Exam BIMM21, June 3rd 2016
1.
Tumors of epithelial origin are the most common form of cancer in humans. Which of
the following is classified as a tumor of epithelial origin:
a)
b)
c)
d)
2.
c-myc overexpression is sufficient to induce lymphoma
c-myc overexpression is likely not sufficient to induce lymphoma
c-myc was expressed in few B cells, resulting in monoclonal growth
c-myc is not a very potent oncogene
Slow transforming retroviruses can be useful for studying:
a)
b)
c)
d)
5.
hyperplasia; metaplasia; dysplasia
dysplasia; metaplasia; hyperplasia
hyperplasia; dysplasia; metaplasia
metaplasia; dysplasia; hyperplasia
In a transgenic mouse model of Burkitts lymphoma, the c-myc gene is placed under
the control of IgH enhancer. At first, there is no sign of tumor but after some time the
mice develop monoclonal B cell lymphomas. This suggests that:
a)
b)
c)
d)
4.
melanoma
glioma
osteosarcoma
adenocarcinoma
In some cancers, a progressive development from normal to highly malignant cell
types can be seen. The proposed order in which the different gradients of
abnormality appear, starting from normal tissue and ending with malignant tissue, is:
a)
b)
c)
d)
3.
Name:
insertional mutagenesis
oncogenes picked up by retroviruses
loss of heterozygosity
identification of tumor suppressor genes
Cancer cells have a different metabolism as compared to normal cells. What is the
main explanation as to why cancer cells use the type of metabolism often referred to
as “the Warburg effect”?
a) Many cancer cells have inadequate supply of oxygen and rely on anaerobic
glycolysis for energy production
b) Highly proliferative cells like cancer cells need high amounts of ATP
c) Cancer cells are metabolically reprogrammed to use aerobic glycolysis
d) Metabolic intermediates from the TCA cycle can then be used for other
biosynthetic reactions
6.
The myc oncogene can be activated by:
a)
b)
c)
d)
7.
Which mechanism can lead to oncogene activation:
a)
b)
c)
d)
8.
gene amplification
chromosomal translocation
proviral integration
all of the above
chromosomal translocation
genetic mutation
truncation
all of the above
The human papilloma virus is an oncogenic DNA virus that cause cervical cancer by:
a) inhibiting p53
b) inhibiting pRb
c) inhibiting both p53 and pRb
d) inhibiting p53 and cyclin-dependent kinase inhibitor p16INK4A
9.
Control of the pRb function is disturbed in principally all human tumors. Which type
of deregulation would promote advancement through the cell cycle restriction point?
a)
b)
c)
d)
promoter methylation of CDK4
amplification of p27Kip1
p27Kip1 degradation
loss of cyclin D1 expression
10. Which of the following statements regarding NK cells is true?
a)
b)
c)
d)
belong to the adaptive immune response
require activation by T cells for killing tumor cells
recognize tumor cells expressing MHCI-antigen complexes
kill cells by releasing toxic compounds
11. O6-methylguanine DNA methyltransferase (MGMT) is a DNA repair protein that
removes methyl groups from DNA (most often on O6 guanine). In many glioma
patients, the MGMT gene is affected by promoter methylation. These patients are
therefore particularly sensitive to:
a)
b)
c)
d)
temozolomide, an alkylating agent
cisplatin, a DNA cross linker
doxorubicin, a topoisomerase inhibitor
5-fluorouracil, a pyrimidine analogue
12. Trastuzumab (Herceptin) is a monoclonal antibody and used as a targeted treatment
in a certain type of breast cancer. What does Herceptin target?
a)
b)
c)
d)
a tyrosin kinase receptor
an intracellular kinase
a G-protein-coupled receptor
extracellular VEGF
13. In hypoxic cells, the mechanism that leads to stabilization of the hypoxia inducible
factor α subunit (HIF-α) involves:
a)
b)
c)
d)
degradation of prolyl-4-hydroxylases (PHDs)
loss of VHL function
loss of HIF-α hydroxylation
binding to the HIF-β subunit
14. The seed-and-soil hypothesis suggested by Paget in 1889 suggests that:
a)
b)
c)
d)
circulating tumor cells are shielded from NK-cells by platelets
tumor microenvironment is important for metastatic growth
site-specific metastasis depends on anatomical location of the tumor
factors are secreted by primary tumor cells that prepares distant sites for
metastatic growth
15. Gleevec is a targeted therapy that is used for treatment of chronic myeloid
leukemia. Its main mechanism of action is:
a)
b)
c)
d)
induced differentiation of leukemic cells
inhibition of a tyrosin kinase receptor
inhibition of an intracellular tyrosin kinase
inhibition of the proteasome
16. To become activated a T cell requires 3 signals. Which of the following is hampered by
CTLA-4?
