The Genetics of Cancer - Practice Questions - CH14 PDF

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Chapter 14: The Genetics of Cancer Multiple Choice Identify the choice that best completes the statement or answers the question. ____

1. A patient states that she has heard that the origin of most cancers is “genetic.” What is the best

response? A. “The development of most cancers is predetermined and not affected by environmental factors.” B. “Cancers arise in cells that have alterations in the genes.” C. “Cancer is more common among males than females.” D. “The majority of cancers are inherited.” ____

2. Which theory of carcinogenesis has the most support? A. DNA damage, which permits overexpression of oncogenes B. RNA damage, which results in incomplete protein formation C. Autoantibodies, which attack specific “self” tissues and organs D. The failure of embryonic tissues to undergo normal differentiation

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3. By which process does “promotion” assist in cancer development? A. Inflicting mutations at specific sites on the exposed cell’s DNA B. Stimulating or enhancing cell division of cells damaged by a carcinogen C. Increasing the transformed cell’s capacity for error-free DNA repair D. Making cancer cells appear more normal and escaping immunosurveillance

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4. How is progression different from metastasis? A. Progression cannot occur unless the process of metastasis occurs first. B. Metastasis occurs in both benign and malignant cells, whereas progression is a

feature that is unique to malignant cells. C. Metastasis is dependent on gene mutations in suppressor genes, and progression is

dependent on gene mutations in oncogenes. D. Progression involves continual gene changes in a cancer cell that enhance its

degree of malignancy, whereas metastasis is the ability of the cell to invade other tissues. ____

5. Which of the following benign tumors usually express aneuploidy? A. Lipomas B. Leiomyomas C. Neurofibromas D. Neuroblastomas

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6. How is a complete carcinogen different from an incomplete carcinogen? A. Complete carcinogens damage oncogenes, and incomplete carcinogens damage

suppressor genes. B. Complete carcinogens damage suppressor genes, and incomplete carcinogens

damage oncogenes. C. Incomplete carcinogens are more likely to induce sporadic cancers. D. Complete carcinogens are more likely to induce sporadic cancers. ____

7. Which statement regarding the biology of cancer is always true?

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A. B. C. D.

Cancer cells arise from normal cells. Testicular cancer is strongly associated with excessive masturbation. When cancer cells are exposed to air, their growth rate becomes uncontrolled. The biggest risk factor for cancer development is having a first-degree relative with cancer.

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8. Which of these qualities is common to cancer cells? A. Apoptosis of damaged cancer cells occurs at a high rate. B. Telomeres of cancer cells have pronounced shortening. C. Their production of cell adhesion molecules is excessive. D. They continue to grow even when surrounded by other cells.

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9. How are malignant tumors different from benign tumors? A. Malignant tumors grow by expansion, and benign tumors grow by invasion. B. Malignant tumors lose plasma membranes, and benign tumors continue to produce

them. C. Benign tumors retain parental cell functions, and malignant tumors lose parental

cell functions. D. Benign tumors have totally normal features, and malignant tumors have totally

abnormal features. ____ 10. Which feature is considered anaplastic? A. Loss of a distinctive appearance B. Having a larger nuclear-to-cytoplasmic ratio C. Failure to undergo apoptosis at the appropriate time D. The ability to undergo mitosis when nutrition is poor ____ 11. Which cancer type is associated with a 9;22 translocation t(9;22)? A. Acute promyelocytic leukemia B. Acute lymphocytic leukemia C. Chronic lymphocytic leukemia D. Chronic myelogenous leukemia ____ 12. By which process does “initiation” assist in cancer development? A. Enhancing the cell division of cells damaged by a carcinogen B. Inflicting mutations at specific sites on the exposed cell’s DNA C. Increasing the transformed cell’s capacity for error-free DNA repair D. Making cancer cells appear more normal and escaping immunosurveillance ____ 13. Which statement best describes the role of tumor suppressor genes in cancer development? A. Tumor suppressor genes control or modify the activity of oncogenes, reducing the

risk for cancer development. B. The presence of tumor suppressor genes increases the risk for gene damage by

environmental carcinogens. C. Tumor suppressor genes reduce/suppress immune function, increasing the risk for cancer development. D. Tumor suppressor genes are a type of oncogene that is only active in germline cells and tissues. ____ 14. Which type of body tissue has the highest risk for cancer development?

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A. B. C. D.

Bone tissue because its absorption of radiation is cumulative Connective tissue that remains functional throughout life Brain tissue because it does not respond well to injury Any tissue that retains the ability to divide

