1.
One of the following is not affected in cancer development?
Correct Answer
D. Activation of tumor suppressor genes
Explanation
Tumor suppressor genes play a crucial role in preventing the development of cancer. When these genes are activated, they help regulate cell growth and division, preventing the formation of tumors. However, in cancer development, these tumor suppressor genes are often inactivated or mutated, allowing uncontrolled cell growth and tumor formation. Therefore, the activation of tumor suppressor genes is not affected in cancer development, as it is the loss of their function that contributes to the disease.
2.
Insensitivity to growth-inhibiting signals is one of the cancer hallmarks, one of the following is false about it.
Correct Answer
B. In sporadic cases, one mutated allele is inherited
Explanation
In sporadic cases, one mutated allele is not inherited. Sporadic cases of cancer occur when there is no family history of the disease and the mutations in tumor suppressor genes arise randomly in somatic cells. This means that the mutated allele is not inherited from either parent but occurs during a person's lifetime.
3.
What is the checkpoint in the cell cycle that is regulated by the RB gene?
Correct Answer
C. G1 to S
Explanation
The checkpoint in the cell cycle that is regulated by the RB gene is the G1 to S checkpoint. This checkpoint ensures that all necessary conditions for DNA replication are met before the cell progresses from the G1 phase to the S phase. The RB gene plays a crucial role in regulating the progression of the cell cycle by inhibiting the activity of certain proteins that promote cell division. When the RB gene is functioning properly, it prevents the cell from entering the S phase until it has received the appropriate signals and conditions for DNA replication.
4.
TP-53 is one of the genes that is playing a role in cancer development, one of the following is true about it.
Correct Answer
D. A mutation in the TP-53 gene can be acquired or inherited
Explanation
A mutation in the TP-53 gene can be acquired or inherited. This means that a person can either develop a mutation in the TP-53 gene during their lifetime due to environmental factors or it can be passed down from their parents. This mutation in the TP-53 gene is significant because TP-53 is a tumor suppressor gene that helps regulate cell division and prevent the formation of cancerous cells. When a mutation occurs in this gene, it can disrupt its normal function and increase the risk of developing cancer.
5.
Mutant APC gene will release the amount of one of the following:
Correct Answer
A. B-catenin
Explanation
The mutant APC gene will release the amount of B-catenin. The APC gene is responsible for regulating the levels of B-catenin, a protein involved in cell adhesion and signaling pathways. Mutations in the APC gene can lead to the accumulation of B-catenin, which can then enter the nucleus and activate genes involved in cell proliferation. This dysregulation of B-catenin signaling is a key event in the development of colorectal cancer.
6.
One of the following is not a hallmark of cancer.
Correct Answer
B. Programmed cell death
Explanation
Programmed cell death, also known as apoptosis, is actually a hallmark of cancer. Cancer cells often evade apoptosis, which is the normal process of cell death that occurs when a cell is damaged or no longer needed. This allows cancer cells to survive and continue to replicate. Therefore, programmed cell death is not a hallmark of cancer.
7.
Translocation in Follicular B cell Lymphoma is:
Correct Answer
A. T(18;14)
Explanation
The correct answer is t(18;14). This translocation refers to a specific genetic abnormality found in Follicular B cell Lymphoma, where parts of chromosome 18 and chromosome 14 swap places. This translocation leads to the overexpression of the BCL2 gene, which prevents programmed cell death and promotes the survival of cancerous B cells. This genetic abnormality is a characteristic feature of Follicular B cell Lymphoma and plays a role in the development and progression of the disease.
8.
What are the genes responsible for xeroderma pigmentosum disorder?
Correct Answer
C. Nucleotide excision repair genes
Explanation
Xeroderma pigmentosum is a genetic disorder characterized by extreme sensitivity to ultraviolet (UV) rays and a high risk of developing skin cancer. Nucleotide excision repair (NER) is the DNA repair mechanism responsible for removing UV-induced DNA damage. Mutations in the genes involved in NER, such as XPA, XPC, XPD, XPF, XPG, and DDB2, are responsible for xeroderma pigmentosum. These genes play a crucial role in repairing DNA damage caused by UV radiation, and their dysfunction leads to the accumulation of DNA lesions, increasing the risk of skin cancer development.
9.
