Oncology Flashcards
Which of the following are good prognostic
factors in breast cancer?
Oestrogen receptor positivity
Which one of the following best describe
follicular carcinoma of the thyroid ?
Best treated with surgery and radioisotope
therapy
a 45 years old man has a positive stool guaiac
test during a routine physical examination. A
colonoscopy is performed and a 0.9 cm
circumscribed, pedunculated mass ** on a short
stalk is found in the upper rectum . Which of the
following terms best describes this lesion?
select one
Adenoma.
Which of the following is associated with the
highest risk of breast cancer?
Dense breasts on mammogram
A 53-year-old woman presents with a palpable
mass in the upper outer quadrant of her left
breast . Breast imaging confirms the presence of
a 2.0-cm mass, and a core needle biopsy finds
invasive ductal carcinoma, grade 3, ER < 5%, PR <
5%, HER2 IHC 0 . She proceeded with breast
conserving surgery and a sentinel lymph node
biopsy. Pathology showed a 2.2-cm invasive
cancer with negative margins . A total of two
sentinel lymph nodes were recovered, one of
which contained a 0.8-cm macrometastasis.
Adjuvant chemotherapy and radiotherapy are
planned. What is the preferred next step in
locoregional management?
No further axillary surgery
in cancer of the ovary which of the following is
true?
Common types are cystic
Which of the following statements is/are
CORRECT regarding molecular abnormalities
observed in lung cancer?
Chromosome 3p allele loss is one the
most common events in lung cancer
pathogenesis
Which of the following statements is correct
regarding pulmonary carcinoid tumors?
Surgery has a curative potential for
resectable localized tumors.
Which of the following is true of cancer of the
cervix?
Surface ulceration is common
A 55-year-old man with a 30 pack-year
history of smoking, presents to the emergency
room with shortness of breath . Chest radiograph
demonstrates a right upper lobe opacity.
Computed tomography scan reveals a 3.5-cm
spiculated mass in the peripheral right upper
lobe, which is suspicious for malignancy, without
any hilar or mediastinal lymphadenopathy. What
is the next best step in management?
CT-guided biopsy of the mass
Which of the following parts of pancreas is
most common site for cancers
Head of pancreas
Which three of the following are true in the
treatment of endometrial cancer?
Advanced disease may respond to
antioestrogen therapy
CA-125 is most useful in what aspect of
ovarian cancer management?
Monitoring treatment
Characteristic features of BRCA1-associated
breast cancers include the following except
Estrogen receptor (ER) positive
A 28-year-old woman presented to her
primary care doctor with a right breast mass that
persisted through three menstrual cycles . A
mammogram was not interpretable due to dense
breast tissue , and an ultrasound showed a 2.5-
cm breast mass with associated left axillary
lymphadenopathy . A core biopsy of the breast
mass was obtained, showing invasive ductal
carcinoma, grade 3, ER/PR negative, HER2 2+ by
immunohistochemistry, with a FISH ratio of 4.3
and a HER2 copy number of 9.5 . She reports a
family history of breast cancer in a paternal aunt
at age 35, a history of a brain tumor in that
aunt’s child at age 10, and a history of a bone
cancer in a paternal grandmother. She is referred
for genetic testing . What is the most likely
genetic abnormality identified?
P53 mutation
Colorectal cancer:
commonly arises from pre-existing
adenomas.
Risk factors associated with colorectal cancer
include which one of the following?
Low intake of dietary fibre
Which one of the following is true regarding
the management of NSCLC?
5 year survival rates of 15-20% have been
reported in selected patients treated with
chemo- and radiotherapy
Which one of the following statements is
true of lung cancer?
80% are due to smoking
As regards prognosis of NSCLC:
stage I disease is associated with 5 year
survival rates of 60-80%
Mrs. Hanna is a 42-year-old woman who has
breast cancer metastatic to bone and liver . Her
pain has been well controlled on sustained-
release morphine, 120 mg PO bid, for 3 months .
Which of the following is most likely to occur as a
result of this treatment ?
Pharmacologic tolerance
The following statements regarding screening
for breast cancer are correct
Studies have shown an approximate 30%
reduction in mortality with screening using
mammography.
