Chapter 7 (Questions 2008-2009 Compiled)

General pathology 2008-2009
Compiled by Bhupinder Bawa

Q1. All of the following are the markers of anaplasia except?
A. Cellular and nuclear pleomorphism

B. Nucleus to cytoplasm ratio of 1:4
C. Presence of tumor giant cells
D. Bizarre mitotic figures
E. Loss of polarity
Q2. All of the following are true regarding rate of growth of a neoplasm except?
A. Fast growing tumors have high cell turnover

B. Most cells in cancers remain in G0 or G1 phase
C. Growth rate is inversely correlated to differentiation
D. With tumor growth more cells enter proliferative pool
E. Latent period before a tumor is clinical detectable is more than 90
days
Q3. Which of the following is the appropriate term for a rest of normal tissue in an
abnormal location?
A. Teratoma
B. Adenoma
C. Normoma
D. Choristoma
E. Hamartoma
Q4. Marked dysplastic changes involving the entire thickness of the epidermis but
confined to the normal tissue boundaries is termed:
A. Carcinoma
B. Carcinsarcoma
C. Carcinoma in situ
D. Carcinoma in vivo
E. Squamous cell carcinoma
Q5. What is malignant neoplasia of skeletal muscle called?
A. Leiomyoma
B. Rhabdomyoma
C. Musculosarcoma
D. Leiomyosarcoma
E. Rhabdomyosarcoma
Q6. Which is not a typical characteristic of poorly differentiated neoplastic cells?
A. Increased mitosis
B. Hyperchromatic nuclei
C. Loss of normal polarity
D. Cellular and nuclear pleomorphism
E. Increased production of normal secretory product
Q7. Which feature can typically be used to distinguish neoplastic from dysplastic
cells?
A. Disorderly architecture
B. Hyperchromatic nuclei
C. Cellular pleomorphism
D. Abnormal mitotic figures
E. Nuclear:cytoplasmic ratios
Q8. Which of the following is not a characteristic of anaplasia
A. Mitoses
B. Loss of polarity
C. Pleomorphism
D. Tumor giant cells
E. Abnormal nuclear morphology
Q9. By the time a tumor is clinically detectable, most cells are in which stage of the
cell cycle?
A. S
B. M
C. G0
D. G1
E. G2
Q10. Next to the development of distant metastasis, what is the most reliable feature
that differentiates a malignant from a benign neoplasm?
A. Mitotic rate
B. Rate of growth
C. Tissue invasiveness
D. Size of primary tumor
E. Cellular differentiation
Q11. Which of the following cellular or tissue changes would least likely lead to
malignant transformation?
A. Atrophy
B. Dysplasia
C. Metaplasia
D. Hyperplasia
E. Regeneration
Q12. Which of the following regulatory genes can be involved with malignant
cellular transformation when mutated?
A. Protooncogenes
B. DNA repair genes
C. Tumor suppressor genes
D. Genes regulating apoptosis
E. All of the above
Q13. Mutations in all of the following genes can lead to inherited cancer syndromes
EXCEPT?
A. p53
B. APC
C. BRCA1
D. p14ARF
E. p161NK4A
Q14. The most important factors that determine the rate of tumor growth are:
1. Rate of cell loss

2. The cell of origin
3. Increased cell cycle time
4. Doubling time of tumor cells
5. Fraction of tumor cells in the replicative pool
A. 1, 2
B. 1, 3, 4
C. 1, 4, 5
D. 3, 4, 5
E. 4, 5
Q15. A mammary carcinoma is most likely to metastasize via:
A. Lymphatic spread
B. Seeding into a body cavity
C. Hematogenous dissemination
D. Implantation into surrounding tissues following biopsy
E. All of the above are equally likely
Q16. Which of the following is not a pathway of metastasis
A. Local expansion
B. Lymphatic spread
C. Hematogenous spread
D. Seeding of body cavities
E. None of the above
Q17. Which of the following is not a change in cell physiology to determine

malignant phenotype
A. Evasion of apoptosis
B. Defects in DNA repair
C. Sustained angiogenesis
D. Limitless replicative potential
E. Insufficency in self-growth signals
Q18. Which of the following is not a target of genetic damage in tumor formation
A. Genes that regulate apoptosis

B. Genes involved with DNA repair
C. Growth-promoting protooncogenes
D. Genes involved with cytoskeletal formation
E. Growth-inhibiting tumor suppression genes
Q19. Which of the following serves as a marker for clonality in B-cell lymphoma?
A. Uniform cytoplasmic staining for CD21

