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KuImmunology 7th Edition Owen Punt Stranford Test Bank
ISBN-13: 978-1464119910
ISBN-10: 1464119910
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Chapter 19 Cancer and the Immune System
- The major difference between benign and malignant tumors is that:
- benign tumors are capable of metastasis.
- malignant tumors do not invade surrounding tissue.
- benign tumors are not neoplasms.
- malignant tumors are capable of uncontrolled growth.
- All of the above.
Answer: D
Section: Terminology and Common Types of Cancer
Difficulty: 1
Hint: Benign means harmless; malignant means harmful.
- The MOST common kind of cancers are carcinomas, which:
- are derived from epithelial tissue.
- include breast and colon cancer.
- include leukemia.
- Both a and b
- All of the above
Answer: C
Section: Terminology and Common Types of Cancer
Difficulty: 1
Hint: Leukemia is not a carcinoma.
- Metastasis is NOT which of the following?
- A property of benign tumors
- Invasion of new sites tumor cells
- The production of secondary tumors
- A property of malignant tumors
- Extremely dangerous
Answer: A
Section: Terminology and Common Types of Cancer
Difficulty: 1
Hint: Dislodging and invasion are very dangerous.
- Hematopoietic tumors include all but which of the following?
- Lung cancer
- Leukemia
- Lymphoma
- Myeloma
- These are all hematopoietic tumors.
Answer: A
Section: Terminology and Common Types of Cancer
Difficulty: 2
Hint: Lung cancer is a carcinoma.
- While leukemias used to be defined according to speed of onset, now they are defined as:
- acute and chronic, where chronic is longer lasting.
- acute and chronic, where chronic involves less mature cells.
- acute and chronic, where chronic involves more mature cells.
- lymphocytic or myelogenous, where lymphocytic involves lymphocytes.
- lymphocytic or myelogenous, where lymphocytic involves any white blood cell.
Answer: C
Section: Terminology and Common Types of Cancer
Difficulty: 2
Hint: Acute leukemias are derived from immature cells.
- Malignant transformation of cells usually means that they:
- grow in a density independent fashion.
- have reduced dependence on growth factors.
- are not anchorage dependent.
- Both A and B.
- All of the above.
Answer: E
Section: Malignant Transformation of Cells
Difficulty: 1
Hint: Consider the normal requirements for growth of cells; malignant cells obviate almost all of those.
- Carcinogens are NOT:
- agents that induce DNA mutations.
- agents that induce transformation.
- energy such as ionizing radiation.
- viruses such as Epstein-Barr virus.
- chemicals such as formaldehyde.
Answer: D
Section: Malignant Transformation of Cells
Difficulty: 1
Hint: Carcinogens are abiotic factors.
- Oncogenes:
- were originally discovered in viruses.
- have been found to be normal parts of cellular function.
- often regulate cell growth.
- are mutated or disregulated in cancer.
- All of the above.
Answer: E
Section: Malignant Transformation of Cells
Difficulty: 1
Hint: Rous sarcoma virus was the first agent found to cause cancer.
- Tumor-suppressor genes are NOT:
- normally regulating cell growth.
- called anti-oncogenes.
- causes of cancer when they become inactive.
- causes of cancer when they become activated.
- Both A and C.
Answer: D
Section: Malignant Transformation of Cells
Difficulty: 2
Hint: The normal function of tumor suppressors is to restrict cell division.
- Hallmarks of tumor transformation include all of the following EXCEPT:
- growth-factor independence.
- dependence of tumor suppressors.
- evasion of apoptotic signals.
- All of these are hallmarks of tumor transformation.
Answer: C
Section: Malignant Transformation of Cells
Difficulty: 2
Hint: Angiogenesis and evasion of apoptosis are both necessary.
- Most tumor antigens:
- are products of viruses.
- target the tumor for immune recognition.
- are not recognized as self antigens.
- are oncogene products.
- Both B and C.
Answer: D
Section: Tumor Antigens
Difficulty: 2
Hint: Tumors are self tissues.
- T cells can recognize tumor antigens from each of the following classes, EXCEPT for:
- antigens encoded genes exclusively expressed tumors (e.g., viral genes).
- antigens encoded variant forms of normal genes that are altered mutation.
- antigens that are expressed at lower than normal levels.
- antigens normally expressed only at certain stages of development.
- antigens that are overexpressed in particular tumors.
Answer: C
Section: Tumor Antigens
Difficulty: 1
Hint: T-cell recognition depends on protein production, not its absence or reduction.
- Tumor-specific antigens:
- trigger T-cell killing of the tumor.
- can be difficult to identify.
- are strongly selected against the immune system.
- Both A and B.
- All of the above.
Answer: E
Section: Tumor Antigens
Difficulty: 1
Hint: If the tumor cells are killed, what survives are those that are not targeted.
- Tumor-associated antigens:
- are not normal cellular proteins.
- are viral proteins.
- have abnormal expression patterns.
- Both A and B.
- All of the above
Answer: C
Section: Tumor Antigens
Difficulty: 2
Hint: These are up-regulated genes.
