MCQ Quiz- Epigenetics

MCQ Quiz: Epigenetics

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Epigenetics is the study of heritable changes in gene expression that occur without altering the underlying DNA sequence, providing a crucial layer of genetic control. From the role of DNA methylation in cancer to the development of drugs that target histone-modifying enzymes, epigenetics is a frontier of medicine with profound implications for pharmacy. This quiz for PharmD students will test your knowledge of the key mechanisms, enzymes, and therapeutic relevance of the epigenetic code.

1. Epigenetics is best defined as the study of:

  • Changes in the DNA nucleotide sequence.
  • The structure of the DNA double helix.
  • Heritable changes in gene expression that do not involve a change in the DNA sequence itself.
  • The process of DNA replication.

Answer: Heritable changes in gene expression that do not involve a change in the DNA sequence itself.

2. Which of the following is a major epigenetic mechanism?

  • DNA Methylation
  • Histone Modification
  • Non-coding RNA-mediated regulation
  • All of the above

Answer: All of the above

3. In mammals, DNA methylation typically occurs at which nucleotide base?

  • Adenine
  • Guanine
  • Thymine
  • Cytosine (specifically in a CpG context)

Answer: Cytosine (specifically in a CpG context)

4. Increased DNA methylation in the promoter region of a gene is generally associated with:

  • Gene activation or increased transcription.
  • Gene silencing or decreased transcription.
  • The initiation of DNA replication.
  • The repair of a DNA double-strand break.

Answer: Gene silencing or decreased transcription.

5. The enzymes that are responsible for adding a methyl group to DNA are called:

  • Histone deacetylases (HDACs)
  • DNA methyltransferases (DNMTs)
  • DNA polymerases
  • Helicases

Answer: DNA methyltransferases (DNMTs)

6. Histones are proteins that package DNA into a compact structure called chromatin. Chemical modifications of histone “tails” can:

  • Change the DNA sequence.
  • Alter chromatin structure to regulate gene accessibility and expression.
  • Only occur during DNA replication.
  • Prevent the DNA from unwinding.

Answer: Alter chromatin structure to regulate gene accessibility and expression.

7. Histone acetylation, the addition of an acetyl group, is an epigenetic mark that is typically associated with:

  • A more condensed chromatin structure (heterochromatin).
  • Gene silencing.
  • A more open chromatin structure (euchromatin) and active transcription.
  • The termination of transcription.

Answer: A more open chromatin structure (euchromatin) and active transcription.

8. The enzymes that add acetyl groups to histones are called ________, while the enzymes that remove them are called ________.

  • DNMTs; HDACs
  • HATs; DNMTs
  • HDACs; HATs
  • HATs; HDACs

Answer: HATs; HDACs

9. A region of the genome that is heavily methylated and has deacetylated histones would most likely be:

  • Actively transcribed.
  • Transcriptionally silenced (heterochromatin).
  • In the process of being replicated.
  • A promoter for a housekeeping gene.

Answer: Transcriptionally silenced (heterochromatin).

10. Certain anticancer drugs, such as vorinostat, work by inhibiting which class of epigenetic enzymes?

  • DNA methyltransferases (DNMTs)
  • Histone acetyltransferases (HATs)
  • Histone deacetylases (HDACs)
  • DNA polymerases

Answer: Histone deacetylases (HDACs)

11. The principle behind using an HDAC inhibitor as a chemotherapeutic is to:

  • Promote a more condensed chromatin structure.
  • Reactivate the expression of silenced tumor suppressor genes.
  • Cause widespread DNA damage.
  • Inhibit DNA replication in all cells.

Answer: Reactivate the expression of silenced tumor suppressor genes.

12. “Epigenetic inheritance” refers to the idea that:

  • Only changes in the DNA sequence can be passed to daughter cells.
  • Epigenetic marks can sometimes be passed down through cell division (mitosis) and even across generations (meiosis).
  • All epigenetic marks are erased during every cell division.
  • The environment has no effect on an organism’s genes.