Which of the following is a rare site of breast
cancer metastases?
Kidney
Which one of the following statements is
true of small cell lung cancer (SCLC)
Approximately 80% of patients respond
to chemotherapy
Characteristic presenting features of left
sided colorectal tumours include:
acute large bowel obstruction.
Which one of the following statements is
true of systemic treatment of NSCLC?
Epidermal growth factor receptor tyrosine
kinase inhibitors (EGFR-TKI) such as erlotinib
have proven active in previously treated
patients with advanced NSCLC
Which of the following statements is
INCORRECT regarding large cell neuroendocrine
tumors (LCNEC)?
Paraneoplastic syndromes are commonly
associated with LCNEC
All of the following statements regarding
ovarian cancer are true,EXCEPT
A. Mucinous tumor types are resistant to
chemotherapy
B. Clear cell variant is associated with
hypocalcema **
C. Endometroid variants are sometimes
associated with endometriosis
D. Immunostains on ovarian cancers
positivee typical cytokerate 7 and
cytokeratin 20 negative
Which of the following statements about
HER2 is FALSE?
HER2 signaling is effected through
homodimer formation
Risk factors for the development of NSCLC
(non small cell lung cancer) include:
Occupational radon exposure.
which syndrome is characterized by the
presence of breast cancer, soft tissue sarcoma,
leukemia and prostate cancer?
Li- fraumeni syndrome.
Which of the following is not necessary
when a patient first presents with a breast lump
Chest x – ray.
Which of the following is the most common
site of distant metastasis from head and neck
cancers :
Lung
Which one of the following symptoms is rare
in patients with progressive lung cancer ?
Urinary retention
Which one of the following statements is
true of surgery for non - small cell lung cancer
( NSCLC ) ?
Post - operative mortality rate is
approximately 10 %
Which of the following statements is true
regarding adjuvant treatment for early breast
cancer ?
Combination chemotherapy reduces
recurrence and improves survival in selected
patient groups
Which of the following is true about head
and neck lymph node levels : Select one :
a) Levels II to IV : internal jugular vein lymph
nodes.
b) All of the above.
c) Level V : posterior triangle
d) Level I : submental and submandibular
areas.
In treatment of metastatic breast cancer ?
trastuzumab ( herceptin ) in combination
with chemotherapy improves survival in
patients who have tumours that overexpress
HER 2.
Which one of the following is true regarding
lung cancer:
80-90% of small cell carcinomas have
spread beyond the thorax at the time of
diagnosis.
Which of the following is not an effective
treatment of breathlessness associated with lung
cancer?
Nebulised opioids
Which one of the following statements is
true of mesothelioma
All deaths due to mesothelioma should be
discussed with the coroner
features associated with poor prognosis in
colorectal cancer Include?
Presence of involved lymph nodes.
Surgery for liver metastasis from colorectal
cancer is?
Associated with 16-40% 5 year survival.
5 fluorouracil based chemotherapy?
Improves 5 year survival rates for patients
with Duke’s C tumours by approximately 7%.
which of the following is a feature of
colorectal cancer?
In Duke’s A disease >90% patients are
cured by surgery alone.
Bevacizumab:
Is a monoclonal antibody that targets
vascular endothelial growth factor (VEGF).
regarding metastasis from colorectal cancer
and symptomatic management of them:
Liver capsular pain usually responds well
to non-steroidal anti-inflammatory drugs.
acute bowel obstruction in advanced
colorectal cancer:
Should be treated with using a syringe
driver containing a mixture of anti-emetics,
analgesics and anti-spasmodics.
which of the following are true of breast
cancer?
The life time risk for a woman of
developing breast cancer is 1/9.
risk factors for breast cancer Include?
Young age at menarche.
the following statements regarding
screening for breast cancer are correct?
Studies have shown an approximately 30%
reduction in mortality with screening using
Mammography.
which of the following statements is true of
breast cancer treatment?
Radiotherapy should be given to all male
breast cancer patients after Mastectomy.
which of the following statements is true of
palliative treatment of metastatic breast cancer?
Increased back pain and weak legs
requires prompt investigation.
