pathophysiology week 1

Question 1

1. The most common tumor-suppressor gene defect identified in cancer cells is

Answer 1

p53 mutations

Question 2

2. Cancer grading is based on

Answer 2

The degree of cellular differentiation and the number of mitoses (proliferation); how the cancer cells look; how abnormal the cancer cells and tissue look under a microscope when compared to healthy cells, cell differentiation

Question 3

3. The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of

Answer 3

tumor necrosis factor

Question 3

4. Socioeconomic factors influence disease development because of (Select all that apply.)

Answer 3

environmental toxins, overcrowding, nutrition, hygiene

Question 4

5. When determining additional data to gather before making a diagnosis, what factors need to be considered? (Select all that apply.)

Answer 4

Patient history, symptoms, physical examination findings, and diagnostic test results.

Question 5

6. Indicators that an individual is experiencing high stress include all the following except

Answer 5

pupil constriction
(these are indicators: Physical Indicators Elevated blood pressure Increased muscle tension Elevated pulse rate Increased respiration Sweaty palms Cold extremities (hands and feet) Fatigue Tension headache Upset stomach: nausea, vomiting, diarrhea Change in appetite Change in weight Increased blood catecholamine level Hyperglycemia Restlessness Insomnia Behavioral and Emotional Indicators Anxiety (nonspecific fears) Depression Increased use of mind-altering substances (e.g., alcohol, chemical substances) Change in eating, sleeping, or activity pattern Mental exhaustion Feelings of inadequacy; loss of self-esteem Increased irritability Loss of motivation Decreased productivity Inability to make good judgments Inability to concentrate Increased absenteeism and illness Increased proneness to accidents)

Question 6

7. Which is the correct effect of excessive cortisol production?

Answer 6

immune suppression

Question 7

9. The primary adaptive purpose of the substances produced in the alarm stage is

Answer 7

energy and repair

Question 7

8. All the following stress-induced hormones increase blood glucose except

Answer 7

aldosterone

Question 8

13. The production of this hormone can increase during stress to enhance immune function

Answer 8

growth hormone

Question 8

14. This hormone thought to moderate stress response and produce a calming effect.

Answer 8

Oxytocin

Question 8

10. Aldosterone may increase during stress, leading to (Select all that apply.)

Answer 8

decreased urinary output
increased sodium retention
increased blood volume

Question 9

15. The _________ is the behavioral adaptive response to a stressor using culturally based coping mechanisms.

Answer 9

coping mechanisms, coping

Question 9

11. In regards to the Multistep Nature of Carcinogenesis, which is false about the Progression stage

Answer 9

all true
Mutant, proliferating cells begin to exhibit malignant behavior.
Cells whose phenotype gives them a growth advantage proliferate more rapidly
Evolved tumor cells differ significantly from the normal tissue

Question 10

12. This endogenous opioid produces sedation and euphoria

Answer 10

endorphins

Question 11

16. Which is false about Stress?

Answer 11

(all true about stress: Physical, chemical, or emotional factor resulting in tension of body, Actual physical and mental state that tension produces, Real or perceived threat to homeostasis, Direct consciously or indirect unconsciously sensed threat to the stability of the organism)

Question 12

17. Which is NOT a stress response of the body? Select all that apply

Answer 12

(Effects of stress response influenced by:
Genetics, socioeconomic status, prior susceptibilities, preexisting health status, allostatic state, ability to manage stress.)

Question 13

19. This tumor marker is associated with carcinomas of the colon, pancreas, lungs, stomach and heart.

Answer 13

CEA (Carcinoembryonic antigen)

Question 14

18. Which one is false about Malignant Tumor?

Answer 14

True: can kill host if untreated, Confirmed by invasive or metastasizing nature, Tissue-specific differentiation (does not closely resemble tissue type of origin), Grows rapidly, May initiate tumor vessel growth, Frequently necrotic, Dysfunctional

Question 15

21. The ________ identifies causal factors that, acting in concert, provoke a particular disease or injury.

Answer 15

etiology

Question 16

20. The cellular response indicative of injury due to faulty metabolism is

Answer 16

intracellular accumulation

Question 17

22. The stage during which the patient functions normally, although the disease processes are well established, is referred to as

Answer 17

Subclinical stage

Question 17

23. Infectious injury often results from (Select all that apply.)

Answer 17

exotoxins
endotoxins
enzymes from white blood cells

Question 18

25. Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.)

