1. Where can cancerous cells develop?

a) Only in the lungs

b) Only in the breast
c) Only in the skin
d) From any tissue within the body
Answer: d) From any tissue within the body

2. What is a tumor?
a) A mass of cancerous tissue
b) A benign growth of cells
c) A cyst filled with fluid
d) A blood clot
Answer: a) A mass of cancerous tissue

3. How many diseases are encompassed by the term "cancer"?

a) Less than 50
b) Around 100
c) More than 200
d) Exactly 500
Answer: c) More than 200

4. What happens as cancerous cells multiply?

a) They form normal tissues
b) They invade and destroy normal adjacent tissues
c) They transform into stem cells
d) They stop multiplying
Answer: b) They invade and destroy normal adjacent tissues

5. Which of the following is NOT a characteristic of cancer?

a) Uncontrolled cell proliferation
b) Invasion of adjacent tissues
c) Crowding out normal cells in the bloodstream
d) Decreased blood supply to affected tissues
Answer: d) Decreased blood supply to affected tissues

6. What is the main cause of cancer?

a) Genetic mutations
b) Bacterial infections
c) Allergies
 d) Aging
Answer: a) Genetic mutations

7. Which of the following is NOT a risk factor for developing cancer?

a) Tobacco use
b) Exposure to certain chemicals
c) Regular physical exercise
d) Family history of cancer
Answer: c) Regular physical exercise

8. What is metastasis in relation to cancer?

a) The formation of a tumor
b) The shrinking of a tumor
c) The spread of cancer to distant tissues or organs
d) The removal of cancerous cells from the body
Answer: c) The spread of cancer to distant tissues or organs

9. Which type of cancer arises from epithelial tissue?

a) Carcinoma
b) Sarcoma
c) Leukemia
d) Lymphoma
Answer: a) Carcinoma

10. Which type of cancer primarily affects muscles, bone, and cartilage?
a) Carcinoma
b) Sarcoma
c) Leukemia
d) Lymphoma
Answer: b) Sarcoma

11. Which type of cancer involves excessive production of leukocytes?

a) Carcinoma
b) Sarcoma
c) Leukemia
d) Lymphoma
Answer: c) Leukemia
12. Which type of cancer affects the lymph nodes and spleen?
a) Carcinoma
b) Sarcoma
c) Leukemia
d) Lymphoma
Answer: d) Lymphoma

13. What percentage of all cancers are carcinomas?

a) 89.3%
b) 1.9%
c) 3.4%
d) 5.4%
Answer: a) 89.3%

14. Which type of cancer primarily affects blood cells and bone marrow?
a) Carcinoma
b) Sarcoma
c) Leukemia
d) Lymphoma
Answer: c) Leukemia

15. Proto-oncogenes can be upregulated into oncogenes, leading to:

a. Inhibition of tumor growth
b. Induction of cell death
c. Uncontrolled cell growth
d. Recognition by the immune system
Answer: c. Uncontrolled cell growth

16. Tumor suppressor genes function to:

a. Promote tumor growth
b. Inhibit cell division
c. Induce cell death
d. Downregulate oncogenes
Answer: b. Inhibit cell division

17. Which gene is commonly associated with tumor suppression?

a. Oncogene K-ras
b. Tumor suppressor p53
c. Proto-oncogene c-myc
 d. Oncogene HER2
Answer: b. Tumor suppressor p53

18. Mutations in tumor suppressor genes can lead to:

a. Upregulation of oncogenes
b. Downregulation of oncogenes
c. Uncontrolled cell growth
d. Immune recognition of tumor cells
Answer: c. Uncontrolled cell growth

19. Which of the following can induce cell death and inhibit tumor growth?
a. Proto-oncogenes
b. Oncogenes
c. Tumor suppressor genes
d. Physical carcinogens
Answer: c. Tumor suppressor genes

20. The transformation of normal cells into malignant cells can be induced by:
a. Daily cell division
b. Chemical carcinogens
c. Physical carcinogens
d. Viruses
Answer: All of the above

21. The immune system recognizes and destroys cells that have become:
a. Proto-oncogenes
b. Oncogenes
c. Antigenically different from normal cells
d. Tumor suppressor genes
Answer: c. Antigenically different from normal cells

22. Which of the following is associated with uncontrolled cell growth?

a. Tumor suppressor genes
b. Oncogenes
c. Chemical carcinogens
d. Viruses
Answer: b. Oncogenes
23. Spontaneous mutations during daily cell division can contribute to:
a. Recognition by the immune system
b. Downregulation of oncogenes
c. Transformation of normal cells into malignant cells
d. Inhibition of tumor growth
Answer: c. Transformation of normal cells into malignant cells

24. Proto-oncogenes can be upregulated into oncogenes, leading to:

a. Inhibition of tumor growth
b. Induction of cell death
c. Uncontrolled cell growth
d. Recognition by the immune system
Answer: c. Uncontrolled cell growth

