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Year 5 Exams > Oncology LEK > Flashcards

Oncology LEK Flashcards

1
Q

The treatment of pre-invasive cervical cancer consists in:
a. Excision of the affected part of the cervix
b. strict cytologic and colposcopy examination once a month
c. simple hysterectomy
d. radicalhysterectomy
e. Brachytherapy

A

a. Excision of the affected part of the cervix

Pre-invasive cervical cancer, often referred to as cervical intraepithelial neoplasia (CIN), is a precursor to invasive cervical cancer. This condition can be treated effectively by surgically excising the affected part of the cervix, typically through procedures like LEEP (loop electrosurgical excision procedure) or cold-knife conization.

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2
Q

Early gastric cancer is defined as:
a. malignant neoplasm crossing the gastric wall, with metastases to the
lymph nodes but with no metastases to the distant organs
b. Does not exceed the stomach wall
c. Malignant neoplasm of the stomach categorized as T2 by the TNM
classification
d. Malignantneoplasminmucousandsubmucousmembranes,butnot infiltrating the muscle membrane of the stomach
e. Malignant neoplasm of the stomach diagnosed in a patient under 50 years of age

A

d. Malignant neoplasm in mucous and submucous membranes, but not infiltrating the muscle membrane of the stomach

Early gastric cancer is a malignancy that is confined to the mucosa and submucosa, regardless of the presence or absence of lymph node metastasis. It has not yet infiltrated the muscularis propria or beyond.

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3
Q

Screeningprogramsarescientificallyjustifiedinpracticeforthedetectionof: 1) Breastcancer
2) prostatecancer 3) cervicalcancer 4) lungcancer
5) colorectalcancer 6) melanoma
The correct answer is:
a. 1,3,5
b. 1,2,3,5 c. 1,3,4,5 d. 1,2,3,4,5 e. 1,3,5,6

A

a. 1,3,5 (Breast cancer, cervical cancer, colorectal cancer)

Screening programs are justified for these cancers because early detection can significantly improve outcomes. Breast cancer screening typically involves mammography, cervical cancer screening involves Pap smears and HPV testing, and colorectal cancer screening can involve colonoscopy, stool tests, or other methods. Screening for other cancers like prostate and lung cancer may also be beneficial, but this can depend on factors like age, risk level, and individual patient circumstances.

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4
Q

An increased level of prostate-specific antigen (PSA):
a. Justifies the diagnosis of prostate carcinoma
b. indicated the need of transrectal ultrasound-guided fine-needle
biopsy
c. Indicates the need of transrectal ultrasound with excision for histologic examination
d. requirespelvicmagneticresonanceimaging
e. requires use of positron emission tomography

A

b. indicates the need of transrectal ultrasound-guided fine-needle biopsy

Elevated PSA levels may suggest the presence of prostate cancer or other conditions such as an enlarged or inflamed prostate. However, PSA is not definitive for diagnosing prostate cancer and further tests, like a transrectal ultrasound-guided fine-needle biopsy, are needed to confirm the diagnosis.

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5
Q

Fever in a patient with breast cancer who recently received a subsequent course of adjuvant postoperative chemotherapy:
a. May be due to treatment-induced neutropenia
b. is always an indication for the use of granulocyte-colony stimulating agents
c. is always an indication for the primary use of antifungal agents
d. AandBaretrue
e. A.b and C are true

A

May be due to treatment-induced neutropenia

Fever in patients who recently received chemotherapy could be a sign of febrile neutropenia, a condition characterized by low white blood cell counts and fever. This can indicate a severe infection that requires immediate medical attention.

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6
Q

In cancer patients with acute lysis syndrome laboratory abnormalities include:
a. uric acid
b. potassium
c. phosphates
d. correctanswersAandB
e. correct answers A,B,C

A

e. correct answers A,B,C (uric acid, potassium, phosphates)

Tumor lysis syndrome is a potentially life-threatening condition that can occur after treatment of cancer, particularly with rapidly proliferating malignancies. It is characterized by metabolic abnormalities including hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.

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7
Q

Carcinoembryonic antigen level assessment is of most value in:
a. Breast cancer
b. Lung cancer
c. colorectal cancer
d. pancreaticcancer
e. stomach cancer

A

c. colorectal cancer

Carcinoembryonic antigen (CEA) is a type of tumor marker. It’s often used to monitor response to treatment and check for recurrence in people with colorectal cancer. It can also be used to a lesser extent in the management of other cancers, such as breast or lung cancer, but it is most valuable in colorectal cancer.

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8
Q

Which of the following was the most frequently occurring malignant tumor in Polish women for the 5 years (2010-2014)?
a. Breast cancer
b. Endometrial cancer
c. cervical cancer
d. ovariancancer
e. lung cancer

A

a. Breast cancer

As of my knowledge cut-off in 2021, breast cancer is the most common cancer in women worldwide and this has been the case in Poland during 2010-2014 as well. Note that statistics can change over time.

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9
Q

Symptoms of ovarian cancer do not include:
a. pain in the lower abdomen or pelvis
b. oliguria
c. increase in the abdominal circumference
d. Tympanites,abdominaldistention
e. urge incontinence

A

b. oliguria

Early gastric cancer is characterized by its restriction to the mucosa and submucosa, irrespective of the presence or absence of lymph node metastasis. It is defined as such since it has not yet invaded the muscle membrane or deeper layers of the stomach wall. The other options listed describe more advanced stages of gastric cancer or aren’t related to the staging of gastric cancer.

