Cancer Qs Flashcards

1
Q

Which is the most common cause of cancer in females

Bowel
Prostate
Lung
Breast
Melanoma

A

Which is the most common cause of cancer in females

Bowel
Prostate
Lung
Breast
Melanoma

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2
Q

Which is the most common cause of cancer in men

Bowel
Prostate
Lung
Breast
Melanoma

A

Which is the most common cause of cancer in men

Bowel
Prostate
Lung
Breast
Melanoma

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3
Q

What is the single largest preventable cause of cancer within the UK? [1]

A

Smoking

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4
Q

Which of the following is not screened for cancer in the UK?

Retinoblastoma:
Bowel-FiT
Cervical
Ovarian
Breast

A

Which of the following is not screened for cancer in the UK?

Retinoblastoma:
Bowel-FiT
Cervical
Ovarian
Breast

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5
Q

Which of the following types of cancer is traditionally detected late on?

Thyroid
Oesophageal
Bladder
Ovarian
Breast

A

Which of the following types of cancer is traditionally detected late on?

Thyroid
Oesophageal
Bladder
Ovarian
Breast

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6
Q

Which of the following causes the upregulation of RAD51

Rb
BRCA1
WT1
BRCA2
p53

A

Which of the following causes the upregulation of RAD51

Rb
BRCA1
WT1
BRCA2
p53

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7
Q

p21 works at which cell cycle checkpoint? [1]

A

G1 to S phase

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8
Q

Name the gene that cause this function depicted
APC

TERT

P21

P53

BRCA1

A

Name the gene that cause this function depicted

APC

TERT: telomerase RT

P21

P53

BRCA1

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9
Q

BRCA1 / 2 is commonly associated with breast and which other type of cancer:

colorectal
rectal
ovarian
kidney
melonoma

A

BRCA1 / 2 is commonly associated with breast and which other type of cancer:

colorectal
rectal
ovarian
kidney
melonoma

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10
Q

An increase in mole greater than which size would suggest a melonoma?

Larger than 1/2 inch
Larger than 1/4 inch
Larger than 1/3 inch
Larger than 1/5 inch
Larger than 1/6 inch

A

An increase in mole greater than which size would suggest a melonoma?

Larger than 1/2 inch
Larger than 1/4 inch
Larger than 1/3 inch
Larger than 1/5 inch
Larger than 1/6 inch

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11
Q

But the following in order of cancer development:

Initiation; Hyperplasia; Dysplasia; In situ cancer; Metastasis; Invasive Cancer
Initiation; Dysplasia; Hyperplasia; In situ cancer; Metastasis; Invasive Cancer
Initiation; Dysplasia; Hyperplasia; In situ cancer; Invasive Cancer; Metastasis
Initiation; Hyperplasia; Dysplasia; Invasive Cancer; In situ cancer; Metastasis;
Initiation; Dysplasia; Hyperplasia; Invasive Cancer; In situ cancer; Metastasis

A

But the following in order of cancer development:

Initiation; Hyperplasia; Dysplasia; In situ cancer; Metastasis; Invasive Cancer
Initiation; Dysplasia; Hyperplasia; In situ cancer; Metastasis; Invasive Cancer
Initiation; Dysplasia; Hyperplasia; In situ cancer; Invasive Cancer; Metastasis
Initiation; Hyperplasia; Dysplasia; Invasive Cancer; In situ cancer; Metastasis
Initiation; Dysplasia; Hyperplasia; Invasive Cancer; In situ cancer; Metastasis

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12
Q

Which of the following is often indicative of early neoplastic process

Hyperplasia
Dysplasia
In situ cancer
Invasive cancer

A

Which of the following is often indicative of early neoplastic process

Hyperplasia
Dysplasia
In situ cancer
Invasive cancer

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13
Q

The location of prostate cancer metastasis is typically:

Breast
Liver
Kidney
Rectum
Bone

A

The location of prostate cancer metastasis is typically:

Breast
Liver
Kidney
Rectum
Bone

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14
Q
A
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15
Q
  1. What TNM classification below best describes this finding: very large tumor with 1 regional lymph node involvement, and spread to two regional organs?

A. T1N1M2
B. T4N1M1
C. T1N1M1
D. T4N1M2

A
  1. What TNM classification below best describes this finding: very large tumor with 1 regional lymph node involvement, and spread to two regional organs?

A. T1N1M2
B. T4N1M1
C. T1N1M1
D. T4N1M2

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16
Q
  1. The category “T” in the TNM system stands for:(Required)
    A. Time
    B. Tumor (primary)
    C. Tissue (primary)
    D. Tumor (secondary)
A
  1. The category “T” in the TNM system stands for:(Required)
    A. Time
    B. Tumor (primary)
    C. Tissue (primary)
    D. Tumor (secondary)
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17
Q

Colon cancer commonly metastasises to the

Brain
Bone
Kidney
Liver
Prostate

A

Colon cancer commonly metastasises to the

Brain
Bone
Kidney
Liver
Prostate

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18
Q

‘high immune cell density in the outer invasive margin and low density in the core’ describes which of the following

Immune-desert tumour
Inflamed tumour
Immune-included tumour
Immnune-excluded tumour

A

‘high immune cell density in the outer invasive margin and low density in the core’ describes which of the following

Immune-desert tumour
Inflamed tumour
Immune-included tumour
Immnune-excluded tumour

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19
Q

‘There is a tumour, but no T Cell army is present to mount an attack’ describes which of the following

Immune-desert tumour
Inflamed tumour
Immune-included tumour
Immnune-excluded tumour

A

‘There is a tumour, but no T Cell army is present to mount an attack’ describes which of the following

Immune-desert tumour
Inflamed tumour
Immune-included tumour
Immnune-excluded tumour

