2023, October
Mechanisms of Disease 2 - Practise Mid-term exam 2023
Question 1: Hanahan and Weinberg described ten traits (Hallmarks of Cancer) that occur frequently
during cancer development. To which hallmark does the Warburg effect relate to?
A. Avoiding immune destruction
B. Deregulating cellular energetics
C. Inducing angiogenesis
D. Tumour promoting inflammation
Question 2: To which hallmark of cancer does the loss of the Retinoblastoma protein refer to?
A. Evasion of growth suppression
B. Enabling replicative immortality
C. Sustaining proliferative signalling
D. Deregulating cellular energetics
Question 3: What is the relation between driver and passenger genes in cancer?
A. In a highly mutated tumour, mutations will most often occur at driver genes than at
passenger genes.
B. Recurrent mutations in different tumours are more likely to occur in passenger genes than in
driver genes.
C. Mutations at driver genes are often the first hit leading to cancer development.
D. Oncogenes and tumour suppressor genes are considered passenger genes.
Question 4: Genetic alterations in cancers are frequently found in the MYC proto-oncogene. Which
of the following events can lead to MYC activation?
A. Deletion of the 5th exon of the MYC gene.
B. Insertion of a single base in the coding region of the MYC
C. MYC gene amplification
D. Methylation of the MYC promoter
Question 5: Why is the incidence of prostate cancer higher in “developed countries” in comparison
to “developing countries”?
A. Alcohol consumption and obesity are more frequent in developed countries.
B. Diets in developing countries include factors that are protective for prostate cancer.
C. Prostate cancer incidence is associated with higher life expectancy.
D. The differences in incidence are due to distinct genetic backgrounds between the
populations.
Question 6: What is a major mechanism by which the Human Papillomavirus induces oncogenic
transformation?
A. Binding of E6 protein to KRAS, leading to constitutive activation of this protein.
B. Induction of chronic inflammation and consequent transformation of healthy tissues.
C. Binding of E7 protein to proteins involved in cell cycle checkpoints.
Question 7: Which DNA repair process removes nucleotide mismatches introduced by DNA
polymerases during replication?
A. Base excision repair
B. Mismatch repair
C. Non-Homologous End-Joining
D. Nucleotide excision repair
, 2023, October
Question 8: Which DNA repair mechanism repairs DNA damage introduced by cellular exposure to X-
rays such that no mutations are introduced?
A. Mismatch repair
B. Non-homologous end joining
C. Homologous recombination
D. Nucleotide excision repair
Question 9: What does the concept of “synthetic lethality” refer to?
A. The combination of standard chemotherapy and radiotherapy.
B. The targeting of two, or more, cellular mechanisms that are essential for cell survival.
C. The use of a synthetic compound that is lethal to healthy cells.
D. The use of 5-FU for the treatment of mismatch repair-deficient colorectal cancers.
Question 10: Which lifestyle-related advice would you specifically provide to a patient diagnosed
with a genetic defect in the Nucleotide-Excision Repair (NER) gene ERCC4?
A. Avoid red-meat consumption
B. Avoid a sedentary lifestyle
C. Avoid sun exposure
D. Avoid intake of oestrogen
Question 11: A young patient (30 years old) with an uveal melanoma may have a genetic
predisposition for this disease. Which gene is most likely involved in that case?
A. BAP1
B. CDKN2A
C. MLH1
D. TP53
Question 12: What is the most common inheritance pattern of hereditary cancer syndromes?
A. Autosomal dominant disease
B. Autosomal recessive disease
C. De novo mutations
D. X-linked dominant disease
Question 13: How can therapeutic intervention be influenced by the clonal composition of cancers?
A. Treatments will be most successful when they specifically target minor clones.
B. Tumours with high clonal heterogeneity are less likely to develop resistance to therapies.
C. Treatments will target ideally mutations present in all cancer clones.
Question 14: Which selection pressure is likely to be involved in the acquisition of KRAS activating
mutations in cancers?
A. The presence of BRAF activating mutations in cancer cells
B. Hypoxic environment in cancer tissues
C. Immune recognition of cancer cells
D. Anti-EGFR cancer therapy
Question 15: Solid tumours can metastasize through lymphogenic, hematogenic or local routes.
What is an example of local distribution?
