Deck 8: Health Care and the Human Genome

Question 1

We know enough about inheritance and genetics to some great things with disease prevention and cure, so what's the problem?

A) We can't cure everything.
B) The money for further research is running out.
C) There isn't much more to discover.
D) This gives us the tools to do great harm too.
E) We shouldn't be "playing God" with people.

Answer 1

D

Question 2

What is a Eugenics Law?

A) Any law having to do with genetic research
B) A law against being feebleminded
C) A law designed to improve the human stock by controlling who reproduces
D) A law outlawing sterilization of humans against their will
E) A law against pregnancy outside of marriage

Answer 2

A

Question 3

Who was Carrie Buck?

A) The woman behind the test case of Virginia's Eugenics Law, which led to it being upheld by the Supreme Court such that forced sterilizations could occur
B) The first woman to be committed against her will to the Colony for Epileptics and Feebleminded
C) The first woman to be officially declared "feebleminded" by the state of Virginia's Eugenics law
D) The mother of the first woman to be subjected to sterilization against her will according to a eugenics law
E) The daughter of the first woman to be subjected to sterilization against her will according to a eugenics law

Answer 3

A

Question 4

In the early 1900s, many states passed eugenics laws in order to prevent biologically defective people from having children. What was their goal in doing this?

A) It was a form of punishment for criminals.
B) To reduce the number of people on welfare
C) To prevent genetic diseases
D) To improve the status of children
E) To improve the "human stock"

Question 5

According to the eugenics laws common in the United States in the early 20^th century, on what grounds could someone be sterilized?

A) They were a convicted criminal.
B) They were "insane, idiotic, imbecilic, or mornonic."
C) They were poor or homeless.
D) They were blind or deaf.
E) Any of the above

Question 6

When eugenics was practiced in the United States, who typically got to decide if a person should be sterilized?

A) Their family
B) A judge
C) A board of "experts"
D) A doctor
E) A jury

Question 7

What is genetic determinism?

A) It says that if you have a human genome, you're human.
B) It says that your genes don't entirely determine everything about you.
C) It says that your genes determine everything about you.
D) It's the study of what it is that genes determine about you.
E) It's the study of how genes determine your traits.

Question 8

According to genetic determinism, should eugenics laws work?

A) Yes, because they remove the problem-causing genes from the population
B) Yes, because the genes that cause problems are easily defined
C) No, because genes aren't the only things that cause "defects"
D) No because it's impossible to remove every "bad" gene from a population
E) One has nothing to do with the other.

Question 9

What do we now know about genes that explains why eugenics policies can't really work?

A) Genes aren't related to feeblemindedness.
B) There are no specific genes which define human abilities or personalities.
C) It's impossible to remove a gene from a population just through selective breeding.
D) Human abilities and personalities are entirely controlled by our environment.
E) Genes will mutate right back to their abnormal state, even if they're fixed.

Question 10

Even if eugenics laws were somehow ethical, why would it be difficult to apply them from a cultural standpoint?

A) Nobody is "normal."
B) Cultural definitions of "normal" or "attractive" change over time and from place to place.
C) Judges aren't smart enough to say whether someone is "abnormal."
D) Individuals' traits or personalities change over time.
E) It would be cheaper to "fix" abnormalities through medical psychological intervention.

Question 11

How do we know that genes do not solely determine our personality?

A) Scientists can measure what genes do and they don't determine personality.
B) Scientists can predict personality traits based on one's genome.
C) Identical twins have identical genes and identical personalities.
D) Identical twins have identical genes but different personalities.
E) Scientists are still working on this question so we don't really know.

Question 12

What is the cause of most spontaneous miscarriages in pregnancies?

A) Something the mother ate
B) Some activity of the mother
C) Defective genes in either parent
D) Drinking alcohol
E) Serious genetic mutations

Question 13

What is the point of prenatal genetic screening?

