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Name: __________________________ Date: _____________
1. In an otherwise normal cell, what happens if one mistake is made during DNA
replication?
A) Nothing; mistakes just happen.
B) A cell cycle checkpoint detects the error and pauses the cell cycle so the error can
be corrected.
C) The cell will begin to divide out of control, forming a malignant tumor.
D) Mistakes are never made during DNA replication.
E) The mutation will be inherited by the individual's offspring.
2. Why does wearing sunscreen reduce cancer risk?

A) Sunscreen can repair damaged DNA.
B) Sunscreen can activate checkpoints in skin cells.
C) Sunscreen can reduce the chance of mutations caused by exposure to UV radiation
present in sunlight.
D) It does not reduce cancer risk; sunscreen causes mutation and actually increases
cancer risk.
E) Sunscreen can prevent cells with mutations from being destroyed.
3. A mutation can cause a change _____.

A) in the amino acid sequence of a protein
B) in the shape of a protein
C) in the way the cell cycle is regulated
D) that is beneficial to the cell
E) all of these
4. At which point does a mutation exert its potentially dysfunctional effects in a cell?
A) during DNA replication
B) during protein translation
C) after a protein is produced
D) during DNA transcription
E) only during cell division
Page 1
5. DNA mutations can arise from uncorrected errors in DNA replication, inheritance, and
_____.
A) a poor diet lacking in vitamins and minerals
B) chronic sleep deprivation
C) environmental insults
D) catching an influenza virus from a person with mutated genes
E) abnormal cell division
6. Look at the mutagens illustrated in Infographic 10.3. Of these, which are most easily
avoidable, and which are not avoidable?
7. Are all mutations bad? Explain your answer.
8. What are some differences and some similarities between tumor suppressor genes and
oncogenes?
9. What would you say to a niece if she asked you how she could reduce her risk of breast
cancer? (Assume there is no family history of breast cancer.) How might each of your
suggestions reduce her risk?
10. Why is age a risk factor for cancer?
11. What is the role of BRCA1 in normal cells?
12. A 28-year-old male graduate student was born with an inherited predisposition to colon
cancer due to a mutation in a DNA repair gene called MLH1. He has recently been
diagnosed with colon cancer. At the cellular and genetic level, was he born with colon
cancer? Was he born with a predisposition to colon cancer? At birth, were cells in his
colon genetically identical to cells in his liver? Now that he has colon cancer, are his
cancer cells genetically identical to his normal colon cells? Explain your answers.
13. People like Lorene Ahern have inherited a mutated version of BRCA1. Why does this
mutation pose a problem? Why are these people at high risk of developing breast cancer
when they still have a functional BRCA1 allele? Describe how the protein encoded by
normal BRCA1 compares to that encoded by mutant alleles of BRCA1.
Page 2
14. Nellie has a family history similar to Lorene Ahern's. Nellie's mother died at an early
age from breast cancer, as did her maternal aunt (her mother's sister). Nellie is not yet
35 but has started having annual mammograms. She has also been tested for BRCA1 and
BRCA2 mutations. She has a BRCA2 mutation and is considering prophylactic surgery.
Her younger sister, Anne, doesn't want to know the results of Nellie's genetic testing
because if Nellie has a BRCA2 mutation, then there is a chance that Anne could have
inherited the same mutation from their mother. Does Nellie or Nellie's doctor have an
obligation to tell Anne about the test results? What about Nellie's older brother? Should
he be told? There are personal and medical benefits and risks to consider here.
15. José is a 32-year-old landscaper living in Phoenix, Arizona. He and his 64-year-old
father, Ray, were both diagnosed with metastatic melanoma within 2 months of one
another. Both had their tumors biopsied to look for potential targets for targeted therapy.
The BRAF proto-oncogene from each of their tumors was sequenced. Their cancer cells
were analyzed for expression of PD-L1 (see Infographic 10.7). The data are shown in
the table below.
a. Transcribe and translate the BRAF gene sequences from José's and Ray's tumors.
What amino acid is at position 600 in each?
b. Zelboraf is a drug that stops division of metastatic melanomas by blocking the
activity of a mutant (oncogenic) BRAF protein that has a glutamic acid at position 600
(the proto-oncogene has a valine at position 600). Keytruda is an antibody drug that
blocks the interaction between PD-L1 on cancer cells and its binding partner (PD-1) on
immune cells (see IG 10.7). Given their individual tumors, what treatment(s) are
available for José and for Ray? Consider both targeted and traditional therapies and
justify your answer.
c. From the information presented, do you think this is more likely to be a case of
inherited cancer, or two cancers that just happened to occur in these two family
members? Explain your answer, and consider other risk factors that may be involved for
José and Ray.
Page 3
16. If you wanted to change your lifestyle to reduce your risk of developing cancer, what
specific steps could you take with respect to each of the following? Be as specific as you
can. Take your age and gender into consideration as you consider each factor.
a. alcohol consumption
b. sun exposure
c. tobacco use
d. exposure to pesticides
e. meat preparation (cooking method)
17. A mutation causes a substitution of one amino acid for another in the encoded protein.
What type of mutation is this?
A) silent
B) nonsense
C) missense
D) insertional frameshift
E) deletional frameshift
18. Which of the following is a known mutagen?

A) cigarette smoke
B) sunlight
C) charred meat cooked at high temperatures
D) X-rays
E) All of the answers are known mutatgens.
19. Why does wearing sunscreen reduce cancer risk?

A) Sunscreen can repair damaged DNA.
B) Sunscreen can activate checkpoints in skin cells.
C) Sunscreen can reduce the chance of mutations caused by exposure to UV radiation
present in sunlight.
D) It doesn't; sunscreen causes mutation and actually increases cancer risk.
E) Sunscreen can prevent cells with mutations from being destroyed.
20. In an otherwise normal cell, what happens if one mistake is made during DNA
replication?
A) Nothing; mistakes just happen.
B) A cell cycle checkpoint detects the error and pauses the cell cycle so the error can
be corrected.
C) The cell will begin to divide out of control, forming a malignant tumor.
D) A checkpoint will force the cell to carry out apoptosis, a form of cellular suicide.
E) The mutation will be inherited by the individual's offspring.
Page 4
21. Which of the following can cause cancer to develop and progress?
A) a proto-oncogene
B) an oncogene
C) a tumor suppressor gene
D) a mutated tumor suppressor gene
E) both an oncogene and a mutated tumor suppressor gene
F) both an oncogene and a tumor suppressor gene
22. Which form of breast cancer treatment is the least specific for the cancer cells?
A) chemotherapy
B) targeted therapy
C) immunotherapy
D) lumpectomy
23. A woman with a BRCA1 mutation

A) will definitely develop breast cancer.
B) is at increased risk of developing breast cancer.
C) must have inherited it from her mother because of the link to breast cancer.
D) will also have a mutation in BRCA2.
E) None of the answers are correct.
24. Which of the following family histories most strongly suggests a risk of inherited breast
cancer due to BRCA1 mutations?
A) many female relatives who were diagnosed with breast cancer in their 70s
B) many relatives with skin cancer
C) many relatives diagnosed with skin cancer at an early age
D) many female relatives diagnosed with breast cancer at an early age
E) many female relatives with both early breast cancer and ovarian cancer
25. Which of the following women would be most likely to benefit from genetic testing for
breast cancer?
A) a 25-year-old woman whose mother, aunt, and grandmother had breast cancer
B) a healthy 75-year-old woman with no family history of breast cancer
C) a 40-year-old woman who has a cousin with breast cancer
D) a 55-year-old woman whose older sister was just diagnosed with breast cancer
E) All women can benefit from genetic testing for breast cancer.
26. Define apoptosis. Why is apoptosis important?
Page 5
27. What is the purpose of the cell cycle checkpoints? What happens when a cell no longer
responds to these checkpoints?
28. Define metastasis. Do all cancers enter this stage?
29. Where do cancer cells differ in their cell cycle from normal cells?
30. Dermatologists looking for skin cancer usually don't worry about circular moles with
smooth edges, but they are concerned about moles with irregular shapes. What does the
shape of the mole tell the dermatologist about what is likely going on at a cellular level?
31. Doctors always hope to detect cancer in the early stages of tumor formation. What are
the problems associated with detecting cancer in the late stages?
32. Why do cancer patients undergoing chemotherapy and radiation therapy lose their hair?
33. Explain how radiation leads to apoptosis.
34. Explain why radiation therapy is NOT appropriate treatment for a metastasized cancer.
35. Most adults survive chemotherapy, but unborn children frequently do not. Why do you
think that is? Specifically, what is the difference between an adult and an unborn child
that would account for this difference?
36. You are trying to discover a new way to treat breast cancer that would specifically target
cancerous cells and not normal cells. You notice that cancerous breast cells express a
specific protein on their membranes, which normal cells do not express. Can you think
of a way to use this fact to your advantage?
37. List three types of genetic mutations that may occur.
38. Doctors will screen individuals with a strong family history of breast cancer for
mutations in the BRCA1 gene. Explain why someone who does not test positive for a
mutation can still be at risk for a BRCA1 mutation and breast cancer.
Page 6
39. How often do mistakes occur when copying DNA? Do all these mistakes appear in the
final, copied DNA?
40. Why should pregnant women never be given X-rays?
41. How can changing the DNA sequence change a protein's function?
42. Which type of mutation do you think is most harmful to a cell, a base substitution (e.g.,
an A is replaced by a G) or a base insertion (e.g., ACG becomes ACTG)? Why?
43. What is a mutagen?
44. What are the three main ways a person can acquire a mutation in their DNA?
45. For a mutation to become an allele it must occur in one of three possible locations. What
are those three?
46. Even though DNA repair enzymes correct most errors, approximately 1 in every one
billion nucleotides still contains an error. The human genome, however, is 3 billion
bases long. In an average adult, there are 50 trillion to 100 trillion cells, all of which
contain these 3 billion bases, and these trillions of cells divide all the time. Given all
this, why do you think people don't have cancer more often?
47. Explain how alterations of the BRCA proteins could lead to cancer.
48. If one has an inherited allele known to be linked to an increased risk of cancer, what are
some suggestions to lower the risk?
49. What is a carcinogen?
50. List at least five carcinogens.
Page 7
51. You have just had a BRCA analysis, in which your doctor ran tests to check for
abnormal BRCA alleles. You learn that you have a BRCA allele that has been associated
with cancer. Neither of your parents has this allele. How could this occur?
52. You've just received the results of your BRCA analysis (a check for abnormal BRCA
alleles). The results say that you carry one normal BRCA1 allele and one BRCA1 allele
associated with cancer, and two BRCA2 alleles that are associated with cancer. Does this
mean you will get cancer? Explain.
53. DNA insertions can have significant effects on an organism. How can adding DNA
cause an impact?
54. A woman who desires children but is about to undergo chemotherapy is told by her
doctor that she should consider having several of her eggs removed and stored for future
use. Why might a doctor encourage her to do this?
55. Under normal conditions, when a cell has too much DNA damage to be repaired, what
happens?
56. Explain the difference between an oncogene and a proto-oncogene. How is this related
to cancer?
57. There are two classes of genes that, when mutated, frequently lead to cancer. Which
class of these two types of genes promotes cell division and differentiation, and which
class of genes inhibits the cell cycle in order to make repairs?
58. What role does an oncogene play in generating a tumor?
59. Why do people become more likely to develop cancer as they age?
60. You are accidentally exposed to high levels of radiation in the upper part of your body
that damaged your DNA and caused you to develop throat cancer. You are concerned
that you will pass these mutations on to your children. Should you be concerned? Why
or why not?
Page 8
61. “A person who inherits a mutation in a cell cycle regulatory gene will develop cancer.”
Is this a true statement? Explain.
62. You have a family history of breast cancer and your doctor has just confirmed that you
have several alleles that have been linked to cancer. Is there anything you can do to
avoid cancer? Explain.
63. How can mutations in BRCA1 lead to an accumulation of mutations in the cell?
64. What is the role of estrogen in a woman's risk of developing breast cancer, especially if
she has a mutation in one of her BRCA genes?
65. Explain the effect of environmental mutagens in determining whether a woman with a
mutation in one of her BRCA genes will actually get cancer.
66. Women with mutations in their BRCA genes who have developed cancer may choose to
have their breasts, ovaries, or both removed. Does this eliminate or just reduce the risk
of cancer coming back? Explain your answer.
67. If a man inherits a mutation in one of his BRCA genes, is he at increased risk for cancer
compared with men who inherit normal copies of BRCA genes? Is he at a lower or
higher risk for cancer than a woman with the same mutation? Explain your answers.
68. If a cell sustains irreparable DNA damage during the S phase of the cell cycle the cell
will undergo _________.
69. Chemotherapy and radiation target both __________ and ___________ cells.
70. Mutations in a gene can lead to the development of new ______ for the gene.
Page 9
71. A specific gene, called GRAB, prevents a cell from entering mitosis if there are any
signs of DNA damage. This means that GRAB would be a type of
A) cell cycle checkpoint.
B) tumor-causing gene.
C) non-hereditary gene.
D) growth signal.
E) mutation.
72. Apoptosis
A) occurs in normal cell division.
B) contains several checkpoints.
C) is programmed cell death.
D) is a mechanism of cell repair.
E) ensures equal DNA in cytokinesis.
73. Cell cycle checkpoints detect and control