25. Tumor suppressor genes function to:

a. Promote tumor growth
b. Inhibit cell division
c. Induce cell death
d. Downregulate oncogenes
Answer: b. Inhibit cell division

26. Which gene is commonly associated with tumor suppression?

a. Oncogene K-ras
b. Tumor suppressor p53
c. Proto-oncogene c-myc
d. Oncogene HER2
Answer: b. Tumor suppressor p53

27. Mutations in tumor suppressor genes can lead to:

a. Upregulation of oncogenes
b. Downregulation of oncogenes
c. Uncontrolled cell growth
d. Immune recognition of tumor cells
Answer: c. Uncontrolled cell growth

28. Which of the following can induce cell death and inhibit tumor growth?
a. Proto-oncogenes
b. Oncogenes
c. Tumor suppressor genes
 d. Physical carcinogens
Answer: c. Tumor suppressor genes

29. The transformation of normal cells into malignant cells can be induced by:
a. Daily cell division
b. Chemical carcinogens
c. Physical carcinogens
d. Viruses
Answer: All of the above

30. The immune system recognizes and destroys cells that have become:
a. Proto-oncogenes
b. Oncogenes
c. Antigenically different from normal cells
d. Tumor suppressor genes
Answer: c. Antigenically different from normal cells

31. Which of the following is associated with uncontrolled cell growth?

a. Tumor suppressor genes
b. Oncogenes
c. Chemical carcinogens
d. Viruses
Answer: b. Oncogenes

32. Spontaneous mutations during daily cell division can contribute to:
a. Recognition by the immune system
b. Downregulation of oncogenes
c. Transformation of normal cells into malignant cells
d. Inhibition of tumor growth
Answer: c. Transformation of normal cells into malignant cells

33. Which of the following is an example of the inherited etiology of tumors?

a. Expression of inherited oncogene
b. Human papilloma virus
c. Poly cyclic hydrocarbons
d. Ultraviolet irradiation
Answer: a. Expression of inherited oncogene
34. Which type of virus is associated with human T-cell leukemia?
a. DNA virus
b. RNA virus
c. Herpes type 2 virus
d. Human papilloma virus
Answer: b. RNA virus

35. Which chemical compound is known to cause sarcomas?

a. Aromatic amines
b. Alkyl nitroso amines
c. Poly cyclic hydrocarbons
d. Human papilloma virus
Answer: c. Poly cyclic hydrocarbons

36. What is the effect of ultraviolet irradiation on tumor development?

a. Activation of tumor suppressor genes
b. Inhibition of oncogenes
c. Induction of DNA damage
d. Suppression of viral genes
Answer: c. Induction of DNA damage

37. Which of the following is an example of a viral etiology of tumors?

a. Ultraviolet irradiation
b. Poly cyclic hydrocarbons
c. Herpes type 2 virus
d. Alkyl nitroso amines
Answer: c. Herpes type 2 virus

38. What is the main cause of spontaneous tumor development?

a. Exposure to chemicals
b. Inherited oncogenes
c. Viral infections
d. Failure in cellular growth control
Answer: d. Failure in cellular growth control

39. Which type of radiation is associated with tumor development?

a. Ultraviolet
b. Infrared
c. X-ray
 d. Gamma-ray
Answer: c. X-ray

40. Which viral infection is associated with cervical cancer?

a. Human T-cell leukemia virus
b. Human papilloma virus
c. Herpes type 2 virus
d. Epstein-Barr virus
Answer: b. Human papilloma virus

41. Which chemical compound is known to cause mammary carcinoma?

a. Poly cyclic hydrocarbons
b. Alkyl nitroso amines
c. Aromatic amines
d. Ultraviolet irradiation
Answer: c. Aromatic amines

42. What is the effect of inherited oncogenes on tumor development?

a. Activation of tumor suppressor genes
b. Downregulation of viral genes
c. Expression of abnormal growth-promoting genes
d. Induction of DNA damage
Answer: c. Expression of abnormal growth-promoting genes

43. Which of the following is one of the primary roles of the immune system in tumor
prevention?
a. Elimination of benign tumors
b. Protection from bacterial infections
c. Suppression of viral infections
d. Induction of inflammation
Answer: c. Suppression of viral infections

44. The immune system helps prevent tumorigenesis by:

a. Promoting the establishment of an inflammatory environment
b. Suppressing the elimination of pathogens
c. Identifying and eliminating tumor cells
d. Enhancing tumor growth and progression
Answer: c. Identifying and eliminating tumor cells
45. Tumor immune surveillance refers to:
a. The immune system's ability to detect viral infections
b. The process of eliminating benign tumors
c. The immune system's identification and elimination of cancerous or
precancerous cells
d. The promotion of an inflammatory environment conducive to tumorigenesis
Answer: c. The immune system's identification and elimination of cancerous or
precancerous cells