Which of the following may lead to oral
tongue cancers in individuals younger than 40
years of age:
A) TP53 (Li-Fraumeni syndrome).
B) Fanconi anemia.
C) Familial atypical multiple mole melanoma
(FAMMM) syndrome.
D) All of the above
HPV-positive oropharyngeal cancers show
improved response to therapy when compared
to HPV-negative cancers of the same site. HPV-
16 is responsible for what fraction of these
patients.
90%
HPV-positive cancers show improved
response to therapy when compared to HPV-
negative cancers of which sites:
Oropharynx
Which of the following is true about head
and neck lymph node levels:
a) Level I : submental and submandibular
areas
b) Levels II to IV : internal jugular vein lymph
nodes
c) Level V : posterior triangle
d) All of the above
Which of the following is a variant of
squamous cell carcinoma of the head and neck
region:
a) Lymphoepithelioma
b) Spindle cell carcinoma
c) Verrucous carcinoma
d) Undifferentiated carcinoma
e) All of the above
All of the following cancers have the
tendency to spread to bilateral neck nodes
except :
a) Tongue base
b) Soft palate
c) Nasopharynx
d) Hard palate
Which of the following head and neck region
cancer has the highest risk of lymph node
metastasis:
Squamous cell carcinoma
Panendoscopy is recommended for head and
neck cancers because the risk of synchronous
primary cancers is the upper aerodigestive tract
is:
1 - 10%
In the treatment of head and neck cancers,
all of the following are advantages of surgery
compared with radiotherapy except:
More amount of tissue can be addressed
with surgery
In the treatment of head and neck cancers,
all of the following are advantages of radiation
therapy compared with surgery except:
a) Post procedural surgical complications
may be avoided with radiation therapy
b) Radiation may result in better cosmetic
outcomes as no tissue is actually removed
c) Elective radiation of neck is potentially a
less morbid procedure than surgery
d) Salvage of a surgical failure with radiation
is easier than salvaging a radiation therapy
failure with surgery
Conventional radiation therapy in head and
neck cancer primary site is once-daily
fractionation, 66 to 70 Gy per fraction, 5 days a
week. There are alternatives schedules available
too, which of the alternative schedules leads to
survival benefit compared with conventional
schedule:
Hyperfractionation
Intensity-modulated RT (IMRT) provides a
more conformal does distribution compared to
conventional techniques of RT and it reduces the
does to the normal tissues. Which of the
following is not a disadvantage of IMRT:
The “beam on” time is decreased
Radical neck dissection is potentially a very
morbid procedure. To avoid the complications
associated with it, while maintaining the good
ontological outcome, modified radical neck
dissections (MRND) are performed. Which of the
following is a type of MRND:
Type I : cranial nerve (CN) XI is spared
b) Type II : CN XI and internal jugular vein are
spared
c) Type III : CN XI, the internal jugular vein,
and the sternocleidomastoid muscles are
spared
d) All of the above
Which of the following modality is more
effective in the management of clinically node
negative (N0) neck
a) Radiation
b) Surgery
c) Both are equally effective
Which of the following immunotherapy
molecules are approved in platinum refractory,
recurrent or metastatic head and neck cancer
a) Pembrolizumab
b) Nivolumab
c) Both of the above
Radiation therapy is combination with
surgery is indicated in many head and neck
cancer subsites. All of the following clinical
situations are indications for pre-operative
rather than postoperative RT, except:
Mobile-neck nodes
Which of the following are indications of
postoperative RT in head and neck cancers:
a) Close (< 5 mm) or positive margins
b) Extracapsular extension (ECE)
c) N2a or greater cervical node classification
d) Invasion of the soft tissues of the neck
e) Lymph-vascular invasion
f) Perineural invasion (PNI)
g) T3 to T4 tumor classification
h) > 5 mm of subglottic invasion
i) all of the above
Chemotherapy in combination with
radiation is employed in the management of
various head and neck cancer sites. This
approach when used without surgery leads to
organ preservation and good oncological
outcomes. Which of the following are methods
of delivering chemotherapy with radiation:
a) Concurrent chemotherapy and radiation
b) Induction chemotherapy followed by
