National University NUR 510 Advanced Pathophysiology Module 2
(pdf) | 2026/2027 | Q&A | Nursing
1. A 45-year-old patient with a strong family history of breast cancer
undergoes genetic testing and is found to have a mutation in the BRCA1
gene. This gene normally functions as a:
A) Tumor suppressor gene involved in DNA repair
B) Proto-oncogene that promotes cell division
C) Oncogene that prevents apoptosis
D) DNA repair gene that enhances mutagenesis
Correct Answer: Tumor suppressor gene involved in DNA repair
Rationale: BRCA1 is a tumor suppressor gene that encodes a protein
essential for repairing double-strand DNA breaks through homologous
recombination. Loss of function mutations in BRCA1 lead to genomic
instability and increased cancer risk, distinguishing it from proto-oncogenes
or oncogenes that promote proliferation.
2. A researcher is studying a family with multiple members affected by early-
onset colorectal cancer. Genetic testing reveals a mutation in the APC gene.
This gene is classified as a:
A) Tumor suppressor gene
B) Proto-oncogene
C) Oncogene
D) DNA mismatch repair gene
Correct Answer: Tumor suppressor gene
Rationale: The APC (adenomatous polyposis coli) gene is a tumor suppressor
that normally regulates cell proliferation by controlling β-catenin levels.
,Mutations in APC lead to uncontrolled cell growth and familial adenomatous
polyposis, a condition with high colorectal cancer risk.
3. A patient with Li-Fraumeni syndrome has a germline mutation in the TP53
gene. This gene encodes a protein that functions primarily to:
A) Arrest the cell cycle and initiate DNA repair or apoptosis in response to
DNA damage
B) Promote cell cycle progression through G1/S checkpoint
C) Activate telomerase to prevent cellular senescence
D) Enhance DNA polymerase fidelity during replication
Correct Answer: Arrest the cell cycle and initiate DNA repair or apoptosis in
response to DNA damage
Rationale: The p53 protein, encoded by TP53, is a critical tumor suppressor
that responds to cellular stress by activating genes involved in cell cycle
arrest, DNA repair, and apoptosis. This "guardian of the genome" function
prevents propagation of damaged DNA.
4. Which of the following is a characteristic feature of oncogenes compared
to tumor suppressor genes?
A) Oncogenes typically require loss of both alleles for cancer development
B) Oncogenes are often activated by gain-of-function mutations
C) Oncogenes normally function to inhibit cell proliferation
D) Oncogenes are inherited in an autosomal recessive pattern
Correct Answer: Oncogenes are often activated by gain-of-function mutations
Rationale: Oncogenes are mutated or overexpressed forms of proto-
oncogenes that promote cell proliferation through gain-of-function
,mechanisms. Unlike tumor suppressors, which require biallelic inactivation, a
single mutated allele of an oncogene can drive cancer development.
5. A 60-year-old patient with a history of chronic Helicobacter pylori infection
develops gastric adenocarcinoma. The mechanism by which H. pylori
contributes to carcinogenesis is primarily through:
A) Chronic inflammation leading to increased cell proliferation and
mutagenesis
B) Direct injection of oncogenic proteins into gastric epithelial cells
C) Production of aflatoxin that damages DNA
D) Integration of viral DNA into the host genome
Correct Answer: Chronic inflammation leading to increased cell proliferation
and mutagenesis
Rationale: H. pylori infection causes chronic gastritis, which increases cellular
turnover and exposes dividing cells to mutagenic reactive oxygen species.
This inflammation-driven carcinogenesis is a classic example of how chronic
infection promotes cancer.
6. A pathologist examines a biopsy from a patient with chronic Barrett's
esophagus. The normal stratified squamous epithelium has been replaced by
columnar epithelium with goblet cells. This cellular adaptation is termed:
A) Metaplasia
B) Dysplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: Metaplasia
, Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another. In Barrett's esophagus, chronic acid reflux causes
squamous epithelium to transform into columnar epithelium, which is more
resistant to acid but carries malignant potential.
7. A patient with chronic obstructive pulmonary disease (COPD) has a biopsy
showing replacement of normal ciliated columnar epithelium with stratified
squamous epithelium in the bronchi. This change is most consistent with:
A) Squamous metaplasia
B) Squamous dysplasia
C) Squamous cell carcinoma
D) Glandular hyperplasia
Correct Answer: Squamous metaplasia
Rationale: Chronic irritation from cigarette smoke causes the normal ciliated
columnar epithelium of the airways to undergo squamous metaplasia. This
protective adaptation replaces cells more susceptible to injury but also
creates a field at risk for malignant transformation.
