Deck 9: Cancer, Autoimmunity, and Psychosocial Stress

Question 1

A cancer begins when

A) many cells in a tissue simultaneously activate distinct oncogenes
B) inherited genes malfuntion and produce apoptosis
C) a single cell accumulates several random somatic mutations
D) none of the above

Answer 1

none of the above

Question 2

Which of the following is true about cancer

A) it is a dsease of modern society
B) it was described in ancient Chinese medical texts
C) it was attributed to lack of black bile
D) it is more prevalent in underdeveloped societies

Answer 2

it was described in ancient Chinese medical texts

Question 3

Primary defense against cancer appear to be

A) immune attack
B) DNA repair
C) activation of cell-death mechanisms
D) both b and c

Answer 3

both b and c

Question 4

Psychiatric disorders such as depression and schizophrenia

A) are both known to decrese the risk of cancer
B) clearly have no effect on cancer risk
C) have been thought to have opposite effects on cancer risk
D) generally increase the risk of cancer due to stress

Question 5

The lethality of a malignant tumor is promoted by

A) immune surveillance
B) angiogenesis
C) apoptosis
D) DNA polymerase

Question 6

The rate of new cancer cases per year is lowest in

A) the United States
B) Western Europe
C) Eastern Africa
D) the Phillipines

Question 7

Extraversion, a personality characteristic associated with positive affeect

A) protects against cancer
B) has a paradoxic effect on cancer risk
C) increases the risk of melanoma
D) has no predictive value with respect to cncer risk

Question 8

The effect of psychosocial stress on cancer

A) has been amply demonstrated
B) remains the major focus of the research
C) has been difficult to establish due to the heterogeneity of cancers
D) appears secondary to access to care

Question 9

Recognition that autoimmunity was a cause of disease was not evident until

A) 1904
B) 1951
C) 1957
D) 1965

Question 10

The clonal-selection theory of immune responsiveness postulates that

A) lymphocytes have unique antigen-recognition structures that are inherited
B) antigen-recognition structures are randomly generated
C) lymphocytes that recognize self-antigen are not normally generated
D) self-reactive lymphocytes are an aberration

Question 11

Driver mutations

A) are not directly implicated in causing malignancy
B) have been observed to affect more than 5000 genes
C) affecting less than five genes can cause malignancy
D) are more numerous than passenger mutations

Question 12

The modern foundation for our current views about cancer was first proposed in the

A) mid-nineteenth century
B) 1960s
C) late 1950s
D) early 1900s

Question 13

Support for the view that cancer is not simply a genetic disorder comes from

A) studies of the impact of carcinogens
B) research on the cancer rates of migrating populations
C) the effects of diet
D) all of the above

Question 14

Research on immune activity and cancer survival

A) has been focused mostly on NK activity
B) has found support for higher NK activity being beneficial
C) has found support for lower NK activity being beneficial
D) all of the above

Question 15

Which of the following is true about the impact of psychosocial factors on cancer

A) psychosocial factors are irrelevant
B) animal studies support the relevance of psychosocial factors
C) research on cervical cancer has not provided any evidence of impact
D) only cancers without viral etiology can be affected

Question 16

The concept of cancer immunoediting refers to the fact that cancer cells

A) evolve to counteract immune attack
B) are eliminated by well orchestrated immune attack
C) are capable of metastsis
D) none of the above

Question 17

Which of the following is a false statement

A) cancer causes neurological disorders
B) Burkitt's lymphoma is caused by a virus
C) most cancers are caused by viruses
D) inflammation can promote cancer growth

Question 18

Psychosocial treatment for cancer patients

A) has been proven to increase longevity by the work of Speigel
B) is not beneficial according to Andersen's research
C) appears to improve mental well-being
D) is a wasteful according to Fox

Question 19

Which of the following is true

A) a "fighting spirit' accelerates cancer progression
B) low social support predicts more rapid cancer progression in men
C) social support protects against the occurrence of cancer
D) stressful life events are strongly associated with cancer diagnosis

Question 20

A recessive cancer gene also known as the guardian of the genome is

A) p53
B) BRAF
C) JAK2
D) GATA3

Question 21

Which of the following is true in the case of rheumatoid arthritis

A) onset is always gradual
B) psychosocial stress has not been found to have an impact
C) monozygotic twins show concordances in excess of 70%
D) prevalence is affected by socioeconomic status

Question 22

HLA B27 is found in nearly 90% of individuals diagnosed with

A) paraneoplastic syndromes
B) ankylosing spondylitis
C) rheumatoid arthritis
D) none of the above

Question 23

Adverse psychosocial experiences in early life

A) are not predictive with respect to autoimmune disorders in general
B) appear to be protective against autoimmune disorders
C) increase likelihood of hospitalization in adulthood for autoimmune disorders
D) decrease the risk of autoimmune disorders in males only

Question 24

Psychosocial stress has been found to be less clearly associated with

A) multiple sclerosis
B) insulin-dependemt diabetes
C) inflammatory bowel disease
D) systemic lupus erythematosus

Question 25

Multiple sclerosis is affected by non-genetic factors including place of birth. Risk of MS associated with birth place

A) remains constant after relocation
B) changes to that typical of a new setting after relocation at any age
C) changes to that typical of a new setting after relocation at an early age
D) changes to that typical of a new setting only if relocation is sudden

Question 26

Which of the following does not increase the risk of autoimmune disorders

A) having two X-chromosomes
B) living near the equator
C) exposure to toxic chemicals like mercury
D) pregnancy

Question 27

Most prevalent among autoimmune disorders are

A) thyroid disorders
B) disorders of the joints
C) disorders affecting multiple organ systems
D) central nervous system disorders

Question 28

Autoimmune activity may be unleashed as a result of infection due to

A) molecular mimicry
B) unmasking of cryptic self-antigen
C) activation of co-stimulatory signaling
D) all of the above

Question 29

Which of the following is false in the case of SLE

A) it afflicts females most of all during the child bearing years
B) its incidence is identical across racial/ethnic groups
C) genetic predictors of risk include HLA class II molecules
D) several distinct single neuclotide polymorphisms are associated with SLE risk

Question 30

Autoimmune thyroid disease is

A) extremely rare
B) seldom associated with stressful experiences
C) typically an unremitting condition
D) none of the above

Question 31

Autoimmune attack may be initiated by a failure

A) to delete autoreactive B and T cells
B) to clear immune complexes
C) of complement fixation to antibody-bound antigen
D) all of the above

Question 32

Which of the following is true

A) SLE flares up during pregnancy
B) an early description of MS onset was associated with trauma
C) both a and b
D) none of the above

Question 33

Rheumatoid factor has been found to be

A) a highly specific marker of arthritis
B) present in well adjusted sisters of arthritic women who are not arthritic
C) absent in more than 70% of females with rheumatoid arthritis
D) high in pregnant women

Question 34

The observation that a self-antigen present in multiple organs may be the target of autoimmunity in only one organ

A) has been called autophagy
B) is prove that single genetic loci are involved
C) underscores the importance of microenvironmental triggers
D) proves that risk-associated loci must be linked to cytokine genes

Question 35

Rheumatoid arthritis has historically been linked to

A) over expression of aggression
B) failure to acknowledge anger
C) excessive independence
D) both b and c