A) To find out the gender of the baby
B) To abort the pregnancy
C) To look for potential genetic diseases or developmental problems
D) To raise money for further genetic research
E) To "build" the best baby possible

Question 14

What is the goal of gene therapy?

A) To cure genetic diseases
B) To improve appearance
C) To improve intelligence
D) To produce drugs that will replace defective genes
E) To produce artificial genes to replace defective natural genes

Question 15

What is the idea behind somatic gene therapy?

A) A genetic disorder can be cured by inserting a normally functioning gene into the patient.
B) A genetic disorder can be cured by removing the dysfunctional gene from the family tree.
C) Sound waves administered to the defective area can alter the mutation of a gene back to normal.
D) Medical treatment of a genetic disorder can mask the effects of a dysfunctional gene.
E) Physical therapy can train a dysfunctional gene to work properly.

Question 16

The first successful gene therapy for children missing an enzyme involved in lymphocyte production cured what type of disorder?

A) A brain disorder
B) A swelling in the lymph nodes
C) An immunodeficiency
D) A weakness in the red blood cells
E) A viral infection

Question 17

What is the general procedure for carrying out somatic gene therapy?

A) The dysfunctional genes are excised from the egg and sperm cells of the parents and replaced with correctly functioning versions such that any resulting embryos are healthy.
B) A properly functioning version of the dysfunctional gene causing a disorder is injected into a virus and the virus then infects the cells of the patient, thus giving them a working copy of the gene and treating the disease.
C) A dysfunctional gene causing a disorder in a patient is fixed via mutation such that it works again, thus treating the disease.
D) The dysfunctional genes causing a disorder in a patient are excised from his or her cells and correctly functioning genes are injected in via a virus, thus treating the disease.
E) Prenatal screening is done to identify dysfunctional genes, and these are excised from the embryo's cells and replaced with properly functioning genes, thus treating a potential disease.

Question 18

Which of the following statements about germ-line and somatic gene therapy is not true?

A) Germ-line gene therapy has not been tried on humans.
B) Germ-line and somatic gene therapies have both been tested on animals.
C) Both gene therapies involve replacing a defective gene with a properly functioning version.
D) Both gene therapies are getting increasingly routine as disease treatments.
E) Somatic gene therapy has been successfully used to treat a genetic disease.

Question 19

Why did scientists inject genes encoding for a green fluorescent protein into rhesus monkeys?

A) Glowing green rhesus monkeys would be popular in zoos or as pets.
B) The green protein treats an immunodeficiency disease in the monkeys similar to AIDS.
C) It was a mutation that was easily seen in subsequent generations of the monkeys so it could be traced as it passed through the family, illustrating inheritance patterns.
D) Rhesus monkeys cannot see the color green so the mothers would not reject any green babies.
E) The monkeys' biology is similar to humans and they were trying to develop methods to insert disease genes into the monkeys so the diseases could be studied.

Question 20

With the study of the green fluorescent protein in the rhesus monkeys, how many eggs were treated and how many monkeys with the gene were successfully carried to term by their surrogate mothers and lived?

A) 20 eggs; 10 lived
B) Hundreds of eggs, 1 lived
C) Hundreds of eggs, 52 lived
D) 100 eggs; 12 lived
E) Hundreds of eggs, none lived

Question 21

The following are arguments against somatic gene therapy, followed in each case by a defense against the argument. Which one doesn't make any sense?

A) We shouldn't "play God;" isn't any medical intervention sort of "playing God?"
B) It's not safe; new medical treatments are generally somewhat risky.
C) It might not work; new medical treatments generally have mixed results.
D) It's very expensive; this is true of many new medical treatments.
E) Biologically, it can't work; with more study we might be able to make it work.

Question 22

Which of the following is not true of somatic gene therapy?

A) It's a proven technique to treat genetic disease in an individual.
B) The technique has proven potential to treat genetic disease in an individual.
C) It's somewhat risky because scientists can't completely control where the genes are inserted.
D) It's easier to use to treat "loss of function" genetic diseases, where a dysfunctional gene can merely be replaced by one that doesn't work.
E) It's expensive, so there may be somewhat limited access.