A) DNA content.
B) signals that promote cell division.
C) DNA damage.
D) proper chromosome alignment.
E) All of the above.
74. Cell division is usually kept under control by

A) apoptosis.
B) a single checkpoint in cytokinesis.
C) several checkpoints in the cell cycle and by apoptosis.
D) suicide checkpoints.
E) cell cycle repair mechanisms.
75. At the G2 checkpoint, cells pause to

A) wait until there is a need for them to divide.
B) make sure that all chromosomes have been copied and are undamaged.
C) make sure that the spindle is fully formed.
D) wait until all chromosomes are lined up properly.
E) make sure that the homologous chromosomes are wrapped around each other.
Page 10
76. At the G1 checkpoint, cells pause to
A) wait until there is a need for them to divide.
B) make sure that all chromosomes have been copied and are undamaged.
C) make sure that the nuclear envelope is intact.
D) make sure that all chromosomes are lined up properly.
E) make sure that the homologous chromosomes are wrapped around each other.
77. Programmed cell death is called

A) apoptosis.
B) endocytosis.
C) cytokinesis.
D) cytolysis.
E) mitosis.
78. Proteins scan chromosomes for damage during the

A) G1 checkpoint.
B) beginning of the synthesis phase.
C) apoptosis phase.
D) G2 checkpoint.
E) metaphase checkpoint.
79. There are several points during the cell cycle when the cell will check to be sure
everything is progressing normally, without mistakes, and confirm that the cell should
continue to the next phase of the cycle. When do these “cell cycle checkpoints” occur?
A) between G1 and S, and between G2 and mitosis
B) between G1 and G2, between G2 and mitosis, and during mitosis
C) between G1 and S, between G2 and mitosis, and during mitosis
D) between S and G2, between G2 and mitosis, and during cytokinesis
E) during S and cytokinesis
80. The cell cycle checkpoints are responsible for checking that the cell is prepared to move
on to the next stage in cell division. For example, the G1-to-S checkpoint ensures that
the cell has all the components and signals necessary to go on to S phase and that the
appropriate signals are present. The G2 checkpoint checks whether the
A) chromosomes have been separated properly.
B) DNA has been replicated properly.
C) chromosomes have aligned properly.
D) DNA has decondensed.
E) cell organelles have duplicated properly.
Page 11
81. What might be the result of a mutation in one of the proteins responsible for the G1
checkpoint?
A) The cell would continue to S phase without signals to divide being present.
B) The cell would divide uncontrollably.
C) The cell would move through the cell cycle more rapidly than normal.
D) Nothing; one of the other checkpoints would make up for its absence.
82. If a cell is irreparably damaged, it undergoes programmed cell death, called

A) apoptosis.
B) cell division.
C) metastasis.
D) cytokinesis.
E) mitosis.
83. Cancer consists of too much

A) cell division.
B) translation.
C) apoptosis.
D) toxin production.
E) DNA replication.
84. Which of the following help(s) to prevent cancer?

A) cell cycle checkpoints
B) apoptosis
C) DNA repair enzymes
D) regulation of the cell cycle
85. Cancer is
A) an organ that becomes malignant.
B) a metastatic cell.
C) unregulated apoptosis.
D) unregulated cell division.
E) regulated cell division.
Page 12
86. Cancer may be caused by
A) a cell cycle checkpoint problem.
B) failure in apoptosis.
C) unregulated cell division.
D) failure in DNA repair mechanisms.
87. Cell division in cancerous tumors

A) proceeds until apoptosis.
B) is regulated by the cell cycle.
C) progresses at a predicted rate.
D) is regulated by checkpoints.
E) accumulates DNA damage.
88. The medical condition of cells growing out of control is called

A) cytokinesis.
B) cancer.
C) metastasis.
D) apoptosis.
E) tumorization.
89. Cells that have accumulated too much chromosomal damage can
A) lead to the formation of a tumor.
B) lead to cancer.
C) cause the cell to destroy itself (apoptosis).
D) lead to uncontrolled cell division.
90. How could a cancerous cell evade apoptosis?

A) The cell responds to environmental signals.
B) The cell goes through the cell cycle too quickly for apoptosis to occur.
C) The cell has a mutation in a checkpoint protein.
D) The cell is stuck in one phase of the cell cycle.
E) Cancerous cells can't evade apoptosis.
Page 13
91. What causes cancer to kill people?
A) Cancer cells accumulate DNA mutations.
B) Tumors can spread to other parts of the body.
C) Cancer cells crowd out normal cells and disrupt organ functions.
D) Cancer cells have uncontrolled cell division.
E) Tumors cells contain abnormal DNA
92. True or False: Chemotherapy treatments only kill the cancer cells and don't affect
normal, healthy cells.
A) True
B) False
93. Chemotherapy is used in the battle against

A) breast cancer.
B) colon cancer.
C) skin cancer.
D) prostate cancer.
94. Chemotherapeutics act on

A) all dividing cells.
B) cancer cells.
C) all cells.
D) apoptotic cells.
E) dividing cancer cells.
95. Radiation therapy for cancer works by

A) burning the cells, thereby killing them.
B) damaging the cell's DNA, resulting in cell death.
C) interfering with the cell's mitotic spindle.
D) dissolving the tumor through heating.
E) freezing the cells, thereby killing them.
96. Physical side-effects from chemotherapy and radiotherapy could be maximally reduced
by
A) targeting specific tumor cells.
B) reducing amounts of drug or radiation.
C) reducing exposure time.
D) better detection methods.
E) using multiple drugs with radiation.
Page 14
97. Side-effects of chemotherapy, such as vomiting, hair loss, and bruising occur because
A) cancerous cells release toxins that poison the rest of the body.
B) cancerous cells have overtaken normal cells, causing malfunctions.
C) chemotherapeutic drugs specifically target cancerous cells.
D) chemotherapeutic drugs kill both normal and cancerous cells.
E) the body has an immune reaction to chemotherapeutic drugs.
98. Radiation and chemotherapy typically have all of the following side-effects EXCEPT
A) blurry vision.
B) nausea.
C) diarrhea.
D) vomiting.
E) hair loss.
99. Metastasis is
A) an effective form of treatment for cancer.
B) part of cell division, when chromosomes line up.
C) a state of rest for the cell, between divisions.
D) a state of active cell division.
E) the spread of cancer from one location in the body to another.
100. When cancer has spread to many areas of the body, the most common form of treatment
is
A) surgery to remove the tumors.
B) radiation directed at the tumors.
C) chemotherapy drugs injected into the bloodstream.
D) heat therapy directed at the tumors.
E) cold therapy directed at the tumors.
101. What is the name of the organization that oversees the quality control of pharmaceutical
drugs produced in the United States?
A) National Institutes of Health (NIH)
B) Environmental Protection Agency (EPA)
C) Federal Drug Administration (FDA)
D) Centers for Disease Control (CDC)
E) U.S. Department of Agriculture (USDA)
Page 15
102. Why would a drug that specifically kills rapidly dividing cells make a good
chemotherapeutic agent?
A) The drug would only target cancer cells.
B) The drug would not affect normal cells.
C) Cancer cells divide more rapidly than most normal cells.
D) Unlike radiation therapy, the drug would target a specific population of cells.
E) Cancer cells are the only cells dividing in a mature human.
103. Most chemotherapy drugs are effective because they

A) increase protein production.
B) increase the immune system response needed to fight cancer.
C) kill cancer cells only without affecting healthy cells.
D) interrupt cell division.
E) destroy the plasma membrane, thus causing cell death.
104. All of the following could be effective cancer treatments EXCEPT

A) a drug that enhances apoptosis.
B) a drug that increases DNA replication.
C) a drug that prevents formation of the mitotic spindle.
D) a drug that increases the immune system response.
E) a drug that makes cells more permeable to drugs.
105. Chemotherapy drugs interfere with

A) cell division.
B) chromosome duplication.
C) spindle formation.
D) chromosome separation during mitosis.
Page 16
106. One promising new treatment for cancer uses “angiogenesis inhibitors” such as
Avastin®. This treatment works because a growing tumor requires additional nutrients,
and thus excretes substances to encourage growth of new blood vessels to “feed” the
tumor. Angiogenesis inhibitors prevent that blood vessel growth. What might be one
benefit of this treatment over traditional chemotherapy?
A) It would not affect most dividing cells, and so it would be more specific than
traditional chemotherapy.
B) It would be able to target all tumors, and so it would be less selective than
C) It would starve cells in a tumor, which would kill them more gradually than
D) It targets only rapidly dividing cells because those are the ones that form tumors.
107. If you ran a pharmaceutical company, what would be the most effective series of steps
for your company to discover new drugs from plants and bring them to market?
A) Identify likely drug sources, test chemicals on cultured cells, select the most
effective chemical, convert chemical into a form for delivery into humans, do
clinical trials, get FDA approval for drug sales, scale up drug supply.
B) Identify likely drug sources, select the most effective chemical, convert chemical
into a form for delivery into humans, test chemicals on cultured cells, do clinical
trials, get FDA approval for drug sales, scale up drug supply.
C) Identify likely drug sources, select the most effective chemical, test chemicals on
cultured cells, convert chemical into a form for delivery into humans, do clinical
trials, scale up drug supply, get FDA approval for drug sales.
D) Get FDA approval for drug sales, identify likely drug sources, test chemicals on
cultured cells, select the most effective chemical, convert chemical into a form for
delivery into humans, do clinical trials, scale up drug supply.
E) Get FDA approval for drug sales, identify likely drug sources, test chemicals on
cultured cells, do clinical trials, select the most effective chemical, convert
chemical into a form for delivery into humans, scale up drug supply.
108. If you were going to set up a clinical trial of a new chemotherapy drug that would be
used in addition to traditional treatment for prostate cancer, who would you use as the
control group for your experiment?
A) patients with prostate cancer who received no treatment
B) patients with prostate cancer who received traditional treatment alone
C) patients with prostate cancer who were given the trial drug but no traditional
treatment
D) patients with prostate cancer who received traditional treatment plus the trial drug
E) healthy patients with no prostate cancer
Page 17
109. How many alleles for a single trait are present in each human cell?
A) 1
B) 2
C) 23
D) 46
E) 4
110. Alleles are located

A) on chromosome 17 only.
B) in random locations on chromosomes.
C) at a specific position on each of a pair of chromosomes.
D) on one chromosome of each pair.
E) on chromosomes 13 and 17.
111. What is an example of a mutation in an allele?