radiation therapy
c) Induction chemotherapy followed by
concurrent chemoradiation
d) All of the above Answer : all of the above
Which of the following is the most accepted
management protocol advanced nasopharyngeal
cancers:
Concurrent chemoradiation followed by
maintenance chemotherapy
In larynx cancer management, organ
preservation is desired by both patients and
physicians. The seminal trials done on this
subject like VA trail and EORTC trail have shown
feasibility and good oncological outcomes of
radiation with or without chemotherapy in the
management of larynx cancers. Which of the
following is false regarding organ preservation
approaches in the management of larynx cancer:
In a meta analysis of VA, EORTC and
GETTEC trials of larynx cancer, there was a
non-significant trend towards improved
survival in the chemoradiation arm
All of the following are true regarding
squamous cell cancers of lips except :
Vermillion border of lower lip is the most
common site of origin
Which of the following is not true regarding
cancers of the floor of mouth:
Mandible invasion is a fairly early feature
All of the following are true regarding
cancers of oral tongue except
Granular cell myoblastoma is a rare by
highly malignant tumor involving oral tongue
Which of the following the therapeutic
modality of choice for discrete early lesions of
retromolar trigone:
Surgery
Which of the following is not anatomically a
part of oropharynx :
Pyriform fossa
For early lesions of oropharynx, which of the
following provides the best oncological outcome:
a) RT
b) Open surgery
c) TORS/TLM
d) All of the above
The treatment of choice for BOT squamous
cell carcinoma is:
RT
Which of the following is the treatment of
choice for soft palate carcinoma
RT
Which of the laryngeal cancer subsite has
the highest propensity for cervical lymph node
spread :
Subglottis
In which of the following situation in larynx
cancer, hemilaryngectomy which is potentially a
voice preserving surgery, can not be done:
Extension to the supraglottic or
interarytenoid area
Which of the following cancers of
supraglottis are better suited for surgery by
> 6 mL
Which of the following is not anatomically a
part of hypopharynx
Valleculae
Retropharyngeal lymph node involvement is
frequent in pharyngeal wall tumors, which of the
following is the preferred modality of treatment
for these tumors:
RT
Nasopharyngeal carcinoma affects
individuals slightly younger age than other head
and neck squamous cell carcinoma. Which of the
following is not a type of nasopharyngeal
carcinoma :
a) Keratinizing
b) Nonkeratinizing
c) Undifferentiated
d) Basaloid Answer
e) all of the above
For cancers of the nasal vestibule, which is
the preferred treatment :
Radiation
Which of the following is not true regarding
malignancies of salivary glands
In the management of parotid gland
tumors, facial nerve needs to be sacrificed
often
kit is commonly expressed in
Adenoid cystic cancer
Minor salivary gland tumors are most
commonly found on
Hard palate
Which of the following is goal of oral cavity
reconstruction
a) Obliteration of the oral cavity
b) Maintaining premaxillary contact
c) Maintaining the finger function of the
tongue
d) Facilitate retention and movement of
sections within the oral cavity
e) Optimize sensation of the remaining
native tissue and the revascularized free
tissue transfer
F) all of the above
Which of the following is true of ovarian
cancer?
It is the most common gynaecological
cancer in the UK
Which one of the following statements
regarding screening for ovarian cancer is correct?
Trials of potential screening methods for
ovarian cancer are ongoing.
Which one of the following symptoms is an
uncommon presentation of ovarian cancer?
Chest pain
Which of the following is true of staging of
ovarian cancer?
Stage III describes disease which has
spread to the peritoneum beyond the pelvis
Which of the following statements is true
regarding prognosis of ovarian cancer?
Stage III disease has a median 5 year
survival of 20%
In treatment of ovarian cancer:
Optimal debulking surgery has been
demonstrated to significantly improve
survival
Which of the following statements is true
of first line chemotherapy for epithelial ovarian
cancer?
Median survival following
platinum/taxane chemotherapy is 2-3 years
Which of the following is true of treatment
for relapsed epithelial ovarian cancer?
