Question 2 (1 point) Saved Based on the information from both your patient and his

Question 2 (1 point) Saved Based on the information from both your patient and his family, what genetic disorder should you most suspect? Question 2 options: Multiple endocrine neoplasia Li Fraumeni syndrome Carney complex type I Familial adenomatous polyposi Question 3 (1 point) What gene is most often defective in this disorder? Question 3 options: p53 K1F1B VHL ret PRKAR1A Question 4 (1 point) Dr. Faiyaz shares your suspicion. She then shares with you her concerns about his sister Carla (5), despite the fact that she does not have cancer. Why do you think she should be concern? Question 4 options: none of the above mutation in gene associated with this syndrome is contagious people with this syndrome may develop cancer in their lifetime people with this syndrome will develop cancer in their lifetime Question 5 (1 point) With respect to this genetic disorder, would it be possible for a person with cancer to have two parents who do not have cancer? Question 5 options: YES NO Question 6 (1 point) Saved Carlos agreed to get a genetic test. In order to test Carlos for a genetic disorder, Dr. Faiyaz will probably take a sample of cells containing his genomic DNA by swabbing his cheek or taking a blood sample. Why is it important to use non-cancerous cells to test Carlos for a genetic disorder instead of the biopsy (cancerous) tissue? Question 6 options: Non-cancerous cells have better quality DNA Non-cancerous cells are easier to isolate Non-cancerous cells contain germline DNA B and C Disease Unfortunately, the results from Carlos’s biopsy are in and it appears that he has adrenocortical carcinoma (ACC). Fortunately, Dr. Faiyaz is on the cutting edge of developing treatments for this condition. She is a part of a consortium of researchers that are trying to catalog all of the different genes that may be involved in adrenal cancer. This will help physicians and scientists to discover drugs to target specific cancer-contributing gene products. Dr. Faiyaz and her collegues find the following in Carlos’s cancer; loss of p53 gene, loss of APC and a point mutation in KRAS gene. Question 7 (1 point) Which of the following statements are true? Question 7 options: p53 gene is a tumour suppressor p53 is a transcriptional factor loss of p53 leads to progression of cancer all of the above Question 8 (1 point) What would you expect cells to be like if they did not have properly functioning p53? Question 8 options: the absence of p53 could cause cells to replicate with damaged DNA that could ultimately lead to cancer the absence of p53 could cause cells to skip mitosis and stay in S phase of the cell cycle the absence of p53 would have no effect on the cells. the absence of p53 inside cells would cause them to divide more rapidly. Question 9 (1 point) Which of the following statements are true: Question 9 options: APC is an oncogene APC is important for self-renewal kras is a tumour suppressor gene kras contributes to apoptosis Treatment Dr. Faiyaz treats Carlos cancer by surgery and combination chemotherapy. Despite this Carlos’s cancer progressed. The malignancy inundated his body, spreading first to his lymph nodes then to his lungs. There are currently no effective treatments approved in the clinic for Carlos’s type of cancer. Despite trying to maintain a professional level of emotional distance, you have become attached to Carlos. You spend evenings searching the medical literature for potential treatments, including clinical trials, to help him. You find several clinical trials testing immunotherapy for patients with advanced ACC (like Carlos has). You take another biopsy of Carlos’s cancer and find out the following; tumour cells have high levels of PD-1 expression, low levels of MHC expression and many TILs. Question 10 (1 point) Based on these findings, you suggest that Carlos enrols in the clinical trial testing which drug? Question 10 options: ipilimumab (targets the CTLA-4 protein) approved for melanoma nivolumab (blocks PD-1) and effective against a number of cancer types kymriah (CAR T cell-based) approved for ALL treatment none of the above Question 11 (1 point) After his treatment, Dr. Faiyaz reviews Carlos’s CT scan only to find that there was no trace of malignancy anywhere. Astonishing! Carlos is happy that he survived this cancer but is still worried about passing on this cancer causing genetic syndrome to his future children. What is the chance that Carlos will pass on the mutated copy of this gene (gene that caused the genetic syndrome) to any of this future children? Question 11 options: 100% 50% 0% 25% Question 12 (1 point) If Carlos’s children inherit this gene which will predispose them to getting cancer, does that mean that he or she will definitely get cancer someday? Question 12 options: True False

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