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20
Q

Atezolizumab binds to which of the following

PDL1
PDL2
CTLA4
PD1

A

Atezolizumab binds to which of the following

PDL1
PDL2
CTLA4
PD1

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21
Q

Pembrolizumab binds to which of the following

PDL1
PDL2
CTLA4
PD1

A

Pembrolizumab binds to which of the following

PDL1
PDL2
CTLA4
PD1

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22
Q

Ipilimubab binds to which of the following

PDL1
PDL2
CTLA4
PD1

A

Ipilimubab binds to which of the following

PDL1
PDL2
CTLA4
PD1

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23
Q

Tremelimubab binds to which of the following

PDL1
PDL2
CTLA4
PD1

A

Tremelimubab binds to which of the following

PDL1
PDL2
CTLA4
PD1

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24
Q

State 4 red flags for colorectal cancer [4]

A

Unexplained weight loss
Unexplained rectal bleeding
Over 60 & IDA
Over 60 & changes in bowel habit

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25
State 5 red flags for ovarian cancer [5]
Persistent abdomial distension Feeling full Loss of appetite Pelvic or abdominal pain Increased frequency of urination
26
State a red flag for oeseophogeal cancer [1]
Dysphasia
27
**c-fos** causes what type of gain of function mutation? * Point mutation of non-coding region: promotor/enhancer region * Point mutation of coding region * Gene amplification * Translocation / transposition **Which type of cancer is this seen in?**
**Non-coding region (promotor/enhancer region). E.g. c-Fos (transcription factor)** Seen in **melanomas**
28
**Bcl2** causes what type of gain of function mutation? * Point mutation of non-coding region: promotor/enhancer region * Point mutation of coding region * Gene amplification * Translocation / transposition **Which type of cancer is this seen in?**
**Translocation / transposition**: induction blocks apoptosis (anti-apoptotic gene). Overexpression by (t14:18) (q32; 21). Leads to **follicular lymphoma**
29
**c-H-ras** causes what type of gain of function mutation? * Point mutation of non-coding region: promotor/enhancer region * Point mutation of coding region * Gene amplification * Translocation / transposition **Which type of cancer is this seen in?**
**Coding region point mutation**: leads to **bladder** cancer [1]
30
State the point mutation that occurs in c-H-ras mutation [1]
E.g. c-H-ras: **(Gly)** **GGC – (Val) CTG.**
31
K-ras is an oncogene that belongs to Growth factor receptors Signal transduction proteins Transcription factors Anti-antopic proteins
K-ras is an oncogene that belongs to Growth factor receptors **Signal transduction proteins** Transcription factors Anti-antopic proteins
32
C-myc is an oncogene that belongs to Growth factor receptors Signal transduction proteins Transcription factors Anti-antopic proteins
C-myc is an oncogene that belongs to Growth factor receptors Signal transduction proteins **Transcription factors** Anti-antopic proteins
33
B-Raf is an oncogene that belongs to Growth factor receptors Signal transduction proteins Transcription factors Anti-antopic proteins
B-Raf is an oncogene that belongs to Growth factor receptors **Signal transduction proteins** Transcription factors Anti-antopic proteins
34
# Tumour Suppressor Genes: Loss of Function Name two regions in which point mutations can occur: Within the control element [1] Within the gene [1]
Within the control element: **Bax** Within the gene: **P53**
35
Which of the following is a pro-apoptopic tumour suppressor gene? BRCA Bcl2 Bax pRB p53
Which of the following is a pro-apoptopic tumour suppressor gene? **Bax**
36
Which of the following is a caretaker tumour suppressor gene? BRCA Bcl2 Bax pRB p53
Which of the following is a caretake tumour suppressor gene? **BRCA**
37
Which of the following are gatekeeper tumour suppressor genes? [2] BRCA Bcl2 Bax pRB p53
**p53 & pRb**
38
The list below all fall under which category Growth factors (signalling proteins); Receptors (e.g. tyrosine kinase receptors; Intracellular signalling proteins e.g. kinases; Transcription factors; Anti-apoptotic proteins Oncogene Gatekeepers Caretakes Proto-oncogenes
The list below all fall under which category Growth factors (signalling proteins); Receptors (e.g. tyrosine kinase receptors; Intracellular signalling proteins e.g. kinases; Transcription factors; Anti-apoptotic proteins Oncogene Gatekeepers Caretakes **Proto-oncogenes**
39
HER2 Receptor is what type of receptor? GPCR Enzyme-linked Nucleus binding Tyrosine-kinase
HER2 Receptor is what type of receptor? GPCR Enzyme-linked Nucleus binding **Tyrosine-kinase**
40
Which of the following is not a category of a proto-oncogene? Growth factor Growth factor receptor Tyrosine kinase activation Anti-apoptopic gene Pro-apoptopic gene
Which of the following is not a category of a proto-oncogene? **Pro-apoptopic gene**
41
Which of the following is not part of the role of gatekeeper ? * Apoptosis - related genes * Directly supresses growth/restricts proliferation * Cell cycle/cell division regulator genes * Maintains genetic stability: DNA repair proteins * Check point control genes
Which of the following is not part of the role of gatekeeper ? * Apoptosis - related genes * Directly supresses growth/restricts proliferation * Cell cycle/cell division regulator genes * **Maintains genetic stability: DNA repair proteins** - caretaker * Check point control genes
42
Cyclin E/CDK2 plays a critical role in which stage of cell cycle? G1/S G1/M G2/M S/G2
Cyclin E/CDK2 plays a critical role in which stage of cell cycle? **G1/S**
43
Cyclin B/CDK1 plays a critical role in which stage of cell cycle? G1/S G1/M G2/M S/G2
Cyclin B/CDK1 plays a critical role in which stage of cell cycle? **G2/M**
44
A 30-year-old woman with a family history positive for ovarian cancer in her mother and endometrial cancer in her grandmother. Her father recently passed away from metastatic pancreatic cancer. She is an Ashkenazi Jew. A screening mammogram is normal. Menarche occurred at 9 years and had she her first child at age 20. If a breast cancer gene mutation is present, for which of the following should she be screened or undergo surveillance? A. Endometrial cancer B. Cervical cancer C. Ovarian cancer D. Pancreatic cancer
