Scientific American Biology for a

Changing World with Core Physiology

3rd Edition Shuster Test Bank
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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

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 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.

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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.

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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.

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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?

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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.

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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.

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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?

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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.

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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.

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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.

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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.
E) All of the above.

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
E) All of the above.

85. Cancer is
A) an organ that becomes malignant.
B) a metastatic cell.
C) unregulated apoptosis.
D) unregulated cell division.
E) regulated cell division.

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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.
E) All of the above.

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.
E) All of the above.

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.

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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.
E) All of the above.

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.

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 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)

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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.
E) All of the above.

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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
traditional chemotherapy.
C) It would starve cells in a tumor, which would kill them more gradually than
traditional chemotherapy.
D) It targets only rapidly dividing cells because those are the ones that form tumors.
E) All of the above.

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

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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
E) All of the above.

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.
E) All of the above.

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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.

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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.
E) All of the above.

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.
E) All of the above.

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
E) All of the above.

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.
E) None 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.
E) All of the above.

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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.
E) All of the above.

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.
E) None of the above.

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.”
E) None of the above.

Page 24
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.
E) None of the above.

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.

Page 25
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.
E) All of the above.

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
E) All of the above.

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
E) All of the above.

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.
E) All of the above.

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
E) All of the above.

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
E) All of the above.

166. In a cell with the following mutations, which would you expect to be LEAST likely?
A) BRCA1 and BRCA2
B) BRCA1
C) BRCA1, BRCA2, Her2, and p53 mutations
D) BRCA1, BRCA2, and p53 mutations
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
E) All of the above.

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
E) All of the above.

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.

Page 31
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
E) None of the above.

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.
E) All of the above.

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.

Page 33
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
E) All of the above.

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
E) All of the above.

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.
E) All of the above.

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
C) BRCA1, BRCA2, Her2, and p53 mutations
D) BRCA1, BRCA2, and p53 mutations
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.
E) None of the above.

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
E) All of the above.

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

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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

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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

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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.

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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.

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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

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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

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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

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229. E
230. A
231. D
232. E
233. B
234. D
235. C
236. A

Page 51