McqMate
These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Uncategorized topics .
| 251. |
Predisposing factors to oesophageal adenocarcinoma include the following except |
| A. | Achalasia |
| B. | Gastro-oesophageal reflux disease |
| C. | Alcohol |
| D. | Smoking |
| E. | Ingestion of caustic substances |
| Answer» A. Achalasia | |
| 252. |
Young woman with amenorrhoea & large uterus. CXR shows rounded opacities. What is the best test to monitor this condition? |
| A. | CEA |
| B. | HCG |
| C. | -fetoprotein |
| D. | LDH |
| Answer» C. -fetoprotein | |
| 253. |
How would you treat metastatic Ca Breast in a postmenopausal woman? |
| A. | Anti-oestrogen |
| B. | Oestrogen |
| C. | Progesterone |
| D. | Anti-androgen |
| E. | Aromatase inhibitor |
| Answer» A. Anti-oestrogen | |
| 254. |
What is the best prognostic indicator of post op survival for Ca Breast? |
| A. | Tumour size |
| B. | Lymph node involvement |
| C. | HER 2 +ve |
| D. | Tumour grade/ stage |
| E. | Age |
| Answer» D. Tumour grade/ stage | |
| 255. |
Which malignancy is least amenable to treatment? |
| A. | Adeno Ca of axillary lymph nodes |
| B. | Adeno Ca with sclerotic lesion in bone |
| C. | Adeno Ca in liver |
| D. | Squamous cell Ca in cervical lymph nodes |
| E. | Poorly differentiated Ca in chest – midline (?mediastinal lymph nodes) in a young man |
| Answer» B. Adeno Ca with sclerotic lesion in bone | |
| 256. |
Associations for 1o Ca can be made for all of the following except |
| A. | Adeno Ca mets in the liver in a middle aged man |
| B. | Adeno Ca mets in axillary lymph nodes in a woman |
| C. | Squamous Cell mets in cervical lymph nodes in a smoker |
| D. | Mediastinal Adeno Ca in a young man |
| E. | Skeletal sclerotic lesion in vertebrae in an elderly man |
| Answer» D. Mediastinal Adeno Ca in a young man | |
| 257. |
Mechanism of drug resistance of chemotherapeutic drugs |
| A. | P glycoprotein |
| B. | P53 |
| C. | Bcl 2 |
| D. | P450 |
| Answer» A. P glycoprotein | |
| 258. |
A middle-aged man has a melanoma fully excised. What is the most important reason to follow him closely? |
| A. | Local and systemic recurrence |
| B. | New site recurrence |
| C. | In transit metastasis |
| D. | Lymph nodes |
| E. | New primary |
| Answer» A. Local and systemic recurrence | |
| 259. |
A 68 year old man is admitted to the ER having had three large maroon colored stools. On arrival, he passes more bloody stools and clots. He is pale, orthostatic and tachycardic. NG aspirates are bilious. After resuscitation is begun, which of the following is the most appropriate initial test? |
| A. | Angiography |
| B. | Nuclear medicine red blood cell scan |
| C. | Rigid proctoscopy |
| D. | Colonoscopy |
| E. | Barium enema |
| Answer» C. Rigid proctoscopy | |
| 260. |
The most common mode of spread of colon cancer is |
| A. | Hematogenous |
| B. | Lymphatic |
| C. | Direct extension |
| D. | Implantation |
| Answer» B. Lymphatic | |
| 261. |
The following is the most important prognostic determinant of survival after treatment for colorectal cancer? |
| A. | Lymph node involvement |
| B. | Transmural extension |
| C. | Tumor size |
| D. | Histologic differentiation |
| E. | DNA content |
| Answer» A. Lymph node involvement | |
| 262. |
A 68-year-old man presents to his primary care physician for a routine physical examination. The patient‟s medical history is significant for hypertension. The patient is found to have guaiac-positive stools and is subsequently referred for colonoscopy. Colonoscopy reveals a “golf ball”-size, near-obstructing tumor in the descending colon, not admitting the scope. The biopsy is positive for adenocarcinoma of the colon. Which of the following is the next step in the management of this patient? |
| A. | Full metastatic workup first, and if negative, then plan for colon resection |