B. Uniform cytoplasmic staining for CD79a
C. A high mitotic rate in a uniform population of lymphocytes
D. Demonstration of immunoglobulin receptor gene rearrangement
E. Demonstration of a monomorphic population of medium lymphocytes
Q20. Which of the following is/are considered to be recessive oncogenes?
A. RB
B. p53
C. p16INK4A
D. a and b
E. a, b and c
Q21. Which of the following can phosphorylate RB?
A. Cyclin D/cdk4
B. Cyclin D/cdk6
C. Cyclin E/cdk2
D. A only
E. All of the above
Q22. p16INK4a can cause cell cycle arrest by one of following ways?
A. p53 activation
B. p53 degradation
C. inhibiting cyclin D/cdk4 complex
D. inhibiting cyclin E/cdk 2 complex
E. all of the above
Q23. A defect in DNA before replication is detected and repaired at which of the
following checkpoints?
A. S phase
B. M phase
C. G1/S transition
D. G2/M transition
E. All of the above phases
Q24. Which of the following is needed to progress through both the G1/S and G2/M
checkpoints?
A. CDK 2
B. CDK 1
C. Cyclin D
D. Cyclin E
E. Cyclin A
Q25. Hypophosphorylated RB is complexed to which of the following?
A. E2F/DP1/Histone deacetylase
B. Histone deacetylase/E2F
C. DP1/ Histone deacetylase
D. E2F/DP1
E. E2F
Q26. Cell cycle inhibitor p161NK4 functions by which of the following mechanisms?
A. Binds to RB
B. inhibits MDM2
C. Inhibits Cyclin E/CDK2
D. Binds to Cyclin D/ CDK4
E. inactivates Cyclin B/ CDK 1
Q27. Which of the following are constitutively expressed in a cell?
1. CDK2
2. CDK4
3. Cyclin A
4. Cyclin D
5. Cyclin E
A. 1, 2
B. 1, 2, 3
C. 2, 4
D. 3, 4, 5
E. 4, 5
Q28. The cyclin-CDK complex required to drive the cell through the G1/S restriction
point is:
A. Cyclin A-CDK2
B. Cyclin B-CDK1
C. Cyclin D-CDK4
D. Cyclin E-CDK2
E. Cyclin F-CDK3
Q29. Place in order the sequence of events that leads to activation of the cell cycle:
1. Transcription of cyclin D
2. Activation of transcription factor E2F
3. Stimulation of the cell by growth factors
4. Cyclin D binds CDK4 and phosphorylates RB
5. Removal of histone deacetylase from chromatin
A. 1, 3, 2, 4, 5
B. 3, 1, 4, 5, 2
C. 3, 2, 1, 5, 4
D. 3, 2, 1, 4, 5
E. 3, 5, 4, 1, 2
Q30. Following DNA damage, the role of p53 is to:
A. Activate histone deacetylase

B. Block cyclin-CDK complexes via activation of p21
C. Trigger apoptosis by activation of pro-apoptotic genes
D. a and b
E. b and c
Q31. Which of the following cyclins is first detectable in G1 of the cell cycle?
A. Cyclin A
B. Cyclin B
C. Cyclin C
D. Cyclin D
E. Cyclin E
Q32. Which of the following is the transcription factor activated by phosphorylation
of retinoblastoma susceptibility protein (RB)?
A. DP1
B. EF2
C. CDK-4
D. CDK-2
E. p16INK4
Q33. Which of the following would not likely result from a mutation leading to a
decreased production of p14ARF?
A. Decreased levels of p21
B. Decreased levels of p53
C. Increased levels of MDM2
D. Increased activation of EF2
E. All of the above would likely result
Q34. Which of the following is the correct progression of the cell cycle
1. Formation of Cyclin D/cdk4
2. Formation of Cyclin E/cdk2
3. Formation of Cyclin A/cdk2
4. Formation of Cyclin B/cdk1
5. Phosphorylation of RB
A. 1,2,3,4,5
B. 1,5,2,3,4
C. 1,2,5,3,4
D. 1,2,3,5,4
E. 5,4,3,2,1
Q35. The main barrier to cell-cycle progression is
A. Phosphorylation of RB
B. The G1/S phase transition
C. Formation of Cyclin D/cdk 4
D. Inactivation of Cip/Kip family
E. Inhibition of INK4/ARF family
Q36. Uncontrolled RAS activity is prevented by?
A. GAP
B. GTP
C. RAF-1
D. MAP kinases
E. Farnesyl transferase
Q37. Dysregulation of which of the following transcription factor is seen in Burkitt
lymphoma?
A. MYC
B. MYB
C. FOS
D. JUN
E. Cyclin D
Q38. p53 helps in DNA repair by transcription of ?
A. p21
B. BAX
C. BCL-2
D. MDM2
E. GAAD45
Q39. A genetic defect leading to overexpression of β-catenin and considering no

WNT signaling can have all of the following except?
A. Increased expression of c-MYC and cyclin D

B. Increased adhesiveness of mutant cells
C. Increased degradation of β-catenin
D. Increased intracellular free APC
E. Increased proliferation of cells.
Q40. Inhibition of cellular proliferation by TGF- is mediated by upregulation of

which CDK inhibitor?
A. p53
B. p21
C. p27
D. cip/kip
E. P16INK4a
Q41. If DNA damage is repaired successfully cell cycle progression continues by?
A. Activation of CDK inhibitor protein p21

B. Proteolysis of p53 by ubiquitin proteosome pathway
C. Activation of MDM2 by p53 which degrade p21
D. Self degradation of p53 by activation of MDM2
E. All of the following
Q42. Which of the following statements about p53 protein is FALSE?
A. It is a DNA-binding protein confined to the nucleus

B. MDM2 normally inhibits its activity by causing increased p53 degradation
C. Increased p53 leads to cell-cycle arrest
D. Increased p53 can induce BAX, leading to apoptosis
E. Mutation of one p53 allele causes a 100% increase in risk for malignant cell
transformation
Q43. Which of the following is not a transcription factor oncogene?