The response rate to platinum
chemotherapy is approximately 60% in those
who relapse more than 2 years after
completion of platinum based first line
chemotherapy
In metastatic epithelial ovarian cancer:
bowel obstruction is common and is
usually managed medically using
subcutaneous medication given via a syringe
driver
Risk factors for prostate cancer include
which one of the following
Black race
Which of the following is true regarding
prostate cancer
It accounts for approximately 30% of all
cancers in men
In diagnosis of prostate cancer:
all patients should have a digital rectal
examination (DRE)
Which one of the following statements is
true of prostate cancer?
PSA >50ng/ml is often associated with
distant bone metastases
Which of the following statements is true in
management of prostate cancer which is
confined to the prostate gland?
Active surveillance is a valid approach
In metastatic prostate cancer:
hormone therapy will produce responses
in around 70% of men with bone metastases
Side effects of hormone treatment rarely
include which one of the following?
Myelopsuppression
In treatment of hormone refractory
prostate cancer:
docetaxel and prednisolone have been
shown to increase median survival by 2
months
Which one of the following statements is
true of prostate bone metastases and their
complications?
Prophylactic orthopaedic intervention may
be required for bone lesions at high risk of
fracture
Which one of the following symptoms is
rare in patients with progressive prostate
cancer?
Haematemesis.
Which of the following is true of
endometrial cancer?
It can be caused by treatment for
breast cancer.
Cancer staging has several purposes. All
statements are correct regarding cancer staging
except?
All given statements are true.
Which of the following statements is true
about the pathology of breast cancer
Paget’s disease of the nipple is
always associated with an underlying
cancer.
Which one of the following is not a
presenting feature of oesophageal cancer:
Pulmonary aspiration.
In the above 76 year old gentleman, a PET
scan does not reveal any other sites of
metastatic disease and a mediastinoscopy does
not reveal the presence of carcinoma cells in
the mediastinal or hilar lymph nodes. What
stage is the patient’s lung cancer with 3 cm in
diameter?
Stage 1
a 58-year-old man with a 700-pack-
peryear smoking history presents to the
emergency department with shortness of
breath and hemoptysis. Portable chest
radiography demonstrates a large mass
centrally located within the left lung field. The
serum calcium is 13.0 mg/dl (normal 8.5 to
10.2). the metabolic abnormality described
here is likely due to elaboration of which
substance:
Parathyroid-related hormone.
Which one of the following statements is
true about the prognosis of lung cancer?
Small cell histology is a poor prognostic
factor.
Which one of the following is true about
the treatment of colorectal cancer:
Advanced stages of the disease responds to
VEGF (vascular endothelial growth factor)
inhibitors.
Surgical management of malignant
primary tumors have several components
besides:
Removal of malignant tumor with a clear
margin of normal tissue.
External beam radiotherapy is the most
common of treatment in clinical use. There are
several types of external beam machines
besides:
Macrovoltage machine.
Which of the following is true of the
treatment of ovary cancer?
Chemotherapy with cisplatin And paclitaxil
is standard in stage III.
Which of the following tumors of the liver
is most common hepatic tumor of childhood?
Hepatoblastoma.
A 50-year-old woman has a stage 2 HER2-
positive breast cancer and will recieive a
trastuzumab-based regimen . She asks you
about the toxicity profile. You reply that
trastuzumab is generally safe, but rare adverse
effects can include:
Renal impairment, lowering of cardiac
ejection fraction, infusion reaction
Which of the following applies to cancer
of the ovary:
There is 50 per cent risk in patients with the
BRCA1 gene.
Which of the following statements are
true about mesothelioma?
There is with asbestos.
Which of the following liver tumors is
benign?
Cavernous hemangiomas.
Which of the following is true of
choriocarcinoma:
Metastases are present in a third of women
at presentation.
5-fluorouracil based chemotherapy?
Improves 5-year survival rates for patients with Duke’s C tumours by ~7%
Which of the following is true of systemic treatment of NSCLC
EGFR-TKI have proven active in previously treated patients
Bevacizumab
Targets VEGF
Acute bowel obstruction in advanced colorectal cancer
Should be treated with using a syringe driver containing a mixture of anti-emetics, analgesics and
anti-spasmodics.