A. Peritoneal metastases from ovarian carcinoma.
B. Lung and pleural metastases from colon carcinoma.
C. Supraclavicular metastasis from cervical carcinoma.
D. Liver metastases from rectal carcinoma.
Mechanisms of Disease 2 - Practise Mid-term exam 2023
Question 1: Hanahan and Weinberg described ten traits (Hallmarks of Cancer) that occur frequently
during cancer development. To which hallmark does the Warburg effect relate to?
A. Avoiding immune destruction
B. Deregulating cellular energetics
C. Inducing angiogenesis
D. Tumour promoting inflammation
Question 2: To which hallmark of cancer does the loss of the Retinoblastoma protein refer to?
A. Evasion of growth suppression
B. Enabling replicative immortality
C. Sustaining proliferative signalling
D. Deregulating cellular energetics
Question 3: What is the relation between driver and passenger genes in cancer?
A. In a highly mutated tumour, mutations will most often occur at driver genes than at
passenger genes.
B. Recurrent mutations in different tumours are more likely to occur in passenger genes than in
driver genes.
C. Mutations at driver genes are often the first hit leading to cancer development.
D. Oncogenes and tumour suppressor genes are considered passenger genes.
Question 4: Genetic alterations in cancers are frequently found in the MYC proto-oncogene. Which
of the following events can lead to MYC activation?
A. Deletion of the 5th exon of the MYC gene.
B. Insertion of a single base in the coding region of the MYC
C. MYC gene amplification
D. Methylation of the MYC promoter
Question 5: Why is the incidence of prostate cancer higher in “developed countries” in comparison
to “developing countries”?
A. Alcohol consumption and obesity are more frequent in developed countries.
B. Diets in developing countries include factors that are protective for prostate cancer.
C. Prostate cancer incidence is associated with higher life expectancy.
D. The differences in incidence are due to distinct genetic backgrounds between the
populations.
Question 6: What is a major mechanism by which the Human Papillomavirus induces oncogenic
transformation?
A. Binding of E6 protein to KRAS, leading to constitutive activation of this protein.
B. Induction of chronic inflammation and consequent transformation of healthy tissues.
C. Binding of E7 protein to proteins involved in cell cycle checkpoints.
Question 7: Which DNA repair process removes nucleotide mismatches introduced by DNA
polymerases during replication?
A. Base excision repair
B. Mismatch repair
C. Non-Homologous End-Joining
D. Nucleotide excision repair
, 2023, October
Question 8: Which DNA repair mechanism repairs DNA damage introduced by cellular exposure to X-
rays such that no mutations are introduced?
A. Mismatch repair
B. Non-homologous end joining
C. Homologous recombination
D. Nucleotide excision repair
Question 9: What does the concept of “synthetic lethality” refer to?
A. The combination of standard chemotherapy and radiotherapy.
B. The targeting of two, or more, cellular mechanisms that are essential for cell survival.
C. The use of a synthetic compound that is lethal to healthy cells.
D. The use of 5-FU for the treatment of mismatch repair-deficient colorectal cancers.
Question 10: Which lifestyle-related advice would you specifically provide to a patient diagnosed
with a genetic defect in the Nucleotide-Excision Repair (NER) gene ERCC4?
A. Avoid red-meat consumption
B. Avoid a sedentary lifestyle
C. Avoid sun exposure
D. Avoid intake of oestrogen
Question 11: A young patient (30 years old) with an uveal melanoma may have a genetic
predisposition for this disease. Which gene is most likely involved in that case?
A. BAP1
B. CDKN2A
C. MLH1
D. TP53
Question 12: What is the most common inheritance pattern of hereditary cancer syndromes?
A. Autosomal dominant disease
B. Autosomal recessive disease
C. De novo mutations
D. X-linked dominant disease
Question 13: How can therapeutic intervention be influenced by the clonal composition of cancers?
A. Treatments will be most successful when they specifically target minor clones.
B. Tumours with high clonal heterogeneity are less likely to develop resistance to therapies.
C. Treatments will target ideally mutations present in all cancer clones.
Question 14: Which selection pressure is likely to be involved in the acquisition of KRAS activating
mutations in cancers?
A. The presence of BRAF activating mutations in cancer cells
B. Hypoxic environment in cancer tissues
C. Immune recognition of cancer cells
D. Anti-EGFR cancer therapy
Question 15: Solid tumours can metastasize through lymphogenic, hematogenic or local routes.
What is an example of local distribution?
A. Peritoneal metastases from ovarian carcinoma.
B. Lung and pleural metastases from colon carcinoma.
C. Supraclavicular metastasis from cervical carcinoma.
D. Liver metastases from rectal carcinoma.