A 30-year-old woman with a family history positive for ovarian cancer in her mother and endometrial cancer in her grandmother. Her father recently passed away from metastatic pancreatic cancer. She is an Ashkenazi Jew. A screening mammogram is normal. Menarche occurred at 9 years and had she her first child at age 20. If a breast cancer gene mutation is present, for which of the following should she be screened or undergo surveillance? **C. Ovarian cancer**
45
A 45-year-old female presents after screening mammography to the office. A mass is seen in the lower inner quadrant of the left breast. She reports age at menarche to be 9 years, her first child-birth at age 28 years age. She never took any oral contraceptive pills but is currently on hormone replacement therapy. Her father was diagnosed with breast cancer at age 60 with positive genetic testing for breast cancer. Diagnostic mammogram and stereotactic biopsy confirm invasive ductal carcinoma. Which of the following most adversely affected the lifetime risk of this patient to develop breast cancer? A. Early menarche B. Hormone replacement therapy C. Family history D. Age at first childbirth
**C. Family history**
46
1. What is the difference between a proto-oncogene and an oncogene? [2 marks]
Proto-oncogene is a gene which facilitates normal cell growth OR diffrentaion OR division OR cell migration.[1 mark] When a proto-oncogene is mutated it becomes an oncogene, there is a gain of function which drives the initation and pregression of cancer so e.g there would be uncontrolled growth.[1 mark]
47
1. One of the functions of the *BRCA* genes is to facilitate repair of DNA damage. What type of DNA repair does BRCA1 and BRCA2 facilitate? [1 mark]
Homologous recombination (1/2 mark) of double-stranded DNA breaks (1/2 mark).
48
What type of genes are BRCA 1/2? [1]
Tumour supressor gene [1]
49
If tissue has 60% differentation, what grading would does it have? Grade I Grade II Grade III Grade IV
If tissue has 60% differentation, what grading would does it have? Grade I: 0-25% Grade II: 25-50% **Grade III** - 50-75% Grade IV: 75%+
50
What is the worst TNM score someone could have? 4 5 6 7 8
What is the worst TNM score someone could have? **8**: T4;N3;M1
51
A 66-year-old male presents after a small mass was discovered on colonoscopy. Initial workup reveals carcinoma in situ. What is the most likely TNM classification for this patient? A. T1N1M0 B. TisN0M0 C. T0N0M0 D. TisN3M1
**B. TisN0M0**
52
A 52-year-old female presents with a newly diagnosed breast tumor. She is unsure of her exact staging but states that she remembers her tumor is T1. Under the TMN classification, a T1 tumor is most consistent with which of the following? A. A large tumor with extensive invasion B. Involvement of several regional lymph nodes C. Carcinoma in situ D. A small, minimally invasive tumor
D. A small, minimally invasive tumor
53
# Breast cancer E-cadherin is a phenotypic marker in breast cancer. Describe what levels of E-cadherin would be like in an individual with poor prognosis [1]
**Low** E-cadherin: worse prognosis E-cadherin is a cell adhesion molecule that is expressed in normal breast tissue The loss of E-cadherin expression is a very early change in lobular breast carcinogenesis and the normal protein plays a tumor-suppressive and invasion-suppressive role.
54
Melonomas larger than what size (inch /or mm) would suggest that it is malginant? [1]
Larger than ¼ inch (6mm)
55
In the context of a diagnosis of prostate cancer, metastatic spinal cord compression needs to be ruled out with an CT spine CT brain PET scan MRI spine
**MRI Spine** CT spine would be less useful as MRI is better suited at imaging neural tissues to assess for cord compression.
56
In the context of a diagnosis of prostate cancer, metastatic spinal cord compression needs to be ruled out with an CT spine CT brain PET scan MRI spine
**MRI Spine** CT spine would be less useful as MRI is better suited at imaging neural tissues to assess for cord compression.
57
You are working as a junior doctor in a GP practice as part of one of your rotations. You are reviewing the bloods of a 74-year-old male patient who presented with nausea and intermittent vomiting. The patient also complained of 'aching all over' especially in his back and limbs, he says over the last few months he found himself feeling low. He suspects his low mood has led to weight loss and has lost 15kg in the past 3 months. He has been smoking 40 cigarettes a day for the past 60 years and complains of having a 'smoker's cough', explaining that sometimes his handkerchief is 'red stained'. On review of his blood work, you notice marked hypercalcaemia, anaemia and raised white cells. Based on these findings, what is the most likely diagnosis? Squamous cell carinoma of the lung COPD Ductal carcinoma in situ Chronic renal failure Parathyroid adenoma
Squamous cell carinoma of the lung
58
Mrs Frank is a 62-year-old lady who presents to you with a two-day history of lower back pain. She tells you that started gradually and has been progressively worsening. Upon further questioning, she tells you that the pain radiates down both legs and she has been a bit wobbly on her feet. She has also been incontinent of urine this afternoon. You read in her patient notes that she has recently been diagnosed with breast cancer. Given the most likely diagnosis, which of the following first-line management options would be most appropriate? Prescribe bisphosphonates Urgent MRI scan Urgent full body x-ray Insert a catheter and organise follow up in a week Reassurance and NSAID analgesia
Urgent MRI scan
59
A sixty-year-old female presents to the acute medical unit with a two-month history of weight loss and fatigue. Abdominal examination is significant for splenomegaly and an FBC reveals anaemia and leukocytosis (WCC of 48). The patient is referred to haematology and a diagnosis of chronic myeloid leukaemia is made. Which of the following medications has dramatically improved prognosis in recent years? Infliximab Imatinib Vincristine Rituximab
