Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 12: Cancer BiologyMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. Which cancer originates from connective tissue?a. Osteogenic sarcomab. Basal cell carcinomac. Multiple myelomad. AdenocarcinomaANS: ACancers arising from connective tissue usually have the suffix -sarcoma. Carcinomas arise in epithelial tissue. Myeloma arises in the bone marrow.PTS: 1 DIF: Cognitive Level: Remembering 2. Carcinoma refers to abnormal cell proliferation originating from which tissue origin?a. Blood vesselsb. Epithelial cellsc. Connective tissued. Glandular tissueANS: BOnly cancers arising from epithelial cells are called carcinomas. Connective tissue cancers are called sarcomas. Glandular tissue cancers are named adenocarcinomas. Malignant cancers can invade blood vessels.PTS: 1 DIF: Cognitive Level: Remembering 3. Carcinoma in situ is characterized by which changes?a. Cells have broken through the local basement membrane.b. Cells have invaded immediate surrounding tissue.c. Cells remain localized in the glandular or squamous cells.d. Cellular and tissue alterations indicate dysplasia.ANS: CCarcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.PTS: 1 DIF: Cognitive Level: Remembering 4. Which term is used to describe a cell showing a loss of cellular differentiation?a. Dysplasiab. Hyperplasiac. Metaplasiad. AnaplasiaANS: DAnaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and the loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a significant increase in nuclear size with evidence of ongoing proliferation. Dysplasia is the presence of an abnormal cell type within a tissue and often is called “precancerous.” Hyperplasia is an enlargement of an organ or tissue due to increased production of its cells, also often considered precancerous. Metaplasia is an abnormal change in the characteristics of a tissue.PTS: 1 DIF: Cognitive Level: Remembering 5. What are tumor cell markers?a. Hormones, enzymes, antigens, and antibodies that are produced by cancer cellsb. Receptor sites on tumor cells that can be identified and markedc. Cytokines that are produced against cancer cellsd. Identification marks that are used in administering radiation therapyANS: ATumor (biologic) markers are substances produced by both benign and malignant cells that are found either in or on the tumor cells or in the blood, spinal fluid, or urine. Tumor markers may include hormones, enzymes, genes, antigens, and antibodies. Tumor markers are not receptor sites, cytokines, or identification marks for radiation.PTS: 1 DIF: Cognitive Level: Remembering 6. What is one function of the tumor cell marker?a. To provide a definitive diagnosis of cancerb. To treat certain types of cancerc. To predict where cancers will developd. To screen individuals at high risk for cancerANS: DScreening and identifying individuals at high risk for cancer are ways tumor markers can be used. The two other uses for these markers are to help diagnosis a specific type of cancer (not give a definitive diagnosis) and to follow the clinical course of a tumor.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 7. Which statement supports the hypothesis that intestinal polyps are benign neoplasms and the first stage in the development of colon cancer?a. Cancer cells accumulate slower than noncancer cells.b. An accumulation of mutations in specific genes is required to develop cancer.c. Tumor invasion and metastasis progress more slowly in the gastrointestinal tract.d. Apoptosis is triggered by diverse stimuli, including excessive growth.ANS: BMultiple genetic mutations are required for the evolution of full-blown cancer. This sequential development of cancer has been well documented in the transformation of benign colon polyps to colon cancer.PTS: 1 DIF: Cognitive Level: Remembering 8. Autocrine stimulation is the ability of cancer cells to do what?a. Stimulate angiogenesis to create their own blood supplyb. Encourage secretions that turn off normal growth inhibitorsc. Secrete growth factors that stimulate their own growthd. Divert nutrients away from normal tissue for their own useANS: CCancer cells must have mutations that enable them to proliferate in the absence of external growth signals. To achieve this, some cancers acquire the ability to secrete growth factors that stimulate their own growth, a process known as autocrine stimulation. The other options describe other activities of cancer cells, but not autocrine stimulation.PTS: 1 DIF: Cognitive Level: Remembering 9. What is apoptosis?a. Normal mechanism for cells to self-destruct when growth is excessiveb. Antigrowth signal activated by the tumor-suppressor gene Rbc. Mutation of cell growth stimulated by the TP53 gened. Transformation of cells from dysplasia to anaplasiaANS: ANormal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Unchecked proliferation could lead to malignancy.PTS: 1 DIF: Cognitive Level: Remembering 10. A student studying biology asks the professor to describe how the ras gene is involved in cancer proliferation. What explanation by the professor is best?a. It suppresses the action of the tumor-suppressor genes.b. It changes the way the growth promotion genes work.c. A mutation in this gene allows continuous cell growth.d. It activates a cell surface receptor that allows signaling to the nucleus.ANS: CUp to one-third of all cancers have an activating mutation in the gene for an intracellular signaling protein called ras. This mutant ras stimulates cell growth even when growth factors are missing. The remaining options do not describe how ras contributes to cancer formation and growth.PTS: 1 DIF: Cognitive Level: Understanding 11. The professor explains to students that oncogenes are genes that are capable of what?a. Undergoing mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferationb.
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