True about BRCA-1 & BRCA-2 genes:
Correct Answer
D. All of the following are correct
Explanation
The BRCA-1 and BRCA-2 genes are tumor suppressor genes that are found in 50% of familial breast cancers and ovarian cancers. These genes play a role in repairing damaged DNA and preventing the growth of abnormal cells. It is true that the BRCA gene is rarely inactivated in sporadic cases, meaning that it is more commonly associated with hereditary cases of cancer. Therefore, the correct answer is that all of the statements provided are correct.
10.
One of the following is not a positive angiogenic factor.
Correct Answer
A. Thrombospondin1 (TSP-1)
Explanation
Thrombospondin1 (TSP-1) is not a positive angiogenic factor because it is known to have anti-angiogenic properties. While HIF-1a, VEGF, and TGF are all positive angiogenic factors that promote the formation of new blood vessels, TSP-1 inhibits angiogenesis by binding to and neutralizing pro-angiogenic factors. Therefore, TSP-1 acts as a negative regulator of angiogenesis rather than a positive one.
11.
Accumulate mutations in tumor cells leads to:
Correct Answer
C. All of them are correct
Explanation
Accumulating mutations in tumor cells can lead to a more aggressive nature of the tumor, as these mutations can result in increased cell proliferation, resistance to cell death, and enhanced ability to invade surrounding tissues. Additionally, accumulating mutations can lead to non-antigenic growth, meaning that the tumor cells can evade the immune system's recognition and destruction. Finally, these mutations can also promote invasion and metastasis, allowing the tumor cells to spread to distant sites in the body. Therefore, all of the given options are correct.
12.
Which of the following is responsible for the attachment of tumor cells to matrix components in the metastasis process?
Correct Answer
B. Laminin & integrin receptors
Explanation
Laminin and integrin receptors are responsible for the attachment of tumor cells to matrix components in the metastasis process. Laminin is a protein found in the extracellular matrix that helps anchor cells to the matrix, while integrin receptors are cell surface receptors that bind to laminin and other matrix proteins, allowing cells to adhere to the matrix and migrate. This attachment is crucial for tumor cells to invade surrounding tissues and form metastases in distant organs.
13.
One of the following doesn't influence the site of metastasis?
Correct Answer
B. Size of the tumor
Explanation
The size of the tumor does not influence the site of metastasis. Metastasis is the spread of cancer cells from the primary tumor to other parts of the body. It is influenced by various factors such as the anatomical location of the primary tumor, the presence of complimentary adhesion molecules between tumor cells and target organs, the release of chemoattractants by target organs, and the presence of protease inhibitors in certain tissues. However, the size of the tumor itself does not determine where the cancer cells will metastasize to.
14.
The least common site for a lung tumor to spread to is:
Correct Answer
A. Ovaries
Explanation
The least common site for a lung tumor to spread to is the ovaries. Lung tumors typically have a higher likelihood of spreading to other parts of the body, such as the brain, adrenal glands, or liver. However, the ovaries are less commonly affected by metastasis from lung tumors compared to other organs.
15.
One of the following is false about chemical carcinogens.
Correct Answer
C. They can't be natural substances
Explanation
Chemical carcinogens are substances that can cause cancer by damaging the DNA in our cells. They are typically electrophilic, meaning they have a tendency to react with DNA and cause damage. Initiator or mutagen is a specific type of chemical carcinogen that induces irreversible DNA damage, leading to the initiation of cancer. Chemical carcinogens can be both synthetic and natural substances. Examples of chemical carcinogens include nitrosamines and alkylating agents. Therefore, the statement "they can't be natural substances" is false.
16.
Which of the following is not a skin cancer?
Correct Answer
A. Neuroblastoma
Explanation
Neuroblastoma is not a skin cancer. It is a type of cancer that develops in immature nerve cells, usually found in the adrenal glands, which are located on top of the kidneys. Skin cancers, on the other hand, typically originate in the skin cells. Squamous cell carcinoma, basal cell carcinoma, and melanoma are all types of skin cancer that can develop from different types of skin cells.
17.
Which HPV strains have a high risk of developing Squamous cell CA in the cervix?
Correct Answer
C. HPV 16 & 18Â
Explanation
HPV strains 16 and 18 have a high risk of developing Squamous cell CA in the cervix. These two strains are known as high-risk types of HPV and are responsible for causing the majority of cervical cancer cases. HPV 16 and 18 are considered high-risk because they have a higher likelihood of causing abnormal cell changes in the cervix that can progress to cancerous cells. Regular screening and vaccination against these HPV strains are important for preventing cervical cancer.
18.
Burkitt lymphoma is mostly related to which virus?