a)
b)
c)
d)
antigen presentation signal
co-stimulatory signal
cytokine stimulated signal
all of the above
17. Targeted therapeutics, in particular tyrosine kinase inhibitors, have revolutionized
cancer treatment in recent years. Such drugs are particulary successful when:
a)
b)
c)
d)
There is large intratumoral heterogeneity with regards to genetic aberrations
Single specific mutations act as drivers of tumor growth
Tumors have upregulated expression of drug efflux pumps
There is a potent immune response towards the tumor
18. Clear cell renal cell carcinomas are unusually vascular tumors. What’s the primary
reason?
a) The normal kidney is an unusually vascular tissue
b) Clear cell renal cell carcinomas have a pseudo-hypoxic phenotype resulting in
excessive angiogenesis
c) Renal cancer cells require more oxygen than other tumor cells
d) VHL loss in clear cell renal cell carcinomas results in decreased degradation of
VEGF, leading to increased angiogenesis
19. Tumor cells generally consume more glucose than normal cells. This fact can be
exploited in the clinic. How?
a) Glucose consumption by tumor cells allow for PET-CT-based imaging of 18F-FDG in
tumor detection
b) Glucose consumption by tumor cells allow for CT-MRI-based imaging of 18F-FDG in
tumor detection
c) Glucose consumption by tumor cells allow for bioluminescence-based imaging of
18F-FDG in tumor detection
d) Glucose consumption by tumor cells allow for ultrasound-based imaging of 18F-FDG
in tumor detection
20. Epithelial-to-mesenchymal transition is thought to promote:
a)
b)
c)
d)
Tumor cell differentiation
Tumor cell migration
Tumor cell proliferation
Tumor cell death
21. Tumors can acquire resistance to targeted therapeutics by
a)
b)
c)
d)
Acquiring novel mutations
Selection of pre-existing drug resistant clones
Reversibly altering tumor cell phenotype
All of the above
22. The cancer stem cell model is based primarily on the finding that:
a) The most aggressive tumors have a stem cell-like phenotype, whereas
differentiated tumors are less aggressive
b) Only a minority of cells present in a tumor can propagate tumor growth when
transplanted in mice
c) Stem- and progenitor cells are easier to transform in mouse models than
differentiated cells
d) Cells undergoing EMT acquire a stem cell-like phenotype
23. Tumor blood vessels exhibit
a)
b)
c)
d)
Non-hierarchical organization
Leakiness
Variable diameter
All of the above
24. Cancer cells frequently use glycolysis rather than oxidative phosphorylation. This
might seem surprising, as
a) Glycolysis generates only 2 ATP/glucose, whereas oxidative phosphorylation
generates 36 ATP/glucose
b) Oxidative phosphorylation is faster than aerobic glycolysis
c) Tumors are generally more hypoxic than normal tissues
d) All of the above
25. Glycolytic cancer cells release lactate into the microenvironment. What is a
consequence of this?
a) Lactate will lower the pH in the microenvironment, leading to extracellular matrix
remodeling
b) Lactate will increase the pH in the microenvironment, leading to extracellular
matrix remodeling
c) Lactate activates the immune system to promote tumor growth
d) Lactate activates the immune system to promote an anti-tumor immune response
26. Which of the following can be a late side-effect of radiation therapy?
a)
b)
c)
d)
Carcinogenesis
Infertility
Fibrosis
All of the above
27. Bevacizumab (Avastin) is a monoclonal antibody against VEGF. Which cell type is
primarily targeted by anti-VEGF treatment?
a)
b)
c)
d)
tumor cells
pericytes
cancer-associated fibroblasts
endothelial cells
28. Cancer-associated fibroblasts (CAFs) contribute to many steps during tumorigenesis.
Which of the following is true for CAFs?
a)
b)
c)
d)
CAFs secrete molecules that increase extracellular matrix stiffness
CAFs secrete factors that promote tumor cell proliferation
CAFs have increased glycolysis
All of the above
29. Panitumumab is a monoclonal antibody targeting the EGFR that is commonly used in
the treatment of colon cancer. Many tumors develop resistance to panitumumab.
Which is the most likely resistance mechanism?
a)
b)
c)
d)
Upregulation of EGF ligand
Downregulation of EGF ligand
Downregulation of EGFR
Acquired activating mutation in KRAS
30. Epithelial-to-mesenchymal transition (EMT) has been shown to induce stem cell
characteristics of breast cancer cells. What’s the conclusion from these experiments?
a)
b)
c)
d)
The cancer stem cell phenotype is plastic and reversible
Cancer stem cells are derived from normal breast tissue stem cells
EMT is required for tumor-initiation and metastatic spread
EMT is required for therapeutic resistance