| B. | A course of radiation therapy prior to any resection |
| C. | Plan for pre-operative chemotherapy |
| D. | Do metastatic work up, but plan for colon resection anyway |
| E. | Schedule a barium enema to evaluate the proximal colon |
| Answer» D. Do metastatic work up, but plan for colon resection anyway | |
| 263. |
For previous patients, after the appropriate evaluation, the patient undergoes surgery. No intraoperative evidence of metastases is identified. Postoperatively, the pathology report reveals that the tumor is an adenocarcinoma invading into the pericolonic fat, with 2 involved lymph nodes. After the patient recovers from surgery, which of the following is the most appropriate next step in his management? |
| A. | Abdominal CT scan every 6 months |
| B. | No further therapy is indicated, because the involved nodes were removed |
| C. | Chemotherapy with 5-fluorouracil (5-FU) based regimen |
| D. | Measurement of CEA levels yearly |
| E. | Colonoscopy every 6 months |
| Answer» C. Chemotherapy with 5-fluorouracil (5-FU) based regimen | |
| 264. |
A 65-year-old woman with no significant past medical history presents to the emergency department with a 2-day history of left lower quadrant abdominal pain. The patient denies nausea and vomiting, although she claims decreased oral intake. She also reports a low-grade fever and mild diarrhea. She describes a milder episode several years ago, which resolved on its own. On physical examination, the patient is found to have left lower quadrant tenderness with some mild guarding, but no rebound. She is hemodynamically stable, and her heart rate is 82 per minute. In the initial management of this patient, which of the following is the most sensitive diagnostic test? |
| A. | Complete blood count, SMA-7 |
| B. | An obstructive series |
| C. | A barium enema study |
| D. | Abdominal/pelvic CT with oral contrast |
| E. | Abdominal ultrasound |
| Answer» D. Abdominal/pelvic CT with oral contrast | |
| 265. |
A 60-year-old man presents for an annual physical examination. The examination is normal except for a palpable mass in the rectum on digital rectal examination. The patient denies any change in bowel habits and feels well. Rectal cancer is suspected. What is the next best step in the evaluation of this patient? |
| A. | Computed tomography scan of the abdomen and pelvis |
| B. | Double-contrast barium enema |
| C. | Flexible sigmoidoscopy with biopsy of the lesion |
| D. | Full colonoscopy with biopsy of the lesion |
| E. | Magnetic resonance imaging scan of the abdomen and pelvis |
| Answer» D. Full colonoscopy with biopsy of the lesion | |
| 266. |
A 78-year-old woman with coronary artery disease and severe chronic obstructive pulmonary disease is admitted to the hospital with painless jaundice. CT scan reveals the presence of multiple lesions in the liver, suggestive of metastases, and a nearly obstructing upper rectal mass. Colonoscopy demonstrates a large, ulcerated tumor in the proximal rectum and a residual lumen of less than 1 cm in diameter. While in the hospital, the patient develops a large bowel obstruction. What is the best treatment modality for this patient? |
| A. | Immediate radiation therapy of the rectal mass |
| B. | Placement of a colonic decompression tube |
| C. | Emergency surgery with resection of the mass |
| D. | Emergency surgery with creation of a diverting colostomy |
| E. | Placement of a rectal self-expanding metal stent |
| Answer» E. Placement of a rectal self-expanding metal stent | |
| 267. |
A 57-year-old man is found to have a rectal mass 3 cm from the anal verge on digital rectal examination. Subsequent colonoscopy and biopsy confirm rectal adenocarcinoma. EUS examination demonstrates penetration of the tumor into, but not through, the muscularis propria, but shows significant perirectal lymph nodes. CT scan of chest/abdomen/pelvis demonstrates no metastases. The patient is staged as T2N1M0. What procedure should be attempted to remove the primary lesion in this patient? |
