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General pathology and immunology

Carcinogens, paraneoplastic syndromes, and tumor markers

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SAMPLE QUESTION

Investigators culture bladder epithelial cells with equal concentrations of urinary extracts from long-term cigarette smokers or nonsmokers. The smoker-derived extracts produce more DNA adducts and more mutations after replication. A fractionation step that removes the mutagenic compounds eliminates this difference without altering cell viability or nutrient availability.

Which mechanism best connects an inhaled exposure to urothelial carcinogenesis?