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10
Q

Which of the following must be performed first in the case of a patient with a liver tumor diagnosed incidentally on ultrasound and a suspicion of cancer metastasis?
a. Accurate medical history, contrast enhanced CT of the abdomen, endoscopy of the upper and lower gastrointestinal tract
b. Accurate medical history and core needle biopsy of the tumor for histopathological examination
c. Accurate medical history and PET-CT as soon as possible
d. Accuratemedicalhistory,contrastenhancedCToftheabdomenand
urgent decision on laparotomy and partial hepatectomy with tumor
resection
e. All the above statements are false

A

a. Accurate medical history, contrast enhanced CT of the abdomen, endoscopy of the upper and lower gastrointestinal tract

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11
Q

In which of the following breast areas breast cancer most frequently resides?
a. Retroareolar
b. upper inner quadrant
c. lower outer quadrant
d. lowerinnerquadrant
e. upper outer quadrant

A

e. upper outer quadrant

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12
Q

Cancers of unknown origin:
1) represent 3-10% of all malignant tumors;
2) do not require detailed diagnostics, because the primary site may be identified in 5% of cases only
3) are most frequently adenocarcinomas;
4) are more frequent in women
5) are indications for positron emission tomography.
The correct answer is:
a. 1,2 b. 1,3 c. 1,3,5 d. 2,3,4 e. 2,4

A

c. 1,3,5

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13
Q

Pancreatic cancer may be related to:
a. Obesity
b. smoking tobacco
c. diabetes
d. correctanswer:AandB
e. correct answer: A,B and C

A

e. correct answer: A,B and C

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14
Q

The typical management of acute tumor lysis syndrome includes:
a. Hydration and forced diuresis
b. allopurinol administration
c. Glucocorticoids administration
d. A and B
e. A, B, C

A

d. A and B

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15
Q

Cancer-related ileus:
a. Is most frequent in patients with ovarian cancer and gastrointestinal tumors
b. May be caused by a mechanical obstruction or may be related to metabolic
disorder
c. Is always an indication for using somatostatin analogues
d. A and B are true
e. A, B and C are true

A

d. A and B are true

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16
Q

Cancer staging:
a. is important to determine the prognosis for patients
b. helps to select the best method of treatment
c. is based on TNM classification for all malignant tumors
d. A and B are true
e. A, B and C are true

A

d. A and B are true

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17
Q

Which of the following is the most common cause of death due to neoplastic disease in women in Poland?
a. Lung cancer
b. Breast cancer
c. cervical cancer
d. ovariancancer
e. colon cancer

A

a. Lung cancer

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18
Q

Bronchoscopy in a patient with a suspicion of lung cancer: 1) is one of the basic diagnostic examinations; 2) should be applied to peripheral lesions only; 3) may include tissue sampling for histologic examination; 4) provides cellular material sampling for cytological examination; 5) may be performed only in patients with the normal values of respiratory function tests. The correct answer is:
a. 1,2
b. 1,3,4
c. 2,4,5
d. 1,2,5
e. All the answers are correct

A

b. 1,3,4

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19
Q
  1. A 72-year-old woman in the 4th stage of chronic kidney disease and with
    severe back pain was admitted to the department of nephrology with the suspicion
    of monoclonal immunoglobulin deposition disease in the course of multiple
    myeloma. Indicate the examinations that allow to confirm the diagnosis:
    1) presence of plasmocytes in the bone marrow > 10%;
    2) nephrotic proteinuria;
    3) presence of monoclonal immunoglobulins in the serum and in the urine;
    4) haematuria;
    5) deposits of light or heavy immunoglobulin chains in the kidney glomeruli.
    The correct answer is:

a. 1,2,5 b. 1,2,4 c. 1,3,5 d. 1,3,4 e. 2,4,5

A

c. 1,3,5

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20
Q

Which of the following is not a risk factor for endometrial cancer?
a. Obesity
b. smoking tobacco
c. Diabetes
d. exogenous estradiol
e. late menopause

A

b. smoking tobacco

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21
Q

Which of the following is not typical of cervical cancer?
a. Urinary urgency
b. Bloody vaginal discharge with unpleasant smell
c. intermenstrual bleeding
d. abdominalpain
e. contact bleeding

A

a. Urinary urgency

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22
Q

The most frequent origin of metastasis in the liver is:
a. prostate cancer
b. colon cancer
c. kidney cancer
d. thyroid cancer
e. parathyroid carcinoma

A

b. colon cancer

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23
Q

Indicate the true sentences regarding screening for the neoplastic disorders of female genital organs:

1) screening for vaginal and vulvar cancer is not performed because of the low incidence of these tumours;
2) screening for endometrial cancer is not performer because its first symptoms, i.e. uterine bleeding, are easily noticed by women and reported to their doctors;
3) screening for non-epithelial tumours of the ovaries, the uterus and the vagina is not performed because of the low incidence of these tumours;
4) screening for endometrial cancer is performed and includes ultrasound imaging, the measurement of the markers: CA 125, HE 4 (human epididymis protein 4) and chorion gonadotropin;
5) Screening for cervical cancer is performed and includes a cytological test, a test which sensitivity reaches 85-90% in leading centers.

The correct answer is:
a. 1,2,3
b. 1,5
c. 3,4,5
d. 4,5
e. 1,3,4

A

a. 1,2,3

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24
Q

Which of the following concerning carcinoma of the ampulla of Vater is false?
a. predominant sign of carcinoma of the ampulla of Vater is painless mechanical
jaundice
b. carcinoma of the ampulla of Vater may lead to so called courvoisier’s sign
c. Percentage of resection operation in carcinoma of the ampulla of Vater is
significantly lower in pancreatic head cancer
d. long term results of treatment are better in carcinoma of the ampulla of Vater
than in pancreatic cancer
e. its incidence in males and females is similar

A

c. Percentage of resection operation in carcinoma of the ampulla of Vater is
significantly lower in pancreatic head cancer

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25
Q

Which of the following concerning pancreatic cancer is false?
a. More than 95% of cases of pancreatic cancer is ductal cancer,
b. usually located in the body of pancreas Mechanical jaundice may be the first sign of pancreatic cancer
c. About 15-30% of pancreatic cancers are resectable at diagnosis
d. Primary surgical techniques used in the treatment of cancer of the body of the pancreas is partial pancreatic resection
e. TNM classification is the most commonly used method for the evaluation of tumor staging

A

b. usually located in the body of pancreas Mechanical jaundice may be the first sign of pancreatic cancer

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26
Q

Which of the following is relative contraindication to conservative surgery in breast cancer?
a. Tumor diameter exceeding 3cm
b. lack of patients consent to conservative surgery
c. synchronous bilateral breast cancer
d. contraindications to radiotherapy
e. Breast cancer in males

A

c. synchronous bilateral breast cancer

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27
Q

The most common neuroendocrine pancreatic tumor is:
a. Gastrinoma
b. Somatostatinoma
c. VIPoma
d. Glucagonoma
e. Insulinoma

A

e. Insulinoma

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28
Q

In the TNM classification of colon cancer T1 denotes infiltration of:
a. Mucous membrane
b. Submucous membrane
c. muscle membrane
d. serous membrane
e. neighboring organs