Answer 18

Catecholamines
ACTH
Glucocorticoids

Question 19

24. Is the term used for a tumor whose origin is (nerve, bone, muscle).

Answer 19

Sarcoma

Question 20

26. Which is false about Hydropic swelling?

Answer 20

all true -Hydropic swelling: cellular swelling because of accumulation of water, First manifestation of most forms of reversible cell injury, Results from malfunction of sodium-potassium pump with accumulation of sodium ions within the cell, Any injury that results in loss of energy (ATP) will also result in swelling, -Characteristics: Large, pale cytoplasm, Dilated endoplasmic reticulum, Swollen mitochondria -Generalized swelling of cells in organs can lead to increase in size and weight: “megaly.”

Question 21

27. In reversible cell injury, the intracellular accumulations are characterized by the following except:

Answer 21

TRUE: Accumulation of water (hydropic swelling) Fatty change Accumulation of proteins Glycogen accumulation Pigment accumulation

Question 22

28. This type of gangrene forms of coagulative necrosis characterized by blackened, dry, wrinkled tissue separated by a line of demarcation from healthy tissue.

Answer 22

Dry Gangrene

Question 22

29. The _________ is the probability that a test will be negative when applied to a person without a particular condition.

Answer 22

Specificity

Question 23

30. The __________ subsequent pathologic condition resulting from an illness.

Answer 23

sequela

Question 24

31. The _______ are peptides produced and secreted by white blood cells.

Answer 24

immune cytokines

Question 25

32. The _________ is the description of how etiologic factors are thought to alter physiologic function and lead to the development of clinical manifestations that are observed in a particular disorder/disease.

Answer 25

Pathogenesis

Question 26

33. According to the cancer staging chart, the survival rate percentage for re with stage IV cancer at 10 years is _____

Answer 26

15%

Question 27

34. The ______ is the process of forming new blood vessels.

Answer 27

Angiogenesis

Question 28

35. What is the percentage of developing breast cancer for women with a family history of breast cancer and an inherited defect in the BRCA1 gene?

Answer 28

50% risk of developing breast cancer

Question 29

36. What virus is associated with adult T-cell leukemia/lymphoma?

Answer 29

HTLV-1 (Human T-cell leukemia virus type 1)

Question 30

37. The __________ are proteins that must be assembled at the promoter area to begin gene transcription.

Answer 30

transcription factors

Question 31

38. Which is false about Cancer drug therapy?

Answer 31

all true Systemic administration of anticancer chemicals to treat cancers known or suspected to be disseminated in the body, Finds cancer cell targets in the body, Most are cytotoxic, Not selective for tumor cells (normal cell death may also occur), Most effective on rapidly dividing cells, Several courses ensure all cancer cells killed, Serious side effect: bone marrow suppression, Promising approach is to inhibit angiogenesis by the tumor with antiangiogenic drugs

Question 31

39. Which is True about Cancer Radiation Therapy?

Answer 31

Kills tumor cells by damaging nuclear DNA Kills cells that are nonresectable because of location, missed by surgery, or undetected May not kill cells directly, but initiates apoptosis Small doses of radiation over several treatments (difficult to kill at once because cells are on different cycles) Some normal cells killed during radiation therapy

Question 32

40. About cervical cancer screening, which one is false?

Answer 32

all true Age 21–29: cervical cytology every 3 years Age 30–65: cervical cytology + HPV test every 5 years or cervical cytology alone every 3 years Age 65+: women who have had regular cervical cancer screening with normal results should not be tested again Women with history of precancerous cervical changes or cancer diagnosis should be tested for at least 20 years after that diagnosis even if testing goes past age 65 No screening for women <21 years old or who have undergone total hysterectomy for noncancer reasons Age 21–29: cervical cytology alone every 3 years Age 30–65: cervical cytology alone every 3 years, HPV testing alone every 5 years; HPV + cervical cytology every 5 years No screening <21 years old, hysterectomy without cervix, no history of CIN 2, CIN 3, or HPV

Question 33

45. About the use of Stem Cell Transplantation for cancer treatment, which one is false?

Answer 33

all true -Used to manage life-threatening disorders in which patient’s bone marrow cannot manufacture white blood cells, red blood cells, or platelets -Used in malignant and nonmalignant disorders -Provides a method to restore bone marrow function after high-dose irradiation or chemotherapy -Need donor  Tissue-matched individual to patient: allogeneic  An identical twin: syngeneic  Patient’s own stem cells: autologous

Question 33

44. Which is false about Small Cell−Manufactured Peptides?

Answer 33

all true Secrete into extracellular space Diffuse to nearby cells Interact with receptors on target cell surface Activate signaling cascade; can produce autocrine signaling (excessive self-stimulated growth)