46. In tumor immune surveillance, the immune system recognizes tumor cells based on:
a. Their expression of viral antigens
b. Their suppression of inflammation
c. Their ability to induce pathogens
d. Their expression of tumor-specific antigens or molecules
Answer: d. Their expression of tumor-specific antigens or molecules

47. One of the roles of the immune system in tumor prevention is to:
a. Promote the establishment of an inflammatory environment
b. Delay the resolution of inflammation
c. Eliminate tumor cells that express tumor-specific antigens
d. Facilitate the growth and progression of tumors
Answer: c. Eliminate tumor cells that express tumor-specific antigens

48. How does the immune system protect the host from virus-induced tumors?
a. By promoting viral infections
b. By suppressing viral infections
c. By inducing inflammation in tumor cells
d. By promoting the growth of tumor cells
Answer: b. By suppressing viral infections

49. Which of the following is an example of a viral antigen?

a. Viral proteins and glycoproteins
b. Tumor-specific antigens
c. Tumor-specific transplantation antigens
d. Oncofetal antigens
Answer: a. Viral proteins and glycoproteins
50. Tumor-specific antigens (TSA) are developed by tumor cells in response to:
a. Viral infections
b. Carcinogens
c. Alteration of MHC antigens
d. Fetal development
Answer: b. Carcinogens

51. Tumor-specific transplantation antigens (TSTA) are expressed by tumor cells due to:
a. Viral infections
b. Carcinogens
c. Alteration of normally present MHC antigens
d. Fetal development
Answer: c. Alteration of normally present MHC antigens

52. Carcino-embryonic antigens (CEA) are normally expressed during:

a. Adult life in the gastrointestinal tract
b. Fetal life on the fetal gut
c. Fetal life in the pancreas
d. Adult life in the breast
Answer: b. Fetal life on the fetal gut

53. Alpha fetoprotein (AFP) is normally expressed during:

a. Adult life in the liver
b. Fetal life in the liver
c. Adult life in the pancreas
d. Fetal life in the breast
Answer: b. Fetal life in the liver

54. Which type of tumor antigen is specifically associated with hepatoma?

a. Viral antigens
b. Tumor-specific antigens (TSA)
c. Tumor-specific transplantation antigens (TSTA)
d. Oncofetal antigens (Alpha fetoprotein)
Answer: d. Oncofetal antigens (Alpha fetoprotein)

55. New antigens produced by virally infected host cells under the control of viral nucleic
acid are an example of:
a. Viral antigens
b. Tumor-specific antigens (TSA)
 c. Tumor-specific transplantation antigens (TSTA)
d. Oncofetal antigens
Answer: a. Viral antigens

56. Tumor cells expressing new MHC antigens due to alteration of normally present MHC
antigens are categorized as:
a. Viral antigens
b. Tumor-specific antigens (TSA)
c. Tumor-specific transplantation antigens (TSTA)
d. Oncofetal antigens
Answer: c. Tumor-specific transplantation antigens (TSTA)

57. Which type of tumor antigen is associated with the gastrointestinal tract, pancreas,
biliary system, and breast cancer?
a. Viral antigens
b. Tumor-specific antigens (TSA)
c. Tumor-specific transplantation antigens (TSTA)
d. Oncofetal antigens (Carcino-embryonic antigens)
Answer: d. Oncofetal antigens (Carcino-embryonic antigens)

58. Which cells are involved in the cellular immune response against tumors?
a. Cytotoxic T lymphocytes
b. Natural killer cells
c. Macrophages
d. All of the above
Answer: d. All of the above

59. Which immune cells are responsible for antibody-dependent cellular cytotoxicity
(ADCC)?
a. Cytotoxic T lymphocytes
b. Natural killer cells
c. Macrophages
d. B cells
Answer: b. Natural killer cells

60. The immune surveillance mechanism involves the continuous surveying of the body by
the immune system for the presence of:
a. Normal cells
b. Foreign cells
 c. Abnormal cells
d. Inflammatory cells
Answer: c. Abnormal cells

61. The immune response to a tumor is believed to be:

a. A delayed event
b. An early event
c. An unpredictable event
d. A gradual event
Answer: b. An early event

62. The immune system's role in tumor immune surveillance is to:

a. Delay tumor growth
b. Destroy abnormal cells
c. Support tumor growth
d. Suppress immune responses
Answer: b. Destroy abnormal cells

63. Which type of immune cells are specifically responsible for directly killing tumor cells?
a. Cytotoxic T lymphocytes
b. Natural killer cells
c. Macrophages
d. B cells
Answer: a. Cytotoxic T lymphocytes