| A. | Endoscopic mucosal resection (EMR) to remove the lesion |
| B. | Endoscopic argon plasma coagulation (APC) therapy to cauterize and ablate the lesion |
| C. | Surgical transanal excision of the lesion |
| D. | Neo-adjuvant chemoradiation followed by transanal excision |
| E. | Neo-adjuvant chemoradiation followed by abdominoperineal resection (APR) |
| Answer» E. Neo-adjuvant chemoradiation followed by abdominoperineal resection (APR) | |
| 268. |
A 70-year-old man is found to have distal rectal cancer during a screening colonoscopy. The patient undergoes preoperative staging and is found to have a 1.5-cm rectal mass that does not invade the muscularis propria of the rectal wall. There is no regional lymphadenopathy and no evidence of distant metastases. The patient is staged at T1N0M0. The patient is advised to undergo APR but refuses because it will lead to anal sphincter loss and permanent colostomy. Which of the following represents a viable alternate therapeutic option for this patient? |
| A. | Chemotherapy alone |
| B. | Radiation therapy alone |
| C. | Chemoradiation therapy |
| D. | Full-thickness surgical removal of tumor (transanal excision) |
| E. | Endoscopic ablation of the tumor with Argon Plasma Coagulator (APC). |
| Answer» D. Full-thickness surgical removal of tumor (transanal excision) | |
| 269. |
Which of the following may be appropriate initial therapy for a 4 cm cancer of the anal canal? |
| A. | Local excision |
| B. | Abdominoperineal resection |
| C. | Combined chemotherapy and radiotherapy |
| D. | Laser therapy |
| E. | Cryotherapy |
| Answer» C. Combined chemotherapy and radiotherapy | |
| 270. |
Which of the following processes is most likely to be associated with apoptosis? |
| A. | Nucleosomal DNA laddering |
| B. | Loss of plasma membrane integrity |
| C. | Swelling of the nucleus |
| D. | Endoreduplication |
| Answer» A. Nucleosomal DNA laddering | |
| 271. |
The purpose of a phase II clinical trial is to: |
| A. | estimate the toxicity of treatment to be tested. |
| B. | estimate the efficacy of treatment to be tested. |
| C. | estimate the preclinical toxicity of an experimental agent. |
| D. | determine a safe starting dose of an experimental agent. |
| Answer» B. estimate the efficacy of treatment to be tested. | |
| 272. |
Which of the following chemotherapy agents is most effective against soft tissue sarcoma? |
| A. | Thiotepa |
| B. | Cyclophosphamide |
| C. | Dactinomycin |
| D. | Doxorubicin |
| Answer» D. Doxorubicin | |
| 273. |
What number of axillary lymph nodes removed for sampling during a level I/ II node dissection for breast cancer most likely would require postoperative radiation therapy to the axilla? |
| A. | 02 |
| B. | 06 |
| C. | 08 |
| D. | 10 |
| Answer» A. 02 | |
| 274. |
Which of the following types of cancer was associated with a statistically significant improvement in survival for patients who had one to three solitary brain metastases and received whole brain radiation therapy with the addition of stereotactic radiosurgery, according to results of the RTOG 9508 phase III trial? |
| A. | Breast cancer |
| B. | Renal cell cancer |
| C. | Non-small cell lung cancer |
| D. | Melanoma |
| Answer» C. Non-small cell lung cancer | |
| 275. |
In RTOG 8501, what was the 5-year overall survival rate for patients who had esophageal cancer and received radiation therapy alone? |
| A. | 00% |
| B. | 10% |
| C. | 25% |
| D. | 35% |
| Answer» A. 00% | |
| 276. |
Which of the following tumor stages is correctly matched to the appropriate prostate cancer involvement or invasion? |
| A. | Stage T2b is associated with tumor involvement of more than one half of one lobe but not both lobes of the prostate. |