A. FOS
B. JUN
C. MYB
D. MYC
E. RAS
Q44. Which of the following mutations would most likely lead to uncontrolled RAS
activity?
A. ATPase
B. GTPase
C. ADP kinase
D. GTP kinase
E. all of the above
Q45. Which of the following is not a recognized protooncogene
A. SIS
B. RAS
C. MYC
D. ECFR
E. BCL-2
Q46. Which of the following is not a characteristic of oncogene mutations
A. Homozygous loss of p53

B. Abnormal expression of cyclins
C. Self-production of growth factors
D. Constitutive dimerization of growth factor receptors
E. Mutant proteins binding to GTP-ase activating proteins
Q47. Which of the following is not a tumor suppressor gene
A. RB
B. p53
C. RAS
D. INK4a
E. APC/β-catenin
Q48. Which of the following describes oncogenesis via the RB gene
A. “two-hit” hypothesis
B. Loss of heterozygosity
C. Loss of a single normal allele
D. A&B
E. B&C
Q49. What is the order of oncogenesis in the APC/ β-catenin pathway
1. β-catenin binds with TCF

2. Germ line mutation of APC gene
3. Increased transcription of Cyclin D
4. Uncontrolled proliferation of cell line
5. Increase in cellular levels of β-catenin
A. 1,2,3,4,5
B. 2,3,5,1,4
C. 2,5,1,3,4
D. 2,5,1,4,3
E. 5,4,3,2,1
Q50. Which of the following is false regarding the p53 gene and its protein?
A. The p53 protein is localized in the cell nucleus

B. The p53 induced cell-cycle arrest occurs in late G1 phase
C. p53 induces activation of BAX after successful repair of DNA
D. Most mutations are acquired in somatic cells, not in the germ line
E. Li-Fraumeni syndrome results from inheriting one mutant p53 allele
Q51. Which of the following changes result in increased cellular β-catenin?
1. Increased WNT
2. Decreased WNT
3. Increased APC
4. Decreased APC
5. Increased E-cadherin
A. 1,3
B. 1,4
C. 2,3
D. 2,4
E. 2,4,5
Q52. All of the following can act as anti-angiogenesis factor except?
A. Endostatin
B. Tumstatin
C. Vasostatin
D. Angiostatin
E. Thromobospondin-1
Q53. p53 can inhibit angiogenesis by all of the following methods except?
A. Increased synthesis of thrombospondin-1
B. Decreased synthesis of VEGF
C. Decreased synthesis of HIF-1
D. Decreased synthesis of bFGF
E. None of the above.
Q54. A double strand break in DNA is sensed by?
A. ATM
B. RAD15
C. BRCA-1
D. BRCA-2
E. CHEK-2
Q55. Which of the following are caretaker genes?
A. Genes involving RB pathway

B. Genes involving p532
C. Mismatch repair genes
D. DNA repair genes
E. C and D both
Q56. Which of the following is an early event in development of colorectal cancers?
A. Loss of p53 gene

B. Mutation of RAS gene
C. Loss or mutation of APC
D. Loss of TGF- receptor I gene
E. Loss of tumor suppressor gene
Q57. The most important angiogenic factor/s in tumors is/are?
A. VEGF
B. bFGF (basic fibroblast growth factor)
C. PDGF
D. a and b
E. All of the above
Q58. Which of the following does NOT play a role in metastasis of an epithelial
tumor?
A. Secretion of proteases
B. Mobilization of VEGF
C. Downregulation of integrins
D. Down-regulation of E-cadherin expression
E. Upregulation of laminin and fibronectin receptors
Q59. Gene translocations can activate protooncogenes in which of the following
ways?
A. Inactivation of p53
B. Overexpression of protooncogenes by removal from their regulatory elements
C. Recombination and formation of hybrid genes that encode growth-promoting proteins
D. B and C
E. All of the above
Q60. Caretaker genes are genes that:

A. Directly control tumor growth
B. Prevent tumor formation when both alleles are normal
C. Promote tumor growth by causing genetic translocations
D. Require only mutation of one allele to cause tumor growth
E. Affect genomic stability but do not directly control tumor growth
Q61. Which of the following sequences will result in tumor formation?

A. Application of an initiator only
B. Repeated application of a promoter at weekly intervals
C. Application of promoter followed by application of an initiator
D. Application of initiator followed by monthly applications of a promoter
E. Application of an initiator followed by repeated application of a
promoter at twice-weekly intervals
Q62. Which of the following statements about initiation of chemical carcinogenesis is

incorrect?
A. Most carcinogens are electrophiles
B. Most carcinogens require metabolic activation
C. DNA is the primary target of carcinogenic compounds
D. Most carcinogens are metabolized by the cytochrome P-450 pathway
E. Carcinogen-induced DNA damage usually results in initiation of
carcinogenesis
Q63. Which of the following is not involved with pro-apoptosis or pro-apoptotic

pathways?
A. p53
B. MYC
C. BAX
D. BCL-2
E. BRCA-1
Q64. Which is true regarding telomeres and telomerase?