A) a base change in the gene coding sequence
B) a base change in the gene's regulatory regions
C) a deletion of a base within the gene
D) an insertion of a base within the gene
112. How many copies of any particular gene does an individual human have?
A) 4
B) 1
C) 2
D) 46
E) 23
113. True or False: Different versions of a gene are called alleles; a mutation in a gene can
create an allele.
A) True
B) False
114. Gene mutations can arise when nucleotides are

A) added to the gene.
B) taken away from the gene.
C) changed within the gene.
D) mismatched within the gene.
Page 18
115. An allele is
A) any section of DNA.
B) a gene.
C) a specific section of a chromosome.
D) an alternate version of a gene.
E) a pair of genes.
116. Different alleles are the result of

A) mutations in RNA sequences.
B) any change in DNA sequences.
C) changes in DNA sequence within a gene.
D) changes in the size of a chromosome.
E) any kind of radiation damage.
117. How many different alleles of a gene like BRCA1 can an individual have?
A) Several hundred, since there are hundreds of known BRCA1 alleles
B) Four: two from their father and two from their mother
C) Only two: one from their father and one from their mother
D) One for males and hundreds for females
E) One for males and two for females
118. A mutation is best described as an error in

A) DNA.
B) mRNA.
C) protein.
D) enzymes.
E) cell division.
119. Most new alleles arise via

A) large rearrangements of genes.
B) exchanges of genes during crossing over.
C) mutations in existing genes.
D) changes in DNA polymerase that alter how polymerase copies DNA.
E) changes in the beginning and ending of a gene.
Page 19
120. Bob and Linda are a newly married couple. They hope to have a child but are having
trouble getting pregnant. They visit a fertility clinic, where they receive a variety of
tests. One test shows that Bob is healthy but carries a single disease-causing allele for
CFTR (the gene that can cause cystic fibrosis), but Linda does not. This means that
A) Bob's DNA sequence for CFTR is different from Linda's.
B) Bob has two different versions of the CFTR gene.
C) Linda does not have any copies of the CFTR gene.
D) Bob is unable to ever have children.
E) Both A and B
121. There are several different alleles for flower color in carnations. One of them causes
white flowers; a different allele of the same gene causes red flowers. This means that all
of the following are true, EXCEPT
A) white carnations have different DNA sequences than red carnations.
B) white carnations and red carnations have somewhat different proteins.
C) a carnation plant could have one copy of the white allele and one copy of the red
allele.
D) a carnation plant could have two copies of the white allele and two copies of the
red allele.
122. A newly identified mutation in mice, called “darkened dorsal,” causes a dark stripe
along the mouse's back. This mutation is located at a specific location on chromosome
2. A different sequence at this same chromosomal position results in a fur color pattern
called “nonagouti.” Based on this information, darkened dorsal and nonagouti are
different
A) genes for fur color.
B) alleles for the same gene.
C) mutations of the same chromosome.
D) chromatids.
123. Which of the following is TRUE?

A) Alleles are usually harmful because they result from mutations.
B) Alleles are just different versions of the same gene.
C) Normal, healthy individuals don't usually carry alleles.
D) An individual may have one, two, or three alleles for a particular trait.
E) None of the above.
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124. What would be the best way to distinguish between two alleles and two genes?
A) Examine the proteins they produce; most genes would produce very similar
versions of the same protein, but two alleles would produce very different proteins.
B) Examine the proteins they produce; a gene produces one protein, and an allele
produces two different proteins.
C) Examine their DNA; the DNA sequences of two different alleles would be more
similar to each other than the sequences of two different genes.
D) You can't distinguish between them; there's no actual difference between alleles
and genes.
E) Determine their chromosomal location; alleles will always be on different
chromosomes, but genes will always be on different copies of the same
chromosome.
125. A mutation would most likely be inherited if it is located in a ____ cell.

A) skin
B) body
C) sperm
D) liver
126. Which sequence is the complementary DNA sequence of ATG GGC CTG?
A) ATG GGC CTG
B) TAC CCG GAG
C) TUC CCG GUC
D) TAC CCG GAC
E) TAC CCC GAC
127. Which sequence is a result of a single mismatch in DNA replication of the sequence
ATG GGC CTG?
A) ATG GGC CTC
B) AAG GGC CTC
C) TAC CCG GTC
D) TGC CCG GAG
E) TUC CCG GUC
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128. The number of errors made by DNA polymerase during DNA replication that pass
through the cell's repair checkpoints is estimated at
A) 1 in 100 bases mismatched.
B) 1 in 1000 bases mismatched.
C) 1 in 1,000,000 bases mismatched.
D) 1 in 10,000,000,000 bases mismatched.
E) 1 in 10 bases mismatched.
129. The enzyme that copies DNA makes a mistake approximately every 10,000 to 100,000
bases. Surprisingly, however, if we examine newly copied DNA, we see that the actual
error rate is lower than this. How is that possible?
A) The bases are self-correcting; the DNA will fix any errors as it is copied.
B) The cell is immediately killed if it contains a mistake in its DNA.
C) There are other enzymes that find errors in DNA and repair them.
D) All of the above.
130. DNA mutations can

A) be detrimental.
B) be beneficial.
C) have no effect.
D) All of the above.
E) A or B only
131. Why aren't all mutations that occur in DNA inherited by our offspring?
A) Only mutations in the DNA contained in the sperm and eggs will be inherited.
B) Each cell has different DNA in it, with only the genes that cell needs.
C) DNA that is mutated can't be inherited; the cell corrects it before passing it on.
D) DNA that is inherited can't have more than one mutation in it.
E) Some mutations occur in noncoding regions of genes, so they are not inherited.
132. What would happen if the enzyme that makes DNA added a nucleotide to the middle of
a coding region of a gene?
A) It would change the reading frame of the DNA and possibly lead to a change in the
amino acid sequence of the protein made from that gene.
B) It wouldn't matter because it is in a coding region.
C) It is only one nucleotide so it wouldn't matter; more than one nucleotide would
need to be added to change a protein.
D) It would make longer mRNA and protein from that gene.
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133. Do all mutations that occur within the DNA sequence result in abnormal protein
expression, and therefore affect the function of the protein?
A) Yes, regardless of the location of the mutation, protein expression and function will
be adversely affected.
B) No, mutations occurring within the noncoding regions of the DNA sequence will
not affect overall protein structure.
C) No, DNA repair enzymes are designed specifically to “proofread” the DNA and
they catch most mistakes.
D) Yes, any mutations located within the DNA sequence will affect the structure of
the protein.
E) B and C
134. Which of the following cannot lead to a mutation?

A) replacing thymine with uracil when making RNA
B) deleting a portion of a gene
C) replacing thymine with guanine when copying DNA
D) inserting three base pairs into a gene
E) inserting one base pair into a gene
135. DNA damage is usually repaired

A) in the egg or sperm cells before fertilization.
B) at or before checkpoints in the cell cycle.
C) in the ribosome during translation.
D) by the mitotic spindle.
E) by the complementary strand of DNA.
136. Mutations are

A) always harmful.
B) never neutral.
C) always helpful.
D) never helpful.
E) sometimes harmful, sometimes helpful, and sometimes neutral.
137. Radioactive Man, a comic-book superhero, gained his abilities by falling into a vat of
industrial toxic waste. Is this a likely outcome?
A) Yes, because mutations can be helpful, harmful, or neutral.
B) No, because most mutations are either harmful or neutral.
C) No, because toxic waste is not mutagenic.
D) No, because so many mutations would probably cause cancer or other disease.
E) Both B and D
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138. Amino acid sequences result from the process of
A) transcription.
B) translation.
C) replication.
D) regulation.
E) complementary base pairing.
139. Mutations in DNA sequences may occur during the process of

A) transcription.
B) translation.
C) replication.
D) tumor suppression.
E) apoptosis.
140. Substitution of a nucleotide base in the coding sequence of a gene may alter the protein's
A) amino acid sequence.
B) 3D shape.
C) folding.
D) function.
141. Why might a change in its amino acid sequence lead to a change in the way a protein
functions?
A) Amino acids determine a protein's shape. The wrong shape may not function
normally.
B) A change in the amino acid sequence would not change the final protein.
C) A change in the amino acid sequence would cause a change in the DNA, which
alters the protein.
D) A change in the amino acid sequence causes the DNA to pair incorrectly.
142. How does a mutation in a noncoding region of DNA affect the final shape of the
protein?
A) A mutation in a noncoding region would not affect the final protein shape, but it
could affect gene regulation.
B) A change in the noncoding region leads to a change in amino acid sequence, which
changes the way the protein folds.
C) A change in the amino acid sequence causes the DNA to pair incorrectly.
D) A change in the noncoding region causes the protein to fold “inside out.”
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143. Is the way a protein folds important for its function?
A) Yes, protein function depends on the protein's 3-D structure.
B) Yes, because DNA mutations are caused by protein folding incorrectly.
C) No, as long as the sequence is correct.
D) No, as long as the protein is still soluble.
144. Mutations in DNA occur during

A) transcription.
B) translation.
C) protein modification.
D) RNA duplication.
E) DNA duplication.
145. Which of the following statements is always TRUE?

A) A mutation is harmful.
B) Mutations lead to changes in protein function.
C) Changes in DNA lead to changes in protein function.
D) A change in the DNA may change a protein's shape and function.
E) A change in DNA will lead to cancer.
146. The Ashkenazi Jews have a higher rate of mutated alleles than the general public. All of
the following are possible reasons for this, EXCEPT
A) in their Middle Eastern homeland, intense sunlight led to increased mutations.
B) they are descendants of a small number of individuals.
C) their population expanded and contracted.
D) members usually marry others within the same group.
E) new alleles were not introduced through intermarriage with other groups.
147. Mutations usually affect a protein's

A) size.
B) shape.
C) length.
D) electrical charge.
E) longevity.
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148. If a mutation alters a protein, which of the following is NOT a likely outcome of the
mutation?
A) The shape of the protein may be different.
B) The protein may function differently.
C) The protein may cause a disease or illness.
D) The protein may not function at all.
E) The protein may be repaired by enzymes.
149. Not all mutations are dangerous. Why?

