1.

These are controlled via the complex and largely cryptic interplay between random and
deterministic factors that include genetic programming, environmental stresses, lifestyle,
cellular countdown clocks and molecular repair processes.
A. Aging
B. Longevity
C. Aging and longevity
D. Lifespan

Harpers pg 766

Also: The question uses the word, “these” (not this) so more than one option is involved.

2. What is the turnover time required to replace intercostal skeletal muscle?

A. 15 years
B. 100 years
C. 39 days
D. 9 years

Harpers pg 757

3. It hypothesizes that the changes associated with old age and death itself reflect the
accumulation of damage over time.
A. Longevity
B. Wear and tear theory of aging
C. Lifespan
D. Mitochondrial theory of aging

Harpers pg 756
4. Which of the following examples of hydrolytic damage to biological macromolecules DO NOT
match?
A. Asparagine – abasic site
B. Cytosine – Uracil
C. Glutamine – Glutamate
D. Asparagine – Aspartate

Harpers pg 757

Also: There are two options with Asparagine, so you can assume that one of them is wrong
and the other is correct.

5. An enzyme that protects the cell by converting superoxide is a

A. Kinase
B. Dismutase
C. Ligase
D. Hydrolase

Harpers pg 762
 Superoxide  (superoxide dismutase)
Hydrogen peroxide  (catalase)
6. It can lead to the formation of protein-protein cross-links.
A. Protein glycolysis
B. Protein glycans
C. Protein glycation
D. Protein glucosylation

Harpers pg 761

Also: Glycolysis is the degradation of sugar; proteoglycans are sugar molecules with
attached protein

7. The process of aging can be slowed by ______.

A. Better nutrition
B. Improved living conditions
C. Adequate sleep
D. All of the above
8. Which of the following is consistent with a model for aging in which stresses leading to DNA
damage cause senescence and aging?
A. The DAF-16 protein of C. elegans is involved in the activation of stress responses.
B. Dietary restriction in mammals reduces the production of DNA-damaging free radicals in
the mitochondria.
C. Werner’s syndrome is a premature aging illness, possibly caused by a defect in DNA
repair.
D. All of the above are consistent with a model for aging based on DNA damage.

Harpers pg 766
 Harpers pg 742

Harpers pg 755

9. Which of the following is always the longest?

A. Life expectancy at birth
B. Lifespan
C. Life expectancy at a specified age
D. There is no way of knowing
10. Which of the following cell types has the longest turnover?
A. Intestinal epithelium
 B. Leukocyes
C. Cardiomyocytes
D. Adipocytes

See No. 2

11. It is a relatively weak nucleophile.

A. Blood
B. Plasma
C. Water
D. Lymphocytes

Harpers pg 756

12. Which of the following is NOT a role or characteristic of mitochondria in aging?

A. The efficient production of ATP is essential to cell vitality
B. It plays a central role in programmed cell death
C. It lacks the capacity to repair damage to their DNA
D. It has nothing to do with the biochemistry of aging

Harpers pg 760
13. Which of the following are toxic byproducts of life in an aerobic environment?
A. Generation of hydroxyl radical by the Haber-Weiss reaction
B. Generation of hydroxyl radical via the Fenton reaction
C. Types of reactive oxygen species are encountered in non-living cells
D. A and B only

Harpers pg 758

14. What is the major source of reactive oxygen species in most mammalian cells?
A. Leakage from the electron transport chain
B. Apoptosis
C. Mitochondria
D. Cytochrome P450

Harpers pg 760

15. Which of the following is NOT affecting the reactive oxygen species?
A. Respiration
B. Proteins
C. Chemically prolific
D. Chain reactions multiply the destructiveness of ROS

Harpers pg 758
16. A term referring to the product formed when 2 compounds combine together with nucleotide
bases , polyunsaturated fatty acids, and other biological compounds possessing multiple double
bonds.
A. Adducts
B. Abducts
C. Deducts
D. Adducted

Harpers pg 758

17. Which of the following has the CORRECT pairing of genes encoded by the genome of human
mitochondria?
A. rRNA = 12S, 16S, rRNA
B. tRNA = ND 1-6, ND 4L
C. Subunits of cytochrome oxidase = ATPase 6, ATPase 8
D. Subunits of NADH-ubiquitone oxidoreductase = cytochrome b

Harpers pg 760
18. It is the key participant in apoptosis.
A. Cytochrome P450
B. Mitochondria
C. Free radicals
D. UV radiation

Harpers pg 760

19. Which of the following compounds has the effort to buttress the body’s ability to neutralize ROS
and slow aging?
A. Glutathione
B. UV radiation
C. Fenton reaction
D. Nitric oxide