A. Decreased telomere size will activate p53
B. Telomerase is present in most somatic cells
C. Telomere shortening is activated by telomerase
D. Decreased telomerase activity is common in human cancers
E. Both b and d
Q65. Which is false regarding angiogenesis?

A. p53 can inhibit angiogenesis by inducing thrombospondin-1
B. Vascular networks formed by tumor cells are unstable and leaky
C. The two most important angiogenic factors are VEGF and bFGF
D. Angiogenesis is required for tumors larger than 1-2 mm in diameter
E. Angiogenic switch is the shift from producing angiogenic factors to producing
angiogenic inhibitors
Q66. Which of the following would not promote vascular invasion and metastasis?
A. Over-expression of CD44
B. Down-regulation of E-cadherin
C. Inhibition of type IV collagenase secretion
D. Up-regulation of laminin-binding receptors
E. Increased expression of chemokine receptors
Q67. What is the most common chromosomal abnormality involved in activating

protooncogenes?
A. Deletions
B. Insertions
C. Inversions
D. Translocations
E. Amplifications
Q68. Which of the following is not a “gatekeeper” gene?

A. RB
B. APC
C. NF-1
D. BRCA-1
E. Both a and b
Q69. The carcinogenicity of UVB light is attributable to which mechanism?

A. Immunostimulation
B. Activation of CYCLIN D gene
C. Formation of reactive electrophiles
D. Formation of pyrimidine dimers in DNA
E. Blocking of p53 and RB cell suppression pathways
Q70. Replicative potential of neoplastic cells is dependent on

A. Angiogenesis
B. Telomerase activity
C. Promotion of growth factors
D. Formation of homozygous oncogenes
E. All of the above
Q71. Which are the two most important tumor-associated angiogenic factors
1. bFGF
2. VEGF
3. PDGF
4. TGF-β
5. Angiopoietin 1
A. 1,2
B. 1,3
C. 1,4
D. 1,5
E. 2,3
Q72. Invasion of the ECM by neoplastic cells requires

A. Detachment of neoplastic cells from each other
B. Attachment to matrix components
C. Degradation of the ECM
D. Migration into the ECM
E. All of the above
Q73. Organ tropism of metastasis is due to

A. Endothelial ligand expression
B. Blood and lymphatic supply
C. Specific chemokines
D. A & C
E. B & C
Q74. An example of an epigenetic change is

A. Genetic translocation
B. Fusion of two genes into an oncogene
C. Reduplication and amplification of an oncogene
D. Hypermethylation of a promoter sequence without DNA change
E. None of the above
Q75. Transformation of non-immortalized cells in vitro requires

A. Transformation of a single oncogene
B. Loss of a single tumor suppressor gene
C. Transformation of two or more oncogenes
D. Loss of two or more tumor suppressor genes
E. C & D
Q76. Which of the following is a direct-acting carcinogen

A. Azo dye
B. Aflatoxin B1
C. Alkylating agent
D. Polychlorinated biphenyl
E. Polycyclic aromatic hydrocarbon
Q77. Promoters contribute to tumorigenesis by (Robbins 322)

A. Inhibiting apoptosis
B. Directly damage DNA
C. Initiate cell proliferation
D. Inhibit activation of caretaker genes
E. Change protooncogenes into oncogenes
Q78. The carcinogenicity of UVB light is attributed to (Robbins 323)

A. Formation of pyrimidine dimers in RNA
B. Formation of pyrimidine dimers in DNA
C. Overwhelmed capacity of the NER pathway
D. B & C
E. All of the above
Q79. Which of the following tumor antigens are not used for host immune response
A. Antigens produced by oncogenic viruses
B. Aberrantly expressed cellular proteins
C. Cell-specific differentiation antigens
D. Altered cell surface glycoproteins
E. Products of mutated genes
Q80. Which of the following is not a tumor evasion mechanism

A. Antigen masking
B. Fas ligand expression
C. Immunosuppression
D. Replication of MHC molecules
E. Selective outgrowth of antigen-negative variants
Q81. Which of the following is not a paraneoplastic syndrome

A. sHypercalcemia from skeletal metastases
B. Hypercalcemia from PTHRP production
C. Hypertrophic osteoarthropathy
D. Cushing’s syndrome
E. Dermatomyositis
Q82. Which of the following would NOT stimulate a CD8+ T-cell immune response?
A. Presentation of an overexpressed self-protein
B. Presentation of a radiation-induced mutated self-protein
C. Presentation of a protein encoded by a mutated oncogene
D. Presentation of oncogenic virus-particles by an infected cell
E. Presentation of antigens from a phagocytosed tumor cell by an antigen-presenting cell
Q83. Which of the following disorders is NOT expected as a paraneoplastic

syndrome?
A. Hypoglycemia
B. Hypercalcemia
C. Myasthenia gravis
D. Hypoadrenocorticism
E. Hypertrophic osteopathy
Q84. What is the principle mechanism responsible for tumor immunity?