**Imatinib**
60
A patient with infective endocarditis has Streptococcus bovis grown on blood cultures. Which of the following cancers should this result raise suspicion for? Bladder Oesophageal Lung Gastric Colorectal
**Colorectal**
61
A mutation of which gene is most strongly associated with colon cancer? BRCA2 RB1 p53 TSC1 BRCA1
A mutation of which gene is most strongly associated with colon cancer? BRCA2 RB1 **p53** TSC1 BRCA1
62
Which type of surgical intervention targeted to make a patient's symptoms less severe? Resection Reconstruction Treatment Palliation
Which type of surgical intervention targeted to make a patient's symptoms less severe? Resection Reconstruction Treatment **Palliation**
63
This image shows a method of biopsy. What is it? Transcutaneous Endoscopic Biopsy Laparoscopic Image-directed Open incisional ( portion of the tumor) Open excisional
This image shows a method of biopsy. What is it? Transcutaneous Endoscopic Biopsy **Laparoscopic** Image-directed Open incisional ( portion of the tumor) Open excisional
64
This image shows a method of biopsy. What is it? Transcutaneous Endoscopic Biopsy Laparoscopic Image-directed Open incisional ( portion of the tumor) Open excisional
This image shows a method of biopsy. What is it? Transcutaneous Endoscopic Biopsy Laparoscopic **Image-directed ** Open incisional ( portion of the tumor) Open excisional
65
Which type of surgical treatment would be used for the removal of lymph nodes and an organ/s Local resection Radical resection Supra-radical resections Surgery for metastasis/recurrence Surgical management of complications
Which type of surgical treatment would be used for the removal of lymph nodes and an organ/s Local resection Radical resection **Supra-radical resections** Surgery for metastasis/recurrence Surgical management of complications
66
Dukes Classification is used to assess the extent of which type of cancer Brain Renal Liver Colorectal Duodenal
Dukes Classification is used to assess the extent of which type of cancer Brain Renal Liver **Colorectal** Duodenal
67
A 75-year-old man presents with a three-month history of dyspnea, night sweats, and recurrent hemoptysis. History is significant for a 40-pack-year history of smoking. He also reports unintentionally losing 20 lbs (9 kg) of weight in the past two months. Vital signs on presentation are normal except for an oxygen saturation of 92% on room air. CT scan of the chest with IV contrast shows a 3.5 cm endobronchial mass in the distal left main bronchus. Histopathological evaluation of CT-guided biopsy of the mass confirms a diagnosis of metastatic non-small cell lung cancer. Additionally, the tumor demonstrates high PD-L1 expression. What is the best next therapeutic step in the management of this patient? A. Infliximab B. Atezolizumab C. Rituximab D. Natalizumab
A 75-year-old man presents with a three-month history of dyspnea, night sweats, and recurrent hemoptysis. History is significant for a 40-pack-year history of smoking. He also reports unintentionally losing 20 lbs (9 kg) of weight in the past two months. Vital signs on presentation are normal except for an oxygen saturation of 92% on room air. CT scan of the chest with IV contrast shows a 3.5 cm endobronchial mass in the distal left main bronchus. Histopathological evaluation of CT-guided biopsy of the mass confirms a diagnosis of metastatic non-small cell lung cancer. Additionally, the tumor demonstrates **high PD-L1 expression**. What is the best next therapeutic step in the management of this patient? **B. Atezolizumab**
68
A 71-year-old man with metastatic urothelial carcinoma presents to the clinic for follow-up. He has had progressive disease despite platinum-based therapy. The patient’s ECOG performance status score is 1. Treatment with atezolizumab is being considered. Which of the following best describes the mechanism of action of this drug? A. A humanized monoclonal antibody that blocks vascular endothelial growth factor A B. A humanized monoclonal antibody that blocks tumor necrosis factor-alpha C. A humanized monoclonal antibody directed against human cell surface PD-1 D. A humanized monoclonal antibody that binds to a4 beta-1-integrin
A 71-year-old man with metastatic urothelial carcinoma presents to the clinic for follow-up. He has had progressive disease despite platinum-based therapy. The patient’s ECOG performance status score is 1. Treatment with atezolizumab is being considered. Which of the following best describes the mechanism of action of this drug? **C. A humanized monoclonal antibody directed against human cell surface PD-1**
69
A 54-year old male presents with a 3-month history of worsening cough with recurrent hemoptysis. He has smoked 2 packs of cigarettes a day for the past 30 years. He has had a 10kg(22lb) weight loss during this period. His temperature is 37.3 C (99.1F), blood pressure is 120/76mm Hg, respirations per minute are 20, the pulse is 70/min. A chest x-ray shows a 3-cm mass in his left upper lung lobe with centrally located cavitation. Subsequently, a diagnosis of squamous non-small cell lung cancer is made. Which of the following drugs is approved for use in first-line metastatic squamous NSCLC in combination with paclitaxel and carboplatin? A. Pembrolizumab B. Natalizumab C. Rituximab D. Eculizumab
A 54-year old male presents with a 3-month history of worsening cough with recurrent hemoptysis. He has smoked 2 packs of cigarettes a day for the past 30 years. He has had a 10kg(22lb) weight loss during this period. His temperature is 37.3 C (99.1F), blood pressure is 120/76mm Hg, respirations per minute are 20, the pulse is 70/min. A chest x-ray shows a 3-cm mass in his left upper lung lobe with centrally located cavitation. Subsequently, a diagnosis of squamous non-small cell lung cancer is made. Which of the following drugs is approved for use in first-line metastatic squamous NSCLC in combination with paclitaxel and carboplatin? **A. Pembrolizumab**
70
Rituximab targets B-lymphomas by targeting which cell receptor on malignant B cells? [1]
**CD20**
71
The majority of humanised monoclonal antibodies use which Ig as a backbone? IgA IgD IgE IgG IgM
**IgG**
72
