Deck 19: Cancer and the Immune System

Question 1

The major difference between benign and malignant tumors is that

A)benign tumors are capable of metastasis.
B)malignant tumors do not invade surrounding tissue.
C)benign tumors are not neoplasms.
D)malignant tumors are capable of uncontrolled growth.
E)All of the answers are correct.

Answer 1

D

Question 2

The MOST common kind of cancers are carcinomas, which

A)are derived from epithelial tissue.
B)include breast and colon cancer.
C)include leukemia.
D)All of the answers are correct.
E)None of the answers are correct.

Answer 2

C

Question 3

Metastasis is NOT which of the following?

A)A property of benign tumors
B)Invasion of new sites by tumor cells
C)The production of secondary tumors
D)A property of malignant tumors
E)Extremely dangerous

Answer 3

A

Question 4

Hematopoietic tumors include all but which of the following?

A)Lung cancer
B)Leukemia
C)Lymphoma
D)Myeloma
E)All of the answers are hematopoietic tumors.

Question 5

Leukemias can be defined as

A)either acute or chronic, where chronic is longer lasting.
B)either acute or chronic, where chronic involves less mature cells.
C)either lymphocytic or myelogenous, where lymphocytic involves lymphocytes.
D)either lymphocytic or myelogenous, where lymphocytic involves any white blood cell.
E)both acute/chronic and lymphocytic/myelogenous.

Question 6

Malignant transformation of cells usually means that they

A)grow in a density-independent fashion.
B)have reduced dependence on growth factors.
C)are not anchorage dependent.
D)All of the answers are correct.
E)None of the answers are correct.

Question 7

Carcinogens are NOT

A)agents that induce DNA mutations.
B)agents that induce transformation.
C)energy such as ionizing radiation.
D)viruses such as Epstein-Barr virus.
E)chemicals such as formaldehyde.

Question 8

Oncogenes

A)can be found in some viruses.
B)have been found to be normal parts of cellular function.
C)often regulate cell growth.
D)are mutated or dysregulated in cancer.
E)All of the answers are correct.

Question 9

Tumor-suppressor genes are NOT

A)normally regulators of cell growth.
B)called anti-oncogenes.
C)causes of cancer when they become inactive.
D)causes of cancer when they become activated.
E)either normally regulators of cell growth or causes of cancer when they become inactive.

Question 10

Hallmarks of tumor transformation include all of the following EXCEPT

A)growth-factor independence.
B)dependence of tumor suppressors.
C)angiogenesis.
D)evasion of apoptotic signals.
E)All of the answers are hallmarks of tumor transformation.

Question 11

Which of the following is NOT a gene class that can lead to cancer?

A)Host oncogenes
B)Viral oncogenes
C)Apoptotic genes
D)Tumor-suppressor genes
E)Tumor-activator genes

Question 12

Which of the following is a gene that is commonly mutated in cancers?

A)Ras
B)TP53
C)ADA
D)RAG
E)Both Ras and TP53 are commonly mutated in cancers.

Question 13

MOST tumor antigens

A)are products of viruses.
B)target the tumor for immune recognition.
C)are not recognized as self-antigens.
D)are oncogene products.
E)All of the answers are correct.

Question 14

T cells can recognize tumor antigens from each of the following classes, EXCEPT

A)antigens encoded by genes exclusively expressed by tumors (e.g., viral genes).
B)antigens encoded by variant forms of normal genes that are altered by mutation.
C)antigens that are expressed at lower than normal levels.
D)antigens normally expressed only at certain stages of development.
E)antigens that are overexpressed in particular tumors.

Question 15

Tumor-specific antigens

A)trigger T-cell killing of the tumor.
B)can be difficult to identify.
C)are strongly selected against by the immune system.
D)All of the answers are correct.
E)None of the answers are correct.

Question 16

Tumor-associated antigens

A)are not normal cellular proteins.
B)are viral proteins.
C)have abnormal expression patterns.
D)All of the answers are correct.
E)None of the answers are correct.

Question 17

Alpha-fetoprotein (AFP) is

A)normally expressed by embryos.
B)normal for pregnant women.
C)expressed aberrantly by some cancers.
D)All of the answers are correct.
E)None of the answers are correct.

Question 18

What is the definition of an oncofetal tumor antigen?

A)An oncogene fused to a fetal gene.
B)An antigen derived from a reactivated fetal gene.
C)An antigen found in a nonviable pregnancy.
D)An antigen which is not immunogenic.
E)All of the answers are correct.

Question 19

The immune system does NOT control cancer with which of the following mechanisms?

A)Elimination of transforming viruses.
B)Elimination of tumor inflammation.
C)Induction of apoptosis in cancer cells.
D)Induction of anergy in cancer cells.
E)All of the answers are mechanisms used.

