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5 MD > Oncology - old > Flashcards

Oncology - old Flashcards

1
Q

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
A

d) Both b and c

Testicular Cancer and Non-Hodgkin lymphoma

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2
Q

The most frequent histologic type of laryngeal cancer is:

A

Squamous cell carcinoma

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3
Q

Imatinib is used in the treatment of:

  • a) GIST
  • b) CML
  • c) MALT
  • d) a and b
A

d) a and b

GIST and CML

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4
Q

The mutation of gene BRCA-1 and/or BRCA-2 is/are responsible for?

A

Breast and ovarian cancer

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5
Q

5-year survival rate in stage ED SCLC is?

A

<5%

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6
Q

A cancer-drug with a characteristic NEPHROTOXIC side-effect?

A

Vinblastine

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7
Q

A cancer-drug with a characteristic side-effect of Ototoxicity is?

A

Cisplatin

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8
Q

A cancer-drug with a characteristic CARDIOTOXIC side-effect?

A

Doxorubicin

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9
Q

Which gene is the suppressor gene?

  • a) CHEK2
  • b) RAS
  • c) MSH2
  • d) RAF
A

CHEK2

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10
Q

A mutation of which gene is connected with HNPCC (Lynch syndrome)?

A

MLH1

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11
Q

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
  • a) Annual assessment of marker PSA decreases the risk of death due to prostate cancer
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12
Q

Which method of treatment of NSCLC is not routinely used (is not an element of standard treatment)?

A

Immunotherapy

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13
Q

Dukes and modified Astler-Coller stagining systems are used in:

A

Colorectal Cancers

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14
Q

Dukes B means?

A

T3 and T4 N0 M0

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15
Q

The most frequent histologic type of gallbladder cancer is:

A

Adenocarcinoma

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16
Q

Which gene is not the tumor suppressor gene?

  • a) BRCA-1
  • b) TP53
  • c) RAS
  • d) RB
A

c. RAS

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17
Q

In primary malignant bone tumors, bone pain is:

A

Associated with mobility

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18
Q

Overexpression of the HER-2 receptor occurs in approximately__of patients with breast cancer.

A

10-20%

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19
Q

Overexpression of the HER-2 receptor in breast cancer is an indication to immunotherapy with:

A

Trastuzumab

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20
Q

What is the most important prognostic factor for a patient with breast cancer?

A

Number of lymph nodes involved

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21
Q

With appropriate treatment for Hodgkin disease, the 5-year survival rate is approximately:

A

90%

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22
Q

What is the most important prognostic indicator of survival for a patient with melanoma?

A

Tumor thickness

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23
Q

Renal insufficiency may have developed in patient with multiple myeloma secondary to: (4)

A
  1. Obstruction of collecting tubules by Bence-Jones proteins
  2. Hypercalcemia
  3. Amyloid deposition
  4. Plasma cell infiltration of the kidney
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24
Q

Bevacizumab is a recombinant, humanized monoclonal antibody directed against:

A

VEGF (Vascular Endothelial Growth Factor)

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25
Q

Invasive cervical carcinoma occurs most often between ages:

A

30 and 55

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26
Q

The current standard of care for first-line treatment of SCLC (stage ED) is:

A

Chemotherapy

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27
Q

What is the primary treatment for most patients with early-stage NSCLC?

A

Surgery

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28
Q

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

a) Lymph nodes may enlarge slowly over months or years or they may enlarge rapidly

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29
Q

The preferred treatment for locoregional advanced rectal cancer is:

A

Chemoradiotherapy then TME

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30
Q

Which cancer has the worst prognosis?

A

Pancreatic cancer

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31
Q

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
A

b) CEA

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32
Q

The basic screen test for colorectal cancer is:

A

Occult blood test

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33
Q

EBV can be associated with the development of:

  • a) Nasopharyngeal cancer
  • b) Laryngeal cancer
  • c) Burkitt lymphoma
  • d) Both a and c
A

d) Both a and c

Nasopharyngeal cancer and Burkitt lymphoma

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34
Q

Analgesics from the II step of the analgesic ladder by WHO are:

A
  1. Tramadol
  2. Codeine
  3. Dihydrocodeine
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35
Q

The lowest level of WBC in the peripheral blood (nadir) after chemotherapy occurs most often after __ days:

A

After 6-14 days

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36
Q

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
A

c) Occult blood test

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37
Q

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:

A

Surgery then adjuvant radiotherapy

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38
Q

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:

A

APC

+ Prophylactic proctocolectomy should be performed because the risk of developing colorectal cancer in the age of 45 is 100%

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39
Q

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:

A

Lynch syndrome (HNPCC)

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40
Q

*****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:

A

She should be sent back home and informed that if a fever or chills occur, she ought to go to the nearest hospital

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41
Q

Contraindications to breast-conserving therapy do not include:

A

Metastasis in movable, ipsilateral axillary lymph nodes

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42
Q

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
A

d) a and c

Palpable axillary lymph nodes and Multicentric tumor

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43
Q

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

a) Gonadotrophin-releasing hormone analogue (GnRHA, eg goserelin) generally leads to irreversible ovarian suppression