Which of the following is targeted by Pembrolizumab PD-1 CTLA-4 PD1-Ligand LAG-3 PD2-Ligand
**PD-1**
73
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase MAP Kinase KRAS AKT
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase **MAP Kinase** KRAS AKT
74
Which of the following is targeted by Rituximab CD10 CD12 CD15 CD19 CD20
Which of the following is targeted by Rituximab CD10 CD12 CD15 CD19 **CD20**
75
Which of the following is targeted by Atezolizumab PD-1 CTLA-4 PD1-Ligand LAG-3 PD2-Ligand
Which of the following is targeted by Atezolizumab PD-1 CTLA-4 **PD1-Ligand** LAG-3 PD2-Ligand
76
Which of the following is an example of a CAR-T drug? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following is an example of a CAR-T drug? **Tisagenlecleucel (Kymriah)**
77
Which of the following binds to CD20 in its mechansim of action? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following binds to CD20 in its mechansim of action? **Rituximab**
78
Which of the following binds to CTLA4? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following binds to CTLA4? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab **Ipililumbab** Nivolumab
79
The patient is enrolled in a clinical trial of chimeric antigen receptor-engineered T cells (CAR-T cells). So far, in the early clinical trials, chimeric antigen receptor-engineered T cells (CAR-T cells) have targeted which receptor in the treatment of acute lymphoblastic leukemia? A. CD5 B. CD19 C. CD45 D. CD99
The patient is enrolled in a clinical trial of chimeric antigen receptor-engineered T cells (CAR-T cells). So far, in the early clinical trials, chimeric antigen receptor-engineered T cells (CAR-T cells) have targeted which receptor in the treatment of acute lymphoblastic leukemia? A. CD5 **B. CD19** C. CD45 D. CD99
80
The first-line FDA-approved agent to treat metastatic non-small cell lung cancer is being considered for a 67-year-old patient. It is most appropriate to evaluate this patient for which gene mutation before initiating treatment? A. KRAS B. p53 C. Fragile histidine triad (FHIT) D. Epidermal growth factor receptor (EGFR)
The first-line FDA-approved agent to treat metastatic non-small cell lung cancer is being considered for a 67-year-old patient. It is most appropriate to evaluate this patient for which gene mutation before initiating treatment? A. KRAS B. p53 C. Fragile histidine triad (FHIT) **D. Epidermal growth factor receptor (EGFR)**
81
A 61-year-old female with a known history of non-small cell lung cancer with metastasis to bone and EGFR mutation-positive presents to the oncology clinic to discuss treatment options. The clinician mentions a drug to her as the current first-line treatment option for her form of cancer. The first-line treatment option for this patient is from which of the following drug classes? A. PCSK9 inhibitors B. Tyrosine kinase inhibitors C. Anti-platelet IIb/IIIa receptors D. TNF alpha inhibitors
A 61-year-old female with a known history of non-small cell lung cancer with metastasis to bone and EGFR mutation-positive presents to the oncology clinic to discuss treatment options. The clinician mentions a drug to her as the current first-line treatment option for her form of cancer. The first-line treatment option for this patient is from which of the following drug classes? A. PCSK9 inhibitors **B. Tyrosine kinase inhibitors** C. Anti-platelet IIb/IIIa receptors D. TNF alpha inhibitors
82
Ras mutation is most associated with which type of cancer? Non-small cell lung cancer Colon cancer Pancreatic cancer Papillary thyroid cancer
**Pancreatic cancer**
83
Trastuzumab (Aka Herceptin) inhibits which receptor: HER2 HER2/HER3 EGFR VEGF
Trastuzumab (Aka Herceptin) inhibits which receptor: **HER2** HER2/HER3 EGFR VEGF
84
Pertuzumab inhibits which receptor: HER2 HER2/HER3 EGFR VEGF
Pertuzumab inhibits which receptor: HER2 **HER2/HER3** EGFR VEGF
85
Cetuximab inhibits which receptor: HER2 HER2/HER3 EGFR VEGF
Cetuximab inhibits which receptor: HER2 HER2/HER3 **EGFR** VEGF
86
Kadycycla is formed from the conjugate binding of Herceptin with which molecule? [1] What is its role? [1]
**DM1**; which is an **anti-microtubule agent**
87
A 65-year-old man presents after a recent diagnosis of poorly differentiated squamous cell carcinoma of the tongue. He has a 30 pack-year smoking history. Vital signs are within normal limits. Cervical lymphadenopathy is present on palpation, and a large mass is present on the lateral aspect of the tongue. Laboratory studies show a serum creatinine level of 2 mg/dL. CT of the head and neck shows a large mass on the right lateral border of the tongue. Multiple, enlarged, right-sided cervical lymph nodes are also noted, with the largest being 2.5 cm. CT chest is negative. Molecular testing is significant for EGFR mutation. What is the best initial therapy for this patient? A. Pembrolizumab plus radiation B. Bevacizumab C. Carboplatin D. Cetuximab plus radiation
A 65-year-old man presents after a recent diagnosis of poorly differentiated squamous cell carcinoma of the tongue. He has a 30 pack-year smoking history. Vital signs are within normal limits. Cervical lymphadenopathy is present on palpation, and a large mass is present on the lateral aspect of the tongue. Laboratory studies show a serum creatinine level of 2 mg/dL. CT of the head and neck shows a large mass on the right lateral border of the tongue. Multiple, enlarged, right-sided cervical lymph nodes are also noted, with the largest being 2.5 cm. CT chest is negative. Molecular testing is significant for EGFR mutation. What is the best initial therapy for this patient? **D. Cetuximab plus radiation**
88
Which drug is prescribed as a first line tyrosine kinase receptor in small cell lung cancer? Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which drug is prescribed as a first line tyrosine kinase receptor in small cell lung cancer? Trastuzumab Pertuzumab Osimertinib **Erlotinib** Kadcycla
89
Which drug is prescribed if a mutation to a tyrosine kinase receptor in small cell lung cancer occurs Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which drug is prescribed if a mutation to a tyrosine kinase receptor in small cell lung cancer occurs Trastuzumab Pertuzumab **Osimertinib** Erlotinib Kadcycla
