McqMate
These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Uncategorized topics .
| 151. |
Carcinoma of the esophagus has a poor prognosis because: |
| A. | metastases to liver or lung are usually present before the diagnosis is made |
| B. | the lesion is not accessible to surgery |
| C. | local spread usually prevents complete removal |
| D. | the tumor is radioresistant |
| Answer» C. local spread usually prevents complete removal | |
| 152. |
All of the following correctly describe carcinoma of the esophagus except: |
| A. | male predominance |
| B. | most frequently involves adenocarcinoma |
| C. | patients usually over 50 years of age |
| D. | most frequently of the squamous cell type |
| E. | symptoms may occur late in the disease |
| Answer» B. most frequently involves adenocarcinoma | |
| 153. |
Which of the following is most characteristic of carcinoma of the esophagus? |
| A. | produces symptoms early and is more curable than cancer of the stomach |
| B. | difficult to cure because of local spread |
| C. | characterized by widespread and early metastases |
| D. | has a good response to chemotherapy and therefore is rarely excised or radiated |
| Answer» B. difficult to cure because of local spread | |
| 154. |
The most common type of esophageal cancer in the United States is: |
| A. | adenocarcinoma |
| B. | leiomyosarcoma |
| C. | lymphoma |
| D. | squamous cell carcinoma |
| Answer» D. squamous cell carcinoma | |
| 155. |
What is the significance of intestinal metaplasia in the stomach or colon? |
| A. | It has no significance. |
| B. | It is frequently associated with mildly precancerous inflammatory disease. |
| C. | It is highly precancerous. |
| D. | It is usually associated with heterotopic pancreas. |
| Answer» B. It is frequently associated with mildly precancerous inflammatory disease. | |
| 156. |
Multiple recurrent ulcers in proximal and distal duodenum for several years are likely to be associated with: |
| A. | heavy aspirin intake |
| B. | islet cell adenoma of pancreas |
| C. | smoking |
| D. | excessive bile secretion |
| Answer» B. islet cell adenoma of pancreas | |
| 157. |
In a patient with a chronic peptic ulcer of the stomach, the chance that carcinoma will develop in the ulcer is: |
| A. | over 80% |
| B. | about 50% |
| C. | about 30% |
| D. | very small |
| Answer» D. very small | |
| 158. |
Carcinoma of the stomach usually arises from: |
| A. | smooth muscle cells |
| B. | acid producing cells |
| C. | pepsinogen producing cells |
| D. | mucus producing cells |
| E. | argentaffin cells |
| Answer» D. mucus producing cells | |
| 159. |
Which presents as a bulky mass lesion often with deep central ulceration? |
| A. | leiomyoma of stomach |
| B. | leiomyosarcoma of stomach |
| C. | both |
| D. | neither |
| Answer» C. both | |
| 160. |
Lymphoma of the stomach: |
| A. | may be primary or secondary in the stomach |
| B. | has a better prognosis than carcinoma of the stomach |
| C. | both |
| D. | neither |
| Answer» C. both | |
| 161. |
Which neoplasm is most FREQUENTLY found in the appendix? |
| A. | carcinoid |
| B. | villous adenoma |
| C. | lymphoma |
| D. | adenomatous polyp |
| E. | adenocarcinoma |
| Answer» A. carcinoid | |
| 162. |
The most benign examples of carcinoid tumor usually are found in the: |
| A. | colon |
| B. | appendix |
| C. | ileum |
| D. | stomach |
| Answer» B. appendix | |
| 163. |
Which type of polyp is most LIKELY in a patient presenting with watery mucoid diarrhea? |
| A. | juvenile polyp |
| B. | adenomatous polyp |
| C. | villous adenoma |
| D. | carcinomatous polyp |
| Answer» C. villous adenoma | |
| 164. |
Familial breast cancer is characterized by |
| A. | Account for about 20% of all breast cancer |
| B. | A BRCA1 mutation is the most common genetic changes. |