A) Many mutations occur in noncoding regions.
B) Some mutations can have no effect on proteins.
C) Many DNA mutations are corrected by enzymes
D) Some cells don't use all their genes.
150. If you consider most of the mutations that occur in your DNA, the majority have ______
effects.
A) few or no
B) helpful
C) harmful
D) reversible
E) lethal
151. True or False: If you avoid dangerous chemicals and radiation for your entire life, you
prevent all mutations in your DNA.
A) True
B) False
152. What is the difference between a somatic cell mutation and a germ-line mutation?
A) Only mutations in germ-line cells can be passed on to offspring.
B) Only mutations in somatic cells can be passed on to offspring.
C) Somatic cell mutations cannot lead to cancer, but germ-line mutations can.
D) Germ-line mutations do not involve DNA, but somatic cell mutations do.
E) Somatic cell mutations do not involve DNA, but germ-line mutations do.
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153. Which of the following is a mutagen?
A) UV light
B) smoking
C) blackened meats
D) excessive drinking
154. If a person is a carrier for a disease; he or she has

A) one normal and one defective disease allele and is affected by the disease.
B) two defective disease alleles and is unaffected by the disease.
C) one normal and one defective disease allele and is unaffected by the disease.
D) two defective disease alleles and is affected by the disease.
E) two normal disease alleles and is affected by the disease.
155. Why are Ashkenazi Jews more susceptible to certain hereditary diseases?
A) They have inherited predispositions and carcinogen exposure.
B) They have increased occupational exposure and environmental insults.
C) They are predisposed by exposure to occupational risks.
D) They have an increased carrier rate for these diseases from their ancestors.
E) They all have increased errors in DNA proofreading.
156. How can a person acquire mutations in their DNA?

A) inheritance
B) carcinogens
C) replication errors
D) mutagens
157. Which of the following is NOT a known source of mutations?

A) DNA repair or replication errors
B) chemical or environmental exposure
C) heredity
D) insufficient sleep and poor diet
E) None of the above; all are known sources of mutations.
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158. Inherited mutations
A) predispose individuals to cancer.
B) come from DNA sequence mistakes contained in germ cells.
C) can come from one's mother or father.
D) are errors in DNA that go uncorrected.
159. Which of the following is NOT a known carcinogen?

A) ultraviolet light
B) alcohol
C) charred food
D) smoking
E) None of the above; all are known carcinogens
160. Which of the following are mutagens?

A) sunlight
B) cigarette smoke
C) alcohol
D) blackened meat
161. Which of the following will lead to a new, inheritable allele?

A) a mutation in a sperm cell
B) a mutation in an egg cell
C) a mutation in an embryo
D) a mutation in the brain
E) All of the above except D.
162. A woman with normal BRCA alleles has a child with a man who has one mutated
BRCA1 allele. What is the probability that the child will have a mutated BRCA1 allele?
A) 0%
B) 25%
C) 50%
D) 75%
E) 100%
163. True or False: To get cancer, all you need is a mutation in one essential gene.
A) True
B) False
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164. In a cell with the following mutations, which would you expect to be MOST likely to
cause tumors?
A) BRCA1 and BRCA2
B) BRCA1 and p53 mutation
C) BRCA1, BRCA2, Her2, and p53 mutations
D) BRCA1, BRCA2, and p53 mutations
E) BRCA1, Her2, and p53 mutations
165. Which combination(s) of mutated genes would be most likely to make a cell cancerous?
A) one oncogene
B) one tumor suppressor gene
C) two oncogenes
D) two oncogenes and two tumor-suppressor genes
166. In a cell with the following mutations, which would you expect to be LEAST likely?
A) BRCA1 and BRCA2
B) BRCA1
E) BRCA1, Her2, and p53 mutation
167. What is the number-one preventable cause of cancer?

A) smoking
B) UV light exposure
C) grilled meats and vegetables
D) pollution exposure
E) alcohol
168. The most common cancer among women is

A) prostate cancer.
B) breast cancer.
C) ovarian cancer.
D) nonmelanoma skin cancer.
E) lung cancer.
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169. A normal BRCA1 allele produces normal protein that
A) inhibits transcription.
B) inhibits translation.
C) ensures correct, error-free DNA transcription.
D) allows cells to repair DNA damage.
E) recognizes and destroys incorrectly translated proteins.
170. All of the following are TRUE of breast cancer, EXCEPT

A) it is the second-most common form of cancer in women.
B) mutations in the BRCA genes affect only the breasts and ovaries.
C) BRCA mutations cause only about 50% of all hereditary breast cancers.
D) it affects about 200,000 women in the United States per year.
E) a woman may pass the predisposition for breast cancer to her children.
171. All of the following are TRUE of BRCA genes, EXCEPT

A) there are two genes, and a mutation in either can lead to cancer.
B) when mutated, they produce proteins that are unable to regulate the cell cycle.
C) just one mutated BRCA gene increases a woman's lifetime cancer risk to greater
than 90%.
D) mutations in BRCA genes can lead to either breast or ovarian cancer in women.
E) mutations in BRCA genes can lead to prostate cancer in men.
172. Which of the following would most likely increase an individual's risk of cancer?
A) a mutation in the noncoding region of DNA
B) a mutation in their mother's somatic cells
C) a mutation in a gene for a DNA repairing enzyme
D) an error in transcribing DNA into RNA
173. Which of the following types of mutations is LEAST likely to lead to cancer?
A) a mutation of proto-oncogenes
B) a mutation of tumor suppressor genes
C) a mutation of a gene that codes for DNA polymerase
D) a mutation of a gene that codes for DNA repair enzymes
E) a mutation in a noncoding sequence of a gene
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174. A gene found in a somatic cell is mutated. The resulting protein regulates mitosis but
now has a different 3D shape. What is a likely result?
A) germ-line mutations
B) hereditary mutations
C) cancer
D) down syndrome
E) cystic fibrosis
175. Which of these does NOT directly cause cancer?

A) inherited predispositions
B) solar radiation (UV)
C) tobacco smoking or chewing
D) DNA damage from viruses
E) mutagens in drinking water
176. Which occupation is high risk for a predisposition to cancer?

A) chimney sweeping
B) coal mining
C) cabinet making
D) shoe repair and manufacture
177. Somatic cells are

A) cancer cells.
B) cells that become tumors.
C) cells that become eggs.
D) cells that become sperm.
E) cells that do not become reproductive cells.
178. Which of the following statements is FALSE?

A) All carcinogens are mutagens.
B) Some cancers are hereditary.
C) All mutations can cause cancer.
D) Ultraviolet light can lead to skin cancers, so it is a mutagen.
E) Ultraviolet light can lead to skin cancers, so it is a carcinogen.
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179. Which of the following is most likely to be an INHERITED cancer?
A) skin cancer
B) liver cancer
C) lung cancer
D) prostate cancer
E) stomach cancer
180. A new gene is discovered, called GRAB. It prevents a cell from entering mitosis if there
are any signs of DNA damage. This means that GRAB would be a type of
A) oncogene.
B) tumor-suppressor gene.
C) nonhereditary gene.
D) somatic gene.
E) proto-oncogene.
181. What kind of mutation causes most types of cancer?

A) mutations in skin cells
B) mutations in transcription factors
C) mutations in blood cells
D) mutations in cell cycle genes
182. Many cells in your body stop at the G1 checkpoint and never divide again. Some cells,
like skin cells, will continue past the G1 checkpoint. What types of genes tell a skin cell
to move on past the G1 checkpoint?
A) proto-oncogenes
B) tumor-suppressor genes
C) cell-enhancing genes
D) oncogenes
E) tumor-deflecting genes
183. In healthy cells, if a mutation occurs in a proto-oncogene, what is the gene now termed?
A) tumor regulator
B) Her2
C) cell-cycle regulator
D) tumor suppressor
E) oncogene
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184. Proto-oncogenes are
A) tumor regulators.
B) required for normal cell division.
C) tumor suppressors.
D) cancer causing in normal cells.
E) mutations in oncogenes.
185. In normal cells, tumor suppressors are

A) oncogenes.
B) not required.
C) carcinogens.
D) required for DNA repair or programmed cell death.
E) underexpressed.
186. Permanent activation or overexpression of proto-oncogenes

A) turns tumor suppressors off.
B) is required for normal cell division.
C) has been linked to breast cancer.
D) keeps a cell from dividing.
E) turns tumor suppressors on.
187. In normal cells, lack of functional tumor suppressors would cause

A) an accumulation of mutations in the DNA.
B) division of damaged cells.
C) cancer, possibly.
D) uncontrolled cell division.
188. Apoptosis can be described as

A) division of damaged cells.
B) abnormal cell behavior.
C) uncontrollable cell division.
D) programmed cell death.
E) immortalization of cells.
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189. A proto-oncogene is a gene that
A) tells the cell when to stop the cell cycle.
B) is responsible for DNA repair.
C) is responsible for detecting mutations.
D) tells the cell to go through the cell cycle.
E) causes apoptosis.
190. A tumor suppressor gene is a gene that

A) tells the cell when to stop the cell cycle.
B) is responsible for DNA repair.
C) is responsible for detecting mutations.
D) tells the cell to go through the cell cycle.
E) prevents apoptosis from occurring.
191. When would you need a gene that can stop the cell cycle?
A) when a mutation occurred and the cell needed time to repair it before continuing
B) when there was no immediate need for more cells
C) when a cell had completed DNA replication
D) A and C only
E) A and B only
192. What would happen if a tumor suppressor, such as BRCA1, was mutated?
A) DNA may not be able to be repaired.
B) The cell cycle could continue without stopping when needed.
C) Cells would stop dividing and be unable to get through the cell cycle.
D) A and B only
193. What would happen if a proto-oncogene, such as Her2, were mutated?