90
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase MAP Kinase KRAS AKT
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase **MAP Kinase** KRAS AKT
91
Which drug prevents the HER2/HER3 dimer from forming? Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug prevents the HER2/HER3 dimer from forming? Trastuzumab **Pertuzumab** Cetuximab Kadcycla
92
Herceptin is also known as Trastuzumab Pertuzumab Cetuximab Kadcycla
Herceptin is also known as **Trastuzumab** Pertuzumab Cetuximab Kadcycla
93
Which drug stops HER2 binding to another HER2 Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug stops HER2 binding to another HER2 **Trastuzumab** Pertuzumab Cetuximab Kadcycla
94
Tarceva (Erlotinib) targets which of the following HER2 HER2/HER3 EGFR VEGF
Tarceva (Erlotinib) targets which of the following HER2 HER2/HER3 **EGFR** VEGF
95
Which drug has a side effect of a rash? Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug has a side effect of a rash? **Trastuzumab** Pertuzumab Cetuximab Kadcycla
96
Which drug causesa decline in left ventricular function AND congestive heart failure Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug causesa decline in left ventricular function AND congestive heart failure **Trastuzumab** Pertuzumab Cetuximab Kadcycla
97
Which drug blocks ATP binding to tyrosine kinase receptor Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which drug blocks ATP binding to tyrosine kinase receptor Trastuzumab Pertuzumab Osimertinib **Erlotinib** Kadcycla
98
Which of the following drug binds to B Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which of the following drug binds to B **Trastuzumab** Pertuzumab Osimertinib Erlotinib Kadcycla
99
Which of the following drug binds to C Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
**Pertuzumab**
100
Which drug acts according to this image as a first line drug used for non-small cell lung cancer Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which drug acts according to this image as a first line drug used for non-small cell lung cancer Trastuzumab Pertuzumab Osimertinib **Erlotinib** Kadcycla
101
Brachytherapy is a type of surgial intervention chemotherapy targeted therapy radiotherapy
**radiotherapy**: radioactive seed or implant to deliver targeted radiotherapy
102
This image depicts what type of cancer treatment? [1]
Brachytherapy
103
Stereotactic Radiosurgery useds which type of rays to deliver treatment alpha rays beta rays delta rays gamma rays
**gamma rays**
104
A 67-year-old male patient with an acoustic neuroma presents with progressive left-sided hearing loss. Following an interprofessional team discussion, stereotactic radiosurgery is deemed appropriate. Which of the following best describes the treatment modality used to treat his condition? A. Photons are accelerated against a metal target to generate x-rays B. Electrons are accelerated against a metal target to generate photons C. Intensity-modulated radiation therapy can only vary the shape of the beam to limit the dose D. It is limited to extracranial disease
A 67-year-old male patient with an acoustic neuroma presents with progressive left-sided hearing loss. Following an interprofessional team discussion, stereotactic radiosurgery is deemed appropriate. Which of the following best describes the treatment modality used to treat his condition? **B. Electrons are accelerated against a metal target to generate photons**
105
Neo-adjuvant chemotherapy is common for which type of cancer Breast Prostate Ovarian Stomach
**Ovarian** cancer
106
Cisplatin is a type of alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
Cis**platin** is a type of alkylating agent **platinum agent** anti-metabolite agent topoisomerase inhibitors
107
methotrexate is a type of alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
methotrexate is a type of alkylating agent platinum agent **anti-metabolite agent** topoisomerase inhibitors
108
cyclophosamide is a type of alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
cyclophosamide is a type of **alkylating agent** platinum agent anti-metabolite agent topoisomerase inhibitors
109
which of the following form adducts in their mechanism of action alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
which of the following form adducts in their mechanism of action alkylating agent **platinum agent** anti-metabolite agent topoisomerase inhibitors
110
which of the following form hemorrhagic cystitis as a side effect? alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
which of the following form hemorrhagic cystitis as a side effect? **alkylating agent** platinum agent anti-metabolite agent topoisomerase inhibitors
111
which of the following work by forming hghly reactive molecules which bind to electron-rich nucleophilic moieties alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
which of the following work by forming hghly reactive molecules which bind to electron-rich nucleophilic moieties **alkylating agent** platinum agent anti-metabolite agent topoisomerase inhibitors
112
which of the following work by integrating into host DNA / RNA and inhibiting replication alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
which of the following work by integrating into host DNA / RNA and inhibiting replication alkylating agent platinum agent **anti-metabolite agent** topoisomerase inhibitors
113
methotrexate is a alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
**anti-metabolite agent**
114
Cyclophosphamide is a alkylating agent platinum agent anti-metabolite agent topoisomerase inhibitors
Cyclophosphamide is a **alkylating agent** platinum agent anti-metabolite agent topoisomerase inhibitors
115
Which of the following is topoisomerase II inhibitor which is cardiotoxic and cause dilated cardiomyopathy Irinotecan Topotecan Doxorubicin Epirubicin
**Doxorubicin**
116
tubulin active agents target which part of the cell cycle * G1 * S * G2 * M
**M**
117
Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia? **Capecitabine**
118
