McqMate
These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Uncategorized topics .
| 201. |
Which of the following proto-oncogenes is least likely to be associated with an increased risk of breast cancer? |
| A. | ATM (ataxia telangiectasia) |
| B. | BRCA-1 |
| C. | Bcl 2 |
| D. | HER-2neu |
| E. | Wiskott Aldrich Syndrome |
| Answer» E. Wiskott Aldrich Syndrome | |
| 202. |
A 40-year-old male is operated on for a medullary carcinoma of the thyroid. He expresses concern about his 10 years son getting the disease. The best test: |
| A. | Yearly calcitonin in son |
| B. | yearly pentagastrin-stimulated calcitonin in son |
| C. | DNA analysis for RET proto-oncogene in tumor |
| D. | DNA analysis for RET proto-oncogene in peripheral blood |
| E. | Thyroid ultrasound in son |
| Answer» D. DNA analysis for RET proto-oncogene in peripheral blood | |
| 203. |
Patient with germ cell tumor receiving BEP. Which side-effect would necessitate cessation of the responsible drug: |
| A. | neutropenia |
| B. | high-tone severe hearing loss |
| C. | peripheral neuropathy |
| D. | interstitial lung damage |
| E. | none of above |
| Answer» A. neutropenia | |
| 204. |
A female presents with shortness of breath. CXR is shown with whiteout of Left lung. Told neurone-specific enolase +ve, next best step in management: |
| A. | Bronchoscopy with laser |
| B. | Radiotherapy |
| C. | Chemotherapy |
| D. | Best supportive care |
| E. | Surgical resection |
| Answer» C. Chemotherapy | |
| 205. |
Which of the following best describes the incidence of colon cancer with age: |
| A. | Linear increase with age |
| B. | Linear increase with plateau after age 50 |
| C. | Parabolic |
| D. | Exponential rise after age 50 |
| E. | Bimodal distribution with peaks at age 50 and 70 |
| Answer» D. Exponential rise after age 50 | |
| 206. |
All of the following can occur in germ line leading to breast cancer except which one: |
| A. | BRCA1 |
| B. | BRCA2 |
| C. | Bcl-2 |
| D. | p53 |
| E. | Ataxia telangiectasia gene |
| Answer» C. Bcl-2 | |
| 207. |
Which of the following is the least likely to be involved in hereditary colon cancer: |
| A. | APC gene |
| B. | DNA repair gene |
| C. | Microsatellites |
| D. | Deletion of a gene |
| E. | Chromosomal translocation |
| Answer» E. Chromosomal translocation | |
| 208. |
A 50 year patient presents with metastatic renal cell carcinoma. The best management would be: |
| A. | IFN- |
| B. | IL-2 |
| C. | Vinblastine |
| D. | Best supportive care |
| E. | Progesterone |
| Answer» B. IL-2 | |
| 209. |
The genetic defect in hereditary non-polyposis coli lies in: |
| A. | APC gene |
| B. | DCC gene |
| C. | DNA repair defect |
| D. | proto-oncogene |
| E. | P53 gene |
| Answer» C. DNA repair defect | |
| 210. |
A female with a history of breast cancer removed. Examination revealed previous modified radical mastectomy scar. Diffuse erythema, with nodules and plaquing over and around scar with some extension onto contralateral breast is evident. The most likely diagnosis is: |
| A. | Radiation recall |
| B. | Fungal infection |
| C. | Tumor recurrence |
| D. | Herpes zoster |
| E. | None of above |
| Answer» C. Tumor recurrence | |
| 211. |
Which is the strongest predictor of an increased risk of breast cancer in a 40 ys woman: |
| A. | Early menarche |
| B. | Late first pregnancy > 30 years |
| C. | Previous breast carcinoma in contralateral breast |
| D. | Mother with breast cancer at age 70 |
| E. | Hormone replacement therapy |
| Answer» C. Previous breast carcinoma in contralateral breast | |
| 212. |
A young male has non-Hodgkin's lymphoma. The LMO starts prednisone whilst awaiting a haematology admission. He presents unwell with WCC previously 30, now 2, urate 2.3, K 8.0, phosphate 10, Cr .25. The most likely diagnosis? |
| A. | Urate nephropathy |
| B. | Tumor lysis syndrome |
| C. | Dehydration |
