Deck 17: Cancer and Its Interactions With the Immune System

Question 1

Explain how decreased levels of HLA class I on variant cancer cells can (A)enhance or (B)reduce tumor growth.

Answer 1

A.Enhancement of tumor growth occurs when cancer cells stop expressing HLA class I because these cells are no longer presenting tumor antigens to cytotoxic T cells.Variant cells are consequently able to escape immune detection. B.Tumor cells that lack HLA class I are more susceptible to attack by NK cells.The inhibitory receptor on NK cells fails to engage normally,and this causes tumor cell killing after the activation and release of cytotoxic molecules by the NK cell.

Question 2

Bortezomib has all of the following effects except _____.

A)reducing the supply of peptides needed for MHC class I transport to the cell surface
B)inhibiting tumor-cell proliferation
C)inducing tumor-cell apoptosis
D)inhibiting proteasome activity
E)blocking inhibitory KIRs.

Answer 2

E

Question 3

What are the two main classes of gene that,if not expressed correctly,can lead to malignant transformation?
B.What are the gene products made by each class?

Answer 3

A.Proto-oncogenes and tumor suppressor genes. B.Proto-oncogenes encode proteins that participate in cell division,such as growth factors,growth factor receptors,signal transduction proteins,and activators of gene expression.Tumor suppressor genes encode proteins that inhibit the division of mutant cells; examples are p53,APC,and DCC.

Question 4

_____ is/are commonly associated with the fusion between the BCR gene and the ABL proto-oncogene.

A)Non-small cell lung carcinoma
B)Bladder tumors
C)Melanoma
D)Head and neck squamous cell carcinoma
E)Chronic myelogenous leukemia.

Question 5

domestic dogs and Tasmanian devils,successful passage and growth of tumors through copulation and biting,respectively,are attributed to _____.

A)absence of quiescent cancer stem cells in the tumor
B)limited MHC diversity between animals
C)repression of tumor-specific antigen expression
D)repression of tumor-associated antigen expression
E)lack of regulatory T cells.

Question 6

Provide an example of a monoclonal antibody that can be modified differently to either detect or eradicate a tumor.

Question 7

What are tumor-specific antigens?
B.How do they originate?
C.Give two examples,together with the type of tumor they come from.

Question 8

Which of the following is mismatched?

A)oncology: diagnosis and treatment of tumors
B)carcinoma: characteristic cell types found in benign tumors
C)mutation: changes in DNA involving substitutions,deletions,insertions,recombinations,and translocations
D)leukemia: cancer of the immune system affecting circulating cells
E)malignant transformation: gain of ability to form a cancer.

Question 9

Which of the following is mismatched?

A)tumor suppressor genes: mutated in over 50% of human cancer cases
B)HTLV-1: an RNA retrovirus associated with adult T-cell leukemia
C)Helicobacter pylori: bacterial infection associated with colon cancer
D)sipuleucel-T cell vaccine: treatment for late-stage metastatic prostate cancer
E)cancer immunosurveillance: recognition and elimination of cancer cells by defense mechanisms.

Question 10

Explain why the incidence of cancer is higher in the elderly than in young people.

Question 11

Which of the following cell types in a tumor biopsy would not be associated with a promising prognosis?

A)B cells
B)memory T cells
C)T_FH cells
D)regulatory T cells
E)cytotoxic T cells.

Question 12

Which of the following is not a human monoclonal antibody that is directed at a cell-surface component?

A)rituximab
B)alemtuzumab
C)ibritumomab
D)bevacizumab
E)ipilimumab.

Question 13

What is Li-Fraumeni syndrome?
B.What is the underlying cause?

Question 14

Adoptive transfer of sipuleucel-T-primed dendritic cells is a form of immunotherapy currently used for the treatment of _____.

A)late-stage metastatic prostate cancer
B)multiple myeloma
C)chronic myelogenous leukemia
D)melanoma
E)cervical cancer.

Question 15

Human papillomaviruses express proteins that bind to _____ and block its function.(Select all that apply.)

A)MIC glycoproteins
B)p53
C)CT antigens
D)TLR4
E)Rb.

Question 16

Mutagens that increase one's predisposition to developing cancer are called _____.

A)carcinogens
B)tumor antigens
C)neoplastic mutagens
D)oncogenes
E)proto-oncogenes.

Question 17

What are tumor-associated antigens?
B.How do they originate?
C.Give two examples together with the type of tumor they come from.

Question 18

Cancers develop their own blood supply and become vascularized through _____.

A)apoptosis
B)neoplasia
C)angiogenesis
D)metastasis
E)malignant transformation.

Question 19

_____ agents usually cause single nucleotide substitutions in DNA,whereas _____ agents produce more significant damage to DNA.

A)mutagenic; carcinogenic
B)chemical; physical
C)benign; malignant
D)tumor-associated; tumor-specific
E)benign; oncogenic.

Question 20

Examples of tumor suppressor genes include _____.(Select all that apply.)

A)APC
B)RAS
C)p53
D)ABL
E)DCC.

Question 21

Systemic distribution of cancer cells to other sites of the body through the bloodstream or lymph is a process known as _____.

A)apoptosis
B)neoplasia
C)angiogenesis
D)metastasis
E)malignant transformation.

Question 22

DNA viruses associated with cancer development include _____.(Select all that apply.)

A)human papillomavirus (HPV)
B)human immunodeficiency virus (HIV-1)
C)human herpesvirus 8 (HHV8)
D)Epstein-Barr virus (EBV)
E)malignant transformation.

Question 23

An example of a physical agent that increases an individual's predisposition to developing cancer is_____.(Select all that apply.)

A)cigarette smoke
B)X-rays
C)ultraviolet radiation
D)asbestos
E)exposure to radioactive sources.