Answer: Epigenetic marks can sometimes be passed down through cell division (mitosis) and even across generations (meiosis).

13. A key principle of epigenetics is that the epigenome is dynamic and can be influenced by:

  • Environmental factors.
  • Diet.
  • Stress.
  • All of the above.

Answer: All of the above.

14. MicroRNAs (miRNAs) are a class of non-coding RNAs that act as an epigenetic mechanism by:

  • Modifying histone tails directly.
  • Binding to mRNA molecules to regulate their translation or cause their degradation.
  • Methylating DNA promoters.
  • Creating a physical block on the DNA.

Answer: Binding to mRNA molecules to regulate their translation or cause their degradation.

15. In cancer, a common epigenetic change is the __________ of tumor suppressor genes and the __________ of oncogenes.

  • Hypomethylation; Hypermethylation
  • Hypermethylation; Hypomethylation
  • Acetylation; Deacetylation
  • Deacetylation; Acetylation

Answer: Hypermethylation; Hypomethylation

16. The “Epigenome Roadmap” is a major research project analogous to the Human Genome Project, but it aims to map:

  • The complete DNA sequence of multiple organisms.
  • The locations and patterns of epigenetic modifications across the human genome.
  • All the proteins in the human body.
  • All the metabolic pathways.

Answer: The locations and patterns of epigenetic modifications across the human genome.

17. A pharmacist’s knowledge of “DNA structure” is the foundation for understanding how:

  • DNA methylation can physically block the binding of transcription factors.
  • Histone modifications can alter the accessibility of the DNA.
  • A drug can interact with the DNA helix.
  • All of the above.

Answer: All of the above.

18. The “forging ahead” mindset in pharmacy means embracing personalized medicine, which in the future may involve using a patient’s __________ to guide therapy.

  • Epigenetic profile
  • Blood type only
  • Personal preferences only
  • Age only

Answer: Epigenetic profile

19. A “business plan” for a new biotech company might focus on developing a novel drug that targets a specific:

  • Histone methyltransferase.
  • DNA polymerase.
  • Ribosome subunit.
  • Metabolic enzyme.

Answer: Histone methyltransferase.

20. A “policy” debate in epigenetics centers on:

  • The ethics of “epigenetic editing.”
  • The potential for insurance discrimination based on a person’s epigenetic profile.
  • The regulation of new epigenetic drugs.
  • All of the above.

Answer: All of the above.

21. The “eukaryotic and prokaryotic transcription” course highlights that complex gene regulation via chromatin and epigenetics is a hallmark of:

  • Prokaryotes.
  • Eukaryotes.
  • Both equally.
  • Viruses.

Answer: Eukaryotes.

22. Azacitidine is a chemotherapeutic drug that works by inhibiting:

  • Histone deacetylases.
  • DNA methyltransferases, leading to hypomethylation.
  • Topoisomerase.
  • The proteasome.

Answer: DNA methyltransferases, leading to hypomethylation.

23. The concept of “genomic imprinting” is an epigenetic phenomenon where:

  • A gene is expressed in a parent-of-origin specific manner.
  • Both alleles of a gene are expressed equally.
  • A gene is mutated.
  • A gene is deleted.

Answer: A gene is expressed in a parent-of-origin specific manner.

24. Which of the following is a key difference between a genetic mutation and an epigenetic modification?

  • A genetic mutation is a change in the DNA sequence, while an epigenetic modification is not.
  • Epigenetic modifications are always permanent.
  • Genetic mutations are potentially reversible, while epigenetic modifications are not.
  • Epigenetic modifications have no effect on gene expression.

Answer: A genetic mutation is a change in the DNA sequence, while an epigenetic modification is not.

25. A pharmacist providing MTM for a patient on an epigenetic drug would need to monitor for:

  • A unique and potentially broad range of side effects, as these drugs can alter the expression of many genes.
  • Only the most common side effects listed on the label.
  • No side effects, as these drugs are very safe.
  • Only the drug’s effect on blood pressure.

Answer: A unique and potentially broad range of side effects, as these drugs can alter the expression of many genes.