- Alpha-feto protein (AFP) is:
- normally expressed embryos.
- normal for pregnant women.
- expressed aberrantly some cancers.
- Both A and C.
- All of the above.
Answer: E
Section: Tumor Antigens
Difficulty: 1
Hint: Liver cancer can express AFP.
- The immune system does NOT control cancer with which of the following mechanisms?
- Elimination of transforming viruses
- Elimination of tumor inflammation
- Induction of apoptosis in cancer cells
- Induction of anergy in cancer cells
- It uses all of these mechanisms.
Answer: D
Section: The Immune Response to Cancer
Difficulty: 1
Hint: Anergy is a mechanism of tolerance induction.
- The theory that the immune system actively monitors and eliminates cancer cells is supported the observation that:
- AIDS patients have higher rates of some types of cancer than other populations.
- transplant patients on immunosuppressive therapy have higher rates of some types of cancer than other populations.
- patients who are deficient in adenosine deaminase and on immunosuppressive therapy have higher rates of some types of cancer than other populations.
- Both A and B.
- All of the above.
Answer: D
Section: The Immune Response to Cancer
Difficulty: 2
Hint: ADA deficiency has not yet been linked to cancer.
- Immunoediting does NOT:
- lead to more aggressive tumors natural selection.
- lead to elimination of tumor cells.
- consist of elimination, equilibrium, and escape.
- extend over a period of several to many years.
- Actually, it does all of these.
Answer: E
Section: The Immune Response to Cancer
Difficulty: 2
Hint: Elimination of some tumor cells leads to natural selection of others.
- Variability in the immune response to cancer leads to observations that:
- NK cells and dendritic cells can control cancer cells directly.
- NK cells and dendritic cells can activate a helper T-cell response to control cancer.
- NK cells and dendritic cells can activate a cytotoxic T-cell response to control cancer.
- Th17 cells can activate a response to control cancer.
- All of the above.
Answer: C
Section: The Immune Response to Cancer
Difficulty: 2
Hint: Cancer cells have to evade induction of apoptosis.
- A key role for natural killer cells in controlling cancer is NOT supported the:
- observation that NK-deficient mice have higher than normal rates of sarcoma development.
- observation that NK cells can kill cancer cells in vitro.
- observation that many tumors down-regulate MHC genes, including NK receptors.
- observation that cellular stress up-regulates many NK receptors.
- All of these support the role.
Answer: D
Section: The Immune Response to Cancer
Difficulty: 2
Hint: NK cells kill targets that lack the appropriate signal molecules.
- Responses of the immune system that can promote cancer include all of the following EXCEPT:
- chronic inflammation.
- inhibition of Th1 responses.
- myeloid-derived suppressor cells (MDSCs).
- CTL activation.
- All of these promote cancer.
Answer: D
Section: The Immune Response to Cancer
Difficulty: 2
Hint: CTLs can control tumor growth.
- Immunotherapy designed to target B-cell lymphoma with a monoclonal antibody is easier to administer than other immunotherapies because:
- the lymphoma is more prone to apoptosis.
- an anti-idiotypic monoclonal antibody won’t target bystander cells.
- the lymphoma is able to conduct class switching.
- the lymphoma is localized to specific organs.
- All of the above.
Answer: B
Section: Cancer Immunotherapy
Difficulty: 2
Hint: Lymphomas will have unique antigen receptors.
- Immunotoxins work by:
- inducing apoptosis in the target cells.
- recruiting complement to kill the target cells.
- delivering chemicals specifically to the target cells.
- recruiting NK cells.
- None of the above.
Answer: C
Section: Cancer Immunotherapy
Difficulty: 1
Hint: Toxins are chemical in nature.
- Cytokine treatment of cancer has proven problematic because:
- cytokines can show in vivo toxicity.
- dosages are very hard to control properly.
- cytokines can regulate the production of other cytokines.
- cytokines exert effects on a large number of target cells.
- All of the above.
Answer: E
Section: Cancer Immunotherapy
Difficulty: 1
Hint: Cytokines are great when applied to specific target cells; therapeutic use isn’t like that.
- The use of tumor-specific T cells re-introduced to patients requires all of the following EXCEPT:
- tumor-specific cells being isolated.
- tumor-specific cells being activated in order to overcome tumor-induced anergy.
- the patient being lymphodepleted to facilitate re-introduction.
- tumor-specific cells being depleted of autoreactive clones.
- All of these steps are required.
Answer: D
Section: Cancer Immunotherapy
Difficulty: 2
Hint: Tumors can survive inducing anergy in responsive cells.
- Manipulation of costimulatory signals has potential to treat tumors because:
- tumors that do not provide costimulation induce anergy instead.
- it is relatively easy to isolate and introduce genes to tumor cells.
- modified tumors with increased costimulatory activity can be reintroduced to patients.
- blockage of CTLA-4 on tumors will increase T-cell activation.
- All of the above.
Answer: E
Section: Cancer Immunotherapy
Difficulty: 2
Hint: In order to survive, tumors have to down-modulate positive costimulation, or up-regulate negative costimulation.