| D. | Lymphoma infiltration of kidneys |
| E. | Hyperleucocytosis |
| Answer» B. Tumor lysis syndrome | |
| 213. |
A young female (30 years) had mantle radiotherapy in her teens. The most likely cancer site in her now: |
| A. | Thyroid |
| B. | Breast |
| C. | Bone marrow |
| D. | Lung |
| E. | Lymph nodes |
| Answer» B. Breast | |
| 214. |
The most common mechanism of spread of epithelial ovarian cancer is: |
| A. | Haematogenous |
| B. | Lymphatics |
| C. | Adjacent structures |
| D. | Trans-coelomic |
| E. | Lepidic |
| Answer» C. Adjacent structures | |
| 215. |
A man with metastatic prostate cancer with increasing bone pain. The decision is made to start a GnRH agonist Your advice regarding the likely effect of this: |
| A. | Immediate resolution of symptoms |
| B. | Initial worsening of symptoms over two weeks followed by gradual resolution |
| C. | Delayed resolution of symptoms |
| D. | Slow progressive improvement of symptoms |
| E. | Initial resolution followed by severe worsening of symptoms |
| Answer» B. Initial worsening of symptoms over two weeks followed by gradual resolution | |
| 216. |
Concerning lung cancer: |
| A. | In Australia, the incidence in women is falling. |
| B. | The use of chemotherapy in combination with radiotherapy in patients with stage III non-small cell lung cancer is associated with improved survival. |
| C. | Chemotherapy for metastatic non-small cell lung cancer improves quality of life but not survival. |
| D. | The optimal treatment for limited stage small cell lung cancer is with chemotherapy alone. |
| E. | Paraneoplastic manifestations occur in the majority of patients. |
| Answer» B. The use of chemotherapy in combination with radiotherapy in patients with stage III non-small cell lung cancer is associated with improved survival. | |
| 217. |
Regarding familial breast cancer, which of the following statements is true? |
| A. | The majority of cases are also associated with mutations of the p53 gene. |
| B. | mutation of the BRCA1 gene may be associated with an increased risk of both breast and ovarian cancer. |
| C. | chemoprevention with tamoxifen is of proven benefit. |
| D. | most affected families share the same specific mutation of the BRCA1 gene. |
| E. | about 75% of affected family members develop breast cancer before the age of 35 years |
| Answer» B. mutation of the BRCA1 gene may be associated with an increased risk of both breast and ovarian cancer. | |
| 218. |
BRCA-1: |
| A. | Type of oncogene |
| B. | Associated with male breast cancer |
| C. | Associated with breast and ovarian cancer |
| D. | Associated with sporadic breast cancer |
| E. | Produces a truncated protein |
| Answer» C. Associated with breast and ovarian cancer | |
| 219. |
Oesophageal cancer is associated with: |
| A. | Alcohol abuse |
| B. | Corrosive-associated damage |
| C. | Achalasia |
| D. | Reflux |
| E. | Smoking |
| Answer» E. Smoking | |
| 220. |
Small cell lung cancer is more associated with ( than NSCLC) |
| A. | Hypercalcemia |
| B. | Clubbing |
| C. | Cushing‟s |
| D. | Eaton-Lambert syndrome |
| E. | Hyponatraemia |
| Answer» E. Hyponatraemia | |
| 221. |
Regarding cell kinetics of cancer: |
| A. | 1 cm tumor = 109 cells |
| B. | Cells in G0 are highly sensitive to chemotherapy |
| C. | Common cancers have doubling times of 20 days |
| D. | Intrinsic mutation rate in common cancers ~ 1 in 106 cells |
| E. | Growth in primary cancer decreases in the later stages of development |
| Answer» A. 1 cm tumor = 109 cells | |
| 222. |
73 years female with metastatic breast cancer, on tamoxifen for 6/12. 2/7 Hx of nausea and thirst. Na+ 155, K+ 5.2, urine osm 137. Has multiple mets including sella turcica. Next most appropriate treatment: |
| A. | Saline |
| B. | Fluid restriction |
| C. | Intranasal desmopressin |
| D. | APD |
| E. | Demeclocycline |