A. Innate immunity
B. Macrophage activation
C. CD8+ killing of tumor cells
D. Natural killer cell-mediated tumor lysis
E. Production of complement-fixing antibody
Q85. Which of the following is not involved with cancer cachexia?

A. Increased TNF
B. Reduced food intake
C. Increased basal metabolic rate
D. Nutritional demands of the tumor
E. Alterations in protein and fat metabolism
Q86. Which of the following is not a criterion used for staging tumors?
A. Number of mitoses
B. Size of primary lesion
C. Presence of metastisis
D. Extent of spread to lymph nodes
E. All are criteria
Q87. The principal mechanism of tumor immunity is killing of tumor cell by?
A. Antibodies
B. CD8+ CTLs
C. Macrophages
D. B-lymphocytes
E. Natural killer cell
Q88. Tumor cells can escape immune system by all of the following mechanisms
except?
A. Selective outgrowth of antigen-negative variants

B. Loss or reduced expression of MHC molecules
C. Expression of costimulatory molecules
D. Apoptosis of cytotoxic T-cells
E. Immunusuppression
Q89. Which of the following is the most important molecule implicated in causing
hypercalcemia of malignancy?
A. IL-1
B. TNF-α
C. TGF- α
D. PTHRP
E. Dihydroxyvitamin D
Q90. Which of the following is NOT true regarding chemical carcinogenesis?

A. Initiator causes permanent, irreversible DNA damage
B. Initiator alone is not sufficient for tumor formation
C. Application of promoter can affect DNA directly
D. Promoters can induce tumors in initiated cells
E. Promoters are non-tumorigenic by themselves
Q91. In the absence of ozone shield, which UV wavelength can lead to increased
incidence of cutaneous cancers?
A. UVA
B. UVB
C. UVC
D. Both UVA and UVB
E. Both UVB and UVC
Q92. Which of the following are caretaker genes?

A. Genes involving RB pathway
B. Genes involving p532
C. Mismatch repair genes
D. DNA repair genes
E. C and D both
Q93. Which of the following is an early event in development of colorectal cancers?