Question 23

Assuming they could both work, what is the difference in the outcomes of somatic versus germ-line gene therapy?

A) Somatic treats adults and germ-line treats fetuses.
B) Germ-line treats adults and somatic treats fetuses.
C) Somatic treats disease and germ-line treats physical defects.
D) Somatic treats an individual. Germ-line treats the individual and all their descendants.
E) Germ-line treats genetic diseases and somatic treats infectious diseases.

Question 24

Assuming one could identify a "bad" trait, why might it be impossible to eliminate it by eliminating an associated "bad" gene by germ-line gene therapy?

A) It's impossible to isolate a single gene.
B) The gene eliminated might do other important things, often more than one gene controls a trait, and the environment might matter, too.
C) Sterilization is the only way to prevent a gene getting passed along; it eliminates a whole lot of genes, not just a "bad" one.
D) The environment is always going to influence the genes, so removing a single "bad" one without changing the environment, might not help.
E) There is, as of now, no known correlation between any specific gene and particular illness or disorder.

Question 25

How can prenatal testing and genetic counseling avoid the whole issue of germ-line gene therapy, while still identifying "bad" genes?

A) Defective eggs and sperm can be identified and excised from the parents prior to conception.
B) Only eggs and sperm free of the bad gene can be combined in the lab and only the resulting healthy embryos implanted.
C) The "bad" genes can be identified, along with the risk of passing them on, and then the parents can decide whether to have children at all, or only allow embryos screened to be "healthy" to come to term.
D) If all embryos can be screened for "bad" genes, all those with the "bad" genes can be prevented from developing.
E) If all parents are screened for defective genes, those who have those genes can be prevented from having children.

Question 26

Which of the following are potential problems with germ-line gene therapy?

A) It's not necessarily safe.
B) The treatment is permanent so any mistakes are permanent.
C) It affects more than one person.
D) Removing the gene might disrupt some important function that wasn't known to be related.
E) All of the above are potential problems with germ-line gene therapy.

Question 27

How does the case of sickle cell disease and malaria illustrate a potential complication of germ-line gene therapy?

A) Malaria is not controlled by one single gene.
B) The gene that controls malaria also controls red blood cells.
C) Removing the sickle cell gene prevents sickle cell disease, but it also prevents the development of red blood cells.
D) Having one sickle cell gene doesn't cause a severe version of the disease and it also makes a person resistant to malaria which is important for those living where malaria is prevalent.
E) A person with two sickle cell genes is resistant to mosquito bites which carry malaria, a disease worst than sickle cell.

Question 28

What's wrong with the idea of using germ-line gene therapy to create "perfect" children?

A) Perfect children are always bratty.
B) There is no such thing as a perfect child.
C) Parents wouldn't have any challenges.
D) What's considered "perfect" might change, and everybody couldn't afford to do this.
E) "Designer" children would be viewed as freaks.

Question 29

What is the goal of stem cell research?

A) To be able to grow human babies in the laboratory
B) To be able to grow human stem cells to replace damaged or diseased cells
C) To use injected stem cells to cure cancer
D) To be able to use embryos and fetuses for spare parts for other family members
E) To find a use for the many embryos that are presently frozen but went unused as part of the in vitro fertilization process

Question 30

Which of the following types of stem cells are most useful for medical research?

A) Fetal stem cells
B) Umbilical cord blood stem cells
C) Stem cells from newborns
D) Adult stem cells
E) 5-7-day-old embryonic stem cells

Question 31

Why are embryonic stem cells the most useful for medical research?

A) They're easy to get.
B) There are many stem cells in an embryo.
C) They can develop into any type of cell found in a human body.
D) They can grow.
E) There are lots of unused and unwanted embryos that are thrown away by fertility clinics each year.