26. The “leadership” skill of staying current with scientific literature is critical in epigenetics because:

  • The field is rapidly evolving with new discoveries and drug targets.
  • The principles of epigenetics have not changed in 50 years.
  • It is a requirement for maintaining a pharmacy license.
  • It is not a relevant skill.

Answer: The field is rapidly evolving with new discoveries and drug targets.

27. The “enzymes of DNA metabolism” are distinct from epigenetic enzymes. A DNA polymerase __________, while a DNMT __________.

  • Copies DNA; adds a methyl group to DNA.
  • Adds a methyl group to DNA; copies DNA.
  • Repairs DNA; methylates histones.
  • Methylates histones; repairs DNA.

Answer: Copies DNA; adds a methyl group to DNA.

28. A “molecular biology technique” used to study DNA methylation is:

  • Western blotting.
  • Southern blotting.
  • Bisulfite sequencing.
  • PCR.

Answer: Bisulfite sequencing.

29. A “Clinical Decision Support” system could be designed to:

  • Use a patient’s epigenetic data to recommend a specific dose of a chemotherapy agent.
  • Alert a pharmacist to a dispensing error.
  • Manage pharmacy inventory.
  • Schedule patient appointments.

Answer: Use a patient’s epigenetic data to recommend a specific dose of a chemotherapy agent.

30. The ultimate reason pharmacists study epigenetics is that:

  • It represents a major new frontier for drug targets and personalized medicine.
  • It is an interesting but clinically irrelevant topic.
  • It is only important for understanding basic science.
  • It is required for the NAPLEX exam.

Answer: It represents a major new frontier for drug targets and personalized medicine.

31. The “histone code” hypothesis suggests that:

  • The specific combination of histone modifications dictates the transcriptional state of the local chromatin.
  • There is a second genetic code hidden in the histone proteins.
  • All histones are modified in the exact same way.
  • Histone modifications have no effect on gene expression.

Answer: The specific combination of histone modifications dictates the transcriptional state of the local chromatin.

32. The “writer” enzymes in epigenetics __________, while the “eraser” enzymes __________.

  • Read a mark; add a mark.
  • Add a mark; remove a mark.
  • Remove a mark; read a mark.
  • Add a mark; read a mark.

Answer: Add a mark; remove a mark.

33. An HDAC is an example of an epigenetic:

  • Writer
  • Reader
  • Eraser
  • Mover

Answer: Eraser

34. X-chromosome inactivation is a classic example of large-scale epigenetic silencing, where:

  • Both X chromosomes in a female are actively transcribed.
  • The Y chromosome is silenced.
  • One of the two X chromosomes in a female is randomly inactivated by becoming heterochromatin.
  • The X chromosome is deleted from the cell.

Answer: One of the two X chromosomes in a female is randomly inactivated by becoming heterochromatin.

35. A “negotiation” with a payer for a new, expensive epigenetic drug would require the pharmacist to present:

  • Strong evidence of its clinical efficacy and a clear value proposition.
  • The high price of the drug as the only justification.
  • The novelty of its mechanism.
  • The personal preference of the patient.

Answer: Strong evidence of its clinical efficacy and a clear value proposition.

36. The “financials” of developing epigenetic drugs are characterized by:

  • A low-risk, low-reward profile.
  • A high-risk, high-reward profile due to the complexity of the science and the potential for breakthrough therapies.
  • A guaranteed profit for all companies in the space.
  • A short and inexpensive development timeline.

Answer: A high-risk, high-reward profile due to the complexity of the science and the potential for breakthrough therapies.

37. The “regulation” of a new epigenetic modifier would be the responsibility of the:

  • FDA.
  • DEA.
  • EPA.
  • CMS.

Answer: The FDA.

38. The “service” of pharmacogenomics is closely related to epigenetics because:

  • A patient’s genetic makeup can influence how their epigenetic machinery works.
  • They are the same field of study.
  • Epigenetics is not relevant to drug response.
  • Both are focused on DNA replication.

Answer: A patient’s genetic makeup can influence how their epigenetic machinery works.

