10.A 35-year-old man with a family history of colon carcinoma undergoes a surveillance colonoscopy.It reveals hundreds of polyps in the colon and two focal 0.5 cm ulcerated areas.A biopsy from an ulcer is shown above and reveals irregularly shaped glands that have penetrated into the muscular layer.Which of the following molecular events is believed to occur very early in the evolution of his colonic disease process? A.Activated tumor suppressor genes B.Amplified HER2/neu C Heter Sp53 D.Inhe E.Trans om mitochondria to cytoplasm Ans:C The scenario describes a man with familial adenomatous polyposis.One of the early mutations is likely to be a loss of one allele of the p53 gene,an event associated with the transition from adenoma to carcinoma.Activation of tumor suppressor genes would reduce the likelihood of tumorigenesis.Amplification of HER2/neu (growth factor receptors)is a process implicated in many breast cancers.An inherited APC germline mutation cannot be an early molecular event in the evolution of this disease process.because the inherited copy was already there at the outset. Bcl2 blocks the insertion of a pore into the mitochondrial membrane,which would allow for release of cytochrome c and activation of apoptotic caspases.Thus bel2 is anti-apoptotic;it is associated with lymphoma but mutations are found in many cancers. 11 a clinical study involves patients diagnosed with carcinoma and whose tumor stage is T4NIMI.The patients' rate 5 years from the time of diagnosis is less than 50% egardless of the Which of the follo ing c linical findings is most likely to be characteristic of this group of p tients? A.Cache BC Cardiac murmu D.Loss of sensation1 10. A 35-year-old man with a family history of colon carcinoma undergoes a surveillance colonoscopy. It reveals hundreds of polyps in the colon and two focal 0.5 cm ulcerated areas. A biopsy from an ulcer is shown above and reveals irregularly shaped glands that have penetrated into the muscular layer. Which of the following molecular events is believed to occur very early in the evolution of his colonic disease process? A. Activated tumor suppressor genes B. Amplified HER2/neu C. Heterozygous p53 gene D. Inherited APC germline mutation E. Translocation of BCL2 from mitochondria to cytoplasm Ans: C The scenario describes a man with familial adenomatous polyposis. One of the early mutations is likely to be a loss of one allele of the p53 gene, an event associated with the transition from adenoma to carcinoma. Activation of tumor suppressor genes would reduce the likelihood of tumorigenesis. Amplification of HER2/neu (growth factor receptors) is a process implicated in many breast cancers. An inherited APC germline mutation cannot be an early molecular event in the evolution of this disease process, because the inherited copy was already there at the outset. Bcl2 blocks the insertion of a pore into the mitochondrial membrane, which would allow for release of cytochrome c and activation of apoptotic caspases. Thus bcl2 is anti-apoptotic; it is associated with lymphoma but mutations are found in many cancers. 11. A clinical study involves patients diagnosed with carcinoma and whose tumor stage is T4N1M1. The patients’ survival rate 5 years from the time of diagnosis is less than 50%, regardless of therapy. Which of the following clinical findings is most likely to be characteristic of this group of patients? A. Cachexia B. Cardiac murmur C. Icterus D. Loss of sensation