8. A 55-year-old patient with a 30-pack-year smoking history presents with
hemoptysis. Bronchoscopy reveals a lesion, and biopsy shows atypical
squamous cells extending through the basement membrane. This finding is
most consistent with:
A) Squamous cell carcinoma in situ
B) Squamous metaplasia
C) Invasive squamous cell carcinoma
D) Adenocarcinoma
Correct Answer: Invasive squamous cell carcinoma
(pdf) | 2026/2027 | Q&A | Nursing
1. A 45-year-old patient with a strong family history of breast cancer
undergoes genetic testing and is found to have a mutation in the BRCA1
gene. This gene normally functions as a:
A) Tumor suppressor gene involved in DNA repair
B) Proto-oncogene that promotes cell division
C) Oncogene that prevents apoptosis
D) DNA repair gene that enhances mutagenesis
Correct Answer: Tumor suppressor gene involved in DNA repair
Rationale: BRCA1 is a tumor suppressor gene that encodes a protein
essential for repairing double-strand DNA breaks through homologous
recombination. Loss of function mutations in BRCA1 lead to genomic
instability and increased cancer risk, distinguishing it from proto-oncogenes
or oncogenes that promote proliferation.
2. A researcher is studying a family with multiple members affected by early-
onset colorectal cancer. Genetic testing reveals a mutation in the APC gene.
This gene is classified as a:
A) Tumor suppressor gene
B) Proto-oncogene
C) Oncogene
D) DNA mismatch repair gene
Correct Answer: Tumor suppressor gene
Rationale: The APC (adenomatous polyposis coli) gene is a tumor suppressor
that normally regulates cell proliferation by controlling β-catenin levels.
,Mutations in APC lead to uncontrolled cell growth and familial adenomatous
polyposis, a condition with high colorectal cancer risk.
3. A patient with Li-Fraumeni syndrome has a germline mutation in the TP53
gene. This gene encodes a protein that functions primarily to:
A) Arrest the cell cycle and initiate DNA repair or apoptosis in response to
DNA damage
B) Promote cell cycle progression through G1/S checkpoint
C) Activate telomerase to prevent cellular senescence
D) Enhance DNA polymerase fidelity during replication
Correct Answer: Arrest the cell cycle and initiate DNA repair or apoptosis in
response to DNA damage
Rationale: The p53 protein, encoded by TP53, is a critical tumor suppressor
that responds to cellular stress by activating genes involved in cell cycle
arrest, DNA repair, and apoptosis. This "guardian of the genome" function
prevents propagation of damaged DNA.
4. Which of the following is a characteristic feature of oncogenes compared
to tumor suppressor genes?
A) Oncogenes typically require loss of both alleles for cancer development
B) Oncogenes are often activated by gain-of-function mutations
C) Oncogenes normally function to inhibit cell proliferation
D) Oncogenes are inherited in an autosomal recessive pattern
Correct Answer: Oncogenes are often activated by gain-of-function mutations
Rationale: Oncogenes are mutated or overexpressed forms of proto-
oncogenes that promote cell proliferation through gain-of-function
,mechanisms. Unlike tumor suppressors, which require biallelic inactivation, a
single mutated allele of an oncogene can drive cancer development.
5. A 60-year-old patient with a history of chronic Helicobacter pylori infection
develops gastric adenocarcinoma. The mechanism by which H. pylori
contributes to carcinogenesis is primarily through:
A) Chronic inflammation leading to increased cell proliferation and
mutagenesis
B) Direct injection of oncogenic proteins into gastric epithelial cells
C) Production of aflatoxin that damages DNA
D) Integration of viral DNA into the host genome
Correct Answer: Chronic inflammation leading to increased cell proliferation
and mutagenesis
Rationale: H. pylori infection causes chronic gastritis, which increases cellular
turnover and exposes dividing cells to mutagenic reactive oxygen species.
This inflammation-driven carcinogenesis is a classic example of how chronic
infection promotes cancer.
6. A pathologist examines a biopsy from a patient with chronic Barrett's
esophagus. The normal stratified squamous epithelium has been replaced by
columnar epithelium with goblet cells. This cellular adaptation is termed:
A) Metaplasia
B) Dysplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: Metaplasia
, Rationale: Metaplasia is the reversible replacement of one differentiated cell
type with another. In Barrett's esophagus, chronic acid reflux causes
squamous epithelium to transform into columnar epithelium, which is more
resistant to acid but carries malignant potential.
7. A patient with chronic obstructive pulmonary disease (COPD) has a biopsy
showing replacement of normal ciliated columnar epithelium with stratified
squamous epithelium in the bronchi. This change is most consistent with:
A) Squamous metaplasia
B) Squamous dysplasia
C) Squamous cell carcinoma
D) Glandular hyperplasia
Correct Answer: Squamous metaplasia
Rationale: Chronic irritation from cigarette smoke causes the normal ciliated
columnar epithelium of the airways to undergo squamous metaplasia. This
protective adaptation replaces cells more susceptible to injury but also
creates a field at risk for malignant transformation.
8. A 55-year-old patient with a 30-pack-year smoking history presents with
hemoptysis. Bronchoscopy reveals a lesion, and biopsy shows atypical
squamous cells extending through the basement membrane. This finding is
most consistent with:
A) Squamous cell carcinoma in situ
B) Squamous metaplasia
C) Invasive squamous cell carcinoma
D) Adenocarcinoma
Correct Answer: Invasive squamous cell carcinoma