A

b. Submucous membrane

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29
Q

A 47-year-old woman comes to the office because of a weight gain of 10 kg
during the last 6 weeks. She is hungry all the time. Sometimes she does not
remember what happened a few minutes before. What is the most probable
diagnosis that has to be excluded first?
a. Insulinoma
b. reactive hypoglycemia
c. Type 2 Diabetes
d. Type 1 Diabetes
e. Adrenal Insufficiency

A

a. Insulinoma

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30
Q

Which of the following does not influence (neither positively or negatively) the
risk of colon cancer?
a. Tobacco smoking
b. Age >50 years
c. Aspirin
d. Obesity
e. Angiotensin convertase inhibitors or angiotensin receptor antagonists

A

e. Angiotensin convertase inhibitors or angiotensin receptor antagonists

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31
Q

Wells’ scoring system used to estimate the risk of pulmonary embolism does
not include:
a. Blood platelet count
b. Tachycardia >100/min
c. Hemoptysis
d. Malignant tumor
e. recent surgery

A

a. Blood platelet count

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32
Q

Which of the following colon lesions bears the highest risk of malignant
transformation?
a. Tubulovillous adenoma
b. tubular adenoma
c. villous adenoma
d. hyperplastic poly
e. juvenile polyp

A

c. villous adenoma

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33
Q

Indicate the true statements concerning esophageal cancer:
1) it has a good prognosis;
2) most common type of esophageal cancer is adenocarcinoma;
3) achalasia is one of its risk features;
4) it infiltrates surrounding tissues at early stages and metastases to the lymph
nodes;
5) surgery is the primary mode of treatment.

The correct answer is:
a. 1,2,3,5
b. 1,2,3
c. 1,2,5
d. 3,4
е. 3,4,5

A

e. 3,4,5

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34
Q

“This tumor can develop before puberty but the peak incidence is observed in
women of reproductive age. It easily ruptures which may lead to peritoneal signs
and symptoms demanding urgent surgery. In postmenopausal women it may cause
abnormal bleeding from the reproductive tract. Surgical excision does not guarantee
full recovery as this tumor recurrence may be observed as many as 30 ears after
the initial diagnosis”.

The above is a characteristic of:
a. Ovarian cancer
b. sarcoma
c. Hydatidiform mole
d. Germinoma
e. Granulosa cell tumor

A

e. Granulosa cell tumor

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35
Q

Indicate the true statement concerning ovarian cancer surgery:
a. it strives for tumor sample obtaining and fast radical chemotherapy
application
b. cytoreduction is performed to the highest possible extent
c. only and always the affected ovary is removed
d. following ureterectomy the region of the lesser pelvis may be irradiated
e. neoadjuvant chemotherapy is always used in order to decrease a tumor mass

A

b. cytoreduction is performed to the highest possible extent

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36
Q

When should the next cytological examination be ordered in a 35-year-old
multipara with normal results of the last three cytological examinations and
without any risk factors?
a. in 3 months
b. in 6 months
c. in a year
d. in three years
e. only of some symptoms occur, such as increased vaginal discharge or contact
bleeding

A

d. in three years

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37
Q

A 45-year-old woman with the diagnosis of cervical cancer went to see her
gynecologist. Which of the following data from her medical history is not a risk
factor for this cancer?
a. 5 deliveries
b. numerous viral and bacterial infections of the cervix
c. obesity
d. smoking
e. frequent changing of sexual partners

A

c. obesity

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38
Q

Which of the following are the main symptoms of Hodgkin’s lymphoma in
children

a. Abdominal pain, bleeding, vomiting, dysphaga
b. non-symmetrical lymphadenopathy, affecting mainly cervical and
supraclavicular nodes (firm and painless, forming packets), fever
c. Abdominal pain, bone pain, hepatosplenomegaly, normal lymph nodes
d. Apathy, thrombocytopenic purpura, subfebrile state, predilection for
infections
e. high fever, lesions on the mucosa of the pharynx, Lymphadenopathy,
hepatosplenomegaly

A

b. non-symmetrical lymphadenopathy, affecting mainly cervical and
supraclavicular nodes (firm and painless, forming packets), fever

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39
Q

Alpha-fetoprotein is a laboratory indicator of:
a. Gastrointestinal stromal tumor (GIST)
b. fetal renal cancer
c. Gastric sarcoma
d. Hepatocellular carcinoma
e. pancreatic islet tumor

A

d. Hepatocellular carcinoma

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40
Q

Extranodal lymphoma is most commonly localized in:
a. stomach
b. duodenum
c. small intestine
d. colon
e. rectum

A

a. stomach

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41
Q

Which of the following operations can be performed in the case of
adenocarcinoma localized in the sigmoid colon?
a. Laparoscopic sigmoid resection
b. Hartmann’s procedure by means of laparotomy
c. Sigmoid resection by means of laparotomy
d. Laparoscopic Hartmann operation
e. All of the above

A

e. All of the above

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42
Q

The most common symptom reported by patients with vulvar cancer:
a. pain
b. fever
c. malaise
d. pruritus
e. Dysuria

A

d. pruritus

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43
Q

Which of the following is the most probable diagnosis in the case of impaired
fertility, chronic pelvic pain, painful periods, and dyspareunia?
a. Endometriosis
b. Ovarian cancer
c. cervical cancer
d. Adnexitis
e. premature ovarian failure

A

a. Endometriosis

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44
Q

Microscopic evaluation of the material obtained at the outer opening of the
cervix is called cervical smear (Papanicolaou test) and is used to diagnose
precancerous states or cervical cancer. Which of the following should be advised in
the case of the abnormal result of cervical smear - HSIL (high-grade squamous
intraepithelial lesion)?

a. Repeat cervical smear- twice every 4-6 months
b. perform colposcopy with the biopsy of the suspected lesion and abrasion
of the cervical canal
c. HPV determination
d. repeat cervical smear and determine HPV
e. none of the above

A

b. perform colposcopy with the biopsy of the suspected lesion and abrasion
of the cervical canal

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45
Q

The risk factor for breast cancer is not:
a. Age over 35
b. regular consumption of alcohol
c. obesity
d. late menarche and early menopause
e. use of hormone replacement therapy including oral contraceptives

A

d. late menarche and early menopause

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46
Q

Which of the following does not suggest the development of malignant
melanoma from a nevus?
a. enlargement of the nevus
b. bleeding nevus
c. equal distribution of pigment in the nevus
d. inflammation in the nevus
e. ulceration within the nevus