Question 20

The theory that the immune system actively monitors and eliminates cancer cells is supported by the observation(s) that

A)AIDS patients have higher rates of some types of cancer than other populations.
B)transplant patients on immunosuppressive therapy have higher rates of some types of cancer than other populations.
C)patients who are deficient in adenosine deaminase and on immunosuppressive therapy have higher rates of some types of cancer than other populations.
D)both AIDS patients and transplant patients have higher rates of some types of cancer than other populations.
E)both AIDS patients and patients who are deficient in adenosine deaminase and on immunosuppressive therapy have higher rates of some types of cancer than other populations.

Question 21

Immunoediting does NOT

A)lead to more aggressive tumors by natural selection.
B)lead to elimination of tumor cells.
C)consist of elimination, equilibrium, and escape.
D)extend over a period of several to many years.
E)All of the answers describe immunoediting.

Question 22

Variability in the immune response to cancer leads to observations that

A)NK cells and dendritic cells can control cancer cells directly.
B)NK cells and dendritic cells can activate a helper T-cell response to control cancer.
C)NK cells and dendritic cells can activate a cytotoxic T-cell response to control cancer.
D)T<_H17 cells can activate a response to control cancer.
E)All of the answers are correct.

Question 23

A key role for natural killer cells in controlling cancer is NOT supported by the

A)observation that NK-deficient mice have higher than normal rates of sarcoma development.
B)observation that NK cells can kill cancer cells in vitro.
C)observation that many tumors down-regulate MHC genes, including NK receptors.
D)observation that cellular stress up-regulates many NK receptors.
E)All of the answers support the role.

Question 24

Responses of the immune system that can promote cancer include all of the following EXCEPT

A)chronic inflammation.
B)inhibition of T_H1 responses.
C)myeloid-derived suppressor cells (MDSCs).
D)CTL activation.
E)All of the answers promote cancer.

Question 25

Immunotherapy designed to target B-cell lymphoma with a monoclonal antibody is easier to administer than other immunotherapies because

A)the lymphoma is more prone to apoptosis.
B)an anti-idiotypic monoclonal antibody won't target bystander cells.
C)the lymphoma is able to conduct class switching.
D)the lymphoma is localized to specific organs.
E)All of the answers are correct.

Question 26

Immunotoxins work by

A)inducing apoptosis in the target cells.
B)recruiting complement to kill the target cells.
C)delivering chemicals specifically to the target cells.
D)recruiting NK cells.
E)None of the answers are correct.

Question 27

Cytokine treatment of cancer has proven problematic because

A)cytokines can show in vivo toxicity.
B)dosages are very hard to control properly.
C)cytokines can regulate the production of other cytokines.
D)cytokines exert effects on a large number of target cells.
E)All of the answers are correct.

Question 28

The use of tumor-specific T cells reintroduced to patients requires all of the following EXCEPT

A)tumor-specific cells being isolated.
B)tumor-specific cells being activated to overcome tumor-induced anergy.
C)the patient being lympho-depleted to facilitate reintroduction.
D)tumor-specific cells being depleted of autoreactive clones.
E)All of the answers are required steps.

Question 29

Manipulation of costimulatory signals has potential to treat tumors because

A)tumors that do not provide costimulation induce anergy instead.
B)it is relatively easy to isolate and introduce genes to tumor cells.
C)modified tumors with increased costimulatory activity can be reintroduced to patients.
D)blockage of CTLA-4 on tumors will increase T-cell activation.
E)All of the answers are correct.

Question 30

Which of the following is NOT a cancer immunotherapy?

A)Therapeutic vaccines
B)mAb therapy
C)Checkpoint inhibitors
D)Ex vivo expansion of TIL
E)Radiation therapy

Question 31

Is it better to be diagnosed with an acute lymphoma or a chronic lymphoma? Explain your answer.

Question 32

Why can a conventional vaccine for human papilloma virus also be effective at preventing cancer? Explain.

Question 33

What are the three classifications of cancer - which one is the MOST common?

Question 34

What are the three types of host genes that, when mutated, can lead to tumor formation and cancer? For each type of gene, how do mutations lead to neoplasms? Explain.

Question 35

A tumor does not appear from normal cells overnight.Describe the series of steps that leads to transformation in vivo.

Question 36

Compare and contrast tumor-specific antigens and tumor-associated antigens.

Question 37

Evaluate the immune response to cancer.Why is it a "double-edged sword" that can prevent disease in some instances but inversely lead to disease in others?

Question 38

Gene sequencing from primary tumor cells has revealed a novel mutation in the p53 oncogene.
WT: MEEPQSDPS
Tumor: MEDPQSDPS
Interestingly, this new sequence is well displayed on the cancer patient's own HLA molecules.What two ways could this be an advantage for the patient? Explain.

Question 39

What are two different ways antibodies can be used as treatments for cancer? Explain.

Question 40

If an individual announces that they have discovered the "cure for cancer," why should you be suspicious? Explain.