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44
Q

In postmenopausal women, endocrine therapy should not include:

  • a) Tamoxifen
  • b) Letrozole
  • c) Anastrozole
  • d) Goserelin
A

d) Goserelin

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45
Q

Tumor describing as T2 (according to TNM 2002 classification) in breast cancer means:

A

Tumor more than 2cm but not more than 5cm in greatest dimension

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46
Q

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)
A

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)

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47
Q

Match the following drugs with mechanisms of action:

  1. Trastuzumab
  2. Cetuximab
  3. Imatinib
  4. Rituximab
  5. Bevacizumab

a. bcr-abl kinase b. CD22 c. HER-2 d. EGFR e. VEGF

A

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

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48
Q

Match the following drugs with indications:

  1. Trastuzumab
  2. Cetuximab
  3. Imatinib
  4. Rituximab
  5. Bevacizumab

a. colorectal cancer b. breast cancer c. CML d. head and neck carcinoma e. NSCLC f. non-Hodgkin lymphoma g. GIST

A

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

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49
Q

Patient with lung cancer may present confusion as a symptom of the tumor due to? (3)

A

Low sodium level, High calcium level, Cerebral metastases

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50
Q

The lowest level of WBC in peripheral blood after Chemotherapy occurs most often after__days:

A

5-14 days

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51
Q

The phrase “by mouth, by the clock, by the ladder, and for the individual” directly refers to:

A

Regular scheduling of the medication

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52
Q

Which of the following describes the mechanism of action of the taxanes?

A

Inhibition of microtubule depolymerization

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53
Q

Incidence of a disease is:

A

The amount of new cases of a disease in a specified period of time divided by the total population

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54
Q

The term “oncogene” is applied to genetic elements that have which of the following characteristics?

A

Activation of overexpression leading to the transformed phenotype

55
Q

Metastasis is:

A

The spread of cancer cells from the tumor to distant sites in the patients’ body

56
Q

Choose the main risk factors for cervical cancer:

A

HPV 16/18 infection, multiple sex partners, multiparity

57
Q

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?

A

Leukocoria ; Retinoblastoma

58
Q

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)?

A

Hyperglycemia

59
Q

Typical symptom of SVCS?

A

Facial edema

60
Q

Possible causes of SVCS? (3)

A
  1. Lung cancer
  2. Lymphoma
  3. Ascending aortic aneurysm
61
Q

treatment of SVCS includes? (3)

A
  1. Chemo- and/or radiotherapy
  2. Corticosteroids
  3. Surgery
62
Q

Spinal cord compression may be caused by _ cancer: (3)

A
  1. Prostate cancer
  2. Breast cancer
  3. Lung cancer
63
Q

The most common region of spinal cord compression is:

A

Thoracic

64
Q

The best way to diagnose spinal cord compression is to perform:

A

MRI

65
Q

Basic treatment of spinal cord compression usually includes:

A

Surgery

66
Q

In SiADH, Na is _ in urine and _ in blood

A

Na is high in urine and low in blood

67
Q

SiADH is most common in patients with:

A

SCLC

68
Q

Treatment of SiADH includes:

A

Treating the cause

69
Q

On WHO performance status scale, a patient that is symptomatic and spends >50% of daytime in bed, but is not bedbound will have PS:

A

3

70
Q

The scale used for describing mammograms is called:

A

BiRADs

71
Q

Chemotherapeutic agent that affects NK1 receptor for vomiting:

A

Aprepitant

72
Q

Best way to visualise pericardial effusion:

A

Echocardiography

73
Q

Radiotherapy least likely to cause cardiac damage?

A

Lumbar metastases radiotherapy

74
Q

Where is GIST most common?

A

Stomach

75
Q

Dude with tumor on bottom lip. Best treatment?

A

Surgery or radiotherapy

76
Q

Most common Head and Neck cancer

A

SCC

77
Q

Most common lung cancer?

A

Adenocarcinoma

78
Q

Chemotherapeutic agent that causes peripheral neuropathy?

A

Oxaliplatin

79
Q

Chemotherapeutic agent that causes hemorrhagic cystitis?

A

Chemotherapy

80
Q

Most common brain metastases?

A

From the lung

(lung -> breast -> brain)

81
Q

Prostate screening, optional or mandatory?

A

Optional because low predictive value

82
Q

What do you give for diarrhea caused by chemo?

A

Loperamide

83
Q

Treatment for diarrhea caused by Irenotecan?

A

Atropine

84
Q

SVC syndrome is caused by:

A

NSCLC

85
Q

Hepatic carcinoma marker:

A

AFP

86
Q

Normal colonoscopy screening happens every ___:

A

Every 10 years

87
Q

Name of the Melanoma scale:

A

Breslow

88
Q

BRCA 1 and BRCA 2 increase the risk of ___ cancer:

A

Breast and ovarian cancer

89
Q

Treatment for cancer involving HER2:

A

Trastuzumab

90
Q

APC mutation causes:

A

CRC

91
Q

Why use radio therapy adjunct in CRC:

A

Reduce lcoregional failure

92
Q

What complication may Ifosfamide lead to and which other agent may cause this?