| C. | Associated cancers tend to be more aggressive, of a higher grade, and hormone receptor negative. |
| D. | Follow the same rules of screening as non-familial breast cancer. |
| E. | All of above. |
| Answer» C. Associated cancers tend to be more aggressive, of a higher grade, and hormone receptor negative. | |
| 165. |
A bulky tumor of the rectum exhibits a delicate, velvety, easily bleeding surface. It has no pedicel and its base appears to be as wide as its apex. The process is most probably: |
| A. | inflammatory polyp |
| B. | villous adenoma |
| C. | mucinous adenocarcinoma |
| D. | lymphoid polyp |
| E. | leiomyoma |
| Answer» B. villous adenoma | |
| 166. |
Which is characterized by small size? |
| A. | adenomatous polyp |
| B. | hyperplastic polyp |
| C. | villous adenoma |
| D. | juvenile polyp |
| Answer» B. hyperplastic polyp | |
| 167. |
Which best characterizes Peutz-Jeghers polyps? |
| A. | solitary, hamartomatous, not premalignant |
| B. | multiple, hamartomatous, not premalignant |
| C. | solitary, neoplastic, premalignant |
| D. | multiple, neoplastic, not premalignant |
| Answer» B. multiple, hamartomatous, not premalignant | |
| 168. |
Which of the following factors is most valuable in predicting the biologic behavior of carcinoma of the colon? |
| A. | age of the patient |
| B. | duration of symptoms |
| C. | region of the colon affected |
| D. | diameter of the cancer |
| E. | lymph node metastasis |
| Answer» E. lymph node metastasis | |
| 169. |
Which of the following is most strongly predisposing to colon cancer? |
| A. | ulcerative colitis |
| B. | familial polyposis |
| C. | Crohn‟s disease |
| D. | Peutz-Jegher‟s syndrome |
| Answer» B. familial polyposis | |
| 170. |
Adenocarcinoma of the ascending colon is more likely than adenocarcinoma of the sigmoid colon to: |
| A. | encircle the bowel, causing a stricture or obstruction |
| B. | be bulky |
| C. | both |
| D. | neither |
| Answer» B. be bulky | |
| 171. |
Persistent elevation of serum carcinoembryonic antigen following surgical resection of a carcinoma of the colon suggests: |
| A. | a poorly differentiated neoplasm |
| B. | a second cancer |
| C. | cirrhosis |
| D. | metastases |
| E. | peritonitis |
| Answer» D. metastases | |
| 172. |
In contrast to carcinoma of the right colon, carcinoma of the left colon tends to be associated with: |
| A. | anemia |
| B. | diverticulosis |
| C. | malabsorption |
| D. | obstruction |
| E. | no symptoms |
| Answer» D. obstruction | |
| 173. |
Which of the following lesions of the colon has the least tendency to undergo malignant transformation? |
| A. | ulcerative colitis |
| B. | juvenile polyp |
| C. | villous adenoma |
| D. | polyp of Gardner‟s syndrome |
| Answer» B. juvenile polyp | |
| 174. |
Predisposes to adenocarcinoma: |
| A. | Barrett‟s esophagus |
| B. | achalasia, esophagus |
| C. | both |
| D. | neither |
| Answer» A. Barrett‟s esophagus | |
| 175. |
Predisposes to squamous cell carcinoma: |
| A. | Barrett‟s esophagus |
| B. | achalasia, esophagus |
| C. | both |
| D. | neither |
| Answer» B. achalasia, esophagus | |
| 176. |
A 76-year-old male was admitted for symptoms including constipation, change in stool character and weight loss. Colonoscopy revealed multiple polyps in the rectosigmoid area. An adenomatous polyp was removed. Another colonic tumor was seen in the same patient which was flat with irregular “shaggy rug” surface. A biopsy showed frond-like glandular architecture. Atypical epithelial cells in clusters were seen beneath the muscularis mucosae. The most likely diagnosis is: |
| A. | adenomatous polyp |
| B. | villous adenoma with atypism |
| C. | focus of adenocarcinoma arising in villous adenoma |
| D. | colitis cystica profunda |
| E. | NONE of above |
