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400+ Important Questions Repeated in MD Exams Solved MCQs

These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Uncategorized topics .

351.

Which stage is most appropriate for a patient who has testicular seminoma involving the spermatic cord with multiple 2- to 5-cm paraaortic lymph nodes?

A. Stage IB
B. Stage IIB
C. Stage IIC
D. Stage IIIA
Answer» B. Stage IIB
352.

Which of the following statements about malignant mesothelioma is true?

A. Chemoradiation therapy alone offers promising results.
B. Most patients die of metastatic disease and not of local recurrence.
C. Patients who have the epithelial subtype have a worse prognosis.
D. Mediastinal lymph node involvement affects the prognosis.
Answer» D. Mediastinal lymph node involvement affects the prognosis.
353.

Hodgkin lymphoma most commonly occurs during which decade of life?

A. Second
B. Third
C. Fourth
D. Fifth
Answer» B. Third
354.

BRCA2 is responsible for breast cancer and characterized by:

A. Chromosomal 17 is the location
B. It is less common than BRCA1 in risk of breast cancer
C. Its mutation can be present in sporadic breast cancer
D. It is not responsible for breast cancer in men.
E. It is one of oncogenes
Answer» C. Its mutation can be present in sporadic breast cancer
355.

Soft tissue sarcoma most commonly arises from what site?

A. Head and neck
B. Retroperitoneum
C. Lower extremity
D. Upper extremity
Answer» C. Lower extremity
356.

Which of the following adjuvant systemic therapies would be most appropriate to recommend for an otherwise healthy patient who has HER-2/neu-positive (FISH) ER/PR-negative breast cancer with positive axillary lymph nodes?

A. Four cycles of dose-dense doxorubicin and cyclophosphamide (AC) in conjunction with four cycles of paclitaxel.
B. Four cycles of AC, four cycles of paclitaxel with concurrent trastuzumab, and continuation of trastuzumab for 1 year.
C. Four cycles of paclitaxel, four cycles of AC with concurrent trastuzumab, and continuation of trastuzumab for 1 year.
D. Six cycles of docetaxel, doxorubicin, and cyclophosphamide.
Answer» B. Four cycles of AC, four cycles of paclitaxel with concurrent trastuzumab, and continuation of trastuzumab for 1 year.
357.

Which histology is most likely in men older than 60 years with testicular cancer?

A. Yolk sac tumor
B. Classical seminoma
C. Choriocarcinoma
D. Lymphoma
Answer» D. Lymphoma
358.

Which of the following factors is NOT typically associated with improved overall survival for patients who present with unknown primary tumors of the head and neck region?

A. Radiation doses of >50 Gy
B. Complete resection of the involved lymph nodes
C. Subsequent presentation of the primary tumor
D. Stage N1 versus stage N2 lymph node involvement
Answer» C. Subsequent presentation of the primary tumor
359.

Which of the following conditions should be treated like small cell lung cancer?

A. Combined small cell lung cancer and non-small cell lung cancer
B. Non-small cell lung cancer with neuroendocrine features
C. Large cell neuroendocrine tumors
D. Atypical carcinoid tumors
Answer» A. Combined small cell lung cancer and non-small cell lung cancer
360.

The basal molecular phenotype of breast cancer most commonly is:

A. ER-positive, PR-positive, HER-2/neu-negative.
B. ER-positive, PR-positive, HER-2/neu-positive.
C. ER-negative, PR-negative, HER-2/neu-negative.
D. ER-negative, PR-negative, HER-2/neu-positive.
Answer» C. ER-negative, PR-negative, HER-2/neu-negative.
361.

A 22-year-old man with Hodgkin disease has adenopathy of the right cervical and right supraclavicular regions and weight loss of >10% of his baseline body weight. Which of the following cancer stages is most likely to be associated with this patient's condition?

A. Stage IA
B. Stage IB
C. Stage IIA
D. Stage IIB
Answer» B. Stage IB
362.

A 72-year-old man was found to have an anterior rectal cancer at 2 cm from the anal verge. A CT scan of chest, abdomen and pelvis showed no evidence of metastatic disease. An MR scan of pelvis showed an anterior tumour abutting the prostate gland, radiologically staged as a T3, N1, M0 cancer. What is the most appropriate next step in management?

A. abdominoperineal resection
B. chemotherapy
C. long-course chemoradiation
D. short-course radiotherapy
E. total mesorectal excision
Answer» C. long-course chemoradiation
363.

Which of the following statements about pancreatic cancer is FALSE?