A

c. equal distribution of pigment in the nevus

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47
Q

The Lauren classification concerns:
a. colon cancer
b. stomach cancer
c. pancreatic cancer
d. liver cancer
e. extension of gastric inflammatory changes

A

b. stomach cancer

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48
Q

The increased risk of endometrial cancer has not been associated with:
a. obesity
b. diabetes
c. hypertension
d. late menopause
e. endometriosis

A

e. endometriosis

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49
Q

Which of the following is characteristic of borderline ovarian tumors?
a. no destructive infiltration of the stroma
b. occurrence limited to the ovaries only
c. prognosis similar to that of ovarian cancer
d. no effective treatment options available
e. occurrence in postmenopausal women only

A

a. no destructive infiltration of the stroma

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50
Q

Indicate the true statements concerning vulvar cancer:
1) most commonly it develops from the stratified squamous epithelium;
2) HPV infections play an important role in pathogenesis of some vulvar cancers;
3) supraclavicular lymph nodes are the most common site of metastasis;
4) basic treatment consists in the surgery and radiochemotherapy;
5) hormonal therapy is the most effective method of vulvar cancer treatment.

The correct answer is:
a. only 5
b. 1.2.3
c. 1.2.5
d. 2,3,4
e. 1,2,4

A

e. 1,2,4

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51
Q

What kind of damage to the kidneys can be observed in the course of multiple
myeloma?
1) AL. amyloidosis;
2) focal segmental glomerulosclerosis (FSGS);
3) monoclonal immunoglobulin deposition disease;
4) cast nephropathy;
5) membranous nephropathy.

The correct answer is:
а. 1,3,5
b. 1,3,4
c. 1,2,3,5
d. 2,4,5
е. 3,4

A

b. 1,3,4

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52
Q

Ménétrier’s disease belongs to precancerous condition of:

a. stomach
b. duodenum
c. small intestine
d. large intestine
e. gallbladder

A

a. stomach

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53
Q

Early gastric cancer is defined as:
a. lesion limited only to the epithelium only
b. lesion limited only to the mucous membrane without metastases in the
lymph node
c. lesion limited only to the mucous membrane irrespective of the presence of
metastases in the lymph nodes
d. lesion limited to the mucous membrane and submucosa, regardless of the
presence of metastases in the lymph nodes.
lesion limited to the mucous membrane and submucosa without the
presence of metastases in the lymph nodes

A

d. lesion limited to the mucous membrane and submucosa, regardless of the
presence of metastases in the lymph nodes.

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54
Q

Which of the following is the most common source of metastases to the liver?
a. colon cancer
b. pancreatic cancer
c. gallbladder cancer
d. gastric cancer
e. lung cancer

A

a. colon cancer

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55
Q

The second most common thyroid cancer is:
a. papillary
b. anaplastic
c. follicular
d. medullary
e. multicellular

A

c. follicular

56
Q

Carcinoid is an epithelial tumor derived from cells of the neuroendocrine system and is most commonly located in:
a. digestive tract
b. pancreas
c. thyroid
d. gallbladder
e. adrenal glands

A

a. digestive tract

57
Q

Colorectal cancer is most commonly located in:
a. cecum
b. ascending colon
c. transverse colon
d. descending colon
e. sigmoid colon and rectum

A

e. sigmoid colon and rectum

58
Q

Linitis plastica denotes:
a. cancer extensively infiltrating the stomach wall, giving early metastases
to the lymph nodes
b. colon cancer, which cause obstruction of the lower gastrointestinal tract
c. esophageal cancer, in the course of which the esophagus has the form of a
hard, stiff tube
d. Advanced, unresectable pancreatic cancer
e. rare, primary liver cancer

A

a. cancer extensively infiltrating the stomach wall, giving early metastases
to the lymph nodes

59
Q

A 65-year-old patient in good medical condition, with arterial hypertension and
type 2 diabetes mellitus treated with oral therapy, comes to the gynecologist
because of the moderate hemorrhage from the reproductive tract. Her body weight
is 87 kg and the height is 163 cm. The result of the endometrial biopsy is:
endometrial adenocarcinoma G1. Transvaginal ultrasound imaging suggests
minimal invasion of the endometrium, CT imaging shows no intra-abdominal
dissemination nor pathological pelvic or paraaortic lymph nodes. Indicate the
optimal treatment for this patient:

a. Surgery: hysteroscopic removal of the tumor
b. Surgery: panhysterectomy
c. Radiotherapy (brachytherapy+teletherapy)
d. Chemotherapy (paclitaxel+carboplatin)
e. Hormonal (megestrol acetate)

A

b. Surgery: panhysterectomy

60
Q

What percentage of the patients with diagnosed ovarian cancer are
BRCA1/BRCA2 germinal mutation carriers?
a. 1%
b. 5%
c. 10%
d. 30%
е. 50%

A

c. 10%

61
Q

Chemotherapy as a separate therapeutic strategy (not as a part of a
combination therapy) is the most effective in the treatment of:
a. serous ovarian tumor
b. mucinous ovarian tumor
c. endometrial cancer of the uterus
d. Choriocarcinoma
e. cervical squamous cell carcinoma

A

d. Choriocarcinoma

62
Q

Indicate the true statement concerning gastric cancer::
a. females are affected twice as often as males
b. intestinal metaplasia does not increase the risk of the disease
c. early gastric cancer does not spread to lymph nodes according to is definition
d. Treatment is mostly confined to chemo. and radiotherapy
e. Helicobacter pylori infection 5-fold increases the risk of the Disease

A

e. Helicobacter pylori infection 5-fold increases the risk of the Disease

63
Q

A 25-year-old woman found a lump of 2 cm x 1 cm in size in the upper lateral
quadrant while self-examining her right breast. The biopsy result was ductal
carcinoma. Considering the lymphatic drainage through the Roth path, the lymph
node metastases may be expected in:
a. first level of axillary lymph nodes
b. second level of axillary lymph nodes
c. third level of axillary lymph nodes
d. first and second level of axillary lymph nodes
e. second and third level of axillary lymph nodes

A

e. second and third level of axillary lymph nodes

64
Q

In the classification of macroscopic advanced gastric cancer according to
Bormann, Type I is defined as:
a. a polypoid ulcerated tumor
b. an ulcerated tumor with raised margins
c. A tumor with ulceration, whose margins are hardly visible
d. diffuse cancer (linitis plastical
e. Bormann classification concerns early gastric cancer