| Answer» C. focus of adenocarcinoma arising in villous adenoma | |
| 177. |
An elderly male had rectal bleeding. A flat velvety mass was observed in the cecum. The provisional diagnosis was villous adenoma. A partial colectomy was performed. Invasion through the muscularis mucosae, but not into the muscularis propria, was observed on paraffin sections. Therefore, the final diagnosis was: |
| A. | pseudopolyp |
| B. | adenomatous polyp |
| C. | adenocarcinoma Dukes A |
| D. | adenocarcinoma Dukes B |
| E. | adenocarcinoma Dukes C |
| Answer» C. adenocarcinoma Dukes A | |
| 178. |
A male heavy smoker develops increasing difficulty in swallowing gradually over six months. Constriction of the mid-esophagus is seen on x-ray of barium swallow. The most likely diagnosis is: |
| A. | pulsion diverticulum |
| B. | achalasia |
| C. | hiatal hernia |
| D. | squamous cell carcinoma |
| E. | Mallory-Weiss syndrome |
| Answer» D. squamous cell carcinoma | |
| 179. |
Which of the following chemotherapy drug is likely to be toxic to gonads? |
| A. | Adriamycin |
| B. | Vinblastine |
| C. | Paclitaxel |
| D. | Procarbazine |
| E. | Prednisolone |
| Answer» D. Procarbazine | |
| 180. |
High dose chemotherapy given prior to stem cell transplant may be associated with gonadal failure. Risk is least with the use of |
| A. | Busulfan + cyclophosphamide |
| B. | Cyclophosphamide + TBI |
| C. | Ifosfamide +carboplatin+ Etoposide |
| D. | Fludarabine + ATG |
| Answer» D. Fludarabine + ATG | |
| 181. |
Incidence of Gallbladder cancer is highest in |
| A. | Chile |
| B. | India |
| C. | United Kingdom |
| D. | South Africa |
| Answer» A. Chile | |
| 182. |
Which of the following is least to occur as Gallbladder primary? |
| A. | Adenocarcinoma |
| B. | Squamous cell carcinoma |
| C. | Lymphoma |
| D. | Carcinoid tumor |
| Answer» C. Lymphoma | |
| 183. |
Which of the following is less likely to be associated with Gallbladder cancer? |
| A. | Obesity |
| B. | Use of tobacco and alcohol |
| C. | Aflatoxins |
| D. | Past history of enteric fever |
| Answer» C. Aflatoxins | |
| 184. |
On immunohistochemistry, classical Hodgkin‟s lymphoma Reed sternberg cells are likely to be |
| A. | CD15(-), CD 30(+),CD45(-) |
| B. | CD15(+), CD 30(+),CD45(+) |
| C. | CD15(+), CD 30(+),CD45(-) |
| D. | CD15(-), CD 30(+),CD45(+) |
| Answer» C. CD15(+), CD 30(+),CD45(-) | |
| 185. |
Most common site of metastasis in breast cancer is |
| A. | lung |
| B. | liver |
| C. | bone |
| D. | brain |
| Answer» C. bone | |
| 186. |
Which one of the following cancers is usually associated with a moderate to high uptake of 18F-fluorodeoxyglucose (18 FFDG)? |
| A. | Bladder |
| B. | Colorectal |
| C. | Thyroid |
| D. | Testicular |
| Answer» B. Colorectal | |
| 187. |
Which one of the following is an accurate definition of the sensitivity of a screening test? |
| A. | The percentage of screening tests that is positive |
| B. | The percentage of screening tests that is negative among patients who remain unaffected by the condition of interest after screening |
| C. | The percentage of screening tests that is positive among patients who remain unaffected by the condition of interest after screening |
| D. | The probability of a diagnosis of the condition of interest after a positive screening test |
| Answer» C. The percentage of screening tests that is positive among patients who remain unaffected by the condition of interest after screening | |
| 188. |
Epstein-Barr virus-associated Hodgkin‟s lymphoma is … |
| A. | common in the elderly |
| B. | common in young children |
| C. | more common in industrialized countries |
| D. | more common in females |
| Answer» B. common in young children | |
| 189. |
Treatment of early stage favorable Hodgkin‟s lymphoma … |
| A. | necessarily includes radiotherapy |