A. Approximately 10% to 20% of pancreatic cancers are associated with hereditary factors.
B. New-onset diabetes mellitus may be the first clinical feature in 10% of patients.
C. Tumors of the pancreatic head arise to the right of the superior mesenteric vein- portal vein confluence and include tumors of uncinate origin.
D. The most common physical finding at initial presentation is Courvoisier's sign.
Answer» D. The most common physical finding at initial presentation is Courvoisier's sign.
364.

Which of the following statements about unknown primary head and neck tumors is true?

A. PET imaging is able to detect the primary tumor in 60% of cases.
B. Random biopsies will reveal the primary lesion in 40% of cases.
C. Chest imaging will reveal a primary lung tumor in 20% of cases.
D. Tonsillectomy may reveal the occult primary tumor in 20% of cases.
Answer» D. Tonsillectomy may reveal the occult primary tumor in 20% of cases.
365.

Taxane derivatives elicit cytotoxic effects mainly by which of the following mechanisms?

A. Stabilization of microtubules and prevention of their disassembly
B. Intercalation into DNA and inhibition of DNA replication
C. Inhibition of topoisomerases
D. Inhibition of DNA repair
Answer» A. Stabilization of microtubules and prevention of their disassembly
366.

Which of the following statements about patients who are diagnosed with breast cancer and have supraclavicular lymph node involvement is true?

A. The diagnosis should be classified as stage M1 breast cancer.
B. Approximately 30% of patients will have clinically detectable internal mammary lymph nodes on CT scan of the chest.
C. Over 20% of patients will have lymphedema and brachial plexopathy.
D. Over 20% of patients will survive 10 years with aggressive trimodality therapy.
Answer» D. Over 20% of patients will survive 10 years with aggressive trimodality therapy.
367.

Bladder cancer associated with hydronephrosis and invasion limited to the outer half of the bladder muscle layer corresponds to which T stage?

A. T2
B. T3
C. T4a
D. T4b
Answer» A. T2
368.

A 42-year-old man presented with a 1-month history of altered personality and increased seizure frequency. An MR scan of brain demonstrated an enhancing lesion in the right frontal lobe. Histology revealed a grade 3 oligodendroglioma, with loss of heterozygosity of 1p/19q. What is the most appropriate treatment?

A. chemoradiation with temozolomide
B. cranial irradiation
C. craniospinal irradiation
D. procarbazine, vincristine and lomustine (PCV)
E. temozolomide
Answer» B. cranial irradiation
369.

Which of the following Hodgkin lymphoma subtypes is most closely associated with the development of non-Hodgkin lymphoma?

A. Nodular sclerosis
B. Lymphocyte depleted
C. Lymphocyte predominant
D. Lymphocyte rich
Answer» C. Lymphocyte predominant
370.

Which of the following primary sites is most commonly involved in patients who are diagnosed with Ewing sarcoma?

A. Pelvis
B. Humerus
C. Fibula
D. Tibia
Answer» A. Pelvis
371.

During gene therapy, genes are most commonly transferred into cells by:

A. viral vectors.
B. bacterial plasmids.
C. synthetic oligonucleotide primers.
D. small-interfering RNA (siRNA).
Answer» A. viral vectors.
372.

Which of the following statements about desmoid tumors is true?

A. They commonly metastasize to the lungs.
B. They commonly metastasize to the bones.
C. Surgical excision is the most common treatment of choice.
D. Definitive radiation therapy can achieve local control in 25% of cases.
Answer» C. Surgical excision is the most common treatment of choice.
373.

Multidrug resistance in tumor cells is often attributed to extrusion of drugs mediated by overexpression of which of the following proteins?

A. P-glycoprotein
B. Bcl-2
C. BAX
D. TP53
Answer» A. P-glycoprotein
374.

Which of the following lymph node chains is most commonly involved in patients who present with Hodgkin lymphoma?

A. Inguinal
B. Paraaortic
C. Mediastinal
D. Cervical
Answer» D. Cervical
375.

Which of the following cell cycle phases is most radiosensitive?

A. M
B. S
C. G1
D. G0
Answer» A. M
376.

Based on the results of SWOG 8797 (Peters), which of the following pathologic findings after a radical hysterectomy and pelvic lymph node dissection is an indication for adjuvant chemotherapy with radiation therapy for patients with high-risk cancers of the cervix?

A. Tumor size >5 cm
B. Lymphovascular space invasion
C. Depth of invasion into the deep third of the cervical stroma
D. Microscopic involvement of the parametrium
Answer» D. Microscopic involvement of the parametrium
377.

