Random Questions from Practice Tests Flashcards
1
Q
Mechanism of Action for rolapitant
A
substance P/neurokinin-1 inhibitor
2
Q
Risk factors for adenocarcinomas of the nasal cavity/sinuses
A
Wood dust and leather dust
3
Q
Cancer thorotrast is associated with
A
cholangiocarcinoma
4
Q
Conslidation strategy after induction for CNS lymphoma
A
auto SCT or whole brain RT
5
Q
Drugs in CHOP
A
cyclophosphamide, doxorubicin, vincristine, prednisone
6
Q
Effects of TKI in pregnancy
A
increases fetal malformation and spontaneous abortions
7
Q
In what position does SVC syndrome worsen?
A
Supine
8
Q
What is the presenting triad associated with Plummer-Vinson syndrome, and what cancer is it associated with?
A
Iron deficiency anemia, esophageal webs, dysphagia. Patients are at increased risk of developing Squamous cell carcinoma of the esophagus
9
Q
Appropriate duration of anticoagulation in women who have DVT during pregnancy
A
6 weeks after birth
10
Q
When should chemotherapy be added to adjuvant radiation in patients with head and neck cancer?
A
Positive margins or extracapsular extension
11
Q
Hct goal post cardiac surgery
A
24%
12
Q
What are the initiator caspases?
A
2, 8, 9, 10
13
Q
First line therapy for BRAF WT Melanoma
A
Pembrolizumab or Ipi/Nivo
14
Q
What are the mandatory criteria to diagnose POEMS syndrome
A
Polyneuropathy and Monoclonal plasma cell proliferative disorders (almost always lambda)
15
Q
What does POEMS stand for?
A
Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, and Skin changes
16
Q
What are the major criteria for POEMS and how many do you need for diagnosis?
A
You need one. Castelman disease, sclerotic bone lesions, and VEGF elevation
17
Q
Appropriate treatment for locally advanced BCC that cannot be treated with surgery and radiation
A
Hedgehog pathway inhibitor (vismodegib or sonidegib)
18
Q
How would you treat a grade 1 or 2 metastatic endometroid endometrial carcinoma not eligible for 1st line chemo?
A
Sequential megestrol and tamoxifen
19
Q
What is the mechanism of action and indication for tositumomab?
A
Monoclonal antibody against CD20 receptor. Used to treat relapsed or treatment refractory Non-Hodgkin Lymphoma (NHL)
20
Q
What is the mechanism of action and indication for alemtuzumab?
A
Monoclonal antibody against CD52 receptor; used in management of CLL
21
Q
What is the mechanism of action and indication for Brentuximab vedotin?
A
Monoclonal antibody against CD30 receptor. Used in treatment of Hodgkin’s lymphoma and anaplastic large cell lymphoma
22
Q
How do you calculate an odds ratio?
A
Odds of exposure with cases divided by odds of exposure within controls
23
Q
What hereditary condition is associated with an increased risk fo developing desmoid tumors?
A
Gardner syndrome
24
Q
What are patients with Cowden syndrome at risk for?
A
GI hamartomas, breast/thyroid/uterine cancer
25
How do you define unfavorable disease for early-stage Hodgkin lymphoma according to NCCN guideline?
Bulky mass (>10cm), large mediastinal mass (MMR >.33), ESR>50, presence of any B symptoms, or >3 nodal areas
26
What percentage of men with high-grade PIN will develop prostate cancer within 5 years?
50%
27
What is the optimal treatment regimen for primary mediastinal B-cell lymphoma?
DA-EPOCH-R x 6 cycles
28
What measure do you use to express association between an exposure and outcome in case-control studies?
Odds Ratio
29
What measure do you use to express association between an exposure and outcome in cohort studies?
Relative Risk
30
What enzyme is missing in acute intermittent porphyria?
Porphobilinogen deaminase
31
What is the classic translocation seen in MALT lymphoma?
t(11;18)
32
What is the alteration in Glanzmann's thromabsthenia, and what is the resulting problem?
mutation that inactivates GP2B/3A so unable to immobilize fibrinogen and vWF
33
what is the most common genetic alteration in liposarcoma?
12q amplification involving MDM2 and CDK4 genes
34
what is the mechanism of action of plerixafor?
CXCR4 antagonist which results in the release of hematopoietic stem cells from the marrow
35
What cell surface antigens are expressed by hematopoietic stem cells?
CD34, CD90, CD110, CD117, CD133, CD164
36
What is the cytogenetic abnormality present in >50% of patients with hypereosinophilic syndrome?
del(4)(q12q12): FIP1L1-PDGFRA fusion
37
What defines early stage Hodgkin lymphoma as unfavorable?
Bulky disease (mediastinal mass ratio >0.33 or any mass >10cm); ESR>50; Presence of B symptoms; >3 lymphoid regions
38
What is the most commonly reported variant RARA translocation?
t(11;17)(q23;q21.2): PLZF-RARA
39
What does cryoprecipitate contain?
Fibrinogen, Factor VIII, Factor III, vWF, Fibronectin
40
What are risk factors for local recurrence in soft tissue sarcoma?
