Oncology - old Flashcards
In which of the following cancers is LDH a prognostic factor?
- a) Renal Cancer
- b) Testicular Cancer
- c) Non-Hodgkin lymphoma
- d) Both b and c
d) Both b and c
Testicular Cancer and Non-Hodgkin lymphoma
The most frequent histologic type of laryngeal cancer is:
Squamous cell carcinoma
Imatinib is used in the treatment of:
- a) GIST
- b) CML
- c) MALT
- d) a and b
d) a and b
GIST and CML
The mutation of gene BRCA-1 and/or BRCA-2 is/are responsible for?
Breast and ovarian cancer
5-year survival rate in stage ED SCLC is?
<5%
A cancer-drug with a characteristic NEPHROTOXIC side-effect?
Vinblastine
A cancer-drug with a characteristic side-effect of Ototoxicity is?
Cisplatin
A cancer-drug with a characteristic CARDIOTOXIC side-effect?
Doxorubicin
Which gene is the suppressor gene?
- a) CHEK2
- b) RAS
- c) MSH2
- d) RAF
CHEK2
A mutation of which gene is connected with HNPCC (Lynch syndrome)?
MLH1
Which sentence is true:
- a) Annual assessment of marker PSA decreases the risk of death due to prostate cancer
- b) Annual X-ray pictures decrease the risk of death due to lung cancer
- c) Annual assessment of marker CA125 decreases the risk of death due to ovarian cancer
- d) Annual examination of the stool for occult blood decreases the risk of death due to colon cancer
- a) Annual assessment of marker PSA decreases the risk of death due to prostate cancer
Which method of treatment of NSCLC is not routinely used (is not an element of standard treatment)?
Immunotherapy
Dukes and modified Astler-Coller stagining systems are used in:
Colorectal Cancers
Dukes B means?
T3 and T4 N0 M0
The most frequent histologic type of gallbladder cancer is:
Adenocarcinoma
Which gene is not the tumor suppressor gene?
- a) BRCA-1
- b) TP53
- c) RAS
- d) RB
c. RAS
In primary malignant bone tumors, bone pain is:
Associated with mobility
Overexpression of the HER-2 receptor occurs in approximately__of patients with breast cancer.
10-20%
Overexpression of the HER-2 receptor in breast cancer is an indication to immunotherapy with:
Trastuzumab
What is the most important prognostic factor for a patient with breast cancer?
Number of lymph nodes involved
With appropriate treatment for Hodgkin disease, the 5-year survival rate is approximately:
90%
What is the most important prognostic indicator of survival for a patient with melanoma?
Tumor thickness
Renal insufficiency may have developed in patient with multiple myeloma secondary to: (4)
- Obstruction of collecting tubules by Bence-Jones proteins
- Hypercalcemia
- Amyloid deposition
- Plasma cell infiltration of the kidney
Bevacizumab is a recombinant, humanized monoclonal antibody directed against:
VEGF (Vascular Endothelial Growth Factor)
Invasive cervical carcinoma occurs most often between ages:
30 and 55
The current standard of care for first-line treatment of SCLC (stage ED) is:
Chemotherapy
What is the primary treatment for most patients with early-stage NSCLC?
Surgery
Which of the following statements is true regarding Hodgkin disease?
- a) Lymph nodes may enlarge slowly over months or years or they may enlarge rapidly
- b) With appropriate treatment for HD, the 5-year survival rate is approximately 50%
- c) Chemotherapy is ineffective in the treatment of HD
- d) Radiation is ineffective in the treatment of HD
a) Lymph nodes may enlarge slowly over months or years or they may enlarge rapidly
The preferred treatment for locoregional advanced rectal cancer is:
Chemoradiotherapy then TME
Which cancer has the worst prognosis?
Pancreatic cancer
Which of the following markers is not important in the diagnosis and treatment of testicular cancer?
- a) Beta-hCG
- b) CEA
- c) AFP
- d) LDH
b) CEA
The basic screen test for colorectal cancer is:
Occult blood test
EBV can be associated with the development of:
- a) Nasopharyngeal cancer
- b) Laryngeal cancer
- c) Burkitt lymphoma
- d) Both a and c
d) Both a and c
Nasopharyngeal cancer and Burkitt lymphoma
Analgesics from the II step of the analgesic ladder by WHO are:
- Tramadol
- Codeine
- Dihydrocodeine
The lowest level of WBC in the peripheral blood (nadir) after chemotherapy occurs most often after __ days:
After 6-14 days
Which test is not performed in a patient with the symptoms of rectal cancer?