A

a. a polypoid ulcerated tumor

65
Q

The factors that increase the risk of endometrial cancer include:
1) smoking cigarettes;
2) metabolic syndrome (obesity, diabetes);
3) multiparity;
4) polycystic ovary syndrome;
5) long-term estrogen therapy not balanced with progesterone administration.
The correct answer IS:
a. 1,3,5
b. 3,4,5
c. 2,3,4
d. 2,4
e. 2,4,5

A

e. 2,4,5

66
Q
  1. Indicate the clinical features of germinal neoplasms of the ovary:
    1) occur mainly in young women;
    2) occur mainly in post-menopausal women;
    3) may be diagnosed on the basis of increased blood levels of CA-125, CEA, CA
    15-3;
    4) may be diagnosed on the basis of increased blood levels of LDH, AFP, hCG;
    5) respond well to chemotherapy;
    6) are treated only surgically;
    7) are always malignant tumors.
    The correct answer is:
    a. 1,4,7
    b. 3,4,6
    c. 2,5,6,7
    d. 1,4,5
    е. 2,3,7
A

d. 1,4,5

67
Q

Anemia of chronic disease differs from iron deficiency anemia in:
a. increased serum ferritin concentration
b. decreased total iron binding capacity (TIBC)
c. decreased MCV values
d. Answers A and B are correct
e. The correct answers are A.B,C

A

d. Answers A and B are correct

68
Q

Which of the following is the most characteristic abnormality in patients with
multiple myeloma?
a. generalized lymphadenopathy
b. hepatomegaly
c. splenomegaly
d. osteolytic bone lesions
e. plasmacytic infiltration in the kidneys

A

d. osteolytic bone lesions

69
Q

A 82-year-old man was brought to the ER by his son because of the swollen
and painful left leg. The patient was diagnosed with pulmonary cancer 2 months
ago. Which is the most probable cause of the swelling and the pain in the leg?
a. deep vein thrombosis
b. peripheral arterial disease
c. gout
d. congestive heart failure
e. hypoalbuminemia

A

a. deep vein thrombosis

70
Q

Indicate the true statement concerning diffuse large B-cell lymphoma:
a. it is a potentially curable neoplasm
b. the treatment of choice is monotherapy with a cytostatic agent,
independently on the staging of the disease
c. the progression is always slow
d. Allotransplantation of hematopoietic stem cells is a preferred method in the
first-line treatment
e. is one of the least common lymphomas

A

a. it is a potentially curable neoplasm

71
Q

Indicate the true statement concerning Ewing’s sarcoma:
a. it is more common in girls than in boys
b. primary lesion causes laminated periosteal reaction
c. is a highly differentiated sarcoma
d. it is usually located in an upper limb
e. the most common location of metastases is the liver

A

b. primary lesion causes laminated periosteal reaction

72
Q

Which neoplastic tumors may develop in the abdominal cavity of a child?
1) Wilms’ tumor;
2) neuroblastoma;
3) non-Hodgkin lymphoma;
4) medulloblastoma;
5) Dysgerminoma.

The correct answer is:
a. 1,2
b. 1,2,4
c. 1,2,5
d. 1,2,3,5
e. All the above

A

d. 1,2,3,5

73
Q

In TNM classification of colon cancer the T4 denotes the infiltration of:
a. mucous membrane
b. submucous membrane
c. muscle membrane
d. serous membrane
e. surrounding organs

A

e. surrounding organs

74
Q

Which of the following is not a germ cell tumor of the ovary?
a. germinoma
b. teratoma
c. embryonal carcinoma
d. granulosa cell tumor
e. choriocarcinoma

A

d. granulosa cell tumor

75
Q

Which of the following ovarian tumors is a virilizing tumor
a. sertoli-Leydig cell tumor
b. endometrioid tumor
c. wolffian duct cell tumor
d. corpus luteum cyst
e. fibroblast tumor

A

a. sertoli-Leydig cell tumor

76
Q

The secondary prophylaxis of cervical cancer consists in:
a. pro-healthy style of life to avoid HPV infection
b. cytological screening
c. cervical conization in the case of CIN2+ cytological outcome
d. radical hysterectomy with lymphadenectomy in the case of invasive cancer
e. brachytherapy in the case of metastatic cancer

A

b. cytological screening

77
Q

In which of the following neoplasms brachytherapy is not used as an auxiliary
method?
a. ovarian cancer
b. endometrial cancer
c. cervical cancer
d. vulvar cancer
e. in the all of the above cancers brachytherapy is used as an auxiliary method

A

a. ovarian cancer

78
Q

Lung cancer:
a. is the most commonest cause of cancer deaths in women in poland
b. is associated with tobacco smoking in around 50% of the patients
c. most often has a small-cell carcinoma histological pattern
d. Band C are correct
e. A, B and C are correct

A

a. is the most commonest cause of cancer deaths in women in poland

79
Q

A 64-year-old obese female reports postmenopausal vaginal bleeding. A
cytological smear was obtained and in a transvaginal ultrasound endometrial
hyperplasia was found. The mucosa biopsy was performed and the
histopathological diagnosis of adenocarcinoma was obtained. Pap smear was
normal. The uterus with appendages was completely resected and the lymph nodes
were sampled. In postoperative examination adenocarcinoma cells were found in
the uterus region (no evidence of serous membrane infiltration) and in the cervical
canal near the internal orifice. No evidence of adnexal infiltration or metastases to
the lymph nodes was found. Indicate tumor advancement according to FIGO
classification:
a. IA
b. IB
C. II
d. IA
e. TIB

A

C. II

80
Q
  1. Which of the following are characteristic of a granulosa cell tumor?
    1) most often occurs on both sides;
    2) it is a germ cell tumor;
    3) it is secreting estrogens and inhibin;
    4) it is often accompanied by ascites;
    5) most often occurs before puberty.