Which chemotherapy drug would cause Pulmonary Fibrosis? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Pulmonary Fibrosis? Capecitabine **Bleomycin** Doxorubicin Imatinib
119
Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia? **Capecitabine** Bleomycin Doxorubicin Imatinib
120
Which chemotherapy drug would cause Pulmonary Fibrosis? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Pulmonary Fibrosis? Capecitabine **Bleomycin** Doxorubicin Imatinib
121
Which chemotherapy drug would cause Raspberry Urine? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Raspberry Urine? Capecitabine Bleomycin **Doxorubicin** Imatinib
122
Which chemotherapy drug would cause Peri-Orbital Oedema? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Peri-Orbital Oedema? Capecitabine Bleomycin Doxorubicin **Imatinib**
123
Which chemotherapy drug would cause Flagellate Erythema ? Capecitabine Bleomycin Doxorubicin Imatinib
Which chemotherapy drug would cause Flagellate Erythema ? Capecitabine **Bleomycin** Doxorubicin Imatinib
124
What is drug A called? [1]
Pertuzumab
125
Robotic retroperitoneal lymph node dissection would be used to treat Prostatic cancer Bladder cancer Testis cancer Renal cancer
Robotic retroperitoneal lymph node dissection would be used to treat Prostatic cancer Bladder cancer **Testis cancer** Renal cancer
126
Which of the following prevents HER2 dimerisation Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
**Pertuzumab**
127
Brachytherapy can be used to treat cancer in which location Breast Lung Cervix Liver Stomach
**Prostate** & **cervix**
128
A 67-year-old woman with breast cancer is told by her oncologist that she will require chemotherapy after surgery What is this type of treatment called? Adjuvant Curative Neo-adjuvant Palliative Primary
**Adjuvant**
129
A 67-year-old woman with ovarian cancer is told by her oncologist that she will require chemotherapy before surgery What is this type of treatment called? Adjuvant Curative Neo-adjuvant Palliative Primary
**Neo-adjuvant**
130
There are certain histological features that are characteristic of neoplasia. Which of the following are associated with a benign tumour? High mitotic rate High nuclear:cytoplasmic ratio Irregular margins Organised tissue Presence of necrosis
**Organised tissue**
131
Malignant and benign tumours have different clinical behaviours. Which one of the following is a pathological sign of benign tumours? More frequent and abnormal mitoses Poorly cohesive and infiltrative Regional and distant metastases Slow progressive growth rate Various degrees of anaplasia
**Slow progressive growth rate**
132
Immunotherapy is the latest novel treatment for cancer. Which immunotherapeutic technique has shown dramatic responses in acute lymphoblastic leukaemia (ALL)? Cancer vaccines CAR T-cells PD1 checkpoint inhibitor Pembrolizumab Rituximab
**CAR T-cells**
133
Erlotinib is an orally administered small molecule inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase used to treat Small cell lung cancer Non-small cell lung cancer Adenocarcinoma Squamous cell cancer
Erlotinib is an orally administered small molecule inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase used to treat Small cell lung cancer **Non-small cell lung cancer** Adenocarcinoma Squamous cell cancer
134
Genetic alterations within cells can predispose to the formation of tumours and eventually cancers in the body. Which of the following statements best describes an oncogene? An altered gene that controls the cells structure and function An altered gene that inhibits the growth of differentiated cells An altered gene that promotes apoptosis and inhibits necrosis of cells. An altered gene that promotes cell growth and division An altered gene that regulates the metabolism of tumour cells
**An altered gene that promotes cell growth and division**
135
Tumours are classified on the basis of their cell/tissue of origin. What is a benign tumour arising from adipose tissue (fat) called? Adipocyte adenoma Adipoma Leioangiomyoma Leiomyoma Lipoma
**Lipoma**
136
;Diagnostic tests like biopsies and imaging are used to determine a cancer's grade and its stage. Which of the following is considered a staging criterion? Cytological atypia Mitotic activity Necrosis Resemblance/lack of resemblance to tissue of origin Spread to distant organs
**Spread to distant organs**
137
There are three checkpoints in the cell cycle which allow fidelity of DNA replication and cell division. Which of the following proteins are most likely to be mutated if a damaged cell does not stop at the G2/M checkpoint? B-cell lymphoma 2 (Bcl-2) BRCA 1 (breast cancer 1) Myc p53 pRB (retinoblastoma protein)
**BRCA 1 (breast cancer 1)**
138
Human blood contains chemical buffers which are able to neutralise a small amount of added acid or base. Which of the following is the most important buffer system in the blood? Ammonium buffer system Carbonic acid-bicarbonate buffer system Haemoglobin buffer system Phosphate buffer system Plasma proteins buffer system
**Carbonic acid-bicarbonate buffer system**
139
DNA hypermethylation is observed in the 5’ untranslated region of the genome near to promoter regions of genes, resulting in transcriptional silencing. On which DNA base is hypermethylation most likely to occur? Adenosine Cytosine Guanine Inosine Thymine
**Cytosine**
140
Abnormal epigenetic modifications can be observed in cancer cells. For example, hypomethylation is observed in the 3’ untranslated region of tumour suppressor genes. What is the effect of this epigenetic modification? Activate transcription factors Enhance tumour suppressor gene expression Increase the association between histones and the DNA Promote gene silencing Promote genomic instability
**Promote genomic instability**
141
Cancers are initiated and progress by mutations in genes which result in either a gain or loss of function. Which of the following best describes the gain of function mutation observed in lung adenocarcinoma? Mutation in CDKN2A (cyclin dependent kinase inhibitor) Mutation in Rb (retinoblastoma protein) Mutation in EGFR (epidermal growth factor receptor) Mutation in MYC Mutation in TP53 (tumour protein 53)
**Mutation in EGFR (epidermal growth factor receptor)**
142
