Deck 12: Tumor Invasion and Metastasis

Question 1

Which cells of the immune system provide defense for the host against circulating tumor cells?

A) Cytotoxic T (Tc)and Helper T l (Th1)lymphocytes
B) Neutrophils
C) Macrophages and natural killer cells
D) B-lymphocytes

Answer 1

Macrophages and natural killer cells

Question 2

As a tumor increases in size,some cells undergo apoptosis.The only cells to survive and multiply are those with mutations to one copy of the p53 gene.

Answer 2

False

Question 3

All cancers eventually produce pain.

Answer 3

False

Question 4

Cells of the gut,hair follicles,and bone marrow are affected by chemotherapy and radiation because they have high rates of cell division.

Question 5

All tumor cells that are released into the blood eventually find a compatible tissue to multiply in and create a tumor.

Question 6

How do neoplastic cells survive after they detach from the originating cell?

A) By extending the matrix from the primary cell of origin to adjacent cells
B) By exchanging enzymes and cytokines with originating cells
C) By recruiting growth factors from the extracellular matrix
D) By extending finger-like projections into originating cells

Question 7

What protects tumor cells within an emboli from the host defenses and facilitates attachment to vascular epithelium?

A) Macrophages
B) Fibrin-platelet complex
C) Vascular endothelial growth factor
D) Proteolytic enzymes

Question 8

Direct invasion may be a part of the mechanism of local tumor spreading.

Question 9

Invasion is a prerequisite for metastasis.

Question 10

What is the consequence for cells when the functioning p53 gene is lost due to mutation?

A) Cells undergo apoptosis.
B) Cells escape apoptosis.
C) Cells receive less oxygen.
D) Cells are adhere more readily.

Question 11

Cells with mutant p53 genes escape apoptosis.

Question 12

During angiogenesis,what is the role of platelet factor -4,angiostatin,endostatin,thrombospondin,and interferon alpha and beta?

A) They stimulate the development of new blood vessels.
B) They facilitate the attachment of the tumor implants to new blood vessels.
C) They inhibit the formation of new blood vessels.
D) They prevent the formation of emboli that protect for tumor cells from host defenses.

Question 13

Where does seeding of cancer cells occur?

A) In the pleural space surrounding the heart
B) In the cerebrospinal fluid around the spinal cord
C) In the joints around the synovial fluid
D) In the peritoneal space surrounding the abdominal cavity

Question 14

Infection is the most significant cause of complications and death in cancer patients.

Question 15

What is the role of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF),and transforming growth factor alpha (TGF
)in cell metastasis?

A) To stimulate growth of near by tumor cells
B) To develop new blood vessels to feed cancer cells
C) To prevent cancer cells from escaping apoptosis
D) To act as a chemical gradient to guide cells to blood vessels

Question 16

Cancer cells adhere to one another better than normal cells.

Question 17

What is the most common route for distant metastasis?

A) Seeding
B) Blood
C) Lymphatics

Question 18

After the malignant change of the original cell,it must undergo _____ population doublings to produce a detectable tumor weighing about 1 g.

A) 2
B) 10
C) 30
D) 50

Question 19

Breast cancer cells metastasize to the bone because the chemokines released by the bone attract breast cells to it

Question 20

During metastasis,how do cancer cells cause lysis of the basement membrane of the host cell?

A) By secreting fibronectin
B) By secreting proteolytic enzymes
C) By using laminin receptors
D) By using invadopodia (pseudopodia)

Question 21

MATCHING
Match the phrases with the corresponding terms.
Immunomodulating agents

A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system

Question 22

Which cytokine is involved in producing cachexia syndrome?

A) Interleukin 1 (Il-1)
B) Colony-stimulating factor (CSF)
C) Tumor necrosis factor (TNF)
D) Interleukin 15 (Il-15)

Question 23

Why do nausea and vomiting occur after radiation therapy to the abdomen?

A) Because the patient is receiving chemotherapy at the same time as the radiation therapy
B) Because the radiation is metabolized by the liver,which alters the intestinal mucosa
C) Because the cancer in the gastrointestinal tract causes these clinical manifestations
D) Because the intestinal mucosa is the most radiosensitive tissue and divides rapidly

Question 24

Match the mechanisms causing pain from tumor invasion with the organ commonly involved.
Medullary bone

A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction

Question 25

MATCHING
Match the phrases with the corresponding terms.
Biologic response modifiers

A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system

Question 26

MATCHING
Match the phrases with the corresponding terms.
Interferons

A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system

Question 27

Match the mechanisms causing pain from tumor invasion with the organ commonly involved.
Liver

A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction

Question 28

Which biologic therapy produced by B lymphocytes is capable of binding to target cells?

A) Interferon
B) Interleukin
C) Erythropoietin
D) Monoclonal antibodies

Question 29

Match the mechanisms causing pain from tumor invasion with the organ commonly involved.
Brain

A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction

Question 30

Basal metabolic rates of people with cancer are usually _____ than normal.

A) lower
B) higher
C) fluctuating more
D) no different

Question 31

MATCHING
Match the phrases with the corresponding terms.
Monoclonal antibodies

A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system

Question 32

MATCHING
Match the phrases with the corresponding terms.
Chemotherapy

A)Provides cell-derived antiviral and immunomodulating proteins
B)Provides direct cytotoxic effect on cancer cells
C)Forms antibodies specific for tumor antigen
D)Attacks cancerous cells in the cell cycle
E)Provides nonspecific stimulation of the immune system

Question 33

When patients who have lung cancer develop Cushing syndrome it is an example of a(n)_____ syndrome.

A) aberrant
B) paraneoplastic
C) carcinogenic
D) idiopathetic

Question 34

Interleukin is used as adjuvant therapy for a patient with metastatic renal cell carcinoma.The goal of this type of therapy is to:

A) improve the cellular response to chemotherapy.
B) enhance the immune response to tumor cells.
C) reduce the metastasis of malignant cells.
D) prevent bone marrow depression.

Question 35

Match the mechanisms causing pain from tumor invasion with the organ commonly involved.
Small bowel

A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction

Question 36

A pathology report stages a tumor as T₂,N₁,M_o.What is the meaning of this finding?

A) There is a tumor with no spread to surrounding lymph nodes and no metastasis.
B) There are two malignant tumors and one involved lymph node with metastasis.
C) There is a tumor with spread to surrounding lymph nodes and no metastasis.
D) There is no tumor after two biopsies and one lymph node biopsy and no metastasis.