- a) Per rectum examination
- b) Rectoscopy
- c) Occult blood test
- d) Pelvic CT
c) Occult blood test
A 48-year-old patient is referred to an oncology clinic for consultation. He has recently been diagnosed with nasopharyngeal cancer: the primary tumor is 2cm in diameter and the cervical lymph nodes on the right are enlarged. The best treatment option for this patient is:
Surgery then adjuvant radiotherapy
A 21-year-old man with a family history of FAP was recently diagnosed with multiple colon polyps. The mutations responsible for this syndrome are situation in the gene:
+ The best option for the patient described above is:
APC
+ Prophylactic proctocolectomy should be performed because the risk of developing colorectal cancer in the age of 45 is 100%
A 48-year-old woman was diagnosed with colon cancer. Her father died of rectal cancer at the age of 48, and her sister was diagnosed with endometrial cancer. According to this family history, you suspect the following in this family:
Lynch syndrome (HNPCC)
*****A 53-year-old woman with the history of breast cancer, after mastectomy, currently during adjuvant chemotherapy comes to you and complains of fatigue. She had her last cycle of chemotherapy 7 days ago. Her temperature is 36.9C, BP is 125/90, HR90 and her lungs are clear to auscultation. She doesn’t have any other comorbidities. CBC shows: RBC 3,540,000; Hb 10.3; Hct 29.4; WBC 450; Neutrophils 200; Plt 135,000. In this situation, the appropriate approach to this patient is:
She should be sent back home and informed that if a fever or chills occur, she ought to go to the nearest hospital
Contraindications to breast-conserving therapy do not include:
Metastasis in movable, ipsilateral axillary lymph nodes
Sentinel node biopsy should not be carried out in the case of:
- a) Palpable axillary lymph nodes
- b) T1 primary tumor
- c) Multicentric tumor
- d) a and c
d) a and c
Palpable axillary lymph nodes and Multicentric tumor
Which one of the following sentences about adjuvant endocrine therapy in breast cancer is incorrect?
- a) Gonadotrophin-releasing hormone analogue (GnRHA, eg goserelin) generally leads to irreversible ovarian suppression
- b) Endocrine therapy is not recommended in ER and PR negative breast cancer
- c) Women treated with aromatase inhibitors should recieve vitamin D and calcium supplements
- d) Tamoxifen carries a slightly increased risk (2.5 times) of endometrial cancer, but has no overall effect on non-breast cancer mortality
a) Gonadotrophin-releasing hormone analogue (GnRHA, eg goserelin) generally leads to irreversible ovarian suppression
In postmenopausal women, endocrine therapy should not include:
- a) Tamoxifen
- b) Letrozole
- c) Anastrozole
- d) Goserelin
d) Goserelin
Tumor describing as T2 (according to TNM 2002 classification) in breast cancer means:
Tumor more than 2cm but not more than 5cm in greatest dimension
Which of the following sentences about adjuvant therapy in colon cancer is incorrect?
- a) Adjuvant chemotherapy is recommended for stages C, according to Dukes classification
- b) Adjuvant chemotherapy may be considered in selected node-negative patients (in stage Dukes B with high risk factors for recurrence)
- c) Standard adjuvant treatment consists of fluoropirimidine-based chemotherapy
- d) The monoclonal antibodies against EGFR (cetuximab) in combination with chemotherapy or alone should be considered in majority of patients with stage C (particularly high risk factors for recurrence)
d) The monoclonal antibodies against EGFR (cetuximab) in combination with chemotherapy or alone should be considered in majority of patients with stage C (particularly high risk factors for recurrence)
Match the following drugs with mechanisms of action:
- Trastuzumab
- Cetuximab
- Imatinib
- Rituximab
- Bevacizumab
a. bcr-abl kinase b. CD22 c. HER-2 d. EGFR e. VEGF
1c, 2d, 3a, 4b, 5e
Match the following drugs with indications:
- Trastuzumab
- Cetuximab
- Imatinib
- Rituximab
- Bevacizumab
a. colorectal cancer b. breast cancer c. CML d. head and neck carcinoma e. NSCLC f. non-Hodgkin lymphoma g. GIST
1c, 2d, 3a, 4b, 5e
Patient with lung cancer may present confusion as a symptom of the tumor due to? (3)
Low sodium level, High calcium level, Cerebral metastases
The lowest level of WBC in peripheral blood after Chemotherapy occurs most often after__days:
5-14 days
The phrase “by mouth, by the clock, by the ladder, and for the individual” directly refers to:
Regular scheduling of the medication
Which of the following describes the mechanism of action of the taxanes?