Question 32

There is some controversy over using embryonic stem cells for research. Why?

A) Most people believe that replacing damaged or diseased structures in a human is unethical and "playing God."
B) No religions sanction the use of embryonic stem cells for medical purposes.
C) All religions oppose embryonic stem cell research by science.
D) Some people believe that life or "personhood" begins at conception, and so destroying an embryo at any point for any reason is unethical and wrong.
E) It is not a proven technique for helping people.

Question 33

Do most religions oppose using stem cells in research?

A) Some disapprove of using just stem cells from embryos.
B) Some say any research on stem cells is okay.
C) Some say embryonic stem cell research is okay as long as the embryos would have been destroyed anyway.
D) Some say stem cell use if fine because it's consistent with seeking knowledge and ending human suffering.
E) All of the above

Question 34

What is therapeutic cloning?

A) A nucleus from a healthy cell is taken from a patient and injected into an egg cell with no nucleus, and this cell develops into an embryo with stem cells that "match" the patient and can be used in therapies without risk of transplant rejection.
B) An egg or sperm cell is taken from the patient and combined with an egg or sperm cell with its nucleus removed such that an embryo develops with stem cells that "match the patient" and be used in therapies without risk of transplant rejection.
C) DNA from a patient is extracted and injected into the egg from a similar animal (most often a primate or pig), and the embryo that develops has stem cells which "match" the patient and can be used in therapies without the risk of transplant rejection.
D) "Spare" embryos are saved by parents, and the stem cells in these can be used to treat potential ailments in their children without risk of transplant rejection.
E) Experimental treatments which might work on a patient are first tried using a culture of their cells in the lab. This minimizes risk of the treatment on the actual patient if it appears to work in the lab setting.

Question 35

What is reproductive cloning, and has it ever been shown to work?

A) A nucleus from a parent cell is placed into an egg with the nucleus removed. The resulting embryo is implanted into a surrogate mother and is identical to the parent. No, this has never resulted in a live birth.
B) A nucleus from a parent cell is placed into an egg with the nucleus removed. The resulting embryo is implanted into a surrogate mother and is identical to the parent. Yes, this has been done with a variety of animals.
C) A nucleus from a parent cell is placed into an egg with the nucleus removed. The resulting embryo is grown up in the lab and is identical to the parent. No, this has never resulted in a live birth.
D) A nucleus from a parent cell is placed into an egg with the nucleus removed. The resulting embryo is grown up in the lab and is identical to the parent. Yes, this has been done with a variety of animals.
E) DNA from any individual can be cultured into an organism that exactly matches the original parental source of the DNA. People are increasingly doing this with valuable animals and pets.

Question 36

Reproductive cloning of human is illegal in the United States. True or False?

A) True. Obviously it would be unethical to clone humans.
B) False. There are no restraints on research with potentially valuable medical applications in the United States.
C) True. Only recently though, as only recently has it begun to look as if cloning humans would be possible.
D) False. Twenty-five other countries outlaw human cloning, but the United States does not.
E) True. Although the law has not yet been actively enforced.

Question 37

What is one example of where embryonic stem cells have proven effective in animals, suggesting that a similar process might be helpful for humans?

A) Treating blindness in mice
B) Treating Parkinson's disease in rats
C) Treating heart disease in dogs
D) Treating cancerous tumors in rhesus monkeys
E) Treating nerve disease in horses

Question 38

How can embryonic stem cells be used to advance medical research on disease in humans?

A) Stem cells with known diseases built in can be grown into embryos, which can then be subjected to experimental treatments.
B) Because they won't be rejected by a patient, one's own stem cells can be used in a variety of experimental treatments with minimal risk.
C) Stem cells can have specific genes altered to cause disease, and then by watching how they develop, scientists will learn how a disease develops, and they will have a model to try treatments, rather than using animals.
D) Because stem cells can become any other cell, any stem cells can be used as a trial treatment in anyone.
E) Stem cell treatments are safe to use because they contain embryonic DNA which won't be rejected by a patient.

