Cancer Qs Flashcards
Which is the most common cause of cancer in females
Bowel
Prostate
Lung
Breast
Melanoma
Which is the most common cause of cancer in females
Bowel
Prostate
Lung
Breast
Melanoma
Which is the most common cause of cancer in men
Bowel
Prostate
Lung
Breast
Melanoma
Which is the most common cause of cancer in men
Bowel
Prostate
Lung
Breast
Melanoma
What is the single largest preventable cause of cancer within the UK? [1]
Smoking
Which of the following is not screened for cancer in the UK?
Retinoblastoma:
Bowel-FiT
Cervical
Ovarian
Breast
Which of the following is not screened for cancer in the UK?
Retinoblastoma:
Bowel-FiT
Cervical
Ovarian
Breast
Which of the following types of cancer is traditionally detected late on?
Thyroid
Oesophageal
Bladder
Ovarian
Breast
Which of the following types of cancer is traditionally detected late on?
Thyroid
Oesophageal
Bladder
Ovarian
Breast
Which of the following causes the upregulation of RAD51
Rb
BRCA1
WT1
BRCA2
p53
Which of the following causes the upregulation of RAD51
Rb
BRCA1
WT1
BRCA2
p53
p21 works at which cell cycle checkpoint? [1]
G1 to S phase
Name the gene that cause this function depicted
APC
TERT
P21
P53
BRCA1
Name the gene that cause this function depicted
APC
TERT: telomerase RT
P21
P53
BRCA1
BRCA1 / 2 is commonly associated with breast and which other type of cancer:
colorectal
rectal
ovarian
kidney
melonoma
BRCA1 / 2 is commonly associated with breast and which other type of cancer:
colorectal
rectal
ovarian
kidney
melonoma
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
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
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
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
Which of the following is often indicative of early neoplastic process
Hyperplasia
Dysplasia
In situ cancer
Invasive cancer
Which of the following is often indicative of early neoplastic process
Hyperplasia
Dysplasia
In situ cancer
Invasive cancer
The location of prostate cancer metastasis is typically:
Breast
Liver
Kidney
Rectum
Bone
The location of prostate cancer metastasis is typically:
Breast
Liver
Kidney
Rectum
Bone
- 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
- 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
- The category “T” in the TNM system stands for:(Required)
A. Time
B. Tumor (primary)
C. Tissue (primary)
D. Tumor (secondary)
- The category “T” in the TNM system stands for:(Required)
A. Time
B. Tumor (primary)
C. Tissue (primary)
D. Tumor (secondary)
Colon cancer commonly metastasises to the
Brain
Bone
Kidney
Liver
Prostate
Colon cancer commonly metastasises to the
Brain
Bone
Kidney
Liver
Prostate
‘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
‘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
‘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
‘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
Atezolizumab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Atezolizumab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Pembrolizumab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Pembrolizumab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Ipilimubab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Ipilimubab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Tremelimubab binds to which of the following
PDL1
PDL2
CTLA4
PD1
Tremelimubab binds to which of the following
PDL1
PDL2
CTLA4
PD1
State 4 red flags for colorectal cancer [4]
Unexplained weight loss
Unexplained rectal bleeding
Over 60 & IDA
Over 60 & changes in bowel habit
State 5 red flags for ovarian cancer [5]
Persistent abdomial distension
Feeling full
Loss of appetite
Pelvic or abdominal pain
Increased frequency of urination
State a red flag for oeseophogeal cancer [1]
Dysphasia
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
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
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]
State the point mutation that occurs in c-H-ras mutation [1]
E.g. c-H-ras: (Gly) GGC – (Val) CTG.
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
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
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
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
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
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
Which of the following are gatekeeper tumour suppressor genes? [2]
BRCA
Bcl2
Bax
pRB
p53
p53 & pRb
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
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
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
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
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
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
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
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
- 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]
- 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).
What type of genes are BRCA 1/2? [1]
Tumour supressor gene [1]
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%+
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
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
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
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.
Melonomas larger than what size (inch /or mm) would suggest that it is malginant? [1]
Larger than ¼ inch
(6mm)
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.
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.
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
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
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
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
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
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
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
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
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