The correct answer is:
a. 1,2,4
b. 2,4,5
c. only 3
d. 1,3,5
е. 2,3,5

A

c. only 3

81
Q

A 42-year-old man is suffering from weight loss - 15 kg in 3 months, diarrhea,
increased amount of urine, recurrent urinary tract infections and recurrent oral
mucositis - was admitted to the hospital. The abdomen ultrasound examination
visualized pancreatic head tumor. The tumor biopsy was performed during
endoscopic ultrasonography. The most probable biopsy result is:
a. pancreatic neuroendocrine tumor - VIP-oma
b. pancreatic neuroendocrine tumor- glucagonoma
c. metastasis of colorectal adenocarcinoma
d. pancreatic neuroendocrine tumor - insulinoma
e. pancreatic neuroendocrine tumor - gastrinoma

A

b. pancreatic neuroendocrine tumor- glucagonoma

82
Q

Endometrial cancer is currently the most common female genital cancer in
developed countries. The following are the characteristics of its two subtypes:
1) estrogen dependence (positive E + and P + receptor state);
2) aggressive course, frequent metastases;
3) the most common are mutations PTEN, K-ras, microsatellite instability;
4) the most common histopathological type is endometrioid endometrial cancer;
5) the most common mutations are p-53, HER2-neu, p16.
The correct combination of characteristics of the first subtype of endometrial cancer
is:
a. 1,2,5
b. 2,4,5
c. 3,4
d. 1,3,4
e. only 1

A

d. 1,3,4

83
Q

Which of the following has the smallest application in the treatment of
small-cell lung cancer?
a. chemotherapy
b. radiotherapy
c. radiochemotherapy
d. surgery
e. B,D

A

d. surgery

84
Q

Indicate the true statement concerning vulvar cancer:
a. most often occurs before the age of 40
b. accounts for 3-8% of all female genital malignancies
c. more than 90% of vulvar cancers are glandular cancers
d. the treatment of choice is a systemic treatment
e. five-year survival for women in FIGO stage I is 31%

A

b. accounts for 3-8% of all female genital malignancies

85
Q

Which of the following concerning pancreatic cancer is true?
1) laparoscopy is contraindicated in surgical treatment,
2) jaundice may be one of the first symptoms and may indicate compression of the
bile ducts;
3) head of the pancreas is the most common location;
4) curability is estimated at 50%;
5) women fall ill more often.
The correct answer IS:
a. 1,3
b. 2,3,
c. 2,4,5
d. tylko 1
e. tylko 3

A

b. 2,3,

86
Q

Indicate the true statement concerning the risk factors for ovarian cancer:
a. BRCA2 mutation is more common than BRCA1 mutation in poland
b. Risk of the disease is higher in the bearers
c. Risk of the Disease is similar in the bearers
d. family history of breast cancer does not increase the risk of the disease
e. Long-term use of hormonal contraceptives increases the risk of the disease

A

b. Risk of the disease is higher in the bearers

87
Q

Uterine leiomyomas are the most frequent benign neoplasms of the uterus.
Indicate the false statement concerning their symptoms:
a. they include prolonged heavy periods and intermenstrual bleeding
b. they include pain in the hypogastrium and pressure on the bladder or the
rectum
c. small leiomyomas may be asymptomatic
d. hot flushes are typical symptoms
e. Leiomyomas may be the cause of infertility

A

d. hot flushes are typical symptoms

88
Q

A 30-year-old patient complains of chronic cough (lasting for 3 months),
hemoptysis, 37°C temperature in random measurements, 5 kg weight loss
for the last month, fatigue. Which test will you order first?
a. Lung scintigraphy.
b. Microbiologic sputum analysis.
c. Chest X-ray.
d. Spirometry.
e. Tuberculosis skin test.

A

c. Chest X-ray.

89
Q

The risk of gastric cancer increases in patients with:
a. Gastric adenomatous polyps.
b. Gastritis coexisting with Helicobacter pylori infection.
c. Menetriere’s disease.
d. After partial gastric resection.
e. All the above.

A

e. All the above.

90
Q

Metastatic tumors in the liver are:
a. Less frequent than primary hepatocellular carcinoma.
b. Mostly of colorectal cancer origin.
c. Supplied with blood from portal system vessels.
d. B and C.
e. A, B and C.

A

b. Mostly of colorectal cancer origin.

91
Q

According to current knowledge population-oriented screening programmes
are justified in early detection of:
1) breast cancer;
2) lung cancer;
3) cervical cancer;
4) colorectal cancer;
5) Stomach cancer.
The correct answer is:
a. 1,2
b. 1,3,5
c. 2,3,4
d. 1,3,4
e. 1,2,3,4

A

d. 1,3,4

92
Q

Among the neoplasms listed below the most frequently observed one in acquired
immunodeficiency syndrome (AIDS) is:
a. Kaposi sarcoma
b. melanoma
c. lung cancer
d. ewing sarcoma
e. plasmacytic melanoma

A

a. Kaposi sarcoma

93
Q

Normal findings on conventional chest radiography in a 65-year-old male patient
(history - cigarette smoking for 45 years) presenting with general weakness and
dyspnea as well as shoulder pain do not exclude lung cancer, because malignant
processes may be situated in the area of limited access for radiography. The
statements presented are:
a. Both true with causal association.
b. Both true without causal association.
c. First false, second true.
d. First true, second false.
e. Both false.

A

a. Both true with causal association.

94
Q

a 75-year old man, with a long history of gastroesophageal disease (GERD), for
the last weeks complains of persistent pyrosis and dysphagia while swallowing
solid food. The patient is on proton pump inhibitor (PPI) treatment at one daily dose
before breakfast. In this case a general practitioner should recommend at first:
a. Increasing the dose of PPI (proton pump inhibitor) to twice a day in the
morning and in the evening
b. Adding an H2-receptor blocker at bedtime.
c. An urgent 24-hour pH-metry.
d. Adding a prokinetic drug.
e. An urgent gastroscopy.

A

e. An urgent gastroscopy.

95
Q

The risk of developing a colon cancer in a patient with FAP (familial adenomatous
polyposis) equals to:
а. 50%
b. 30%
c. 5%
d. 100%
e. there is no such risk

A

d. 100%

96
Q

In which of the following situations endoscopy of the upper digestive tract should
be urgently advised in a patient complaining of dyspepsia, which has not been
diagnosed so far?
a. Dysphagia.
b. Unexplained loss of body weight.
c. Pain or burning in the epigastrium.
d. Correct are A and B.
e. Correct are A,B,C.

A

d. Correct are A and B.