| Answer» B. Fluid restriction | |
| 223. |
Pre-menopausal woman found to have left axillary and supraclavicular nodes. Biopsy showed poorly differentiated cancer, oestrogen receptor poor. She has no other Symptoms, examination is otherwise normal and CXR and mammogram are normal. Next step: |
| A. | Endoscopy |
| B. | Bronchoscopy |
| C. | Local XRT |
| D. | Chemo and XRT |
| E. | Hormonal therapy |
| Answer» B. Bronchoscopy | |
| 224. |
A patient with known disseminated lymphoma is anaemic, with Hb = 100, MCV = 74, Fe = 4, Ferritin = 300. This is best explained by: |
| A. | Fe deficiency |
| B. | Impaired release of Fe from macrophages |
| C. | Reduced erythropoietin |
| D. | Reticulocytosis |
| E. | Increased plasma clearance of Fe |
| Answer» C. Reduced erythropoietin | |
| 225. |
Radiotherapy has its most severe effects on which tissues? |
| A. | liver |
| B. | kidney |
| C. | lung |
| D. | bone marrow |
| E. | spinal cord |
| Answer» D. bone marrow | |
| 226. |
Which of the following is more likely to result from the administration of bleomycin? |
| A. | sodium urate |
| B. | calcium pyrophosphate |
| C. | calcium hydroxyapatite |
| D. | calcium oxalate |
| E. | none of above |
| Answer» A. sodium urate | |
| 227. |
Patient with metastatic bowel cancer is taking Codeine 30 mg q4h without adequate analgesia. What is the most appropriate therapy? |
| A. | continue Codeine and add Paracetamol 1g qid |
| B. | stop Codeine, start MS Contain l0 mg bd and Paracetamol 1g qid |
| C. | stop Codeine, start MS Contain 20 mg bd and Paracetamol 1g qid |
| D. | stop Codeine, start MS Contain l0 mg bd and Panadeine ii qid |
| E. | nerve block is now indicated |
| Answer» A. continue Codeine and add Paracetamol 1g qid | |
| 228. |
Concerning the prophylactic use of G-CSF during cancer chemotherapy: |
| A. | it decreases the duration of neutropenia |
| B. | it decreases the severity of the neutropenic nadir |
| C. | it increases platelet numbers |
| D. | it potentiates the effect of chemotherapy |
| E. | it is only useful in established neutropenia |
| Answer» B. it decreases the severity of the neutropenic nadir | |
| 229. |
Phase 2 trial of new cancer drug. Which is least likely to account for variation in results: |
| A. | Size of metastases |
| B. | Site of metastases |
| C. | Gender |
| D. | Performance status |
| E. | Prior therapy |
| Answer» C. Gender | |
| 230. |
Breast cancer, least likely defect: |
| A. | BRCA1 |
| B. | BRCA2 |
| C. | Bcl-2 |
| D. | ATM |
| E. | p53 |
| Answer» C. Bcl-2 | |
| 231. |
In women the biggest risk factor for breast cancer is: |
| A. | Family history |
| B. | Previous contra lateral breast cancer |
| C. | Benign breast disease. |
| D. | Hyperplasia |
| E. | Breast feeding |
| Answer» B. Previous contra lateral breast cancer | |
| 232. |
Best treatment of metastatic renal cell cancer: |
| A. | Sutinib |
| B. | Vindarabine |
| C. | Palliative care |
| D. | Bevacizumab |
| E. | All of above |
| Answer» A. Sutinib | |
| 233. |
Major spread of ovarian cancer |
| A. | Adnexal |
| B. | Lymphatic |
| C. | Blood |
| D. | Peritoneal |
| E. | Seeding |
| Answer» A. Adnexal | |
| 234. |
Patient gets bleomycin, etoposide, and cisplatin. Which cause for cessation of specific drug? |
| A. | Infertility |
| B. | Neutropenic sepsis |
| C. | Interstitial lung disease |
| D. | High frequency hearing loss |
| E. | Vomiting |
| Answer» B. Neutropenic sepsis | |
| 235. |
55 year female - breast cancer 3 yrs ago had mastectomy only Presents with lower back pains. Some neurology - mild --> equivocal plantar. MRI Shows lesions in 3- 4 different vertebra - partially compressing spinal cord. |
| A. | surgical decompression and radiotherapy |
| B. | chemotherapy |
| C. | oestrogen therapy |
| D. | NSAID |
| E. | Steroids |
| Answer» A. surgical decompression and radiotherapy | |
| 236. |