Inhibition of microtubule depolymerization
Incidence of a disease is:
The amount of new cases of a disease in a specified period of time divided by the total population
The term “oncogene” is applied to genetic elements that have which of the following characteristics?
Activation of overexpression leading to the transformed phenotype
Metastasis is:
The spread of cancer cells from the tumor to distant sites in the patients’ body
Choose the main risk factors for cervical cancer:
HPV 16/18 infection, multiple sex partners, multiparity
During the examination of a 2-year old girl, you see an abnormal light reflex in the eyes. What is the name of this sign and what disease should you think?
Leukocoria ; Retinoblastoma
You consult a 40-year old patient that has recently been malignancy. What other paraneoplastic syndrome may you expect in this patient (he also has migrating skin changes of scale-like plaques on his right leg)?
Hyperglycemia
Typical symptom of SVCS?
Facial edema
Possible causes of SVCS? (3)
- Lung cancer
- Lymphoma
- Ascending aortic aneurysm
treatment of SVCS includes? (3)
- Chemo- and/or radiotherapy
- Corticosteroids
- Surgery
Spinal cord compression may be caused by _ cancer: (3)
- Prostate cancer
- Breast cancer
- Lung cancer
The most common region of spinal cord compression is:
Thoracic
The best way to diagnose spinal cord compression is to perform:
MRI
Basic treatment of spinal cord compression usually includes:
Surgery
In SiADH, Na is _ in urine and _ in blood
Na is high in urine and low in blood
SiADH is most common in patients with:
SCLC
Treatment of SiADH includes:
Treating the cause
On WHO performance status scale, a patient that is symptomatic and spends >50% of daytime in bed, but is not bedbound will have PS:
3
The scale used for describing mammograms is called:
BiRADs
Chemotherapeutic agent that affects NK1 receptor for vomiting:
Aprepitant
Best way to visualise pericardial effusion:
Echocardiography
Radiotherapy least likely to cause cardiac damage?
Lumbar metastases radiotherapy
Where is GIST most common?
Stomach
Dude with tumor on bottom lip. Best treatment?
Surgery or radiotherapy
Most common Head and Neck cancer
SCC
Most common lung cancer?
Adenocarcinoma
Chemotherapeutic agent that causes peripheral neuropathy?
Oxaliplatin
Chemotherapeutic agent that causes hemorrhagic cystitis?
Chemotherapy
Most common brain metastases?
From the lung
(lung -> breast -> brain)
Prostate screening, optional or mandatory?
Optional because low predictive value
What do you give for diarrhea caused by chemo?
Loperamide
Treatment for diarrhea caused by Irenotecan?
Atropine
SVC syndrome is caused by:
NSCLC
Hepatic carcinoma marker:
AFP
Normal colonoscopy screening happens every ___:
Every 10 years
Name of the Melanoma scale:
Breslow
BRCA 1 and BRCA 2 increase the risk of ___ cancer:
Breast and ovarian cancer
Treatment for cancer involving HER2:
Trastuzumab
APC mutation causes:
CRC
Why use radio therapy adjunct in CRC:
Reduce lcoregional failure
What complication may Ifosfamide lead to and which other agent may cause this?
Hemorrhagic ovarian cyst
Which substance can we use to avoid hemorrhagic ovarian cyst when giving chemo that may cause it?
Mesna
Name 3 EGFR inhibitors:
- Cetuximab
- Erlotinib
- Gefitynib
Nivolumab - mechanism of action:
MOA: PD-1 MAB, which blocks the negative T-Cell inhibitor, thus allowing the immune system to attack the cancer.
Nivolumab - most common side effect and treatment of that?
Immune-related adverse effects (irAEs), treated with corticosteroids.
Karnofsky performance status - how is it organised and what is it used for?
- 0 = Death, 100 = Normal
- Allows doctors to evaluate a patient’s ability to survive chemo
Mechanism of topotecan/irinotecan leading to diarrhea?
Cause is not known, thought to be deconjugation of metabolite by intestinal bacteria, thus causing an effect on the colonic epithelium. Conclusion, there is intestinal and CNS involvement .
Treatment of mucositis due to chemotherapy:
Oral debridement (mucolytics) and decontamination (antibiotics)
What does BIRAD score = 0 mean?