Correct Answer
D. EBV
Explanation
Burkitt lymphoma is mostly related to the Epstein-Barr virus (EBV). EBV is a common virus that infects B cells, a type of white blood cell. It can cause the uncontrolled growth of these cells, leading to the development of Burkitt lymphoma. This type of lymphoma is more commonly seen in areas with high rates of EBV infection, such as sub-Saharan Africa. HPV, HIV, and HCV are not typically associated with Burkitt lymphoma.
19.
One of the following is false about microbial carcinogens?
Correct Answer
B. EBV playing a role in developing of hepatocellular carcinoma
20.
Regarding tumor immunology, one of the following is false.
Correct Answer
D. All tumors cells have no specific antigens
Explanation
The statement "all tumor cells have no specific antigens" is false. Tumor cells can express specific antigens that are recognized by the immune system. In fact, the presence of specific antigens on tumor cells is one of the reasons why immunotherapy can be effective in treating certain types of cancer. Immunotherapy works by targeting these specific antigens on tumor cells to stimulate the immune system and enhance its ability to recognize and destroy cancer cells. Therefore, it is incorrect to say that all tumor cells have no specific antigens.
21.
The most important Immune cells involved in fighting against tumors are:
Correct Answer
B. CD8+ T-cells
Explanation
CD8+ T-cells are the most important immune cells involved in fighting against tumors. These cells, also known as cytotoxic T-cells, play a crucial role in recognizing and destroying cancer cells. They are able to directly kill tumor cells by releasing cytotoxic substances and activating cell death pathways. Additionally, CD8+ T-cells can also stimulate other immune cells, such as B-cells and natural killer (NK) cells, to enhance the anti-tumor immune response. This makes CD8+ T-cells a key component of the immune system's defense against tumors.
22.
Which of the following antigens are seen in melanoma?
Correct Answer
D. Tyrosinase
Explanation
Tyrosinase is an antigen that is seen in melanoma. Melanoma is a type of skin cancer that originates from melanocytes, the cells responsible for producing the pigment melanin. Tyrosinase is an enzyme involved in the production of melanin, and it is specifically expressed in melanocytes. Therefore, the presence of tyrosinase antigen can be used as a marker for the diagnosis and monitoring of melanoma. The other antigens listed, bcr/abl, HER-2, and HER-1, are not associated with melanoma.
23.
Tumor cells escape immune surveillance by one of the following.
Correct Answer
C. Antigen masking
Explanation
Antigen masking is a mechanism by which tumor cells can evade immune surveillance. This occurs when tumor cells modify or hide their antigens, preventing recognition by the immune system. As a result, the immune system is unable to mount an effective response against the tumor cells, allowing them to proliferate and evade destruction. This strategy helps the tumor cells to escape detection and destruction by the immune system, promoting their survival and progression.
24.
Cushing's syndrome as a paraneoplastic syndrome is mainly related to:
Correct Answer
D. Small cell carcinoma
Explanation
Cushing's syndrome as a paraneoplastic syndrome is mainly related to small cell carcinoma. Small cell carcinoma is a type of cancer that commonly occurs in the lungs, although it can also arise in other parts of the body. It is known to produce various hormones, including adrenocorticotropic hormone (ACTH), which can stimulate the adrenal glands to produce excessive cortisol. This overproduction of cortisol leads to the development of Cushing's syndrome, characterized by symptoms such as weight gain, high blood pressure, and muscle weakness.
25.
Tumor markers are used for?
Correct Answer
D. All of them are correct
Explanation
Tumor markers are substances that are produced by cancer cells or by the body in response to cancer. They can be detected in blood, urine, or tissue samples. These markers are used for various purposes in cancer management. They can help confirm a diagnosis by indicating the presence of cancer. They can also be used to determine the response to treatment by monitoring the levels of the markers over time. Additionally, tumor markers can be helpful in detecting early relapse, as an increase in marker levels may indicate the recurrence of cancer. Therefore, all of the given options are correct uses of tumor markers.
26.
Immunoglobulins are secreted in which type of tumors?
Correct Answer
A. Multiple Myeloma
Explanation
Immunoglobulins, also known as antibodies, are proteins that are secreted by plasma cells. Multiple Myeloma is a type of cancer that affects plasma cells, causing them to produce abnormal amounts of immunoglobulins. This excessive production of immunoglobulins can lead to various symptoms and complications associated with Multiple Myeloma. Therefore, the correct answer is Multiple Myeloma.
27.