97
Q

Some tumor markers play a role in carcinoma diagnostics and monitoring the
effectiveness of treatment. In the case of colorectal cancer the marker that should
be evaluated is:
a. CA 19.9
b. CEA
c. AFP
d. CA125
e. CA 15.3

A

b. CEA

98
Q

Which of these sentences are false with regard to esophageal cancer?
1) cancer markers do not play an important role in diagnosis of esophageal cancer;
2) radiotherapy and chemotherapy are the main therapeutic methods in
adenocarcinoma of the esophagus;
3) incidence rate of the squamous-cell esophageal cancer is positively associated
with gastroesophageal reflux disease (GERD);
4) incidence rate of esophageal adenocarcinoma increases continuously;
5) cellular type and clinical stage of the disease determine the treatment of
esophageal cancer.
The correct answer is:
a. 1,3
b. 2,4
c. 2,5
d. 2,3
e. 4,5

A

d. 2,3

99
Q

Which of the following possess the prognostic value in malignant neoplasms?
a. staging
b. grading
c. age at diagnosis
d. A and B are true
e. A, B and C are true

A

e. A, B and C are true

100
Q

The risk factors of endometrial carcinoma include:
a. Cigarette smoking, hypertension, obesity.
b. Diabetes mellitus, hypertension, obesity.
c. Oral contraception, hypertension, obesity.
d. Talc exposure, cigarette smoking, obesity.
e. Mutation in BRCA1 and BRCA2 genes, diabetes mellitus, obesity.

A

b. Diabetes mellitus, hypertension, obesity.

101
Q

Choose the HPV types with high oncogenic potential:
a. 16,18,39,45.
b. 16,6,11,34.
c. 16,18,6,11.
d. 6,11,34,42.
e. 16,11,34,44.

A

a. 16,18,39,45.

102
Q

The proper management of Pap smear grade 3 is:
a. Electroconization of the cervix.
b. Surgical conization of the cervix.
c. Treatment of vaginal infection and re-Pap.
d. Cervical Biopsy.
e. Cervical biopsy and curettage of the cervical canal.

A

c. Treatment of vaginal infection and re-Pap.

103
Q

Choose the main risk factors for cervical cancer:
a. HPV 16/18 infection, multiple sexual partners, multiparity.
b. HPV 16/18 infection, CMV infection, low socioeconomic status.
c. History of CIN-2, vaginal infection caused by chlamydia trachomatis, low
antioxidant diet.
d. Cigarette smoking, a history of CIN-1, EBV infection.
e. Oral contraceptive use, HSV-2 infection, early sexual initiation.

A

a. HPV 16/18 infection, multiple sexual partners, multiparity.

104
Q

The basic therapy in the management of vaginal cancer includes:
a. 5-fuorouracil chemotherapy.
b. Cisplatin chemotherapy.
c. Radiotherapy.
d. Surgical therapy.
e. Chemoradiotherapy.

A

c. Radiotherapy.

105
Q

The cervical cancer with stromal invasion in depth <= 3mm and linear extent <7
mm is classified as FIGO:
a. Stage O
b. stage la1
c. stage la2
d. stage lb1
e. Stage Ib2

A

b. stage la1

106
Q

The risk factors for cervical cancer include:
1) HPV 16/18 infection;
2) infertility;
3) multiple number of sexual partners;
4) cigarette smoking;
5) oral contraceptive usage.
The correct answer is:
a. 1,2
b. 1,3
c. 1,3,4
d. 1,2,3,4
e. 2,3,4,5

A

c. 1,3,4

107
Q

The most common location for the primary tumor in the case of the metastatic
ovarian cancer is:
a. The breast.
b. The pancreas.
c. The lung.
d. The Stomach.
e. The large bowel.

A

d. The Stomach.

108
Q

The most frequent malignant neoplasm complicating pregnancy is:
a. Melanoma
b. breast cancer
c. ovarian cancer
d. cervical cancer
e. uterine tube cancer

A

b. breast cancer

109
Q

The screening test for cervical cancer is:
1) cytological smear from ectocervix, external opening and endocervix
2) cervical biopsy
3) endocervical curettage
4) HPV-DNA testing
5) HPV-mRNA testing
The correct answer is:
a. only 1
b. 1,4
c. 1,4,5
d. 2,3
e. 4,5

A

a. only 1

110
Q

Which of the following constitute risk factors for endometrial cancer:
1) obesity;
2) diabetes;
3) hypertension;
4) persistent HPV infection;
5) Late Menopause.
The correct answer is:
a. 1,2,3
b. 1,2,3,5
c. 1,3,5
d. 1,2,4
e. 2,4,5

A

b. 1,2,3,5

111
Q

Which of the following infections is the risk factor for cervical cancer?
a. HPV 16
b. HPV 6
c. HSV 2
d. HCV
e. CMV

A

a. HPV 16

112
Q

The most frequent malignant neoplasm in women in Poland is:
a. cervical cancer
b. breast cancer
c. uterine cancer
d. ovarian cancer
e. vulvar cancer

A

b. breast cancer

113
Q

The ovarian germ cell tumors include:
a. Folliculoma
b. thecoma
c. Adenocarcinoma
d. Dysgerminoma
e. sertoli cell tumor

A

d. Dysgerminoma

114
Q

The benign vulvar neoplasm does not include:
a. Angiokeratoma
b. planoepithelal ca.
c. pyogenic granuloma
d. lipomas
e. fibrous histiocytoma

A

b. planoepithelal ca.

115
Q

The rarest metastatic ovarian lesion is:
a. gastric cancer
b. uterine tube cancer
c. breast cancer
d. the metastasis from the other ovary
e. colorectal cancer

A

e. colorectal cancer

116
Q

Hormonal contraceptive pills have been confirmed to protect from:
1) ovarian ca
2) liver ca
3) endometrial ca
4) renal ca
5) cervical ca
The correct answer is:
a. 1,2,3,5
b. 1,3
c. 1,3,4
d. 1,3,4,5
e. 1,3,5

A

b. 1,3

117
Q

Fallopian tube cancer in stage lla:
a. Is confined to the fallopian tube, infiltrates the mucous membrane and
muscular layer.
b. Is confined to the fallopian tube and infiltrates the serous membrane.
c. Extends beyond the fallopian tube but is confined to the pelvis.
d. Extends beyond the pelvis but is confined to the abdominal cavity.
e. Extends beyond the abdominal cavity.

A

c. Extends beyond the fallopian tube but is confined to the pelvis.

118
Q

Choose the main risk factors for cervical cancer:
a. HPV 16/18 infection, multiple sexual partners, multiparity.
b. HPV 16/18 infection, CMV infection, low socioeconomic status.
c. History of CIN-2, vaginal infection caused by Chlamydia trachomatis, low
antioxidant diet.
d. Cigarette smoking, history of CIN-1, EBV infection.
e. Oral contraceptive use, HSV-2 infection, early sexual initiation.