| B. | Stage T2c is associated with nonpalpable tumor involvement of both lobes of the prostate via needle biopsy. |
| C. | Stage T3a is associated with tumor invasion of the prostate apex. |
| D. | Stage T4 is associated with tumor invasion of the seminal vesicles. |
| Answer» A. Stage T2b is associated with tumor involvement of more than one half of one lobe but not both lobes of the prostate. | |
| 277. |
According to GOG 122 (Randall), the survival rate of patients who have surgical stage III-IV endometrial cancer and receive adjuvant abdominopelvic irradiation compared to adjuvant chemotherapy is: |
| A. | worse. |
| B. | similar. |
| C. | improved. |
| D. | not able to be analyzed. |
| Answer» A. worse. | |
| 278. |
A well-lateralized, stage T3N0 squamous cell carcinoma of the nasopharynx has at least a 15% risk of metastasis to the: |
| A. | ipsilateral parotid lymph nodes. |
| B. | ipsilateral submandibular lymph nodes. |
| C. | posterior triangle lymph nodes bilaterally. |
| D. | occipital lymph nodes bilaterally. |
| Answer» C. posterior triangle lymph nodes bilaterally. | |
| 279. |
What is the second leading cause of lung cancer? |
| A. | Exposure to arsenic |
| B. | Exposure to asbestos |
| C. | Exposure to benzene |
| D. | Exposure to radon |
| Answer» D. Exposure to radon | |
| 280. |
Which of the following chromosomal translocations is most commonly associated with Burkitt lymphoma? |
| A. | t(8;14) |
| B. | t(9;22) |
| C. | t(11;14) |
| D. | t(14;18) |
| Answer» A. t(8;14) | |
| 281. |
What is the most common secondary malignant neoplasm inside the radiation field for patients with retinoblastoma? |
| A. | Squamous cell carcinoma |
| B. | Non-Hodgkin lymphoma |
| C. | Fibrosarcoma |
| D. | Osteosarcoma |
| Answer» D. Osteosarcoma | |
| 282. |
Three different lung cancer radiation treatments are being assessed for maximum- tolerated dose. This study is an example of what type of clinical trial? |
| A. | Phase I |
| B. | Phase II |
| C. | Phase III |
| D. | Pilot |
| Answer» A. Phase I | |
| 283. |
Which of the following factors is the most important predictor of disease-free survival and overall survival in patients with breast cancer? |
| A. | Tumor size |
| B. | Mitotic index |
| C. | Axillary lymph node status |
| D. | Histopathologic tumor grade |
| Answer» C. Axillary lymph node status | |
| 284. |
Which of the following diagnostic tests is most useful for determining the tumor stage of esophageal cancer? |
| A. | Esophagogastroduodenoscopy |
| B. | Endoscopic ultrasound |
| C. | PET scan |
| D. | CT scan |
| Answer» B. Endoscopic ultrasound | |
| 285. |
Which of the following studies compared surgery alone versus surgery plus external-beam pelvic irradiation in patients with early-stage endometrial cancer and required all patients to undergo surgical staging with pelvic lymphadenectomy? |
| A. | GOG 99 (Keys) |
| B. | GOG 33 (Morrow) |
| C. | PORTEC (Creutzberg) |
| D. | Norwegian (Aalders) |
| Answer» A. GOG 99 (Keys) | |
| 286. |
Which of the following findings is most likely to be caused by loss of function of right cranial nerve XII? |
| A. | Deviation of the tongue to the left side with protrusion |
| B. | Deviation of the tongue to the right side with protrusion |
| C. | Loss of sweet taste on the right side of the tongue |
| D. | Loss of salty taste on the right side of the tongue |
| Answer» B. Deviation of the tongue to the right side with protrusion | |
| 287. |
Which of the following statements about video-assisted thoracic surgery for patients with lung cancer is FALSE? |
| A. | The postoperative period is shorter. |
| B. | It decreases the risk of intraoperative bleeding. |
| C. | It is a viable alternative to thoracotomy in patients who are frail. |
| D. | Locoregional recurrence is increased. |