Harpers pg 762

20. It is used to track the number of times each somatic cell divides.
A. Telomeres
B. Okazaki fragments
C. Chromosomes
D. Telomerase

Harpers pg 765

21. Which of the following is not a major feature of cancer cells:

A. Self-sufficiency in growth signaling
 B. Evasion of growth suppression
C. Non-invasion of local tissues
D. Resistance to apoptosis

Harpers pg 723

Invasion, not non-invasion

22. DNA damage is vital in the mechanism of carcinogenicity. Which of the following best describes
DNA damage caused by radiant energy?
A. Formation of purine dimers
B. Formation of purinic and pyrimidinic sites
C. Formation of cross-linking of DNA strands
D. Formation of single strand breaks only

Harpers pg 724

Pyrimidine dimers, not purine dimers

Formation of apurinic and apyrimidinic sites, not purinic and pyrimidinic sites

Formation of single or double strand breaks, not only single strand breaks

23. This class of carcinogen acts by introducing novel genes into normal cells.
A. Radiant energy
B. Chemicals
 C. Oncogenic bacteria
D. Oncogenic viruses

Harpers pg 724

24. Which of the following viruses cause cancer by incorporating viral genetic material into the
genome of the host cell after reverse transcription of the viral RNA to viral DNA?
A. Human herpesvirus Type 1
B. Human T-cell leukemia virus Type 1
C. Human papilloma virus
D. Epstein Barr virus

Harpers pg 726

Note:

It is the RNA viruses that use reverse transcription to insert viral RNA.

DNA viruses are usually carcinogenic because they use downregulation of p53 and RB (and
their products).

25. Which virus causes Kaposi sarcoma?

A. Human herpesvirus Type 1
B. Human T-cell leukemia virus type 1
 C. Human papilloma virus
D. Epstein Barr virus

See table in No. 24

26. Oncogene activation is one of the central processes that explains the exponential growth of
tumor cells. It can be activated by various mechanisms. Which mechanism is correctly defined?
A. Gene amplification – an increase in the number of copies of a gene with associated
increase in the RNA and protein made from that gene
B. Chromosomal translocation – A piece of a chromosome is split off, resulting in a gene
product, small GTPase
C. Enhancer insertion – insertion of a viral suppressor gene
D. Promoter insertion – insertion of a viral initiator gene

Harpers pg 726

27. The mechanism of oncogene activation is best seen in:

A. Neuroblastoma
B. Retinoblastoma
C. Burkitt Lymphoma
D. Squamous cell cancer of the skin

See table in No. 26

28. Which of the following does not describe the gatekeeper function of the tumor suppressor
gene?
A. Controls cell proliferation
B. Acts to regulate the cell cycle
C. Recognizes DNA damage
D. Acts to regulate apoptosis

Harpers pg 728
29. Which of the following best describes the tumor suppressor genes?
A. Their mutation is not inherited
B. They often show strong tissue preference
C. Mutation in one allele is sufficient to cause cancer
D. They are known as a gain in function of a gene

Harpers 728

30. Which of the following oncogenes encode small GTPases?

A. P53
B. RAS
C. MYC
D. RB

Harpers pg 728
31. Which of the following is true of miRNAs?
A. miRNAs are short double-stranded RNA molecules
B. miRNAs are tumor suppressors ?
C. miRNAs are either downregulated or upregulated in various types of cancer
D. miRNAs play a role in apoptosis

Harpers pg 728

32. Growth factors and abnormalities of their receptors play major roles in cancer development.
Which of the following statements of growth factors are FALSE?
A. Growth inhibitory factors also exist
B. A number of growth factors have tyrosine kinase activity
C. The kinase activity of growth factors occurs in the external domain
D. Growth factors interact with specific receptors to stimulate specific signaling pathways

Harpers pg 730
33. p53 is one of the notable tumor suppressor genes. Which of the following statements hold true
about p53?
A. p53 downregulates transcription of genes that delay transit through the cycle
B. Mutations in p53 can result in neurofibromatosis
C. Activation of the p53 gene upregulates transcription of BAX
D. p53 is mutated in 75% of human tumors

Harpers pg 728, 734

34. The guardian of the genome refers to:
A. MYC
B. RAS
C. RB
D. p53

See No. 34

35. Genomic instability refers to a high frequency of mutations within the genome of a cellular
lineage. This condition has played a role in carcinogenesis. Microsatellite instability best
described as:
A. It involves expansion of microsatellites *
B. It occurs more often than chromosomal instability
C. Chromosomal and microsatellite instability are mutually exclusive
D. Microsatellite instability involves gain or loss of mismatch repair genes