Question 39

Stem cell procedures are tested and safe. True or False?

A) False. Transplanted stem cells can be rejected and incorrect dosages may cause tumors.
B) True. Scientists and doctors have successfully used stem cell treatments enough that they are confident in their safety at this point.
C) False. Stem cell treatments generally go well, but it is very difficult to get the stem cells cultured in the first place.
D) True. Veterinarians are now routinely using stem cell treatments on animals and it's assumed that they will work in people just as well, and they have so far.
E) False. Stem cell treatments have worked in animals but have so far tended to aggravate symptoms in people.

Question 40

What is one known difficulty precluding routine use of stem cell therapies?

A) They don't always work because sometimes even stem cells can be rejected by patients.
B) Many doctors find use of stem cells objectionable on religious or ethical grounds.
C) Producing stem cells requires hundreds of human eggs and the hormone treatments necessary to allow women to donate eggs can be quite risky.
D) Producing stem cells requires hundreds of human sperm and the hormone treatments necessary to allow men to donate can be quite risky.
E) The technology to extract stem cells from an early embryo does not exist yet.

Question 41

What is a probable risk of stem cell and cloning technology?

A) So far they've both been shown to be safe in trials.
B) We likely will have the knowledge to clone humans at some point
C) There will not be enough human eggs available to meet demand.
D) They cause tumors.
E) The upper classes will use them as tools to keep the lower classes submissive.

Question 42

We no longer have eugenics laws, but how might genetic therapies and screening be used to similar effect (to enhance the "human stock")?

A) If genetic screening is done on everyone, we'll know who has criminal or other defective tendencies and be able to prevent them from reproducing unless we "fix" their genes.
B) If all embryos are screened for defects, parents will have the option of getting them fixed or terminating the pregnancy, such that only good quality people are born.
C) If the government has access to our DNA, they can decide what defects preclude reproduction and create new laws.
D) If all potential parents get genetic screening, those found to have defective genes could be prohibited from reproducing.
E) If all parents are screened for genetic defects, their genes can be fixed before they try to have children.

Question 43

How could the availability of genetic screening lead to loss of privacy?

A) You would know all your potential disease risks.
B) Anybody would know if you had had genetic therapy.
C) Anybody could potentially access your DNA code and see what "defective" genes you had.
D) A computer could be used to "read" your DNA and there would be no way to safeguard that information.
E) With your DNA code, you doctor could predict everything that was going to happen to your health condition, or that of your offspring.

Question 44

How could the availability of genetic screening and then therapies lead to a society of genetic "haves" and "have nots"?

A) We would know who had good genes and who didn't, and only those with the good genes would reproduce.
B) Only those embryos which had defects that could be fixed would be allowed to develop to birth.
C) The people who could afford the technology could get their defective genes fixed, while most people could not afford to do that and would be viewed as "defective."
D) We could "design" all our children and they would end up viewing us as "defective."
E) Insurance companies could refuse health insurance to people with defective genes, so they would not live as long.

Question 45

We can manipulate genes in people, collect stem cells from human embryos, and clone. What must we be careful of as a society as we move forward with these areas of research?

A) That we don't accidently create a mutant species that ends up killing us
B) That the government doesn't get involved in this at all
C) That medical insurance is willing to cover all these types of treatments, in addition to genetic screening
D) That the information in our DNA becomes readily available to everyone
E) That we carefully define ethical and moral boundaries to guide this work

Question 46

Dr. Nancy Wexler is known for her work with what disease?

A) Sina bifida
B) Heart disease
C) Parkinson's disease
D) Huntington's disease
E) Cancer

Question 47

Using medical and family histories, what does Dr. Wexler try to do?

A) Map the specific genes involved in various genetic diseases
B) Cure genetic diseases
C) Find the pattern of genetic diseases in families
D) Find the cause of genetic defects that cause disease
E) Find the environmental triggers that cause a gene to become defective
"Technology Connection"

Question 48

Why doesn't blood typing definitively determine if a particular man fathered a particular child?