Age >50, Recurrent disease at presentation, Positive margins, histologic subtypes (fibrosarcoma and malignant peripheral nerve tumors)
41
What are risk factors for distant recurrence in soft tissue sarcomas?
Tumor size >5cm, high tumor grade, deep location, recurrent disease, leiomyosarcoma
42
What are the 4 most prominent features in dyskeratosis congenita?
aplastic anemia, dystrophic nail changes, reticular skin changes, lingular leukoplakia
43
In addition to aplastic anemia, what clinical findings characterize fanconi anemia?
developmental delay, short stature, microcephaly
44
What is the underlying pathophysiologic dysfunction in dyskeratosis congenita?
telomeric dysfunction (abnormally short telomeres)
45
Which CNS tumor is characterized by 1p and 19q co-deletion?
Oligoastrocytomas
46
Which CNS tumor frequently has an IDH1 mutation?
low grade astrocytoma
47
What are the peripartum anticoagulation recommendations for patients heterozygous for Factor V Leiden mutation?
Low dose LWMH for 6 weeks after delivery if C-section or 1st degree relative with VTE under age 50
48
Which sarcoma histologies are at high risk for lymph node metastasis?
CARE: clear cell, angiosarcoma, rhabdomyosarcoma, epithelioid
49
Which platelet disorder shows normal aggregation with primary and secondary ADP and collagen, but not with ristocetin?
Bernard-Soulier (also has large platelets)
50
Which cyclin binds to cdk4 and 6?
Cyclin D- to signal that cell is ready to advance to S phase from G1
51
Which cyclin regulates progression to M phase?
Cyclin B (by binding to CKD1)
52
What percentage of metastatic melanoma has a BRAF mutation?
50%
53
What is on the US black box warning for Mitomycin C?
hemolytic uremic syndrome
54
What are the most common sites of distant metastases for retroperitoneal sarcoma?
Liver (most common) followed by lung
55
What are the clinical characteristics of Gardner syndrome?
Multiple colyn polyps, osteomas, desmoid tumors, fibromas, thyroid cancer
56
how do you calculate negative predictive value?
True negatives divided by total number of people testing negative
57
What is the mechanism of action of ramucirumab?
IgG monoclonal antibody that targets VEGFR-2
58
What are the two most common resistance mutations to crizotinib?
L1196M and G1269A
59
What are the components of the international prognostic score for Hodgkin Lymphoma?
Age >45; WBC >15, Lymphopenia (<600 or <8% of WBCs), Stage IV, Hgb <10.5, Albumin <4.0, Male
60
What genes are mutated in juvenile hemochromatosis?
hemojuvelin (HJV) or hepcidin (HAMP
61
What is the classic MRI appearance of CNS lymphoma?
"cotton wool appearance"
62
What is the classic MRI appearance of paragangliomas?
"salt and pepper" appearance
63
What percentage of patients with CNS lymphoma have ocular involvement?
15-20%
64
What is the lymphatic drainage of the upper 2/3 of the vagina?
pelvic nodes including internal and external iliacs, and obturator nodes
65
what is the lypmhatic drainage of the lower 1/3 of the vagina?
inguinofemoral nodes
66
Anticoagulation recommendation for pregnancy in FVL homozygous women with no personal/family hx of DVT?
Intermediate dose LMWH post-partum only
67
Anticoagulation recommendation for pregnancy in FVL homozygous women with personal/family hx of DVT?
Intermediate dose LMWH during pregnancy and post-partum
68
What are the 4 most common types of soft tissue sarcoma, in order?
1.) Undifferentiated pleomorphic sarcoma, 2.) Liposarcoma 3.) Synovial sarcoma, 4.) Leiomyosarcoma
69
How many lypmh nodes should be examined in gastrectomy?
15
70
What is the most common genetic abnormality in clear cell sarcoma?
t(12;22)
71
What proteins in the HPV genome act as oncoproteins?
E7 and E8 (through destruction of p53 and Rb)
72
What is the most common subtype of APL?
Hypergranular variant (less common is microgranular)
73
What medications can be used in ACTH-secreting adenomas?
Ketoconazole, metrapone, mitotane
74
What medications can be used in GH-secreting adenomas?
somatostatin analogs (somatostatin, octreotide)
75
What medications can be used for prolactinomas?
Dopamine agonists (bromocriptine, cabergoline)
76
What are the tumor marker cutoffs for good risk nonseminoma?
AFP <1000, B-hCG <5,000, LDH <1.5x ULN
77
What are the tumor markers for poor risk nonseminoma?
AFP >10,000, B-hCG >50,000, LDH >10x ULN
78
What is the most common mutation in NSCLC?
KRAS
79
Treatment for early-stage unfavorable-risk HL?
ABVD x 4 + 30gy IFRT
80
What are the non-taxane microtubule inhibitors?
eribulin and ixabepilone
81
In what setting is pertuzumab approved in the neoadjuvant setting?
Tumor >2cm, positive lymph nodes
82
What agent can eliminate interference of anti-CD38 targeted therapies on antibody screens?
DTT- but will destroy kell antigens
83
What percentage of pancreatic cancer patients present with resectable tumors at baseline?