Harpers pg 731

36. Main proteins of apoptosis:

A. Proteases
B. Phospholipases
C. Nucleases
D. Caspases

Harpers pg 733

37. Major effector of cell damage

A. Caspase-9
B. Caspase-3
C. Procaspase-8
D. Procaspase-9
 Harpers pg 734

38. Which is an example of an anti-apoptotic gene?

A. BAX
B. BAD
C. BCL-2
D. BID

See No. 37

39. The mitochondrial pathway of apoptosis can be initiated by exposure to reactive oxygen species,
DNA damage and other stimuli. The initiator of the mitochondrial pathway is:
A. Caspsae-8
B. Caspase-9
C. Procaspase-3
D. Procaspase-8

Harpers pg 734

40. Apoptosis is a highly regulated pathway that helps in the control of carcinogenesis. Which
statement is true of apoptosis?
 A. Apoptosis results in release of intracellular contents into its surrounding
microenvironment
B. Apoptosis occurs on exposure to external agents
C. Many hydrolytic enzymes (proteases, phospholipases, nucleases) are involved in
apoptosis
D. It is genetically programmed

Harpers pg 733

41. Angiogenesis makes sure that tumor cells get adequate blood supply for continued tumor
growth. Which reflects angiogenesis?
A. Decreased VEGF
B. Increased HIF-1
C. Decreased TGF-β
D. Increased endostatin

Harpers pg 736
 Factors that promote angiogenesis:

 HIF-1
 VEGF
 TGF-β
 Placental growth factor

Factors that inhibit angiogenesis:

 Angiogenin
 Endostatin
42. The earliest event in metastasis is:
A. Intravasation
B. Detachment of tumor cells
C. Migration
D. Extravasation

Harpers pg 736

43. Many cancers are associated with the abnormal production of enzymes, proteins and hormones
called the tumor biomarkers. Which conditions causes an increase in carcinoembryonic antigen?
A. Hepatocellular carcinoma
B. Colorectal carcinoma
C. Germ cell tumor
D. Multiple myeloma
 Harpers pg 739

44. Which of the following is an example of a monoclonal antibody?

A. Imatinib
B. Trastuzumab
C. Denosumab
D. Bevacuzimab *

Harpers pg 740
45. Responsible for the deaths of patients who have cancer:
A. Pneumonia
B. Cardiac arrest
C. Metastasis
D. Rapidly proliferating

Harpers pg 736

46. Which of the following are correctly matched?

A. Hepatitis B – Kaposi Sarcoma
B. Ebstein-Barr Virus – Burkitt Lymphoma
C. Human papillomavirus – Adult T-cell leukemia
D. Hepatitis C – B-cell Lymphoma

See No. 24

47. Which of the following genes is associated with the development of many early-onset
adenomatous polyps which are the immediate precursors of colorectal cancer?
A. APC gene
B. BRCA 1 gene
C. p53
D. RB 1

Harpers pg 732
48. A 33-year-old woman sought consult because of a lump in her breast noted on self-breast
examination. Family history reveals that both her mother and aunt has breast and ovarian
cancer. Given this presentation, her attending physician suspected that the patient may have a
hereditary cancer condition. Which one of the following genes, when mutated, is implicated in
breast and ovarian cancer?
A. p53
B. APC
C. MSH-2
D. BRCA-1

See No. 47

49. A 28-year-old male was brought to the Emergency Room because of jaundice. He had associated
sensorial changes, itchiness, anorexia, weight loss, and decreased urine output. Physical
examination shows an enlarged liver span. The oncologist is considering hepatocellular
carcinoma. Which of the following tumor biomarkers should she consider?
A. Prostate-specific antigen
B. Carcinoembryonic antigen
C. Human chorionic gonadotropin
D. Alpha-fetoprotein

Harpers No. 739

50. With the increasing incidence of cancer and having a family history of cancer, a 21-year-old
woman came to your clinic worried that she may eventually get the disease. She asks you about
preventive measures against cancer. What is the best advice you can give her?
A. She may take non-alcoholic sodas
B. She should undergo routine tests
C. Exercising regularly curtails her risk of developing cancer
D. Sex doesn’t increase her risk of malignancy
 Non-alcoholic sodas still contain sugar. Routine tests are screening, not primary prevention.
Sex can increase risk of malignancy, due to increased risk of exposure to HPV and HIV.

51. Cancer cells use a number of strategies to develop drug resistance. Which of the following is not
a mechanism of drug resistance?
A. Increases drug efflux from the cell
B. Decreased drug activation
C. Decreased drug target expression
D. Drug inactivation

Harpers pg 741