A) DNA may not be able to be repaired.
B) The cell cycle would continue without stopping when needed.
C) Cells would stop dividing and be unable to get through the cell cycle.
D) A and B only
Page 34
194. Which of the following would NOT lead to cancer?
A) an active oncogene
B) a misshapen tumor-suppressor protein
C) a mutated proto-oncogene
D) a tumor-suppressor allele missing 20% of its bases
E) an active proto-oncogene
195. Mutations that cause the cell to divide rapidly, even in the absence of a signal to divide,
are usually mutations of
A) proto-oncogenes.
B) tumor-suppressor genes.
C) DNA polymerase.
D) cell-surface proteins.
E) DNA-repair enzymes.
196. Tumor-suppressor genes can act by making proteins that

A) repair damaged DNA.
B) stop the cell from dividing when there are problems.
C) induce apoptosis.
D) cause cell death.
197. BRCA1 and BRCA2 are ___________, p53 is a ___________, and Her2 is a
__________.
A) tumor-suppressor genes, tumor-suppressor gene, proto-oncogene
B) tumor-suppressor genes; proto-oncogene; tumor-suppressor gene
C) proto-oncogenes; tumor-suppressor gene; proto-oncogene
D) proto-oncogenes; tumor-suppressor gene; tumor-suppressor gene
E) proto-oncogenes; proto-oncogene; tumor-suppressor gene
198. You isolate cells from a tumor and study them. You observe that the cells continue
dividing, even when DNA is damaged, when the cells become crowded, or even when
nutrients run low. These observations lead you to suspect that the cells
A) contain a proto-oncogene.
B) contain an oncogene.
C) contain a mutated tumor-suppressor gene.
D) are infected by a virus.
E) are breast-cancer cells.
Page 35
199. True or False: To get cancer, all you need is a mutation in one essential gene.
A) True
B) False
200. Which set of mutations in a cell would you expect to be LEAST tumorigenic?
A) BRCA1 and BRCA2
B) BRCA1
E) BRCA1, Her2, and p53 mutation
201. A mutation in one cancer-related gene is not enough to cause a cell to become
cancerous. Why?
A) We have more than two copies of every gene.
B) Cell division is controlled by many proteins, not just one.
C) We have two copies of every gene.
D) Nearby cells will repair the mutation.
E) The cell has to divide more times to become cancerous.
202. Which of the following steps (in order) would most likely lead to tumor formation?
A) A mutation in a single cell-cycle gene occurs, then the cell rapidly divides and
spreads.
B) A mutated tumor-suppressor gene is inherited, several proto-oncogenes become
mutated, and the cell dies.
C) A mutation in a cell-cycle gene occurs, then shortly afterwards the cell dies.
D) A mutated tumor-suppressor gene is inherited, other mutations in proto-oncogenes
occur, and the cell rapidly divides and spreads.
E) A proto-oncogene is inherited, mutation converts it into an oncogene, and the cell
rapidly divides and spreads.
203. Why does cancer affect older individuals more frequently than younger people?
A) Older people have more genes than younger people, so the tendency for the genes
to be mutated increases.
B) Cells become more fragile and die more rapidly as people age.
C) Older people tend to smoke, which is a carcinogen and causes cancer.
D) Older people have had more time to accumulate mutations from various sources.
E) Older DNA is more susceptible to mutation than younger DNA.
Page 36
204. What is the difference between mutagens and carcinogens?
A) All mutagens are carcinogens.
B) All carcinogens are mutagens.
C) Carcinogens are any substance that damages DNA and can lead to cancer.
D) B and C
E) None of the above; they are the same thing with different names.
205. Predict what would most likely happen in a cell if BRCA1 were mutated.
A) DNA errors would occur more frequently.
B) The cell would divide much faster.
C) Tumors would form immediately.
D) The cell would pause forever and wait for damage to be repaired.
E) The cell would copy DNA faster and more accurately.
206. You learn from DNA testing that for BRCA1 you have one normal allele and one allele
associated with cancer. For BRCA2, you have two alleles associated with cancer. How
does this affect your risk for cancer?
A) Your risk is the same as any other average human being.
B) You will almost certainly get cancer at a very young age.
C) Your risk is definitely higher than for someone with all mutant alleles for BRCA1
and BRCA2.
D) Your risk is the same as that for someone with a single mutant BRCA1 allele.
E) Your risk is higher than average but depends on other genes you carry and your
lifestyle.
207. The mutant BRCA2 gene predisposes people to cancer. If mutant BRCA2 runs in
Isadora's family, will she automatically get cancer?
A) Yes, because genes like BRCA2 are always inherited if one of your parents has a
mutation.
B) No. Although inherited genes may carry an increased predisposition toward cancer,
it is often nonhereditary mutations that lead to cancer.
C) Yes, because inherited genes that are mutated will cause cancer.
D) No, because more than one mutation is needed to develop cancer.
E) B and D
Page 37
208. Why do people with inheritable high-risk mutations develop cancer at an earlier age?
A) People who have inherited high-risk mutations start life with at least one
predisposing mutation, so they require fewer additional mutations.
B) People who have inherited high-risk mutations always have other environmental
risk factors putting them at higher risk for developing cancer at a younger age.
C) People with inheritable high-risk mutations start expressing the mutated genes at a
younger age.
D) The inherited mutations cause new mutations to occur more easily.
E) All the above.
209. What factors have made the Ashkenazi Jewish population more susceptible to genetic
diseases?
A) They descended from a small group of people.
B) The population has expanded and contracted over time.
C) They tend to marry other Ashkenazis.
D) B and C
E) All the above.
210. If you mother has a single copy of a harmful BRCA gene, what are the chances you
inherited the harmful BRCA allele from her?
A) 0%
B) 25%
C) 50%
D) 75%
E) 100%
Page 38
211. What is the increased risk of breast cancer by age 70 if you have one copy of a
deleterious BRCA1 allele when compared with the general population?
A) 12%
B) 25%–42%
C) 43%–53%
D) 55%–65%
E) 65%
212. What is the increased risk of ovarian cancer by age 70 if you have one copy of a
deleterious BRCA2 allele when compared to the general population?
A) 1.3%
B) 9.7%
C) 11%
D) 39%
E) 55%-65%
Page 39
213. For those women with a mutation in their BRCA1 genes, the risk of developing breast
cancer by age 70 is as high as _________, while in the general population the risk is
_________.
A) 45%; <5%
B) 45%; 12%
C) 45%; 15%
D) 65%; 12%
E) 65%; 15%
214. Why is a person who has inherited one copy of a harmful BRCA allele much more likely
to have early-onset breast cancer or ovarian cancer than a person with two functioning
alleles?
A) Apoptosis is increased, as the tumor suppressors are not functioning.
B) Cell growth is accelerated, as oncogenes are switched on.
C) With the increase of BRCA protein, apoptosis is induced and cell death occurs.
D) Mutations accumulate as DNA repair is slowed and cell growth may accelerate.
E) Cells fail to enter apoptosis and eventually become a tumor.
215. Why does inheriting a mutation in a gene increase one's risk of developing cancer?
A) It takes more than one mutation to develop cancer. People who inherit a mutation
need fewer additional mutations to develop cancer.
B) It takes one mutation to develop cancer. People who inherit a mutation are already
developing cancer as soon as they are born.
C) It takes one mutation in the right gene to develop cancer, so if they inherit a
mutation in a key gene, then they will develop cancer.
D) Inheriting a mutation means we don't need mutations from outside sources to
develop cancer.
Page 40
216. What kinds of preventative measures are available for individuals who have a strong
genetic predisposition to breast cancer?
A) genetic counseling, so they know the risks
B) regular medical screening for cancer
C) a healthy lifestyle, a good diet, and an exercise regimen
D) prophylactic surgery
217. Which of the following is MOST accurate?

A) Women with just one abnormal BRCA allele are less likely to develop skin cancer
than women with no abnormal alleles.
B) Women with two abnormal BRCA alleles are less likely to develop skin cancer than
women with no abnormal alleles.
C) Women with just one abnormal BRCA allele are more likely to develop cancer than
women with no abnormal alleles.
D) Women with just one abnormal BRCA allele are more likely to develop ovarian
cancer than women with two abnormal alleles.
E) Women with two abnormal BRCA alleles are less likely to develop breast cancer
than women with no abnormal alleles.
218. For those women with a mutation in their BRCA genes, the risk of developing breast
cancer by age 50 is as high as _________, while in the general population the risk is
_________.
A) 10%; <5%
B) 20%; <5%
C) 20%; 10%
D) 50%; <5%
E) 50%; 20%
219. In addition to breast cancer, women with a mutation in one of their BRCA genes have an
increased likelihood of developing which of the following other types of cancer?
A) liver
B) lung
C) ovarian
D) skin
E) bone
Page 41
220. If an individual has a germ cell mutation, which of these is a possible source of that
mutation?
A) excessive sun exposure
B) a maternal or paternal allele
C) a paternal allele only
D) a maternal allele only
E) overuse of alcohol
221. How does an acquired mutation in a gene alter the function of a cell?
A) Base pair changes in the gene are passed directly into altered amino acids by a
ribosome.
B) Base pair mutations in a gene are passed directly into mRNA via translation.
C) Base pair mutations in mRNA are passed directly into a protein via transcription.
D) Base pair mutations in a gene are passed directly into mRNA via transcription.
E) Base pair mutations in a gene are passed from mRNA into a protein via
transcription.
222. A potential cancer-causing gene coding for a protein with cell cycle control
responsibilities is a _____, and a gene coding for a protein that stimulates cell division is
a _____.
A) oncogene; mutagen
B) oncogene; proto-oncogene
C) carcinogen; proto-oncogene
D) tumor suppressor; oncogene
E) oncogene; tumor suppressor
223. What is the role of BRCA1 in normal cells?

A) BRCA1 is a proto-oncogene.
B) BRCA1 is an oncogene.
C) BRCA1 is a tumor suppressor.
D) BRCA1 is a mutagen.
E) BRCA1 is a carcinogen.
224. Which of these does not cause cancer to develop and progress?
A) a proto-oncogene acting alone
B) an oncogene acting alone
C) a tumor suppressor gene acting alone
D) a proto-oncogene and a tumor suppressor gene acting together
E) an oncogene and a BRCA1 acting together
Page 42
225. A chemical that causes alterations in DNA is a _____, and if this chemical causes cancer
it is called a(n) _____.
A) mutagen; carcinogen
B) carcinogen; mutagen
C) tumor suppressor; oncogene
D) tumor suppressor; proto-oncogene
E) tumor suppressor; mutagen
226. Tumors that will not spread throughout the body are _____, and those that do spread are
termed _____.
A) malignant; benign
B) benign; malignant
C) mutagen; carcinogen
D) tumor suppressor; proto-oncogene
E) benign; mutagen
227. Which statement accurately describes cancer development?

A) It is a one-step process by which a mutation drives cancer development.
B) It is inherited and is independent of environmental factors.
C) It is a caused by carcinogens that act on inherited alleles that cause cancer.
D) It is a multistep process by which multiple mutations cause a series of events that
lead to cancer.
E) It is a multistep process by which multiple mutagens cause a series of
cancer-causing alleles.
228. What would you say to a niece if she asked you how she could reduce her risk of breast
cancer? (Assume there is no family history of breast cancer.)
A) Reduce sun exposure.
B) Reduce alcohol consumption.
C) Avoid tobacco.
D) Utilize early screening.
E) all of these
229. Why is age a risk factor for cancer?

A) Age provides more time for the cancer cells to accumulate.
B) Age extends the amount of exposures to environmental factors, which can lead to
the progression of cancer.
C) Age causes additional mutations to be acquired that can predispose one to cancer.
D) none of these
E) all of these
Page 43
230. We would all have many more mutations in our genes if not for the _____.
A) activity of repair enzymes
B) death of all mutant cells, removing them from our bodies
C) fact that everybody carries a "good" allele to counter every "bad" allele
D) fact that dividing cells remove all their mutations when they replicate their DNA
E) fact that mutations tend to cancel each other out, leaving mostly functional genes
231. Which is the correct order of events in which breast cancer might develop?
A) inheritance of a mutant BRCA gene > mutation of p53 > additional mutations
permit spreading > replication errors create an oncogene
B) mutation of p53 > inheritance of a mutant BRCA gene > additional mutations
permit spreading > replication errors create an oncogene
C) replication errors create an oncogene > mutation of p53 > inheritance of a mutant
BRCA gene > additional mutations permit spreading
D) inheritance of a mutant BRCA gene > replication errors create an oncogene >
mutation of p53 > additional mutations permit spreading
E) inheritance of a mutant BRCA gene > additional mutations permit spreading >
replication errors create an oncogene > mutation of p53
232. Which statement about decreasing a woman's breast cancer risk if she inherits one of the
mutant BRCA genes is true?
A) Diet and lifestyle changes will effectively decrease her risk to near zero.
B) She can take several medications that make it almost impossible to get breast
cancer, even if she inherits the BRCA gene.
C) Surgical removal of the breasts will decrease a woman's cancer risk to near zero.
D) A woman cannot decrease her cancer risk, so she might as well live life to its
fullest.
E) none of these
233. A woman with a BRCA1 mutation _____.