20%
84
What percentage of pancreatic cancer patients present with metastatic disease at baseline?
50%
85
What is the ETV6-NTRK3 fusion gene relatively pathognomonic for in salivary gland tumors?
mammary analogue secretory carcinoma (MASC)
86
Which molecularly targeted agent would be appropriate for a patient with metastatic melanoma and an NRAS mutation?
Binimetinib
87
What is the flow cytometry phenotype for hairy cell leukemia?
Positive for: CD19, CD20, CD103, CD25, CD11c
88
What is the flow cytometry phenotype for splenic marginal zone lymphoma?
Positive for: CD20, CD79a. Negative for: CD5, CD10, CD23, CD25.
89
What is first-line treatment for splenic marginal zone lymphoma?
single agent rituximab
90
What is the most important factor associated with improved survival in patients with oligodenroglial tumors?
1p and 19q codeletion
91
BRAF V600E is most commonly seen in what type of low grade glioma?
pleomorphic xanthoastrocytoma
92
Treatment for 5q deleted MDS
Lenalidomide
93
In multiple myeloma, is t(4:14) good or poor risk?
poor
94
In multiple myeloma, is t(14:16) good or poor risk?
poor
95
In multiple myeloma, is t(14:20) good or poor risk?
poor
96
In multiple myeloma, are trisomies of odd number chromosomes good or poor risk?
good
97
What are poor risk cytogenetics in multiple myeloma?
17p13, t(4;14), t(14;16), t(14;20)
98
What cells does anaplastic thyroid carcinoma arise from?
follicular cells
99
What condition has normal PT, PTT, TT, with positive urea clot test?
FXIII deficiency
100
Is translocation 12;21 favorable or poor prognosis in ALL?
Favorable (TEL/AML1)
101
Is translocation 16;16 favorable or poor prognosis in AML?
Favorable- can do high dose Ara-C for chemotherapy
102
What are flower cells pathognomonic for?
adult t-cell lymphomas
103
What is the flow cytometry phenotype of adult t-cell leukemia/lymphoma?
CD2-5, CD25. Important: lacks CD7
104
Which subtype of vWD mimics hemophilia A?
vWD type 2N
105
What malignancy is t(8;14)(q24.1;q11.2); MYC-TRA associated with?
T-lymphoblastic leukemia (T-ALL); carries a poor prognosis
106
What is an antidote to 5-FU?
Uridine triacetate
107
Is the absence of MGMT promotor methylation a favorable or poor prognostic indicator in primary glioblastoma?
Poor prognostic factor
108
What is the platelet aggretometry results for Glanzmann thrombasthenia?
Normal aggregation with risotcetin but lack of aggregation with remaining platelet agnosits
109
What is the preferred screening test for porphyria cutanea tarda?
Urine or plasma porphyrins
110
Is wild type NPM1 and FLT3-ITD high poor risk or favorable risk in AML?
Adverse risk
111
What AML risk category is mutated NPM1 with FLT3-ITD High
intermediate
112
What AML risk category is mutated RUNX1?
Adverse
113
What AML risk category is mutated ASXL1?
Adverse
114
What AML risk category is t(6;9) DEK-NUP214?
Adverse
115
What AML risk category is KMT2A rearranged?
Adverse
116
What AML risk category is inv(3)?
Adverse
117
What AML risk category is t(3;3) GATA2,MECOM(EVI1)
Adverse
118
What AML risk category is t(8;21) RUNX1-RUNX1T1?
Favorable
119
What AML risk category is inv(16)?
Favorable
120
What AML risk category is biallelic mutated CEBPA?
Favorable
121
What is enasidenib?
IDH2 inhibitor
122
What is ivosidenib?
IDH1 inhibitor
123
What is the pathognmonic mutation in Waldesntroms?
MYD88
124
What is first-line therapy for metastatic cholangiocarinoma?
Gemcitabine/Cisplatin
125
What is second-line therapy for metastatic cholangiocarcinoma?
FOLFOX
126
Which gene is mutated in congenital gray platelet sydnrome?
NBEAL2
127
What is the treatment for post transfusion purpura?
IVIG 2g/kg of body weight over 2-5 days
128
What maintenance regimen is preferred in adverse risk multiple myeloma?
Bortezomib
129
What is the mechanism of action of plerixafor?
CXCR4 antagonist
130
Which malignancy commonly produces calcitriol?
Lymphoma
131
What gene is mutated in Cowden syndrome?
PTEN (hamartomatous polyps in GI tract)
132
What constitutes grade 1 diarrhea?
<4 bowel movements daily more than his baseline
133
What is the active metabolite of irinotecan?
SN-38
134
What does increased expression of p170 glycoprotein on cancer cells result in?
Increased drug efflux of many chemotherapeutic agents including irinotecan
135
Which chemokine is expressed in nearly all cases of angioimmunoblastic T cell cases?
CXCL13 (cytoplasmic)
136
What regimen should be considered in patients with CNS involvement of multiple myeloma?
Pomalidomide + carfilzomib + dexamethasone
137
What defect is present in Hermansky-Pudlak syndomre?
Absence of dense granules, most common mutation in HPS1