And what does a score = 1 mean?
- 0 = inconclusive/incomplete
- 1 = negative
Hyponatremia causes__?
Hyporeflexia
In the case of lung cancer and finger-clubbing, you can expect that the patient is__:
Schamroth’s window test positive
Minimum amount of node biopsy for colorectal cancer:
12
Lung mass found in imaging, what’s the next step in diagnosing? (r)
a. Biopsy
45 year old woman smoker with 50 pack years, stopped smoking 6 months ago. Asymptomatic. Wants to be screened for lung cancer. What is the screening available?
- a. Low dose helical CT screen.
- b. Chest X-ray
- c. Annual chest X-ray
- d. No screening for lung cancer exists
a. Low dose helical CT screen
Which cancer are these drugs used for? Oxaliplatin, 5-FU, irinotecan, capecitaban.
a. Colon cancer
Which chemotherapeutic drug is most emetogenic?
a. Cisplatin
Which of these drugs cause acne-like rash?
a. Pantumumab
A woman after mammography has Birad 5. What is the next step?
- a. Immediate biopsy
- b. Biopsy in 2-3 weeks
- c. No further tests needed
- d. Further diagnostics tests needed
- e. Benign lesion
a. Immediate biopsy
CEA tumor marker in?
a. Colon cancer
AFP tumor marker in?
a. Hepatocellular carcinoma
What is the only tumor marker that can be used in screening?
a. PSA
Which of these drugs can cause hemorrhagic cystitis?
a. Iphosphamide
What can be used as prophylaxis in the previous question? (hemorrhagic cystitis)
a. Mesna
Early colon cancer was surgically resected in a woman. What is the next step?
- a. Observation
- b. Adjuvant chemo
- c. Adjuvant radio
- d. Surgery
- e. Adjuvant chemoradio
a. Observation
For previous question, what is needed for adjuvant chemotherapy? (colon cancer)
- a. Lymph node involvement
- b. Old age
- c. Young age
a. Lymph node involvement
Colitis as a result of nivolumab treatment. How to treat?
- a. Dexamethasone
- b. Antibiotics
- c. Infliximab
a. Dexamethasone
Breast cancer. ER 90% PR 70% Ki 2% HER2 1%. What type of cacner?
- a. Luminal A
- b. LuminalB
- c. Luminal A+B
- d. Triple negative
a. Luminal A
A patient after recent chemotherapy presents with 39C fever, no other symptoms. What is the next step?
- a. Observation at home
- b. Observation at hospital
- c. Broad spectrum antibiotics
c. Broad spectrum antibiotics
Capecitabine side effects?
a. Hand-foot syndrome.
On what performance scale are you if you have asymptomatic cancer?
- a. PS0
- b. PS1
- c. PS2
- d. PS3
- e. PS4
a. PS0
What is the scale for adverse effects in cancer?
- a. PS scale
- b. Zubrod scale
- c. CTC AE
c. CTC AE
Oxaliplatin most common side effect?
- a. Neurotoxicity
- b. Hand-foot syndrome
- c. Diarrhea
a. Neurotoxicity
What is the best treatment for non-metastatic gastric cancer?
- a. Neoadjuvant + adjuvant chemotherapy plus salvage surgery
- b. Only chemotherapy
- c. Only surgery
a. Neoadjuvant + adjuvant chemotherapy plus salvage surgery
Metastatic gastric cancer with HER2 3+. How to treat?
a. Trastuzumab, cisplatin, 5-FU
What is the most common location for HPV head and neck cancer?
- a. Oropharynx
- b. Hypopharynx
- c. Oral cavity
- d. Larynx
a. Oropharynx
Early oral cancer, best treatment option?
- a. Surgery
- b. Radiotherapy
- c. Chemoradio
a. Surgery
Erlotinib mechanism of action?
a. Tyrosine kinase inhibitor
Erlotibnib is used in which type of cancer?
a. NSCLC
What is the most common histopathology of NSCLC?
a. Adenocarcinoma
Kras mutation must be established before starting treatment in what type of cancer?
a. Colon cancer
What does LD stage of SCLC mean?
- a. The cancer is radiotherapy amendable
- b. Cancer is only limited to the lungs
a. The cancer is radiotherapy amendable
Prophylatic irradiation of the CNS is used when?
- a. Metastasis to CNS in SCLC
- b. Metastasis to CNS in NSCLC
- c. Effective chemotherapy SCLC with no metastasis
c. Effective chemotherapy SCLC with no metastasis