A) Blood typing doesn't tell you anything about the genetics of the father or child.
B) Blood typing can only tell you if a man couldn't have been the father, not if he is.
C) It's difficult to determine the blood type of a child.
D) Because all blood types are unique, there's no way to compare them.
E) Our blood type comes only from our mother.

Question 49

How does paternity testing with DNA work?

A) DNA strands unique to individuals are matched with the individual's fingerprints, and by comparing those, a scientist can determine if a particular man fathered a particular child.
B) DNA strands unique to the mother and potential father are combined, and if they result in strands identical to the child in question, that man had to be the father.
C) DNA strands unique to the mother, father, and child are compared, and based on their percent similarity, it can be determined with pretty good accuracy if this man was the father of this child (with this mother, but we usually know the mother).
D) DNA strands unique to the mother, father, and child are compared, and based on their percent similarity, it can be determined with 99% accuracy if this man was the father of this child (with this mother, but we usually know the mother).
E) If the man's DNA is exactly 50% the same as the child's, he has to be the father.

Question 50

How does genetic screening of embryos lead to skewed sex ratios in some countries?

A) Most commonly, in countries where girls are seen as more valuable to a family, male embryos are terminated more frequently.
B) Most commonly, in countries where boys are seen as more valuable to a family, female embryos are terminated more frequently.
C) In some countries, female embryos are routinely destroyed by law.
D) In some countries male embryos are routinely destroyed by law.
E) It would be unethical to favor male or female children, so this doesn't happen anywhere.

Question 51

The first published study of stem cells being successfully used to produce human tissue was in 2001. What type of cells did the stem cells make?

A) Neurons
B) Skin cells
C) Blood cells
D) Heart cells
E) Cancer cells

Question 52

Why would it be helpful to be able to generate blood cells from stem cells?

A) Donated blood is often contaminated.
B) Blood donors would no longer be needed.
C) Mainly, as a step along the way toward learning how to generate more useful cells
D) There are not enough blood and bone marrow donors to meet the need.
E) It would cost less than using people as donors.

Question 53

Luckily, Virginia was the only state to officially sanction forced sterilizations for "the good of society."

Question 54

Carrie Buck got pregnant out of wedlock and her daughter Vivian was declared to be "feebleminded." How was this determined?

Question 55

What is the name of the idea that genes determine everything about us?

Question 56

How are eugenics laws supposed to improve society?

Question 57

What influences how genes work in an individual?

Question 58

List a disease or disorder that is actually caused by a mutation in a specific gene.

Question 59

The treatment in which a healthy, functioning gene is inserted into a patient to cure a genetic disorder in that patient is called what?

Question 60

Of somatic and germ-line gene therapy, which one potentially affects descendants of the person treated?

Question 61

Is it somatic or germ-line genetic therapy which requires that egg cells be infected by viruses to transmit healthy genes?

Question 62

Is it somatic or germ-line gene therapy which has been successfully used in humans to treat genetic diseases?

Question 63

What is one problem with somatic gene therapy?

Question 64

How is germ line gene therapy similar to eugenics?

Question 65

Pluripotent stem cells are the best to use in medical treatments involving stem cells. Where do those come from?

Question 66

Pluripotent stem cells are potentially most useful in medical treatments because they can produce any type of cell in a body. What can't they do?

Question 67

Are all religions in agreement on the use of embryonic stem cells for medical treatment?

Question 68

Is it possible to clone a human being?

Question 69

What is one example where stem cells have proven effective in animals, demonstrating potential uses in humans?

Question 70

What is one known difficulty involved in the process of developing stem cells for research

Question 71

How is accessibility to treatment a potential problem with new genetic therapies?

Question 72

Who is more likely to support the termination of a pregnancy if the embryo is found to have Down's syndrome, a geneticist or the general public?