A) will definitely develop breast cancer
B) is at increased risk of developing breast cancer
C) must have inherited it from her mother because of the link to breast cancer
D) will also have a mutation in BRCA2
E) none of these
Page 44
234. Which family history most strongly suggests a risk of inherited breast cancer due to
BRCA1 mutations?
A) many female relatives who were diagnosed with breast cancer in their 70s
B) many relatives with skin cancer
C) many relatives diagnosed with skin cancer at an early age
D) many female relatives diagnosed with breast cancer at an early age
E) many female relatives with both early breast cancer and ovarian cancer
235. Why do people with "inherited cancer" often develop cancer at a relatively young age?
A) Predisposition does not increase the chances that other risk factors will lead to the
progression of cancer.
B) All inherited alleles that are associated with cancer cause childhood cancers.
C) Cancer cannot be truly inherited, but certain alleles weaken the normal control
points that prevent cancer, and this causes cancer to appear earlier in life.
D) Younger people are exposed to more risk factors than older people.
E) all of these
236. Which woman would be most likely to benefit from genetic testing for breast cancer?
A) a 25-year-old woman whose mother, aunt, and grandmother had breast cancer
B) a healthy 75-year-old woman with no family history of breast cancer
C) a 40-year-old woman who has a cousin with breast cancer
D) a 55-year-old woman whose older sister was just diagnosed with breast cancer
E) All women can benefit from genetic testing for breast cancer.
Page 45
Answer Key
1. B
2. C
3. E
4. C
5. C
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17. C
18. E
19. C
20. B
21. E
22. D
23. B
24. E
25. A
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
Page 46
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68. apoptosis
69. cancerous; normal
70. alleles
71. A
72. C
73. E
74. C
75. B
76. A
77. A
78. D
79. C
80. B
81. E
82. A
83. A
84. E
85. D
86. E
87. E
88. B
89. E
90. C
Page 47
91. C
92. B
93. E
94. A
95. B
96. A
97. D
98. A
99. E
100. C
101. C
102. C
103. D
104. B
105. E
106. A
107. A
108. B
109. B
110. C
111. E
112. C
113. A
114. E
115. D
116. C
117. C
118. A
119. C
120. E
121. D
122. B
123. B
124. C
125. C
126. D
127. C
128. D
129. C
130. D
131. A
132. A
133. E
134. A
135. B
136. E
Page 48
137. E
138. B
139. C
140. E
141. A
142. A
143. A
144. E
145. D
146. A
147. B
148. E
149. E
150. A
151. B
152. A
153. E
154. C
155. D
156. E
157. D
158. E
159. E
160. E
161. E
162. C
163. B
164. C
165. D
166. B
167. A
168. D
169. D
170. B
171. C
172. C
173. E
174. C
175. A
176. E
177. E
178. C
179. D
180. B
181. D
182. A
Page 49
183. E
184. B
185. D
186. C
187. E
188. D
189. D
190. A
191. E
192. D
193. B
194. E
195. A
196. E
197. A
198. C
199. B
200. B
201. B
202. D
203. D
204. D
205. A
206. E
207. E
208. A
209. E
210. C
211. C
212. B
213. D
214. D
215. A
216. E
217. C
218. D
219. C
220. B
221. D
222. C
223. C
224. D
225. A
226. B
227. D
228. E
Page 50
229. E
230. A
231. D
232. E
233. B
234. D
235. C
236. A
Page 51
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CHAPTER I.
HEALTH.
[Contents]
A.—LESSONS OF INSTINCT.
Nature has guarded the health of her creatures by a marvelous

system of protective intuitions. The sensitive membrane of the eye
resents the intrusion of every foreign substance. An intuitive sense of
discomfort announces every injurious extreme of temperature. To the
unperverted taste of animals in a state of nature wholesome food is
pleasant, injurious substances repulsive or insipid. Captain Kane
found that only the rage of famine will tempt the foxes of the Arctic
coastlands to touch spoiled meat. In times of scarcity the baboons of
the Abyssinian mountains greedily hunt for edible roots, which an
unerring faculty enables them to distinguish from the poisonous
varieties. The naturalist Tschudi mentions a troop of half-tamed
chamois forcing their way through a shingle roof, rather than pass a
night in the stifling atmosphere of a goat stable.
Man in his primitive state had his full share of those protective
instincts, which still manifest themselves in children and Nature-
guided savages. It is a mistake to suppose that the lowest of those
savages [19]are naturally fond of ardent spirits. The travelers Park,
Gerstaecker, Vambery, Kohl, De Tocqueville, and Brehm agree that
the first step on the road to ruin is always taken in deference to the
example of the admired superior race, if not in compliance with direct
persuasion. The negroes of the Senegal highlands shuddered at the
first taste of alcohol, but from a wish to conciliate the good will of
their visitors hesitated to decline their invitations, which
subsequently, indeed, became rather superfluous. The children of
the wilderness unhesitatingly prefer the hardships of a winter camp
to the atmospheric poisons of our tenement houses. Shamyl Ben
Haddin, the Circassian war chief, whose iron constitution had
endured the vicissitudes of thirty-four campaigns, pathetically
protested against the pest air of his Russian prison cell, and warned
his jailers that, unless his dormitory was changed, Heaven would
hold them responsible for the guilt of his suicide. I have known
country boys to step out into a shower of rain and sleet to escape
from the contaminated atmosphere of a city workshop, and after a
week’s work in a spinning mill return to the penury of their mountain
homes, rather than purchase dainties at the expense of their lungs.
The word frugality, in its original sense, referred literally to a diet of

tree fruits, in distinction to carnivorous fare, and nine out of ten
children still decidedly prefer ripe fruit and farinaceous dishes to the
richest meats. They as certainly prefer easy, home-made clothes to
the constraint of fashionable fripperies. The main tenets of our dress-
reformers are [20]anticipated in the sensible garments of many half-
civilized nations. Boys, within reach of a free bathing river, can
dispense with the advice of the hydropathic school. They delight in
exercise; they laugh at the imaginary danger of fresh-air draughts,
and the perils of barefoot rambles in wet and dry. They would cast
their vote in favor of the outdoor pursuit of hundreds of occupations
which custom, rather than necessity, now associates with the
disadvantages of indoor confinement. The hygienic influence of
arboreal vegetation has been recognized by the ablest pathologists
of modern times; avenues of shade trees have been found to
redeem the sanitary condition of many a grimy city, and the eminent
hygienist, Schrodt, holds that, as a remedial institution, a shady park
is worth a dozen drug stores. But all these lessons only confirm an
often manifested, and too often suppressed, instinct of our young
children: their passionate love of woodland sports, their love of tree
shade, of greenwood camps, of forest life in all its forms. Those who
hold that “nature” is but a synonym of “habit” should witness the
rapture of city children at first sight of forest glades and shady
meadow brooks, and compare it with the city dread of the Swiss
peasant lad or the American backwoods boy, sickened by the fumes
and the uproar of a large manufacturing town. A thousands years of
vice and abnormal habits have not yet silenced the voice of the
physical conscience that recalls our steps to the path of Nature, and
will not permit us to transgress her laws unwarned. [21]
[Contents]
B.—REWARDS OF CONFORMITY.
The reward of nature-abiding habits is not confined to the negative

advantage of escaping the discomforts of disease. In the pursuit of
countless competitive avocations the Art of Survival is a chief secret
of success, but in this age of sanitary abuses our lives are mostly
half-told tales. Our season ends before the trees of hope have time
to ripen their fruit; before their day’s work is done our toilers are
overtaken by the shadows of approaching night. Sanitary reforms
would undoubtedly lengthen our average term of life, and an
increase of longevity alone would solve the most vexing riddles of
existence: the apparent injustice of fate, the disproportion of merit
and compensation, the aimlessness, the illusive promises and
baffled hopes of life. For millions of our fellow-men an increase of
health and longevity would suffice to make life decidedly worth living.
Health lessens the temptations to many vices. Perfect health blesses
its possessor with a spontaneous cheerfulness almost proof against
the frowns of fortune and the cares of poverty. With a meal of barley
cakes and milk, a straw couch, and scant clothing of homespun
linen, a shepherd-boy in the highlands of the Austrian Alps may
enjoy existence to a degree that exuberates in frolic and jubilant
shouts, while all the resources of wealth cannot recall the sunshine
which sickness has banished from the life of the dyspeptic glutton. If
happiness could be computed by measure and weight, it would be
found that her richest treasures are not stored in gilded walls, but
[22]in the homes of frugal thrift, of rustic vigor and nature-loving
independence. The sweetness of health reflects itself in grace of
form and deportment, and wins friends where the elegance of
studied manners gains only admirers. Health is also a primary
condition of that clearness of mind the absence of which can be only
partially compensated by the light of learning. Health is the basis of
mental as of bodily vigor; country-bred boys have again and again
carried off the prizes of academical honors from the pupils of refined
cities, and the foremost reformers of all ages and countries have
been men of the people; low-born, but not the less well-born, sons of
hardy rustics and mechanics, from Moses, Socrates, Epictetus,
Jesus Ben Josef, and Mohammed, to Luther, Rousseau, Thomas
Paine, and Abraham Lincoln.
[Contents]
C.—PERVERSION.
Habitual sin against the health-laws of Nature was originally chiefly a

consequence of untoward circumstances. Slaves, paupers,
immigrants to the inhospitable climes of the higher latitudes, were
forced to adopt abnormal modes of life which, in the course of time,
hardened into habits. Man, like all the varieties of his four-handed
relatives, is a native of the tropics, and the diet of our earliest
manlike ancestors was, in all probability, frugal: tree-fruits, berries,
nuts, roots, and edible herbs and gums. But the first colonists of the
winter lands were obliged to eke out an existence by eating the flesh
of their fellow-creatures, and a carnivorous diet thus became the
[23]habitual and, in many countries, almost the exclusive diet of the
nomadic inhabitants.
Alcohol is a product of fermentation, and the avarice of a cruel

master may have forced his slaves to quench their thirst with
fermented must or hydromel till habit begot a baneful second nature,
and the at first reluctant victims of intoxication learned to prefer
spoiled to fresh grape-juice. Sedentary occupations, however
distasteful at first, are apt to engender a sluggish aversion to
physical exercise, and even habitual confinement in a vitiated
atmosphere may at last become a second nature, characterized by a
morbid dread of fresh air. The slaves of the Roman landowners had
to pass their nights in prison-like dungeons, and may have
contracted the first germ of that mental disease known as the night-
air superstition, the idea, namely, that after dark the vitiated
atmosphere of a stifling dormitory is preferable to the balm of the
cooling night wind.
In modern times an unprecedented concurrence of circumstances