64. Which cells directly kill tumor cells in the immune surveillance system?
a. Natural killer (NK) cells
b. Cytotoxic T-cells
c. Macrophages
d. B cells
Answer: a. Natural killer (NK) cells

65. Which lymphokines are produced by cell-mediated T-cells in the immune surveillance
system?
a. Macrophage activation factor
b. γ interferon
c. IL-2
d. All of the above
Answer: d. All of the above
66. What is the role of γ interferon and IL-2 in the immune surveillance system?
a. Activation of natural killer (NK) cells
b. Activation of cytotoxic T-cells
c. Activation of macrophages
d. All of the above
Answer: d. All of the above

67. Which lymphokine is involved in the activation of macrophages in the immune

surveillance system?
a. Macrophage activation factor
b. γ interferon
c. IL-2
d. Tumor necrosis factor (TNF)
Answer: a. Macrophage activation factor

68. B-cells in the immune surveillance system produce specific antibodies against:
a. Normal cells
b. Foreign cells
c. Tumor-associated antigens
d. Inflammatory cells
Answer: c. Tumor-associated antigens

69. Antibody-mediated cytotoxicity in the immune surveillance system involves the killing of
tumor cells by:
a. Cytotoxic T-cells
b. Natural killer (NK) cells
c. Macrophages
d. B cells
Answer: a. Cytotoxic T-cells

70. Activation of macrophages in the immune surveillance system leads to the release of:
a. Sensitized T-cells
b. Macrophage activating factor
c. IgG-coated tumor cells
d. All of the above
Answer: d. All of the above
71. The activation of the classical pathway of complement in the immune surveillance
system leads to the:
a. Killing of cytotoxic T-cells
b. Activation of natural killer (NK) cells
c. Lysis of tumor cells
d. Release of tumor necrosis factor (TNF)
Answer: c. Lysis of tumor cells

72. How do some tumors evade recognition by cytotoxic T lymphocytes (CTLs)?

a. By reducing or lacking MHCI molecules on the tumor cells.
b. By increasing the expression of MHCI molecules on the tumor cells.
c. By enhancing antigen presentation to CTLs.
d. By activating natural killer cells to target CTLs.
Answer: a. By reducing or lacking MHCI molecules on the tumor cells.

73. What term is used to describe tumors that no longer express the antigens they initially
had?
a. Antigen suppression tumors.
b. Antigen loss variants.
c. Immunosuppressive tumors.
d. Antigen-deficient tumors.
Answer: b. Antigen loss variants.

74. Which immunosuppressive factors can be produced by tumors to evade the immune
response?
a. Transforming growth factor (TGF-β) and IL-2.
b. Interferon gamma (IFN-γ) and tumor necrosis factor (TNF).
c. Interleukin-10 (IL-10) and IL-12.
d. Granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-6
(IL-6).
Answer: c. Interleukin-10 (IL-10) and IL-12.

75. What is a potential defect in tumor cells that hinders antigen processing and
presentation?
a. Inability to produce cytokines.
b. Overexpression of MHCII molecules.
c. Deficiency in proteasome activity.
d. Impaired antibody production.
Answer: c. Deficiency in proteasome activity.
76. How can the blocking of receptors on T-cells by specific antigen-antibody complexes
contribute to immune escape?
a. It enhances T-cell activation and proliferation.
b. It promotes tumor cell apoptosis.
c. It inhibits T-cell signaling and effector functions.
d. It induces the release of immunosuppressive cytokines.
Answer: c. It inhibits T-cell signaling and effector functions.

77. Which mechanism of immune escape involves the downregulation or absence of MHCI
molecules on tumor cells?
a. Antigen loss variants.
b. Immunomodulatory cytokine production.
c. Defective antigen processing and presentation.
d. Receptor blocking by antigen-antibody complexes.
Answer: a. Antigen loss variants.

78. Which immunosuppressive factor is known for inhibiting the function of immune cells
and promoting tumor growth?
a. Transforming growth factor (TGF-β).
b. Interleukin-2 (IL-2).
c. Interferon gamma (IFN-γ).
d. Tumor necrosis factor (TNF).
79. Answer: a. Transforming growth factor (TGF-β).

80. What is a potential consequence of tumor cells having a defect in antigen processing and
presentation?
a. Enhanced recognition and elimination by immune cells.
b. Reduced tumor growth and proliferation.
c. Decreased sensitivity to immunotherapy.
d. Increased production of immunosuppressive cytokines.
81. Answer: c. Decreased sensitivity to immunotherapy.

82. How can tumors evade immune surveillance by blocking receptors on T-cells?
a. By inducing T-cell activation and proliferation.
b. By promoting antibody production against tumor antigens.
c. By inhibiting T-cell signaling and effector functions.
d. By enhancing the presentation of tumor antigens.
Answer: c. By inhibiting T-cell signaling and effector functions.