Cisplatin based chemotherapy. Which anti-emetic is most effective >24 post chemotherapy: |
| A. | Dexamethasone |
| B. | Ondansetron |
| C. | Tetracanniboids |
| D. | Maxolon |
| E. | Stemetil |
| Answer» B. Ondansetron | |
| 237. |
Least effective for identifying an unknown primary |
| A. | Axillary lymphadenopathy adenocarcinoma |
| B. | Secondary hepatic metastases adenocarcinoma |
| C. | Mediastinal undifferentiated carcinoma |
| D. | Bone blast secondary |
| Answer» C. Mediastinal undifferentiated carcinoma | |
| 238. |
Middle aged smoker. Whole of left lung – white, collapse. Bronchoscopy shows an undifferentiated carcinoma in the left main bronchus. Presents with cough and haemoptysis. Small left clavicular lymph node palpable. Treatment: |
| A. | Surgery |
| B. | Radiotherapy |
| C. | Chemotherapy |
| D. | Palliation |
| E. | Chemoradiation |
| Answer» C. Chemotherapy | |
| 239. |
Smoker with carcinoma of the lung. Well until recently. Bronchoscopy shows extrinsic compression of the bronchus. Low serum sodium. Diagnosis: |
| A. | Small cell carcinoma |
| B. | Adenocarcinoma |
| C. | Squamous cell carcinoma |
| D. | Large cell carcinoma |
| Answer» A. Small cell carcinoma | |
| 240. |
In a young man testicular malignancy, how does HCG cause gynaecomastia? |
| A. | By stimulating breast directly |
| B. | By increased testosterone |
| C. | By increased oestrogen |
| D. | Action of testicular tumor |
| Answer» C. By increased oestrogen | |
| 241. |
Young lady had radiotherapy for Hodgkin‟s disease. 10 years later, most likely sequelae: |
| A. | Thyroid carcinoma |
| B. | AML |
| C. | Non Hodgkin‟s lymphoma |
| D. | Carcinoma breast |
| E. | Skin cancer |
| Answer» D. Carcinoma breast | |
| 242. |
DNA microsatellite - best description |
| A. | Single locus 2 - 4 base pairs repeats |
| B. | DNA fragments |
| C. | CAG repeat |
| D. | DNA folding |
| Answer» A. Single locus 2 - 4 base pairs repeats | |
| 243. |
Which drug is least likely to affect cytokine production - especially IL-2 in T cells? |
| A. | Prednisone |
| B. | Mycophenalate |
| C. | Tacrolimus |
| D. | Rapamycin |
| E. | Cyclosporin A |
| Answer» B. Mycophenalate | |
| 244. |
Among viruses which are activated due to immunosuppression the least oncogenic virus is |
| A. | HHV8 |
| B. | CMV |
| C. | Hepatitis B |
| D. | EBV |
| E. | Human papillomavirus |
| Answer» B. CMV | |
| 245. |
Disease least likely to have a family predisposition |
| A. | Breast cancer |
| B. | Lung cancer |
| C. | Germ cell cancer of testes |
| D. | Ovarian cancer |
| E. | Prostate cancer |
| Answer» B. Lung cancer | |
| 246. |
Which one of the following drugs has the least bone marrow suppression? |
| A. | Daunorubicin |
| B. | Cisplatin |
| C. | Cyclophosphamide |
| D. | Etoposide |
| E. | Vincristine |
| Answer» E. Vincristine | |
| 247. |
Most common mode of spread of epithelial ovarian tumors occurs to |
| A. | Para aortic lymph nodes |
| B. | Adnexae |
| C. | Bone |
| D. | Lungs |
| E. | Liver |
| Answer» B. Adnexae | |
| 248. |
Changes least likely with familial colonic cancer |
| A. | APC gene mutation |
| B. | DNA repair gene mutation |
| C. | Chromosomal translocation |
| D. | Microsatellite instability |
| E. | Loss of heterozygosity for tumour suppressor genes |
| Answer» C. Chromosomal translocation | |
| 249. |
Small cell lung carcinoma can cause (?all of the following except) |
| A. | Hypercalcemia |
| B. | Cushing‟s syndrome |
| C. | Clubbing |
| D. | Lambert Eaton Myasthenic syndrome |
| E. | SIADH |
| Answer» A. Hypercalcemia | |
| 250. |
BRCA-1 |
| A. | Associated with male breast cancer |
| B. | Associated with sporadic breast cancer |
| C. | Less associated with truncated protein |
| D. | Associated with breast & ovarian carcinoma |
| E. | Is an oncogene |
| Answer» D. Associated with breast & ovarian carcinoma | |
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