Question 24

_____ describes the condition in which a cell becomes able to cause cancer.

A)Malignant mutation
B)Malignant recombination
C)Malignant neoplasm
D)Malignant transformation
E)Malignant suppression.

Question 25

Chemical and physical agents that increase mutation rates by damaging DNA and increase the likelihood of developing cancer are known as _____.

A)oncogens
B)malignant transformers
C)antitumor suppressor agents
D)carcinogens
E)tumor-associated agents.

Question 26

A benign tumor of glandular tissue is known as a(n)_____.

A)sarcoma
B)myeloma
C)adenoma
D)adenocarcinoma
E)lymphoma.

Question 27

Human herpesvirus 8 (HHV8)is associated with the development of _____ in immunocompromised patients.

A)Burkitt's lymphoma
B)chronic myeloid leukemia
C)melanoma
D)myeloma
E)Kaposi's sarcoma.

Question 28

Explain how the immune mechanisms for the detection of cancer cells are (A)similar to and (B)different from those that detect virus-infected cells.

Question 29

Epithelial tumors express MIC proteins on their cell surfaces.
A.Why does this make the tumor cells susceptible to attack by NK cells,γ:δ T cells,and cytotoxic CD8 T cells?
B.How do the tumor cells evade such attack?

Question 30

Which of the following pairs are matched correctly? (Select all that apply.)

A)myeloma: bone marrow
B)benign tumor: encapsulation
C)lymphoma: bone marrow
D)tumor-associated antigens: proteins expressed only by tumor cells
E)sarcoma: epithelial cell.

Question 31

Li-Fraumeni syndrome is linked to a greater risk of cancer as a result of the inheritance of a germline mutation in one copy of _____.

A)TLR-9
B)p53
C)CTLA4
D)heat-shock protein
E)Rb.

Question 32

When the immune system is involved in _____,an appraisal for cancer cells is occurring.

A)malignant transformation
B)apoptosis
C)antineoplasia
D)immunosurveillance
E)immunosuppression.

Question 33

A malignant tumor is characterized by which of the following features? (Select all that apply.)

A)encapsulation
B)localized
C)restricted in size
D)metastasizes to distant sites
E)results from multiple mutations affecting cell division or survival.

Question 34

How is it possible for a tumor-specific antigen to be composed of a unique sequence of amino acids not encoded in the genome of the tumor cell?
B.Give a specific example.

Question 35

Burkitt's lymphoma is a tumor associated with _____ infection,which causes _____ to divide uncontrollably.

A)Epstein-Barr virus; B cells
B)hepatitis B virus; epithelial
C)human T-cell leukemia; hepatocytes
D)human herpesvirus; T cells
E)papillomavirus; uterine cells.

Question 36

Provide examples where tumor cells transferred between a donor and a recipient are either (A)rejected and do not cause cancer,or (B)not rejected and cause cancer.

Question 37

A protein expressed in response to damage to DNA that results in death to the cell is _____.

A)Ras
B)p53
C)Rb
D)Abl
E)MAGEA1.

Question 38

A mechanism by which cancer cells can evade an immune response involves an alteration in the amount of MIC on the cell surface by

A)decreasing the level of MIC transcription
B)cleavage of MIC at the cell surface by a protease
C)switching from a transmembrane form of MIC to a secreted form
D)cytosolic degradation of MIC in proteasomes
E)alternative mRNA splicing resulting in a truncated form of MIC that is no longer able to bind to NKG2D.

Question 39

The efficacy of treating bladder cancer is increased by introducing the BCG vaccine.The vaccine component attributing this antitumor effect is _____,which induces a state of chronic inflammation.

A)mycolic acid
B)unmethylated CpG-containing DNA
C)lipopolysaccharide
D)teichoic acid
E)peptidoglycan.

Question 40

A tumor-associated antigen normally expressed only in the testis is called a _____ antigen.

A)MIC
B)CT
C)male-specific
D)sex chromosome-encoded
E)privileged.

Question 41

Which cytokines are associated with tumor-induced suppression of the immune response? (Select all that apply.)

A)IL-12
B)IL-2
C)TGF-β
D)IL-4
E)IL-10.

Question 42

Proteins not expressed on normal cells but found on tumor cells are called _____.

A)cancer stem cell antigens
B)oncogenic antigens
C)tumor-associated antigens
D)tumor-specific antigens
E)proto-oncogene products.

Question 43

Which of the following is a mechanism by which tumors can evade immune detection? (Select all that apply.)

A)reduction in levels of HLA class I
B)recruitment of regulatory T cells
C)enhancement of inflammatory responses
D)lowering of levels of MIC on the cell surface
E)increase in levels of CT antigens.

Question 44

Which of the following describe types of tumor-associated antigens? (Select all that apply.)

A)They are derived from self proteins to which the immune system is not tolerant.
B)They are derived from proteins encoded by mRNAs that have undergone abnormal post-transcriptional splicing.
C)They are proteins normally expressed in immunologically privileged sites.
D)They are proteins expressed at unusually high levels.
E)They are derived from viral proteins to which the immune system is not tolerant.

Question 45

Which of the following are true for cancer stem cells? (Select all that apply.)

A)They are self-renewing.
B)They are highly susceptible to radiation.
C)They are resistant to toxins used in chemotherapy.
D)They may be present in low numbers without causing relapse.
E)They may cause cancer if donated in organ transplants.

Question 46

One of the side effects of treating tumor patients with anti-CTLA4 monoclonal antibodies is _____.

A)the development of autoimmune disease
B)lymphoproliferative disorder
C)increased levels of mutation in tumor cells
D)upregulation of CT antigens
E)reactivation of embryonic genes.
ANSWERS
IS4 Chapter 17 Testbank answers