A. Loss of p53 gene
B. Mutation of RAS gene
C. Loss or mutation of APC
D. Loss of TGF- receptor I gene
E. Loss of tumor suppressor gene
Answers:
1) B (Robbins pp 273-274)
2) D (Robbins pp 276) as tumor grows more cells leave proliferative pool due to lack of
nutrients, by differentiating or by reversion to G0 phase
3) D (Robbins pp 272)
4) E (Robbins pp 275)
6) E (Robbins pp 274) Generally, the better the differentiation of the transformed cell,
the more completely it retains functional capabilities and morphology
7) D (Robbins pp 275) Mitotic figures are more abundant than usual with cellular
dysplasia, but they almost invariably conform to normal patterns. Abnormal mitotic
figures are an important feature of malignancy.
8) A (Robbins 273/274)
9) C (Robbins p. 276)
11) A (Robbins p. 286)
12) E (Robbins p. 288)
13) D p287 Table 7-6 Robbins. (a) associated with various tumors, (b) Adenomatous
polyposis, (c) Breast cancer and ovarian tumors, (e) Melanoma.
14) C (Robbins p. 276)– total cell-cycle time for many tumors is equal to or longer than
their non-neoplastic counterparts.
15) A (Robbins p. 279, 280)
16) A (Robbins 279)
17) E (Robbins 289)
18) D (Robbins 288)
19) D (Robbins 288)
20) E (Robbins 288) Recessive oncogene = both normal alleles must be damaged for
transformation to occur (refers to tumor suppressor genes).
21) E (Robbins pp 288-291)
22) A (Robbins pp 288)
23) C (Robbins pp 292)
24) A (p 291 fig 7-29 Robbins) CDK 2 is bound to Cyclin E at the G1/S checkpoint and
bound to Cyclin A at the G2/M checkpoint.
25) A (p291 Fig 7-30 Robbins)
26) D ( p291-292 Robbins)
27) A – (Robbins pp 289) The cyclins are induced in a cell following signaling by growth
factors and by induction of transcription by transcription factor E2F. CDKs are
constitutively expressed.
29) B (Robbins pp 290-291)
32) B (Robbins pp 289)
33) E (Robbins pp 291)p14ARF is a cell cycle inhibitor. It normally inhibits MDM2,
which is an inhibitor of p53. So normally, by blocking the inhibitor, you get
increased p53 which increases p21, which is an inhibitor of the cyclin D/CDK4
complex, thus inhibiting the cell cycle. Clear so far? So, if you decrease p14ARF,
you lose inhibition of MDM2. If MDM2 increases, this will inhibit p53. So
decreased p53 will decrease p21 which will release the inhibition of cyclin D/CDK4
complex which will activate EF2 and allow progression into the cell cycle.
35) A (Robbins pp 289) (G1/S transition is the point of no return)
39) D (Robbins pp 304) Increased expression of β-catenin can have increased
transcription of cyclin D, c-MYC increased cell proliferation, however there will
not be increased free APC as whatever APC is there will try to bind to β-catenin
42) E – both alleles need to be lost/mutated before malignant transformation occurs
(p. 302)
43) E (Robbins p. 297) RAS is a signal-transducing oncogene
44) B (Robbins p. 297) GTP hydrolysis converts GTP-bound active RAS to the GDP-
bound inactive form
45) E (Robbins 294) (BCL-2 is an apoptotic gene)
46) A (p53 is a tumor suppressor gene)
47) C (Robbins 300)
48) D (Robbins 299)
49) C (Robbins 304)
51) B (Robbins p. 304)
54) A (Robbins pp 307) ATM protein senses double-strand breaks a type of damage
caused by ionizing radiation and free radicals. BRCA-1, BRCA-2 are involved in
DNA repair by homologous recombination. CHEK-2 is a protein kinase activated by
DNA damage and phosphorylates BRCA-1 and RAD15. RAD15 is an enzyme
involved in DNA recombination repair (Fig 7-39)
57) D (p. 309)
58) C (p. 311-312) Upregulation of integrins usually occurs to allow cells to adhere to
endothelium at distant sites
59) D (Robbins p. 317)
60) E (p. 318)
61) E (p. 320)
62) E (p. 320-321). Carcinogen-induced damage usually does not result in initiation as
DNA repair genes can repair the damage prior to it becoming fixed/permanent.
63) E (Robbins p. 306) BRCA-1 and BRCA-2 participate in DNA repair
64) A (Robbins p. 308)
65) E (Robbins p. 309) Angiogenic switch is when some tumor cells change to an
angiogenic phenotype
66) C (Robbins p. 312)Degradation of basement membrane by type IV collagenases is
important for tumor migration
68) D (Robbins pp 318) - BRCA-1 is a caretaker gene (affect genomic stability)
70) B (Robbins pp 3093) (potential)
73) D (Robbins pp 313) (organ tropism is independent of blood drainage)
74) D (Robbins 315)
75) E (Robbins 317)
76) C (Robbins 321)
77) C (Robbins 322)
78) D (Robbins 323)
79) C (Robbins 329, 330 – Cell specific differentiation antigens are normal self-antigens,
therefore, no immune response is expected)
80) D (Robbins 331 – Loss of MHC molecules is a tumor evasion mechanism)
81) A (Robbins 333)
82) E (p.329-330). This would be presented by MHCII and therefore illicit a CD4+
response.
83) D
85) D (Robbins p. 333)
86) A (Robbins p. 335) - Number of mitoses is involved in grading a tumor
88) C (Robbins pp 331) There is lack of costimulation; another mechanism is antigen
masking.
89) D ( Robbins pp 334) the others are also implicate but the most important is PTHrp
90) C (Robbins pp 320) Promoters does not directly affect the DNA
91) E ( Robbins pp 323) UVB is usually carcinogenic, as UVC is shielded by ozone
94)
General Pathology John Ragsdale

May 31, 2005
Which of the following is not a morphologic change characteristic of anaplastic cells?
A) Pleomorphism
B) Loss of polarity
C) Tumor giant cells
D) Normal differentiation
E) Abnormal nuclear morphology
ANSWER: D Page: 273-275
The following morphologic changes are characteristics of anaplasia except:

A) Large nuclei with coarsely clumped chromatin
B) 1:4 nucleus-to-cytoplasm ratio
C) Pleomorphic cells and nuclei
D) Large numbers of bizarre mitosis
E) Loss of polarity of cells
Answer: B pages 273-274
Which of the followings are main factors determined rate of tumor growth?
1. Tumor cell doubling time

2. The concentration of proteinases produced by tumor cells
3. The fraction of tumor cells that are in the replicative pool
4. The concentration of growth factors produced by tumor cells
5. The rate at which cells are shed and lost in the growing lesions
a. 1,2,3
b. 1,3,4
c. 1,3,5
d. 1,4,5
e. 3,4,5
Answer c ref. page 276
Which of the following is true regarding dissemination of carcinomas?
a. Direct transplantation through surgical instruments is impossible

b. Direct seeding is the most common pathway for the initial dissemination
c. Lymphatic spread is the most common pathway for the initial dissemination
d. Hematogenous spread is the most common pathway for the initial
dissemination
e. Regional lymph node enlargement means dissemination of the primary
carcinoma
Answer c ref. page 279
The following are true regarding cancer metastasis except:

1) Rarely occurs with benign neoplasms
2) Neoplasms may seed to joint space
3) Lymphatic spread is most common pathway for dissemination of Sarcomas
4) Lymphatic spread is most common pathway for dissemination of Carcinomas
5) Hematogenous spread is most common pathway for dissemination of Carcinomas
A) 1, 2
B) 1, 3
C) 2, 3
D) 2, 4
E) 3, 5
Answer: D pages 279-280
The rate of growth of a tumor is determined by the following except:

A) Fraction of tumor cells in replicative pool
B) Shortened length of time for cell cycle
C) Doubling time of tumor cells
D) Rate at which cells are shed
E) Rate of cellular apoptosis
The following cellular changes determine a malignant phenotype except:

A) Have unrestricted proliferative capacity associated with maintenance of telomere
length
B) May not respond to direct inhibitors of cyclin-dependent kinases
C) Capacity to proliferate without external stimuli
D) Frequently have up regulation of p53
E) May fail to repair DNA damage
Answer: D page 289
The following are true regarding the normal cell cycle except:
A) Cyclin D/CDK4 complex phosphorylates RB
B) Exit from mitosis requires inactivation of cyclin B-CDK1
C) Phosphorylation of RB activates the transcriptional activity of E2F
D) Cyclin B-CDK1 is the main mediator that propels cell beyond prophase
E) The G2/M transition is intiated by E2F-mediated transcription of Cyclin D
Answer: E E2F transcribes cyclin A and E pages 290-291

Answer: B page 276
Which of the following cell-cycle inhibitor does p53 induce?
a. p14ARF
b. p16INK4
c. p21
d. p27
e. p57
Answer c ref. page292
The following product of oncogenes causes over expression of growth factor genes
due to role as signal transducer:
A) RB
B) RAS
C) SIS
D) NF-1
E) APC
Answer: B page 294
The following product of oncogenes works with another protein (MAX) as a potent
transcriptional activator of target genes associated with cell proliferation:
A) SIS
B) RAS
C) MYC
D) BRCA-1
E) Cyclin-D
Answer: G page 298
The following tumor suppressor genes and gene products are key regulators of the
cell cycle except:
A) Cyclin D
B) P16INK4a
C) APC/β-catenin
D) CDK4
E) RB
Answer: C page 300
The following prevent RB activation through the CyclinD/CDK4 pathway except:

A) P53
B) TGF-β
C) CDK inhibitors
D) INK 4a inhibitors
E) Oncogenic viruses
Answer: E page 302
The following antigens on tumors are recognized by CD8+ cytotoxic T lymphcytes

except:
A) Oncofetal antigens
B) Glycocalyx molecules
C) Products of mutated oncogenes
D) Overexpressed cellular proteins
E) Antigens produced by oncogenic viruses
Answer : B, it masks cell surface antigens pages 329-331
Protooncogenes can be activated in the following ways except:

A) Chromosomal translocations that remove the gene from its regulatory elements
B) Chromosomal translocation that causes formation of hybrid genes that encode
growth promoting chimeric protein
C) Reduplication and amplification of the genes DNA sequence
D) Hypermethylation of promoter sequences for the gene
E) None of the above
Answer: D , pages 314-315
The following are true regarding the components of chemical carcinogenesis except:
A) Promoters induce tumors in initiated cells
B) Initiators alone can’t cause tumor formation
C) Promoters can be tumorigenic by themselves
D) Direct-acting intitators are highly reactive electrophiles
E) Initiators cause permanent DNA damage that is irreversible and has memory
Answer: C page 319
Matching
A. disorganized but mature mesenchymal or epithelial tissues found in their

normal anatomic location
B. normal mature tissue located at an ectopic site
C. all three embryonic cell layers- endoderm, mesoderm, and ectoderm- can give
rise to this type of tumor
D. term for tumors which stimulate formation of abundant collagen in
surrounding connective tissue
E. abnormal pattern of tissue growth
1. scirrhous
2. dysplasia
3. epithelial
4. choristoma
5. hamartoma
Answer: A5, B4, C3, D1, E2 PBVD pg 253-

256
The size of a cell population can be increased by which of the following mechanisms?
1. shortening of the cell cycle

2. increased rate of stem cell input
3. increased rates of differentiation
4. conversion of quiescent cells into proliferating cells
5. increased rate of release of cytochrome C from mitochondria
A. 1,2,3
B. 1,2,4
C. 1,2,3,4
D. 1,2,3,5
E. 1,2,3,4,5
Answer: C pg 261-262, PBVD
Matching
A. exit from mitosis requires deactivation of this

B. complexes with cyclin D to phosphorylate RB
C. increases p53 levels by inhibiting MDM2 activity
D. causes compaction of chromatin and inhibition of transcription
E. induced by p53 to block cell cycle by binding to cyclin-CDK complexes
1. p21
2. CDK4
3. p14ARF
4. cyclin B-CDK1
5. histone dacetylase
Answer: A4, B2, C3, D5, E1 Robbins pg 289-292
In the absence of APC protein which of the following occur?
1. degradation of β-catenin
2. decreased cell cycle activity
3. increased transcription of c-MYC
4. increased transcription of CYCLIN D1
5. complex formation between β-catenin and TCF
A. 1,2,3
B. 1,3,5
C. 1,4,5
D. 2,3,5
E. 3,4,5
Answer: E pg 304, robbins
Which of the following would result in increased apoptosis?
1. increase in INK4a
2. decrease in MDM2
3. increased transcription of BID
4. increased transcription of BAX
5. increased transcription of BCL-2
A. 1
B. 1,2
C. 1,2,3
D. 1,2,3,4
E. 1,2,3,4,5
Answer: D pg 291, 306

robbins
All of the following are true concerning gatekeeper genes except:
A. are defective in most tumors