65 years old male patient came to a clinic complaining of fatigue with stress when he goes upstairs for example. his CBC test and liver function test are normal, during physical examination his abdominal examination seems to be normal but the doctor noticed that there is a slight swelling in lower limps. here the doctor suspects which of the following?
Correct Answer
C. Right-sided heart failure
Explanation
The correct answer is right-sided heart failure. This is indicated by the patient's symptoms of fatigue and stress when exerting themselves, as well as the presence of swelling in the lower limbs. Right-sided heart failure occurs when the right side of the heart is unable to effectively pump blood to the lungs for oxygenation, leading to fluid accumulation in the body, particularly in the legs and abdomen. The normal CBC and liver function tests suggest that malnutrition and liver cirrhosis are less likely causes of the patient's symptoms.
28.
Pinpoint hemorrhage due to rupture of a
capillary is called
Correct Answer
D. Petechiae
Explanation
Petechiae refers to pinpoint hemorrhage due to the rupture of a capillary. It appears as small, flat, red or purple spots on the skin or mucous membranes. Purpura refers to larger areas of bleeding under the skin, while ecchymoses are larger bruises. Therefore, the correct answer is Petechiae.
29.
One of the following is mismatched
Correct Answer
B. Melena : passing bright red blood per rectum.
Explanation
Melena is actually the passage of black, tarry stools that are sticky and foul-smelling. It occurs when there is bleeding in the upper gastrointestinal tract, such as in the stomach or small intestine. The blood is digested and turns black as it passes through the digestive system. Passing bright red blood per rectum is more indicative of lower gastrointestinal bleeding, which can be seen in conditions such as hemorrhoids or colorectal cancer. Therefore, Melena is the mismatched term in this list.
30.
A 3-year-old boy is seen at his annual pediatrician’s visit with a concern for prolonged nosebleeds. Ever since he was about 2 years old, he has had multiple episodes of nosebleeds that stopped only after hours. On physical exam, his right elbow is slightly swollen and tender to palpation. On further question, there is a family history of unexplained bleeding in the patient’s maternal uncle. Lab results reveal increased PTT that corrects after mixing studies. the child has:
Correct Answer
B. HemopHilia A or B
Explanation
The correct answer is hemophilia A or B. This is suggested by the patient's symptoms of prolonged nosebleeds and the family history of unexplained bleeding. The increased PTT that corrects after mixing studies indicates a deficiency in one of the clotting factors, which is characteristic of hemophilia.
31.
A patient presented to you with deep bleeding and you find PTT to be normal and PT to be prolonged , vitamin K was given but the patient is still bleeding and PT is still prolonged , what is the most likely case in this scenario
Correct Answer
C. Factor VII deficiency
Explanation
In this scenario, the patient's prolonged PT indicates a problem with the extrinsic pathway of the coagulation cascade. Since vitamin K was given and the PT remains prolonged, it suggests that the issue is not related to a deficiency in vitamin K-dependent factors (II, VII, IX, X). Among the given options, Factor VII deficiency is the most likely cause as it is the key factor in the extrinsic pathway. Factor VIII, Factor V, and Factor IX deficiencies are not associated with prolonged PT.
32.
A 9-year-old female experience prolonged bleeding following tooth
extraction. Her family history is significant for an uncle who suffered from an unspecified bleeding disorder. The patient’s laboratory findings are given below:
Hematocrit 43%
Bleeding time Prolonged
PTT Prolonged
PT Normal
Thrombin time Normal
D-dimer Normal
The most likely diagnosis is:Which one do you like?
Correct Answer
A. Von Willebrand disease
Explanation
The patient's prolonged bleeding time, prolonged PTT, and normal PT suggest a defect in the intrinsic pathway of coagulation. This, along with the family history of bleeding disorder, is consistent with von Willebrand disease. Von Willebrand disease is a hereditary bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor, which plays a crucial role in platelet adhesion and stabilization of factor VIII.
33.
Glycoprotein 1b (gb1b) deficiency causes:
Correct Answer
C. Bernard-Soulier syndrome
Explanation
Glycoprotein 1b (gb1b) deficiency is associated with Bernard-Soulier syndrome. This syndrome is a rare inherited bleeding disorder characterized by a deficiency or dysfunction of the glycoprotein 1b-IX-V complex on the surface of platelets. This complex is essential for platelet adhesion to the damaged blood vessel wall. As a result, individuals with Bernard-Soulier syndrome experience prolonged bleeding, easy bruising, and nosebleeds. Von Willebrand disease is caused by a deficiency or dysfunction of von Willebrand factor, Hemophilia B is caused by a deficiency of factor IX, and Glanzmann disease is caused by a deficiency of glycoprotein IIb/IIIa on the platelet surface.
