Question 1

Which of the following best describes the balance that determines net cell growth in tissues?

Accepted Answer

The ratio of cell cycle control to apoptosis control

Question 2

Cellular growth control is primarily regulated by which of the following mechanisms?

Accepted Answer

Activation of gene expression via signal transduction pathways initiated by cell surface receptors

Question 3

Which type of gene mutation is most likely to result in uncontrolled cellular proliferation leading to cancer?

Accepted Answer

Mutation in proto-oncogenes

Question 4

Why are most cancers considered the 'tip of the iceberg' in terms of immune response?

Accepted Answer

Because normal cellular and immune responses usually destroy most cancerous cells before they develop into detectable tumours

Question 5

Which of the following tumour antigens is LEAST likely to be recognized by T cells?

Accepted Answer

Antigens widely expressed at high levels on normal somatic cells

Question 6

In haematopoietic cancers, why is T cell recognition of tumour antigens more likely than in solid organ cancers?

Accepted Answer

Cancerous blood cells come into contact with naive T cells and some express high levels of B7

Question 7

Which of the following is a mechanism by which tumour cells evade immune detection?

Accepted Answer

Downregulation of MHC I expression

Question 8

What is the role of NK cells in tumour recognition?

Accepted Answer

NK cells target cells with low levels of MHC I and unusual surface proteins

Question 9

Which process describes the immune system's iterative selection of tumour cell variants with increasing capacity to survive immune attack?

Accepted Answer

Equilibrium phase of cancer immunoediting

Question 10

Monoclonal antibodies are engineered to bind a single epitope. Which region of the antibody is modified to alter its effector function?

Accepted Answer

Fc region

Question 11

Which monoclonal antibody is used to target CD20 in Non-Hodgkin's lymphoma?

Accepted Answer

Rituximab

Question 12

Trastuzumab (Herceptin) is effective in treating certain breast cancers because it targets which molecule?

Accepted Answer

HER-2 (Human Epidermal Growth Factor Receptor 2)

Question 13

What is the mechanism by which gemtuzumab ozogamicin (Mylotarg) induces apoptosis in acute myeloid leukemia cells?

Accepted Answer

The calicheamicin derivative binds to DNA, causing strand breaks and apoptosis

Question 14

Ipilimumab is a monoclonal antibody that blocks negative signaling from which molecule to enhance T cell activation?

Accepted Answer

CTLA-4

Question 15

Which immunotherapy drug acts by blocking PD-1, allowing T cells to respond to cancer cells?

Accepted Answer

Pembrolizumab

Question 16

Why are antigens not normally expressed on somatic cells considered ideal targets for cancer immunotherapy?

Accepted Answer

They are less likely to induce self-tolerance and cause damage to normal cells

Question 17

Which equation best represents the relationship between cell birth and cell death in determining net cell growth?

Accepted Answer

$$	ext{Net Cell Growth} = 	ext{Cell Birth} - 	ext{Cell Death}$$

Question 18

Which of the following is a potential risk of using vaccines targeting antigens widely expressed at low levels on normal tissues?

Accepted Answer

Induction of autoimmune diseases

Question 19

Which cytokine is known to activate both T cells and NK cells, but is toxic when administered systemically?

Accepted Answer

Interleukin-2 (IL-2)

Question 20

What is the main advantage of CAR-T cell therapy over traditional T cell transfer therapies?

Accepted Answer

CAR-T cells can be engineered to recognize MHC-non restricted structures on tumour cells

Cancer Immunology and Immunotherapy: Microbiology & Immunology AP0506 Study Notes

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