B. can directly control tumor growth
C. includes INK4 proteins, cyclin D, and RB
D. includes p53, MDM2, and mismatch repair genes
E. have increased risk of mutation with loss of caretaker genes
Answer: D pg 318, robbins
Which of the following are retroviruses?
1. SV40
2. Polyoma virus
3. Maedi-Visna virus
4. feline leukemia virus
5. feline immunodeficiency virus
A. 1,2,3
B. 1,4,5
C. 2,3,4
D. 2,3,5
E. 3,4,5
Answer: E pg 288, Table 6-5, PBVD
Which of the following are true concerning antitumor effector mechanisms?
1. the principal mechanism of tumor immunity is killing by CD8+ CTLs

2. cell-mediated immunity is believed to be the most effective antitumor defense
3. release of IFN-γ by NK cells activates MHC antigen independent tumor cell
death via macrophages
4. reduced MHC expression by tumor cells may lead to increased killing by
cytotoxic T lymphocytes
5. granzymes released by CTLs initiate caspase-dependent and caspase-
independent apoptosis of tumor cells
A. 1,2,3
B. 1,2,3,4
C. 1,2,3,5
D. 2,3,4,5
E. 1,2,3,4,5
Answer: C pg 330-331, PBVD pg 275-276

Chapter 7 (Questions 2008-2009 Compiled)

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Chapter 7 (Questions 2008-2009 Compiled)

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General pathology 2008-2009

Compiled by Bhupinder Bawa

A. Cellular and nuclear pleomorphism

A. Fast growing tumors have high cell turnover

Q5. What is malignant neoplasia of skeletal muscle called?

Q6. Which is not a typical characteristic of poorly differentiated neoplastic cells?

Q8. Which of the following is not a characteristic of anaplasia

1. Rate of cell loss

Q15. A mammary carcinoma is most likely to metastasize via:

Q16. Which of the following is not a pathway of metastasis

Q17. Which of the following is not a change in cell physiology to determine

A. Genes that regulate apoptosis

A. Uniform cytoplasmic staining for CD21

Q20. Which of the following is/are considered to be recessive oncogenes?

Q21. Which of the following can phosphorylate RB?

Q25. Hypophosphorylated RB is complexed to which of the following?

Q27. Which of the following are constitutively expressed in a cell?

Q30. Following DNA damage, the role of p53 is to:

A. Activate histone deacetylase

Q35. The main barrier to cell-cycle progression is

Q36. Uncontrolled RAS activity is prevented by?

Q38. p53 helps in DNA repair by transcription of ?

Q39. A genetic defect leading to overexpression of β-catenin and considering no

A. Increased expression of c-MYC and cyclin D

Q40. Inhibition of cellular proliferation by TGF- is mediated by upregulation of

A. Activation of CDK inhibitor protein p21

Q42. Which of the following statements about p53 protein is FALSE?

A. It is a DNA-binding protein confined to the nucleus

Q43. Which of the following is not a transcription factor oncogene?

Q45. Which of the following is not a recognized protooncogene

Q46. Which of the following is not a characteristic of oncogene mutations

A. Homozygous loss of p53

Q47. Which of the following is not a tumor suppressor gene

Q48. Which of the following describes oncogenesis via the RB gene

Q49. What is the order of oncogenesis in the APC/ β-catenin pathway

1. β-catenin binds with TCF

A. The p53 protein is localized in the cell nucleus

Q51. Which of the following changes result in increased cellular β-catenin?

Q52. All of the following can act as anti-angiogenesis factor except?

Q54. A double strand break in DNA is sensed by?

Q55. Which of the following are caretaker genes?

A. Genes involving RB pathway

Q56. Which of the following is an early event in development of colorectal cancers?

A. Loss of p53 gene

Q57. The most important angiogenic factor/s in tumors is/are?

Q60. Caretaker genes are genes that:

Q61. Which of the following sequences will result in tumor formation?

Q62. Which of the following statements about initiation of chemical carcinogenesis is

Q63. Which of the following is not involved with pro-apoptosis or pro-apoptotic

Q64. Which is true regarding telomeres and telomerase?

Q65. Which is false regarding angiogenesis?

Q67. What is the most common chromosomal abnormality involved in activating

Q68. Which of the following is not a “gatekeeper” gene?

Q69. The carcinogenicity of UVB light is attributable to which mechanism?

Q70. Replicative potential of neoplastic cells is dependent on

Q72. Invasion of the ECM by neoplastic cells requires

Q73. Organ tropism of metastasis is due to

Q74. An example of an epigenetic change is

Q75. Transformation of non-immortalized cells in vitro requires

Q76. Which of the following is a direct-acting carcinogen

Q77. Promoters contribute to tumorigenesis by (Robbins 322)

Q78. The carcinogenicity of UVB light is attributed to (Robbins 323)

Q80. Which of the following is not a tumor evasion mechanism