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Select the one best response to each question!
How can normal cells become malignant?
|1. How can normal cells become malignant?
a. Overexpression of oncogenes
b. Underexpression of tumor-suppressing genes
c. Viral infection
d. All of the above
|2. Which of the following best summarizes the concept of tumor development via immunoediting?
a. Cytokines produced by tumor cells are toxic to T cells expressing receptors for tumor-associated antigens.
b. Cells that can escape the immune system have a growth advantage over more immunogenic tumor cells that are destroyed by T cells during immunosurveillance.
c. T-cell activity causes an up-regulation of MHC expression on tumor cells that allows them to escape the immune system.
d. Expression of secreted tumor-associated antigen saturates T-cell receptors and renders them incapable of binding to the actual tumor cells.
|3. A woman goes 3 days per week to a tanning bed for 20 minutes of UV exposure per visit. Which stage of cancer is this?
b. In situ
|4. If a disease is present in 1 in every 10,000 individuals, and a marker can detect this disease with 100 percent sensitivity and 95 percent specificity, what would be the number of false positives for each cancer found?
|5. Each of these markers may be elevated in multiple myeloma except
b. β-2 microglobulin.
c. monoclonal intact immunoglobulin molecules.
d. free monoclonal light chains from the immunoglobulin molecule.
|6. Both AFP and hCG exhibit serum elevations in
b. ovarian germ cell carcinoma.
c. nonseminomatous testicular cancer.
d. all of the above.
|7. Calcitonin and parathyroid hormone levels should not be evaluated as indicating possible tumors without also measuring serum
c. thyroglobulin antibodies.
d. thyroid hormones (TSH, T4).
|8. Consensus guidelines indicate enough evidence to use all of the following for cancer screening in the groups indicated except
a. CA-125/women of reproductive age.
b. AFP/subjects at high risk for liver cancer.
c. fecal occult blood/people over 50 years of age.
d. PSA/men over 50 with at least 10 years of life expectancy.
|9. A 57-year-old man had a massive tumor removed from his colon. His serum specimen had the following results using an automated ELISA antibody sandwich assay for CEA. The stated linearity of the test is 100 ug/L. What should be done?
a. Retest all specimens using a different kit lot.
|10. A tumor found in the prostate does not stain with antibody to PSA. Is this proof that the tumor came from a different organ?
|11. In order to use a tumor marker to monitor the course of the disease, which of the following must be true?
a. The laboratory measures the marker with the same method over the entire course of the patient’s
b. The marker must be released from the tumor or because of the tumor into a body fluid that can be obtained and tested.
c. The marker’s half-life is such that the marker persists long enough to reflect tumor burden but clears fast enough to identify successful therapy.
d. All of the above.
|12. Which of the following markers could be elevated in benign liver disease?
c. CA 15-3
d. CA 19-9
e. All of the above
|13. Choose the incorrect statement.
a. Serum CA 19-9 levels should not be collected from smokers.
b. Serum CA-125 specimen should not be collected from women who are menstruating.
c. Feces for occult blood should not be collected from subjects who recently ate peroxidasecontaining foods.
d. Serum PSA specimens should be collected before any manipulation of the prostate, including digital rectal exam.
|14. Immunotoxin antibodies used for cancer therapy are “humanized” to prevent subjects from developing
a. graft-versus-host disease.
b. heterophile antibodies.
d. serum sickness.
|15. Each marker below is correctly paired with a disease in which it can be used for conditional monitoring except
b. CA-15.3/breast adenocarcinoma.
c. CA 125/ovarian adenocarcinoma.
d. CA-19.9/pancreatic adenocarcinoma.