A

a. HPV 16/18 infection, multiple sexual partners, multiparity.

119
Q

Choose the HPV types of high oncogenic potential:
a. 16,18,39,45.
b. 16,6,11,34.
c. 16,18,6,11.
d. 6,11,34,42.
e. 16,11,34,44.

A

a. 16,18,39,45.

120
Q

The risk factors for endometrial cancer include:
a. Cigarette smoking, hypertension, obesity.
b. Diabetes mellitus, hypertension, obesity.
c. Oral contraceptive usage, hypertension, obesity.
d. Talc exposition, cigarette smoking, obesity.
e. Mutation in BRCA 1 and BRCA 2 genes, diabetes mellitus, obesity.

A

b. Diabetes mellitus, hypertension, obesity.

121
Q

The basic therapy in the management of vaginal cancer includes:
a. 5-fluorouracil chemotherapy
b. Cisplatin chemotherapy
c. Radiotherapy
d. Surgical therapy
e. Chemotherapy

A

c. Radiotherapy

122
Q

Breast cancer prevention in healthy women without risk factors, according to the
recommendations of Polish Union of Oncology, include:
1) self-inspection of the breasts after menses (once a month);
2) ultrasound examination of the breasts every year in women over 30;
3) mammography every 12-24 months in women over 50.
The correct answer is:
a. 1.2.
b. 1,3.
c. 1,2,3.
d. 2.3.
e. Only 3.

A

b. 1,3.

123
Q

The most frequent ovarian cancer is:
a. Mucinous.
b. Serous.
c. Endometrioid.
d. Clear cell.
e. Squamous cell.

A

b. Serous.

124
Q

Which of the following tumours is observed in Lynch I syndrome?
a. Cervical cancer.
b. Vulvar cancer.
c. Endometrial cancer.
d. Vaginal cancer.
e. None of the above.

A

c. Endometrial cancer.

125
Q

Which of the following tumours should be treated with chemotherapy as a
treatment of choice?
1) cervical cancer;
2) choriocarcinoma;
3) ovarian cancer;
4) fallopian tube cancer;
5) vulvar cancer.
The correct answer is:
a. Only 2.
b. 2,3.
c. 3,4.
d. Only 4.
е. 4,5.

A

a. Only 2.

126
Q

CIN-2 found in a patient at 24 weeks of gestation makes it necessary to
perform:
a. Amputation of the cervix.
b. Conization of the cervix.
c. Only repeated colposcopic examinations of the cervix until the delivery.
d. Treatment with glucocorticosteroids and cesarean section at 28 weeks of
gestation.
e. Kriotherapy of the cervix.

A

c. Only repeated colposcopic examinations of the cervix until the delivery.

127
Q

Germinal neoplasms do not include:
a. Embryonic carcinoma.
b. Mature teratoma.
c. Gynandroblastoma.
d. Yolk sac tumor.
e. Gonadoblastoma.

A

c. Gynandroblastoma.

128
Q

The primary mode in the treatment of endometrial carcinoma which is confined
to the uterine corpus is:
a. External beam radiation.
b. Intracavitary radium.
c. Hysterectomy.
d. Chemotherapy.
e. Progestin Therapy.

A

c. Hysterectomy.

129
Q

Ovarian neoplasm most commonly arise from:
a. Celomic epithelium.
b. Nonspecific mesenchyme.
c. Specialized gonadal stroma.
d. Primitive germ cells.
e. Connective tissue elements within the ovary.

A

a. Celomic epithelium.

130
Q

Which of the following ultrasound features indicates malignant ovarian lesion?
a. Mixed cystic and solid lesions of the ovary.
b. Multilocular lesion.
c. Walls between cyst compartments.
d. Internal papillary excrescences.
e. All the above.

A

e. All the above.

131
Q

Which of the following factors definitely increase the risk for endometrial
carcinoma?
a. Premature menopause.
b. Combination (estrogen and progesterone) hormone replacement therapy.
c. Diabetes.
d. Low body mass index.
e. Multiparity.

A

c. Diabetes.

132
Q

Which of the following symptoms best describe the usual manifestation of
invasive cervical carcinoma?
a. Watery, blood-tinged vaginal discharge.
b. Significant hemorrhage.
c. Pelvic pain.
d. Renal failure from ureteral obstruction in the pelvis.
e. All the above.

A

e. All the above.

133
Q

Women with advanced ovarian carcinoma most commonly complain about:
a. Weight loss and dyspareunia.
b. Nausea and abnormal vaginal discharge.
c. Constipation and frequent urination.
d. Abdominal distention and pelvic pain.
e. All the above.

A

e. All the above.

134
Q

A 28-year-old pregnant woman (at the 12 week of her first pregnancy)
presented to the outpatient obstetric-gynecological clinic with abnormal LSIL
cytology. The incorrect procedure is:
a. To repeat Pap smear.
b. To test for HPV.
c. Colposcopy.
d. Diagnostic and therapeutic cervical conization.
e. Answers B and D are true.

A

d. Diagnostic and therapeutic cervical conization.

135
Q

A female patient aged 56, nullipara with BMI 24 kg/m2, complains of
suprapubic ache and difficulty in defecation. Ultrasound examination reveals a large
quantity of free fluid in the abdominal cavity and the presence of a complex cystic
and solid mass with thick septa about 10 cm big located on the left side. The most
probable diagnosis is:
a. Malignant epithelial ovarian tumor.
b. Malignant germ-cell ovarian tumor.
c. Benign ovarian tumor.
d. Theca lutein cyst.
e. Krukenberg Tumor.

A

a. Malignant epithelial ovarian tumor.

136
Q

Indicate the main localization of endometrial cancer metastases:
a. Via lymphatic vessels to the iliac and periaortic lymph nodes.
b. Via lymphatic vessels to the inguinal lymph nodes.
c. Via blood vessels to the lungs.
d. Via blood vessels to the breast.
e. Via intraperitoneal dissemination to the intestines and stomach.

A

a. Via lymphatic vessels to the iliac and periaortic lymph nodes.

137
Q

Which of the following are the risk factors for endometrium cancer:
1) obesity;
2) PCOS;
3) diabetes;
4) hypertension;
5) nulliparity;
6) late menopause.
The correct answer is:
a. 1,2,3,5.
b. 1,3,4,5.
c. 1,3,4,5,6.
d. 2,4,5,6.
e. All the above.

A

e. All the above.

Year 5 Exams (7 decks)

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