has stimulated a feverish haste in the pursuit of wealth, and thus
indirectly led to the neglect of personal hygiene. The abolition of the
public festivals by which the potentates of the pagan empires
compensated their subjects for the loss of political freedom, the
heartless egotism of our wealthy Pharisees, venal justice, and the
dire bondage of city life all help to stimulate a headlong race toward
the goal of the promised land of ease and independence—a goal
reached only by a favored few compared with the multitudes who
daily drop down wayworn and exhausted. [24]
But the deadliest blow to the cause of health was struck by the anti-
natural fanaticism of the Middle Ages, the world-hating infatuation of
the maniacs who depreciated every secular blessing as a curse in
disguise, and despised their own bodies as they despised nature,
life, and earth. The disciples of the world-renouncing messiah
actually welcomed disease as a sign of divine favor, they gloried in
decrepitude and deformity, and promoted the work of degeneration
with a persevering zeal never exceeded by the enlightened
benefactors of the human race. For a period of fifteen hundred years
the ecclesiastic history of Europe is the history of a systematic war
against the interests of the human body; the “mortification of the
flesh” was enjoined as a cardinal duty of a true believer; health-
giving recreations were suppressed, while health-destroying vices
were encouraged by the example of the clergy; domestic hygiene
was utterly neglected, and the founders of some twenty-four different
monastic orders vied in the invention of new penances and
systematic outrages upon the health of the poor convent-slaves.
Their diet was confined to the coarsest and often most loathsome
food; they were subjected to weekly bleedings, to profitless
hardships and deprivations; their sleep was broken night after night;
fasting was carried to a length which often avenged itself in
permanent insanity; and their only compensation for a daily repetition
of health-destroying afflictions was the permission to indulge in
spiritual vagaries and spirituous poisons: the same bigots who
grudged their followers a night of unbroken rest or a mouthful of
[25]digestible food indulged them in quantities of alcoholic beverages
that would have staggered the conscience of a modern beer-swiller.
The bodily health of a community was held so utterly below the

attention of a Christian magistrate that every large city became a
hotbed of contagious diseases; small-pox and scrofula became
pandemic disorders; the pestilence of the Black Death ravaged
Europe from end to end—nay, instead of trying to remove the cause
of the evil, the wretched victims were advised to seek relief in prayer
and self-torture, and a philosopher uttering a word of protest against
such illusions would have risked to have his tongue torn out by the
roots and his body consigned to the flames of the stake.
Mankind has never wholly recovered from that reign of insanity.

Indifference to many of the plainest health-laws of nature is still the
reproach of our so-called civilization. Our moralists rant about the
golden streets of the New Jerusalem, but find no time to expurgate
the slums of their own cities; our missionary societies spend millions
to acquaint the natives of distant islands with the ceremony of
baptism, but refuse to contribute a penny to the establishment of free
public baths for the benefit of their poor neighbors, whose children
are scourged or caged like wild beasts for trying to mitigate the
martyrdom of the midsummer season by a bath in the waters of the
next river. Temperance, indeed, is preached in the name of the
miracle-monger who turned water into alcohol; but millions of toilers
who seek to drown their misery in the Lethe of intoxication are
[26]deprived of every healthier pastime; the magistrates of our
wealthy cities rage with penal ordinances against the abettors of
public amusements on the day when nine-tenths of our laborers find
their only leisure for recreation. Poor factory children who would
spend the holidays in the paradise of the green hills are lured into
the baited trap of a Sabbath-school and bribed to memorize the stale
twaddle of Hebrew ghost-stories or the records of fictitious
genealogies; but the offer to enlarge the educational sphere of our
public schools by the introduction of a health primer would be
scornfully rejected as an attempt to divert the attention of the pupils
from more important topics.
[Contents]
D.—PENALTIES OF NEGLECT.
But the laws of Nature cannot be outraged with impunity, and the aid
of supernatural agencies has never yet protected our ghost-mongers
from the consequences of their sins against the monitions of their
physical conscience. The neglect of cleanliness avenges itself in
diseases which no prayer can avert; during the most filthful and
prayerful period of the Middle Ages, seven out of ten city-dwellers
were subject to scrofula of that especially malignant form that attacks
the glands and the arteries as well as the skin. Medical nostrums
and clerical hocus-pocus of the ordinary sort were, indeed, so
notoriously unavailing against that virulent affection that thousands
of sufferers took long journeys to try the efficacy of a king’s touch, as
recorded by the unanimous testimony of contemporary writers, as
well as in the still [27]current term of a sovereign remedy. A long foot-
journey, with its opportunities for physical exercise, outdoor camps,
and changes of diet, often really effected the desired result; but, on
their return to their reeking hovels, the convalescents experienced a
speedy relapse, and had either to repeat the wearisome journey or
resign themselves to the “mysterious dispensation” of a Providence
which obstinately refused to let miracles interfere with the normal
operation of the physiological laws recorded in the protests of
instinct. Stench, nausea, and sick-headaches might, indeed, have
enforced those protests upon the attention of the sufferers; but the
disciples of Antinaturalism had been taught to mistrust the
promptings of their natural desires, and to accept discomforts as
signs of divine favor, or, in extreme cases, to trust their abatement to
the intercession of the saints, rather than to the profane interference
of secular science.
The dungeon-life of the monastic maniacs, and the abject
submission to the nuisance of atmospheric impurities, avenged
themselves in the ravages of pulmonary consumption; the votaries of
dungeon-smells were taught the value of fresh air by the tortures of
an affliction from which only the removal of the cause could deliver a
victim, and millions of orthodox citizens died scores of years before
the attainment of a life-term which a seemingly inscrutable
dispensation of Heaven grants to the unbelieving savages of the
wilderness. The cheapest of all remedies, fresh air, surrounded them
in immeasurable abundance, craving admission and offering them
the [28]aid which Nature grants even to the lowliest of her creatures,
but a son of a miracle-working church had no concern with such
things, and was enjoined to rely on the efficacy of mystic
ceremonies: “If any man is sick among you, let him call for the elders
of the church, and let them pray over him, anointing him with oil in
the name of the Lord.” “And the prayer of faith shall cure the sick,
and the Lord shall raise him up.”
Thousands of the fatuous bigots who prayed for “meekness of spirit”

continued to gorge themselves with the food of carnivorous animals,
and thus inflamed their passions with the sanguinary, remorseless
propensities of those brutes. Luigi Cornaro, the Italian reformer,
assures us that it was no uncommon thing for a nobleman or prelate
of his century to swallow fourteen pounds of strong meats at a single
meal, and that, after invoking the blessing of Heaven upon such a
repast, the devourer of meat-pies would rise with his paunch
distended “like the hide of a drowned dog.” The “Love of Enemies,”
“forgiveness and meekness,” were on their lips; but those fourteen
pounds of meat-pie worked out their normal result; and among the
carnivorous saints of that age we accordingly find men whose
fiendish inhumanity would have appalled the roughest legionary of
pagan Rome. Cæsar Borgia, the son of a highest ecclesiastic
dignitary, a disciple of a priestly training-school, and himself a prince
of the church, seems to have combined the stealthy cunning of a
viper with the bloodthirst of a hyena. Four times he made and broke
the most solemn treaties, [29]in order to get an opportunity to invade
the territory of an unprepared neighbor. His campaigns were
conducted with a truculence denounced even by his own allies; with
his own hand he poisoned fourteen of his boon companions, in order
to possess himself of their property; twenty-three of his political and
clerical rivals were removed by the dagger of hired assassins or
executed upon the testimony of suborned perjurers. He tried to
poison his brother-in-law, Prince Alphonso of Aragon, in order to
facilitate his design of seducing his own sister; he made repeated,
and at last partly successful, attempts to poison the brother of his
mother and his own father, the pope.
The heartless neglect of sanitary provisions for the comfort of the

poor avenges itself in epidemics that visit the abodes of wealth as
well as the hovels of misery. A stall-fed preacher of our southern
seaport towns may circulate a petition for the suppression of Sunday
excursions, in order to prevent the recreation-needing toilers of his
community from leaving town on St. Collection Day; he may
advocate the arrest of bathing schoolboys, in order to suppress an
undue love of physical enjoyments, or to gratify a female tithe-payer
who seeks an opportunity of displaying her prudish virtue at the
expense of the helpless; he may vote to suppress outdoor sports in
the cool of the late evening, when the inhabitants of the tenement
streets are trying to enjoy an hour of extra Sabbatarian recreation—a
privilege to be reserved for the saints who can rest six days out of
seven, and on the seventh harvest the fruits of other men’s labor. But
epidemics refuse to recognize such distinctions, [30]and the vomit of
yellow fever will force the most reverend monopolist to disgorge the
proceeds of the tithes coined from the misery of consumptive factory
children. Nor can wealth purchase immunity from the natural
consequences of habitual vice. The dyspeptic glutton is a Tantalus
who starves in the midst of abundance. The worn-out tradesman,
whose restless toil in the mines of mammon has led to asthma or
consumption, would vainly offer to barter half his gold for half a year
of health. Thousands of families who deny themselves every
recreation, who linger out the summer in the sweltering city, and toil
and save “for the sake of our dear children,” have received Nature’s
verdict on the wisdom of their course in the premature death of those
children.
[Contents]
E.—REDEMPTION.
It has often been said that the physical regeneration of the human
race could be achieved without the aid of a miracle, if its systematic
pursuit were followed with half the zeal which our stock-breeders
bestow upon the rearing of their cows and horses. A general
observance of the most clearly recognized laws of health would,
indeed, abundantly suffice for that purpose. There is, for instance, no
doubt that the morbid tendency of our indoor modes of occupation
could be counteracted by gymnastics, and the trustees of our
education fund should build a gymnasium near every town school.
As a condition of health, pure air is as essential as pure water and
food, and no house-owner should be permitted to sow [31]the seeds
of deadly diseases by crowding his tenants into the back rooms of
unaired and unairable slum-prisons. New cities should be projected
on the plan of concentric rings of cottage suburbs (interspersed with
parks and gardens), instead of successive strata of tenement flats.
In every large town all friends of humanity should unite for the
enforcement of Sunday freedom, and spare no pains to brand the
Sabbath bigots as enemies of the human race. We should found
Sunday gardens, where our toil-worn fellow-citizens could enjoy their
holidays with outdoor sports and outdoor dances, free museums,
temperance drinks, healthy refreshments, collections of botanical
and zoölogical curiosities. Country excursions on the only leisure day
of the laboring classes should be as free as air and sunshine, and
every civilized community should have a Recreation League for the
promotion of that purpose.
In the second century of our chronological era the cities of the