39. A “health disparity” could be influenced by epigenetics if:

  • A disadvantaged population is disproportionately exposed to an environmental toxin that causes harmful epigenetic changes.
  • All populations have the same epigenetic profile.
  • The concept is not relevant to health disparities.
  • The disparity is caused by a genetic mutation only.

Answer: A disadvantaged population is disproportionately exposed to an environmental toxin that causes harmful epigenetic changes.

40. A pharmacist’s role in “drug use and prevention” is relevant to epigenetics because:

  • Chronic substance use can lead to lasting epigenetic changes in the brain’s reward pathways.
  • Epigenetics has no role in addiction.
  • The use of naloxone can reverse epigenetic changes.
  • This is a purely psychological process.

Answer: Chronic substance use can lead to lasting epigenetic changes in the brain’s reward pathways.

41. The “human resources” department of a biotech company focused on epigenetics would need to recruit scientists with expertise in:

  • Molecular biology and biochemistry.
  • Clinical trial design.
  • Data science and bioinformatics.
  • All of the above.

Answer: All of the above.

42. An “analytics and reporting system” is crucial for epigenetic research to:

  • Manage and analyze the vast datasets generated from whole-genome bisulfite sequencing or ChIP-seq.
  • Track the pharmacy’s inventory.
  • Schedule patient appointments.
  • Create marketing materials.

Answer: Manage and analyze the vast datasets generated from whole-genome bisulfite sequencing or ChIP-seq.

43. A key principle of “eukaryotic transcription” that is not found in prokaryotes is:

  • The regulation of gene expression through the modulation of chromatin structure via epigenetics.
  • The use of a sigma factor.
  • The coupling of transcription and translation.
  • The presence of operons.

Answer: The regulation of gene expression through the modulation of chromatin structure via epigenetics.

44. The “molecular biology technique” called “Chromatin Immunoprecipitation” (ChIP) is used to:

  • Identify the specific DNA sequences that a particular protein (like a modified histone or transcription factor) is bound to in a cell.
  • Amplify a specific gene.
  • Sequence a whole genome.
  • Separate proteins by size.

Answer: Identify the specific DNA sequences that a particular protein (like a modified histone or transcription factor) is bound to in a cell.

45. “Cloning” a gene for an epigenetic enzyme allows researchers to:

  • Produce large quantities of the protein for structural and functional studies.
  • It is not possible to clone these genes.
  • Create a new human being.
  • Directly modify the epigenome of a patient.

Answer: Produce large quantities of the protein for structural and functional studies.

46. A pharmacist’s understanding of “special recombination” is different from epigenetics, but both are mechanisms for:

  • Generating diversity and regulating gene expression.
  • Repairing DNA damage.
  • Replicating the genome.
  • Causing mutations.

Answer: Generating diversity and regulating gene expression.

47. A “chemotherapeutic” like azacitidine is a prodrug that gets incorporated into DNA and then inhibits:

  • Histone deacetylases (HDACs).
  • DNA methyltransferases (DNMTs).
  • Topoisomerases.
  • Kinases.

Answer: DNA methyltransferases (DNMTs).

48. An “antidote” for an overdose of an epigenetic drug would most likely be:

  • Supportive care, as specific chemical antidotes are generally not available.
  • Naloxone.
  • Flumazenil.
  • N-acetylcysteine.

Answer: Supportive care, as specific chemical antidotes are generally not available.

49. The “human factors” of designing an epigenetic drug regimen would involve:

  • Creating a dosing schedule that is manageable for a cancer patient who may be feeling unwell.
  • Making the drug’s packaging difficult to open.
  • Using a very small font for the label.
  • Providing vague instructions for administration.

Answer: Creating a dosing schedule that is manageable for a cancer patient who may be feeling unwell.

50. The ultimate principle of epigenetics in pharmacy is that it provides a new set of _________ for treating human diseases.

  • Financial challenges.
  • Ethical dilemmas.
  • Molecular drug targets.
  • Diagnostic tests.

Answer: Molecular drug targets.

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