogenes.
D) telomere activity.
19. Which of the following genetic events is capable, by itself, of activating an oncogene?
A) Deletion of a proto-oncogene
B) Loss of heterozygosity
C) Amplification
D) All of the above
20. 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
21. 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.
22. 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
23. 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
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24. Helicobacter pylori infection is a bacterial cause of:
A) leukemia.
B) colon cancer.
C) gastric cancer.
D) bladder cancer.
25. 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.
26. 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
27. As a tumor grows, it exerts mechanical pressure on surrounding tissues, which results in:
A) cellular swelling.
B) ischemia.
C) metastasis.
D) extravasation.
28. The extension of cancer to distant tissues and organs is called:
A) apoptosis.
B) tropism.
C) metastasis.
D) malignancy.
29. 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
30. Organ tropism is largely determined by:
A) the presence of specific receptors that the tumor cells can interact with.
B) the presence of connective tissue stroma.
C) the degree of differentiation of the tumor cells.
D) the similarity of the organ to the original source of the tumor.
Critical Thinking Questions
31. Which of the following mutations would help a carcinoma in situ to become an invasive carcinoma?
A. turning on a gene that makes a protease to digest connective tissue
B. turning off a gene that prevents apoptosis
C. amplifying a gene that codes for growth factor receptor
D. overproducing a normal cellular product like mucus
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32. Which of the following is a change that might be triggered by an oncogene?
A. permanently turning off growth signal receptors
B. down regulate the cell cycle to decrease mitosis rate
C. decrease production of cell-to-cell adhesion molecules
D. decrease growth of blood vessels in the area
33. Mutations in which type of gene tend to be responsible for increasing the risk of cancer in cancerprone families?
A. oncogenes
B. tumor suppressor genes
C. cell cycle genes
D. telomerase genes
34. Select the TRUE statement:
A. Loss of heterozygosity is necessary for oncogene activation.
B. Tumor suppressor genes are often mutated through gene amplification.
C. A single genetic mutation can turn a normal cell into a metastatic cancer cell.
D. Epigenetic silencing is a reversible process.
35. Which of the following is LEAST likely to increase one’s risk of cancer?
A. specific viral infections
B. specific bacterial infections
C. suppressing the inflammatory response with NSAIDS
D. decreasing immune system function with immunosuppressant drugs