Roman empire vied in the establishment of free public baths. Antioch
alone had fourteen of them; Alexandria not less than twelve, and
Rome itself at least twenty, some of them of such magnificence and
extent that their foundations have withstood the ravages of sixteen
centuries. Many of those establishments were entirely free, and even
the Thermæ, or luxurious Warm Baths, of Caracalla admitted visitors
for a gate-fee which all but the poorest could afford. Our boasted
civilization will have to follow such examples before it can begin to
deserve its name; and even the free circus games [32](by no means
confined to the combats of armed prize-fighters) were preferable to
the fanatical suppression of all popular sports which made the age of
Puritanism the dreariest period of that dismal era known as the
Reign of the Cross.
The preservation of health is at least not less important than the

preservation of Hebrew mythology; and communities who force their
children to sacrifice a large portion of their time to the study of Asiatic
miracle legends might well permit them to devote an occasional hour
or two to the study of modern physiology. We should have health
primers and teachers of hygiene, and the most primitive district
school should find time for a few weekly lessons in the rudiments of
sanitary science, such as the importance of ventilation, the best
modes of exercise, the proper quality and quantity of our daily food,
the significance of the stimulant habit, the use and abuse of dress,
etc.
Such text-books would prepare the way for health lectures, for health
legislation and the reform of municipal hygiene. The untruth that “a
man can not be defiled by things entering him from without” has
been thoroughly exploded by the lessons of science, and should no
longer excuse the neglect of that frugality which in the times of the
pagan republics formed the best safeguard of national vigor. Milk,
bread, and fruit, instead of greasy viands, alcohol, and narcotic
drinks, would soon modify the mortality statistics of our large cities,
and we should not hesitate to recognize the truth that the remarkable
[33]longevity of the Jews and Mohammedans has a great deal to do
with their dread of impure food.
[Contents]
CHAPTER II.
STRENGTH.
[Contents]
A.—LESSONS OF INSTINCT.
Bodily vigor is the basis of mental and physical health. Strength is

power, and the instinctive love of invigorating exercise manifests
itself in the young of all but the lowest brutes. The bigot who
undermines the health of his children by stinting their outdoor sport
as “worldly vanity,” and “exercise that profiteth but little,” is shamed
by animals who lead their young in races and trials of strength. Thus
the female fox will train her cubs; the doe will race and romp with her
fawn, the mare with her colt. Monkeys (like the squirrels of our
northern forests) can be seen running up and down a tree and
leaping from branch to branch, without any conceivable purpose but
the enjoyment of the exercise itself; dogs run races, young lions
wrestle and paw each other in a playful trial of prowess; even birds
can be seen sporting in the air, and dolphins on the play-fields of the
ocean. In nearly all classes of the vertebrate animals the rivalry of
the males is decided by a trial of strength, and the female
unhesitatingly accepts the victor as the fittest representative of his
species.
Normal children are passionately fond of athletic sports. In western

Yucatan I saw Indian girls climb [34]trees with the agility of a spider-
monkey, and laughingly pelt each other with the fruits of the
Adansonia fig. The children of the South-sea Islanders vie in aquatic
gymnastics. Spartan girls joined in the foot-races of their brothers,
and by the laws of Lycurgus were not permitted to marry till they had
attained a prescribed degree of proficiency in a number of athletic
exercises. Race-running and wrestling were the favorite pastimes of
young Romans in the undegenerate age of the republic; and, in spite
of all restraints, similar propensities still manifest themselves in our
school-boys. They pass the intervals of their study-hours in
competitive athletics, rather than in listless inactivity, and brave frosts
and snowstorms to get the benefit of outdoor exercise even in
midwinter. They love health-giving sports for their own sake, as if
instinctively aware that bodily strength will further every victory in the
arena of life.
The enthusiasm that gathered about the heroic games of Olympia

made those festivals the brightest days in the springtime of the
human race. The million-voiced cheers that hailed the victor of the
pentathlon have never been heard again on earth since the manliest
and noblest of all recreations were suppressed by order of a
crowned bigot. The rapture of competitive athletics is a bond which
can obliterate the rancor of all baser rivalries, and still unites hostile
tribes in the arena of pure manhood: as in Algiers, where the
Bedouins joined in the gymnastic prize-games of their French
foemen: the same foemen whose banquets they would have refused
to share even at the bidding of starvation. In Buda-Pesth I once
[35]witnessed a performance of the German athlete Weitzel, and still
remember the irrepressible enthusiasm of two broad-shouldered
Turks who crowded to the edge of the platform, and, with waving
kerchiefs, joined in the cheers of the uncircumcised spectators.
[Contents]
B.—REWARDS OF CONFORMITY.
The “survival of the fittest” means, in many important respects, the
survival of the strongest. In a state of nature weakly animals yield to
their stronger rivals; the stoutest lion, the swiftest tiger, has a
superior chance of obtaining prey; the stouter bulls of the herd defy
the attack of the wolves who overcome the resistance of the weaker
individuals; the fleetest deer has the best chance to escape the
pursuit of the hunter.
A state of civilization does only apparently equalize such differences.

The invention of gunpowder has armed the weak with the power of a
giant; but the issue of international wars will always be biased by the
comparative strength of sinew and steadiness of nerve of the men
that handle those improved weapons. In the last Franco-Prussian
war the French were favored by an undoubted superiority of arms,
but they were utterly beaten by a nation whose sons had devoted
their youth to gymnastics. The arms of the Gothic giants were of the
rudest description: hunting-spears and clumsy battle-axes; but those
axes broke the ranks of the Roman legionaries, with their polished
swords and elaborate tactics. For the last two thousand years the
wars [36]that decided the international rivalries of Asia, Europe, and
North America nearly always ended with the victory of a northern
nation over its southern neighbors. The men of the north could not
always boast a superiority in science or arms, nor in number, nor in
the advantage of a popular cause; but the rigor of their climate
exacts a valiant effort in the struggle for existence, and steels the
nerves even of an otherwise inferior race. “Fortis Fortuna adjuvat,”
said a Roman proverb, which means literally that Fortune favors the
strong, and which has been well rendered in the paraphrase of a
modern translator: “Force begets fortitude and conquers fortune.”
Nor is that bias of fate confined to the battles of war. In the contests
of peace, too, other things being equal, the strong arm will prevail
against the weak, the stout heart against the faint. Bodily strength
begets self-reliance. “Blest are the strong, for they shall possess the
kingdom of the earth,” would be an improved variation of the gospel
text. The Germanic nations (including the Scandinavian and Anglo-
Saxon) who have most faithfully preserved the once universal love of
manly sports, have prevailed against their rivals in the arena of
industry and science, as well as of war.
An American manufacturer, who established a branch of his

business at Havre, France, hired American and British workmen at
double wages, maintaining that he found it the cheapest plan, since
one of his expensive laborers could do the work of three natives. In
the seaport towns, even of South America and Southern Europe, a
British sailor [37]is always at a premium. American industry is steadily
forcing its way further south, and may yet come to limit the fields of
its enterprise only by the boundaries of the American continent. From
the smallest beginnings, a nation of iron-fisted rustics has repeatedly
risen to supremacy in arms and arts. Two hundred years before the
era of Norman conquests in France, Italy, and Great Britain, the
natives of Norway were but a race of hardy hunters and fishermen. A
century after the battle of Xeres de la Frontera, the half-savage
followers of Musa and Tarik had founded high schools of science and
industry. And, as the fairest flower springs from the hardy thorn, the
brightest flowers of art and poetry have immortalized the lands of
heroic freemen, rather than of languid dreamers. The same nation
that carried the banners of freedom through the battle-storm of
Marathon and Salamis, adorned its temples with the sculptures of
Phidias and its literature with the masterpieces of Sophocles and
Simonides.
Physical vigor is also the best guarantee of longevity. Nature

exempts the children of the south from many cares; yet in the stern
climes of the higher latitudes Health seems to make her favorite
home; in spite of snowstorms and bitter frosts the robust
Scandinavian outlives the languid Italian. In spite of a rigorous
climate, I say, for that his length of life is the reward of hardy habits is
proved by the not less remarkable longevity of the hardy Arab and
the manful Circassian, in climes that differ from that of Norway as
Mexico and Virginia differ from Labrador. Men of steeled sinews
overcome disease [38]as they brave the perils of wars and the
hardships of the wilderness; hospital-surgeons know how readily the
semi-savages of a primitive borderland recover from injuries that
would send the effeminate city-dweller to the land of the shades.
Toil-hardened laborers, too, share such immunities. On the 25th of
March, 1887, Thomas McGuire, the foreman of a number of laborers
employed at the night-shift of the Croton Aqueduct, fell to the bottom
of the pit, a distance of ninety-five feet, and was drawn up in a
comatose condition, literally drenched in his own blood. At the
Bellevue Hospital (city of New York) the examining surgeon found
him still alive, but gave him up for lost when he ascertained the
extent of his injuries. Both his arms were broken near the shoulder,
both thighs were fractured, his skull was horribly shattered about the
left temple and frontal region, six of his ribs were broken and their
splinters driven into the lungs. There seemed no hope whatever for
him, and, after the administration of an anesthetic, he was put in a
cot and left alone to die. To the utter surprise of the attending
surgeon, the next morning found the mass of broken bones still
breathing. His fever subsided; he survived a series of desperate
operations, survived an apparently fatal hemorrhage, and continued
to improve from day to day, till about the middle of June he
recovered his complete consciousness, and was able to sit up and
answer the questions of the medical men who, in ever increasing
numbers, had visited his bedside for the last three weeks. As a
newspaper correspondent sums up his case: “His strong constitution
had [39]repulsed the assaults of death, till finally the grim monster
went away to seek a less obstinate victim.” And, moreover, the
exercise of athletic sports lessens the danger of such accidents: a

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2. Why does wearing sunscreen reduce cancer risk?

3. A mutation can cause a change _____.

7. Are all mutations bad? Explain your answer.

10. Why is age a risk factor for cancer?

11. What is the role of BRCA1 in normal cells?

18. Which of the following is a known mutagen?

19. Why does wearing sunscreen reduce cancer risk?

23. A woman with a BRCA1 mutation

26. Define apoptosis. Why is apoptosis important?

28. Define metastasis. Do all cancers enter this stage?

33. Explain how radiation leads to apoptosis.

37. List three types of genetic mutations that may occur.

40. Why should pregnant women never be given X-rays?

43. What is a mutagen?

49. What is a carcinogen?

50. List at least five carcinogens.

58. What role does an oncogene play in generating a tumor?

73. Cell cycle checkpoints detect and control

74. Cell division is usually kept under control by

75. At the G2 checkpoint, cells pause to

77. Programmed cell death is called

78. Proteins scan chromosomes for damage during the

82. If a cell is irreparably damaged, it undergoes programmed cell death, called

83. Cancer consists of too much

84. Which of the following help(s) to prevent cancer?

87. Cell division in cancerous tumors

88. The medical condition of cells growing out of control is called

90. How could a cancerous cell evade apoptosis?

93. Chemotherapy is used in the battle against

94. Chemotherapeutics act on

95. Radiation therapy for cancer works by

103. Most chemotherapy drugs are effective because they

104. All of the following could be effective cancer treatments EXCEPT

105. Chemotherapy drugs interfere with

110. Alleles are located

111. What is an example of a mutation in an allele?

114. Gene mutations can arise when nucleotides are

116. Different alleles are the result of

118. A mutation is best described as an error in

119. Most new alleles arise via

123. Which of the following is TRUE?

125. A mutation would most likely be inherited if it is located in a ____ cell.

130. DNA mutations can

134. Which of the following cannot lead to a mutation?

135. DNA damage is usually repaired

136. Mutations are

139. Mutations in DNA sequences may occur during the process of

144. Mutations in DNA occur during