____ 15. What event occurring during the latency period of carcinogenesis is most likely to contribute to

cancer development? A. Cellular apoptosis B. Error-free DNA repair C. Exposure to promoters D. Oncogene inactivation ____ 16. What is the result of a mutation occurring in a suppressor gene? A. Gain of a new function B. Loss of an existing function C. Increased “error-prone” DNA repair D. Increased unequal “crossing over” during meiosis I ____ 17. Which statement regarding general cancer development is true? A. The risk for cancer development increases with age. B. Cancers usually develop in tissues that are missing a nucleus. C. Children of older mothers have a greater risk for cancer development. D. Most mutations leading to cancer development occur in structural genes. ____ 18. How does an MSH2 gene mutation contribute to the development of colon cancer? A. Suppressor gene function is enhanced. B. DNA mutations are incorrectly repaired. C. Trinucleotide repeat sequences are enhanced. D. Drug resistance genes undergo amplification. ____ 19. Why are people who have poor DNA repair mechanisms at greater risk for cancer development? A. Their cancers are usually resistant to chemotherapy. B. They have sustained the initial “hit” in all cells and tissues. C. Their somatic mutations are more likely to be permanent. D. They have greater exposure to environmental carcinogens. ____ 20. How does an acquired mutation in a somatic cell gene leading to cancer development affect a

person's ability to pass on a predisposition for that cancer type to his or her children? A. The predisposition can only be passed on if the person with the somatic cell mutation is female. B. The risk for predisposition is dependent upon which tissue type experienced the somatic mutation. C. Multiple somatic mutations are required for passing on a predisposition to cancer development. D. There is no risk of passing on a cancer predisposition from a somatic cell mutation. ____ 21. What is the function of a normal BRCA1 gene? A. Enhances overall cell growth during puberty B. Directs the development of normal breast tissue C. Increases the expression of cytochrome P450 enzymes

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D. Suppresses the growth potential of a variety of oncogenes ____ 22. Which feature is associated exclusively with sporadic cancer? A. The cause is unknown. B. It usually affects both bilateral organs. C. It occurs at the same frequency within a kindred as in the general population. D. It is more likely to occur in younger people with few environmental risks than in

older people. ____ 23. What percentage of common cancers appears to be hereditary? A. 1% to 3% B. 5% to 15% C. 20% to 25% D. About 35% ____ 24. Which characteristic(s) is/are associated with an inherited predisposition for a cancer type? A. Cancers tend to appear at an earlier age than do “sporadic” cancers. B. These cancers are not picked up by routine cancer screening methods. C. The carcinogenesis stage of “promotion” is not required for cancer development. D. They are passed on only to the children of the same gender as the parent with the

predisposition. ____ 25. Juliet tells a nurse that she has three aunts (two on her father’s side, ages 42 and 56, and one on her

mother’s side, age 62) who were diagnosed with breast cancer. She asks if she should have genetic testing. What should the nurse tell her? A. “Your family history indicates a high risk, and you should definitely have genetic testing.” B. “Because no men in your family are affected, it is not inherited cancer, so you don’t need mammograms or any special screening practices.” C. “Because your aunts were older when they got breast cancer, it was probably sporadic, and you should just have regular mammograms like everyone else.” D. “Your family history may indicate an increased risk for breast cancer, and a genetic counselor could help determine whether you could benefit from genetic testing.” ____ 26. A 40-year-old man who has a mother who was diagnosed with breast cancer at age 45, a father who

was diagnosed with smoking-related lung cancer at age 55, a 33-year-old sister with breast cancer, and a 38-year-old sister with ovarian cancer asks if he should be concerned for his cancer risk. What is the best response? A. “Your risk is not affected by this family history because most of the cancers arose in female sex–associated tissues.” B. “You have two first-degree relatives and two second-degree relatives with cancer, which increases your general risk for cancer.” C. “Your risk for breast cancer may be increased and requires more investigation; however, your risk for lung cancer is not affected by this history.” D. “Your risk for cancer is affected by your parents’ cancer development, and you should have genetic counseling on that basis; however, your sisters’ cancers have no bearing on your risk.” ____ 27. Which statement about a “germline” mutation in either a cancer suppressor gene or an oncogene is

accurate?

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A. Cancer risk is increased only in sex hormone–sensitive tissues. B. The gene now has expressive potential but not penetrant potential. C. Cancer risk increases, but additional mutations are required for cancer

development. D. A person inheriting such a mutation has a 100% risk for developing a specific

cancer type. ____ 28. A 22-year-old college student tells his nurse practitioner in the student health center that his mother

died of colon cancer at age 32. He asks if this could have an impact on his health. What is your best response? A. “Yes, you need to have yearly stool tests for occult blood.” B. “Yes, it would be good for you to talk with a genetics counselor.” C. “No, because colon cancer is considered a type of sporadic cancer.” D. “No, your risk would only be increased if your father had the colon cancer.” Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 29. Which personal factors indicate the possibility of a person having a BRCA1 or BRCA2 mutation?

Select all that apply. A. The person has an adopted sister with ovarian cancer. B. The person’s brother was diagnosed with breast cancer. C. The person has always been 20 lb overweight as an adult. D. The patient’s father died of pancreatic cancer at age 44. E. The person is of Ashkenazi Jewish ethnicity. F. The person’s 78-year-old grandmother was just diagnosed with breast cancer. ____ 30. Mutations in which of the following genes are now known to greatly increase the risk for developing

breast cancer? Select all that apply. A. APC B. CDH1 C. CHEK2 D. DCC E. PALB2 F. PTEN

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References Beery, T. A., Workman, M. L., & Eggert, J. A. (2018). Genetics and Genomics in Nursing and Health Care 2nd Edition. Retrieved from Davis Plus: https://davisplus.fadavis.com/ProductDetail/ProductDetail?urls=nursing-advanced-practice-genetics-genomics-health-care-beery-workman-2

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