Question 33

42. Which of the following is NOT abnormal behavior of cancer cells?

Answer 33

all true Cancer cells proliferate despite lack of growth-initiating signals from the environment. Cancer cells escape apoptotic signals and achieve a kind of immortality in that they are capable of unlimited replication. Cancer cells lose their differentiated features and contribute poorly or not at all to the function of their tissue. Cancer cells are genetically unstable and evolve by accumulating new mutations at a much faster rate than normal cells. Cancer cells invade their local tissue and overrun their neighbors (invasion) and spread to distant locations (metastasis). Cancer cells develop proangiogenic signaling abilities, stimulating the growth of their own vascular supply. Cancer cells develop reprogrammed energy metabolism, preferentially using glucose as fuel via aerobic glycolysis, giving these cells survival advantage over their normal cell neighbors. Cancer cells often develop the ability to evade immune surveillance and destruction.

Question 33

43. What is true about Partial carcinogens?

Answer 33

Promoters that stimulate growth Incapable of causing genetic mutations sufficient to singly initiate cancer

Question 33

41. Which is NOT a warning sign of cancer?

Answer 33

all true BOX 7.2 Cancer’s Seven Warning Signs Change in bowel or bladder habits. A sore that does not heal. Unusual bleeding or discharge. Thickening or lump in breast or elsewhere. Indigestion or difficulty swallowing. Obvious change in wart or mole. Nagging cough or hoarseness. BOX 7.3 Cancer’s Warning Signs in Children Continued, unexplained weight loss. Headaches with vomiting in the morning. Increased swelling or persistent pain in bones or joints. Lump or mass in abdomen, neck, or elsewhere. Development of whitish appearance in pupil of the eye. Recurrent fevers not caused by infections. Excessive bleeding or bruising. Noticeable paleness or prolonged tiredness.

Question 34

46. Characteristics of telomerase include (Select all that apply.)

Answer 34

Promoting synthesis of telomere ends. Contributing to cancer cell immortality. Activity allowing a cell to replicate indefinitely.

Question 35

47. The ________ is the time during which the first signs and/or symptoms appear indicating the onset of the disease.

Answer 35

Prodromal Period

Question 36

48. A malignant tumor of the smooth muscle is called___________

Answer 36

Leiomyosarcoma; LMS

Question 37

49. Children exposed to physical and/or psychosocial maltreatment have shown all of the following, except, select all that apply

Answer 37

all true (from the book: Children exposed to physical and/or psychosocial maltreatment have been shown to have smaller cortices in the prefrontal region of the brain, reduced hippocampal volume, altered cortisol levels, and elevated levels of inflammation in comparison with other children.)

Question 38

50. Which is NOT a general cause for atrophy?

Answer 38

all true -Cells shrink and reduce their differentiated functions in response to normal and injurious factors. -General causes Disuse Denervation Ischemia Nutrient starvation Interruption of endocrine signals cell injury -Biochemical pathways Ubiquitin-proteosome system Lysosomes

Question 39

51. Which is false about Proto-oncogenes?

Answer 39

(true: proto-oncogenes are normal cellular genes that promote growth)

Question 40

52. Which is false about Gene and Molecular Therapy?

Answer 40

all true May have high therapeutic potential May be used to suppress overactive oncogenes May replenish missing tumor suppressor function Current uses  Genetic alteration of tumor cells to make them more susceptible to cytotoxic agents or immune recognition  Genetic alteration of immune cells to make them more efficient killers of tumor cells Can be directed at cells other than cancer cells  Enhance the host’s immune system against the cancer  Target the cytoplasmic signaling pathways

Question 41

53. Chronic activation of stress hormones can lead to (Select all that apply.)

Answer 41

cardiovascular disease Depression impaired cognitive function autoimmune disease

Question 42

55. The ________ is the increase in functional capacity related to an increase in cell number because of mitotic division.

Answer 42

Hyperplasia

Question 43

54. As a result of the nutritional deficiency of ____________trace element can provoke the Cardiomyopathy known as Keshan disease.

Answer 43

Selenium

Question 44

56. Which is false about Liquefactive necrosis?

Answer 44

all true Occurs with dissolution of dead cells Liquefication of lysosomal enzymes Formation of abscess or cyst from dissolved dead tissue

Question 45

57. After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

Answer 45

is malignant

Question 46

58. Deficits in immune system function occur in cancer due to (Select all that apply.)

Answer 46

Chemotherapy Cancer Cells Cancer Metastasis to bone marrow Malnutrition

Question 47

59. Of the statements below, the accurate statement regarding nutrition and cellular health is

Answer 47

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types

Question 48

60. Viruses differ from most bacteria in that they (Select all that apply.)

Answer 48

Enter the host cell Use the host’s metabolic processes to survive and replicate Do not produce toxins