| B. | requires 6 to 8 cycles of multiagent chemotherapy |
| C. | with 4 cycles of chemotherapy and low dose involved-filed radiotherapy is the standard of care |
| D. | With complete response to 2 chemotherapy cycles further treatment is not needed. |
| Answer» C. with 4 cycles of chemotherapy and low dose involved-filed radiotherapy is the standard of care | |
| 190. |
Regarding G-CSF - the best description of its mechanism of action and role in chemotherapy is |
| A. | reduced PMN nadir when used as prophylaxis |
| B. | reduced duration of neutropenia when used as prophylaxis |
| C. | not useful unless already neutropenic |
| D. | reduce thrombocytopenia severity |
| E. | potentiates effects of chemotherapy |
| Answer» A. reduced PMN nadir when used as prophylaxis | |
| 191. |
A 44-year-old woman presented with post-coital bleeding. Investigation revealed a 2-cm grade 1, stage IB1 squamous cell carcinoma of the cervix. There was no evidence of lymphovascular space invasion. She had completed her family.What is the most appropriate treatment? |
| A. | brachytherapy |
| B. | chemo-radiotherapy |
| C. | excision cone biopsy only |
| D. | radical hysterectomy |
| E. | vaginal trachelectomy |
| Answer» D. radical hysterectomy | |
| 192. |
Mutations in which gene are least likely to be associated with breast cancer if inherited in the germ-line? |
| A. | ATM (ataxia-telangiectasia) |
| B. | BRCA l |
| C. | BRCA2 |
| D. | Bcl-2 |
| E. | p53 |
| Answer» D. Bcl-2 | |
| 193. |
The least likely to be associated with bowel cancer is |
| A. | Ataxia telangiectasia |
| B. | Der-abl gene translocation |
| C. | BRCA-1 |
| D. | BRCA-2 |
| E. | Pcl-2 |
| Answer» B. Der-abl gene translocation | |
| 194. |
14 year old girl with Hodgkin's disease is treated with radiotherapy (mantle field). Which is the most likely secondary carcinoma that could develop |
| A. | breast |
| B. | Lung |
| C. | thyroid |
| D. | NHL |
| E. | AML |
| Answer» A. breast | |
| 195. |
Young male with germ cell cancer. He is on bleomycin. etoposide and cisplatinum. What side effect would make you stop the treatment? |
| A. | Peripheral neuropathy |
| B. | neutropenic septicaemia |
| C. | interstitial lung disease |
| D. | high tone hearing loss |
| Answer» B. neutropenic septicaemia | |
| 196. |
Most likely route of ovarian cancer spread: |
| A. | peritoneal |
| B. | direct spread to adnexae |
| C. | lymphatic |
| D. | direct spread to other organs |
| E. | none of above |
| Answer» B. direct spread to adnexae | |
| 197. |
Man with medullary carcinoma of thyroid, worried about his son. What do you do? |
| A. | yearly calcitonin |
| B. | look for ret oncogene in the cancer |
| C. | look for ret oncogene in blood |
| D. | pentagastrin stimulation test |
| E. | reassure |
| Answer» C. look for ret oncogene in blood | |
| 198. |
Metastatic renal cell carcinoma, symptomatic: |
| A. | best supportive care |
| B. | radiotherapy |
| C. | Surgery |
| D. | interferon |
| E. | Vinblastine |
| Answer» C. Surgery | |
| 199. |
An older woman with breast cancer with bony metastases who was on aminoglutamethonine. Picture of rash which covered right breast and covered left breast a little, small nodules, some dead skin and a few scaly bits. Most likely cause of rash? |
| A. | fungal |
| B. | radiation |
| C. | aminoglutamethonine reaction |
| D. | skin recurrence |
| E. | zoster |
| Answer» D. skin recurrence | |
| 200. |
Male with bone pain from metastatic prostate cancer will be started on LHRH antagonist. He refuses orchidectomy. His illness will show: |
| A. | immediate improvement |
| B. | initially worse than improvement |
| C. | immediate improvement then decline |
| D. | slow improvement |
| E. | no change |
| Answer» B. initially worse than improvement | |
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