A

Hemorrhagic ovarian cyst

93
Q

Which substance can we use to avoid hemorrhagic ovarian cyst when giving chemo that may cause it?

A

Mesna

94
Q

Name 3 EGFR inhibitors:

A
  1. Cetuximab
  2. Erlotinib
  3. Gefitynib
95
Q

Nivolumab - mechanism of action:

A

MOA: PD-1 MAB, which blocks the negative T-Cell inhibitor, thus allowing the immune system to attack the cancer.

96
Q

Nivolumab - most common side effect and treatment of that?

A

Immune-related adverse effects (irAEs), treated with corticosteroids.

97
Q

Karnofsky performance status - how is it organised and what is it used for?

A
  • 0 = Death, 100 = Normal
  • Allows doctors to evaluate a patient’s ability to survive chemo
98
Q

Mechanism of topotecan/irinotecan leading to diarrhea?

A

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 .

99
Q

Treatment of mucositis due to chemotherapy:

A

Oral debridement (mucolytics) and decontamination (antibiotics)

100
Q

What does BIRAD score = 0 mean?

And what does a score = 1 mean?

A
  • 0 = inconclusive/incomplete
  • 1 = negative
101
Q

Hyponatremia causes__?

A

Hyporeflexia

102
Q

In the case of lung cancer and finger-clubbing, you can expect that the patient is__:

A

Schamroth’s window test positive

103
Q

Minimum amount of node biopsy for colorectal cancer:

A

12

104
Q

Lung mass found in imaging, what’s the next step in diagnosing? (r)

A

a. Biopsy

105
Q

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

a. Low dose helical CT screen

106
Q

Which cancer are these drugs used for? Oxaliplatin, 5-FU, irinotecan, capecitaban.

A

a. Colon cancer

107
Q

Which chemotherapeutic drug is most emetogenic?

A

a. Cisplatin

108
Q

Which of these drugs cause acne-like rash?

A

a. Pantumumab

109
Q

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

a. Immediate biopsy

110
Q

CEA tumor marker in?

A

a. Colon cancer

111
Q

AFP tumor marker in?

A

a. Hepatocellular carcinoma

112
Q

What is the only tumor marker that can be used in screening?

A

a. PSA

113
Q

Which of these drugs can cause hemorrhagic cystitis?

A

a. Iphosphamide

114
Q

What can be used as prophylaxis in the previous question? (hemorrhagic cystitis)

A

a. Mesna

115
Q

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

a. Observation

116
Q

For previous question, what is needed for adjuvant chemotherapy? (colon cancer)

  • a. Lymph node involvement
  • b. Old age
  • c. Young age
A

a. Lymph node involvement

117
Q

Colitis as a result of nivolumab treatment. How to treat?

  • a. Dexamethasone
  • b. Antibiotics
  • c. Infliximab
A

a. Dexamethasone

118
Q

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

a. Luminal A

119
Q

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
A

c. Broad spectrum antibiotics

120
Q
A
121
Q

Capecitabine side effects?

A

a. Hand-foot syndrome.

122
Q

On what performance scale are you if you have asymptomatic cancer?

  • a. PS0
  • b. PS1
  • c. PS2
  • d. PS3
  • e. PS4
A

a. PS0

123
Q

What is the scale for adverse effects in cancer?

  • a. PS scale
  • b. Zubrod scale
  • c. CTC AE
A

c. CTC AE

124
Q

Oxaliplatin most common side effect?

  • a. Neurotoxicity
  • b. Hand-foot syndrome
  • c. Diarrhea
A

a. Neurotoxicity

125
Q

What is the best treatment for non-metastatic gastric cancer?

  • a. Neoadjuvant + adjuvant chemotherapy plus salvage surgery
  • b. Only chemotherapy
  • c. Only surgery
A

a. Neoadjuvant + adjuvant chemotherapy plus salvage surgery

126
Q

Metastatic gastric cancer with HER2 3+. How to treat?

A

a. Trastuzumab, cisplatin, 5-FU

127
Q

What is the most common location for HPV head and neck cancer?

  • a. Oropharynx
  • b. Hypopharynx
  • c. Oral cavity
  • d. Larynx
A

a. Oropharynx

128
Q

Early oral cancer, best treatment option?

  • a. Surgery
  • b. Radiotherapy
  • c. Chemoradio
A

a. Surgery

129
Q

Erlotinib mechanism of action?

A

a. Tyrosine kinase inhibitor

130
Q

Erlotibnib is used in which type of cancer?

A

a. NSCLC

131
Q

What is the most common histopathology of NSCLC?

A

a. Adenocarcinoma

132
Q

Kras mutation must be established before starting treatment in what type of cancer?

A

a. Colon cancer

133
Q

What does LD stage of SCLC mean?

  • a. The cancer is radiotherapy amendable
  • b. Cancer is only limited to the lungs
A

a. The cancer is radiotherapy amendable

134
Q

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
A

c. Effective chemotherapy SCLC with no metastasis

5 MD (7 decks)

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