34.
One of the following doesn't consider as a high risk for thrombosis.
Correct Answer
D. NepHrotic syndrome
Explanation
Nephrotic syndrome is not considered a high risk for thrombosis. Thrombosis is the formation of blood clots in blood vessels, which can be dangerous if they block blood flow. Prolonged bed rest or immobilization, disseminated intravascular coagulation, and prosthetic cardiac valves are known to increase the risk of thrombosis. However, nephrotic syndrome, a kidney disorder characterized by excessive protein loss in urine, does not directly increase the risk of blood clots.
35.
A 10-day old male is being seen in the emergency room due to lethargy and poor feeding. Her anterior fontanel is full. A CT scan demonstrates an intraparenchymal hemorrhage. Coagulation tests are ordered with the following results: PT—37 seconds (normal 9.7-11.2 seconds) and a PTT of 66 seconds (normal 22-36 seconds). This child may have which of the following factor deficiencies.
Correct Answer
A. Factor X
Explanation
Based on the given information, the child has prolonged PT and PTT, indicating a coagulation disorder. Factor X is responsible for the activation of the common pathway of coagulation, which is reflected in both PT and PTT. Therefore, a deficiency in Factor X could explain the prolonged PT and PTT results in this case.
36.
An 8-year-old female with recurrent tonsillitis is referred for a tonsillectomy. Her surgeon orders preoperative laboratory tests, and the results demonstrate a PT of 10.2 seconds (normal 9.7–11.2 seconds) and a PTT of 58 seconds (normal 22–36 seconds). The most appropriate next test to order is:
Correct Answer
D. A mixing study for more than one factor
Explanation
The correct answer is a mixing study for more than one factor. A mixing study is used to determine if a coagulation abnormality is due to a factor deficiency or an inhibitor. In this case, the prolonged PT and PTT suggest a possible deficiency in one or more coagulation factors. By performing a mixing study, the clinician can determine if the prolonged clotting times are corrected when normal plasma is added, indicating a factor deficiency. If the clotting times remain prolonged, it suggests the presence of an inhibitor. Testing for specific factor activities (such as factor VIII or IX) would be appropriate if the mixing study indicates a factor deficiency.
37.
The most common cause of systemic thromboembolism is:
Correct Answer
B. Mural thrombi
Explanation
The most common cause of systemic thromboembolism is mural thrombi. Mural thrombi are blood clots that form on the walls of the heart, typically as a result of conditions like atrial fibrillation or myocardial infarction. These clots can break loose and travel through the bloodstream, causing blockages in other parts of the body. Aortic aneurysm and aortic atherosclerosis can also increase the risk of thromboembolism, but mural thrombi are the most common cause. The option "unknown origin" does not provide a specific cause and is therefore not the correct answer.
38.
One of the following is false regarding this picture
Correct Answer
B. The typical source for such thromboemboli is from small arteries in legs
Explanation
The correct answer is "The typical source for such thromboemboli is from small arteries in legs." This statement is false because the typical source for such thromboemboli is not from small arteries in legs, but rather from deep veins in the legs. Thromboemboli refers to blood clots that break loose and travel through the bloodstream, causing a blockage in another part of the body. In the case of immobilized patients, blood clots often form in the deep veins of the legs due to reduced blood flow and increased stasis. These clots can then break loose and travel to the lungs, causing a pulmonary embolism.
39.
This picture indicates:
Correct Answer
A. Ecchymoses
Explanation
This picture indicates ecchymoses. Ecchymoses are larger bruises that appear as purple or blue patches on the skin. They occur due to bleeding under the skin, usually caused by trauma or injury. Ecchymoses are different from petechiae, which are smaller red or purple spots, and purpura, which are larger patches of purple or red discoloration. Hematomas, on the other hand, are localized collections of blood outside of blood vessels, often forming a lump or swelling.
40.
False about this picture.
Correct Answer
D. The blood supply is not affected at all
Explanation
The correct answer is that the blood supply is not affected at all. This means that the picture does not show any blockage or narrowing of the coronary arteries, which are responsible for supplying blood to the heart muscle. The absence of any occlusive coronary atherosclerosis indicates that there is no obstruction or reduction in blood flow to the heart.