DNA damage from ultra violet light results in the formation of pyrimidine dimers. Which DNA repair mechanism can correct this mutation? Base excision repair Homologous double strand recombination Mismatch repair Non-homologous double strand end joining Nucleotide excision repair
**Nucleotide excision repair**
143
The levels of serum enzymes can be used to detect damage in specific tissues. Elevated levels of which of the following enzymes specifically indicates prostatic carcinoma? Acid phosphatase Alkaline phosphatase Aspartate transaminase Creatinine kinase Lactate dehydrogenase
**Acid phosphatase**
144
TNM staging of a tumour provides information for diagnosis, prognosis and treatment. If a breast tumour sample has been staged as TxN1M0 what would be the best description for this tumour? It is 2cm across or less, there is nodal involvement and the tumour has not metastasised. It is more than 2 centimetres but no more than 5 centimetres across, there is no nodal involvement and the tumour has not metastasised. The tumour size can't be assessed, there is no nodal involvement and the tumour has not metastasised. The tumour size can't be assessed, there is no nodal involvement and the tumour has metastasised. The tumour size can't be assessed, there is nodal involvement and the tumour has not metastasised.
**The tumour size can't be assessed, there is nodal involvement and the tumour has not metastasised.**
145
Stem cells are continuously dividing cells that are required to maintain cell populations in a number of tissues. What is the most common cause of cell senescence in stem cells? Accumulation of point mutations Changes in protein production Epigenetic changes Mitochondrial damage Shortening of telomeres
**Shortening of telomeres**
146
Caspases are proteins that initiate and execute the process of apoptosis in cells. Which of the following caspase proteins is essential to initiate apoptosis through the extrinsic pathway? Caspase 3 Caspase 6 Caspase 7 Caspase 8 Caspase 9
**Caspase 8**
147
Which of the following prevents assembly of microtubules and at higher doses inhibit mitotic spindle formation Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
**Vinblastine**: vinca alkaloids prevent assembly of microtubules
148
Label A & B [2]
A: Vinca alkaloids B: Taxanes
149
Which of the following inhibits disassembly of microtubules Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
Which of the following inhibits disassembly of microtubules Vinblastine **Docetaxel** : taxane Cisplatin Bleomycin Cyclophoshamide
150
Which of the following is an example of an alkylating agent chemotherapy Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
Which of the following is an example of an alkylating agent chemotherapy Vinblastine Docetaxel Cisplatin Bleomycin **Cyclophoshamide**
151
Neoadjuvent chemotherapy is common for which type of cancer Liver Prostate Kidney Ovarian
**Ovarian**
152
Which of the following is formed from cytotoxic glycopeptide antibiotics isolated from the fungus streptomyces verticillus Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
**Bleomycin**
153
Which of the following is an alkylating agent? Trabectedin L-Asparaginase Actinomycin-D Busulfan
Which of the following is an alkylating agent? Trabectedin L-Asparaginase Actinomycin-D **Busulfan**
154
Which of the following is derived from E. coli and deprives tumour cells of the required amino acids and inhibits protein synthesis Trabectedin L-Asparaginase Actinomycin-D Busulfan
**L-Asparaginase**
155
Which of the following binds to the minor groove of DNA, bending the helix towards the major groove, which leads to interference with the intracellular transcription pathways and DNA-repair pathways Trabectedin L-Asparaginase Actinomycin-D Busulfan
Which of the following binds to the minor groove of DNA, bending the helix towards the major groove, which leads to interference with the intracellular transcription pathways and DNA-repair pathways Trabectedin L-Asparaginase **Actinomycin-D** Busulfan
156
Which of the following exerts cytotoxic effects by intercalation between guanine-cytosine base pairs with inhibition of the synthesis of messenger RNA Trabectedin L-Asparaginase Actinomycin-D Busulfan
Which of the following exerts cytotoxic effects by intercalation between guanine-cytosine base pairs with inhibition of the synthesis of messenger RNA Trabectedin L-Asparaginase **Actinomycin-D** Busulfan
157
hemorrhagic cystitis is an AE of which of the following? Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
**Cyclophoshamide**: alkylating agents
158
Methotrexate inhibits which of the following G1 S G2 M
**S**
159
Bleomycin inhibits which of the following G1 S G2 M
Bleomycin inhibits which of the following **G2**
160
paclitaxel & docetaxel inhibit which cell cycle stage G1 S G2 M
**M**
161
Trastuzumab - emtansine (Kadcycla) is used at which stage of breast cancer treatment? First line Second line Third line Fourth line
**Second line**
162
A combination of pertuzumab, trastuzumab and docetaxel is used at which stage of breast cancer treatment? First line Second line Third line Fourth line
**First line**
163
Which of the following is topoisomerase II inhibitor
164
Which drug has a mechanism that works by the development of covalent adducts Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
**Cisplatin**
165
What drug class is Doxorubicin? [1]
Topoisomerase-II inhibitor
166
What drug class are: * Irinotecan * Topotecan
Topoisomerase-I inhbitors
167
Paclitaxel is a Vinca alkaloid Taxane Topoisomerase I inhibitor Topoisomerase II inhibitor
**Taxane**: prevents tublin disassembly
168
Name a cancer that neo-adjuvant chemotherapy is common for [1]
Ovarian
169
Which drug is included alongside trastuzumab & pertuzumab in first line breast cancer treamtnet? Also state its drug class [2]
**docetaxel**: taxane
170
hemorrhagic cystitis is associated with Vinblastine Docetaxel Cisplatin Bleomycin Cyclophoshamide
**Cyclophoshamide**
171
Most common form of radiotherapy are the [], which are used to treat deeper cancers.
Most common form of radiotherapy are the **MV photons**, which are used to treat deeper cancers.