| Answer» D. Locoregional recurrence is increased. | |
| 288. |
According to GOG 99 (Keys), which of the following sites is most likely to be associated with cancer recurrence in a patient who has early-stage endometrial cancer and undergoes TAH-BSO without adjuvant irradiation? |
| A. | Liver |
| B. | Vaginal vault |
| C. | Pelvic lymph nodes |
| D. | Paraaortic lymph nodes |
| Answer» B. Vaginal vault | |
| 289. |
Which of the following laboratory tests is most appropriate for determining if a patient with acromegaly has responded favorably to radiation therapy? |
| A. | Serum glucose level |
| B. | Growth hormone (GH) |
| C. | Thyroid stimulating hormone (TSH) |
| D. | Insulin-like growth factor-1 (IGF-1) |
| Answer» D. Insulin-like growth factor-1 (IGF-1) | |
| 290. |
Which of the following soft tissue sarcomas is most likely to be found in a patient with neurofibromatosis, type 1? |
| A. | Liposarcoma |
| B. | Fibrosarcoma |
| C. | Leiomyosarcoma |
| D. | Malignant peripheral nerve sheath tumor |
| Answer» D. Malignant peripheral nerve sheath tumor | |
| 291. |
Which of the following survival times is most likely to be associated with a patient who has a class II brain metastasis, based on the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA)? |
| A. | 10.2 months |
| B. | 07.1 months |
| C. | 04.2 months |
| D. | 02.3 months |
| Answer» C. 04.2 months | |
| 292. |
Radiation-induced cell death in carcinomas typically occurs immediately after attempting to traverse which phase of the cell cycle? |
| A. | G0 |
| B. | G1 |
| C. | G2 |
| D. | M |
| Answer» D. M | |
| 293. |
Which of the following antigens is a T-cell marker? |
| A. | CD7 |
| B. | CD20 |
| C. | CD30 |
| D. | CD40 |
| Answer» A. CD7 | |
| 294. |
Which of the following statements about adenocarcinoma of the lung is true? |
| A. | It is the most common histologic subtype. |
| B. | It is treated differently than squamous cell carcinoma. |
| C. | It is less likely to metastasize to the brain than other histologies. |
| D. | It is rarely associated with TTF-1. |
| Answer» A. It is the most common histologic subtype. | |
| 295. |
A 9-month-old infant has a mass in the left flank, periorbital ecchymosis, and bone metastasis to the right femur. Biopsy results are consistent with neuroblastoma. What cancer stage would be most appropriate for this patient's condition? |
| A. | Stage 2 |
| B. | Stage 3 |
| C. | Stage 4 |
| D. | Stage 4S |
| Answer» C. Stage 4 | |
| 296. |
Hypoxia adversely affects the treatment and management of cancers because it: |
| A. | increases blood flow to the tumor. |
| B. | impedes adequate blood flow to the tumor. |
| C. | activates molecular pathways contributing to resistance. |
| D. | causes dyspnea and tachypnea in the patient. |
| Answer» C. activates molecular pathways contributing to resistance. | |
| 297. |
What is the best method for minimizing bias in a national trial comparing two arms therapy regimens? |
| A. | Randomization |
| B. | Patient stratification |
| C. | Univariate analysis of prognostic factors |
| D. | Multivariate analysis of prognostic factors |
| Answer» A. Randomization | |
| 298. |
Which of the following primary bone tumors is most common? |
| A. | Ewing sarcoma |
| B. | Malignant giant cell tumor |
| C. | Chondrosarcoma |
| D. | Osteosarcoma |
| Answer» D. Osteosarcoma | |
| 299. |
Which of the following complications is NOT associated with a radical prostatectomy? |
| A. | Proctitis |
| B. | Erectile dysfunction |
| C. | Urinary incontinence |
| D. | Anastomotic stricture |
| Answer» A. Proctitis | |
| 300. |
Which of the following FIGO stages is associated with a patient who has endometrial cancer with extension to the cervical stroma? |
| A. | IC |
| B. | IIA |
| C. | IIB |
| D. | IIIA |
| Answer» C. IIB | |
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