A 29-year-old woman had a 2.5-mm Breslow thickness melanoma removed from her right shin. She was referred for wide local excision of the scar and consideration of sentinel node biopsy. In what proportion of patients with a negative sentinel node biopsy does nodal recurrence subsequently develop in the same lymph node basin?

A. <1%
B. 1–4%
C. 5–9%
D. 10–14%
E. 15–25%
Answer» B. 1–4%
378.

According to the VA Lung Cancer Group's classification, which of the following sites of lymphadenopathy is associated with extensive-stage small cell lung cancer?

A. Ipsilateral hilar lymph nodes
B. Ipsilateral supraclavicular lymph nodes
C. Contralateral supraclavicular lymph nodes
D. Contralateral mediastinal lymph nodes
Answer» C. Contralateral supraclavicular lymph nodes
379.

Which of the following factors increases a patient's risk for the development of leukemia?

A. Occupational exposure to benzene
B. Occupational exposure to aluminum
C. Use of mitomycin C
D. Exposure to HPV
Answer» A. Occupational exposure to benzene
380.

Which of the following genetic abnormalities is most commonly associated with Ewing sarcoma?

A. t(8;14)
B. t(11;22)
C. 1p/19q gene deletion
D. Loss of heterozygosity (LOH) of the retinoblastoma gene
Answer» B. t(11;22)
381.

Which of the following statements about the diagnosis of inflammatory breast cancer is true?

A. There may not be a discrete palpable mass at presentation.
B. At presentation, a patient may report having a longstanding breast mass that developed skin changes over time.
C. A biopsy is not required, since the diagnosis is clinically established.
D. Dermal lymph node involvement must be demonstrated.
Answer» A. There may not be a discrete palpable mass at presentation.
382.

Which of the following cell cycle phase transitions is most affected when the TP53 gene is lost or mutated?

A. G → G01
B. G → S1
C. G2 → M
D. S → G2
Answer» B. G → S1
383.

Which of the following molecular mechanisms is specifically implicated in the oncogenesis of cervical cancer associated with prior HPV infection?

A. The E7 protein expression inactivates p53.
B. The E7 protein expression inhibits Rb function.
C. The E6 protein expression suppresses G -M cell cycle arrest. 2
D. The E6 protein expression activates c-myc.
Answer» B. The E7 protein expression inhibits Rb function.
384.

A 30-year-old man presented with a swelling in the testis and an ultrasound scan confirmed the presence of a malignant mass. Following orchidectomy, he was found to have a 40-mm seminomatous germ cell tumour without non-seminomatous components. There was evidence of vascular invasion within the testis.Investigations: serum lactate dehydrogenase (LDH) 1250 U/L (10–250) serum α-fetoprotein normal serum β-human chorionic gonadotrophin (HCG) 700 U/L (<5) A CT scan of body showed retroperitoneal lymphadenopathy of up to 7 cm in size, a 3- cm mediastinal lymph node and over 30 pulmonary metastases. There were no signs of liver, brain or bone metastases. What is the most appropriate International Germ Cell Cancer Collaborative Group classification?

A. good prognosis because of the absence of liver, bone and brain metastases
B. good prognosis because of the raised HCG and LDH
C. intermediate prognosis because of the presence of lung metastases
D. intermediate prognosis because of the raised serum HCG and LDH
E. poor prognosis because of the raised serum HCG and LDH
Answer» A. good prognosis because of the absence of liver, bone and brain metastases
385.

What is the most common site of metastatic disease in patients with Ewing sarcoma?

A. Lung
B. Bone
C. Bone marrow
D. Lymph nodes
Answer» A. Lung
386.

A 50-year-old woman with early breast cancer presented with fatigue to the accident and emergency department on day 7 of her first adjuvant chemotherapy cycle. On examination, her temperature was 38.5°C, her pulse was 110 beats per minute and her blood pressure was 110/70 mmHg. A full blood count was requested. What is the most appropriate next step?

A. await full blood count result
B. intravenous broad-spectrum antibiotics
C. intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factor (G-CSF)
D. oral broad-spectrum antibiotics
E. oral broad-spectrum antibiotics and G-CSF
Answer» B. intravenous broad-spectrum antibiotics
387.

Which of the following statements about metastasis of breast cancer to the bone is true?

A. Metastasis to the epidural spine is most commonly associated with worsening back pain in the supine position or with the Valsalva maneuver.
B. Compression of the epidural spinal cord associated with breast cancer most commonly has a single site of vertebral metastasis.
C. Radicular pain in the thoracic spine is typically unilateral.
D. Pain from T12, L1 vertebral lesions is not associated with a referred pain pattern to the bilateral iliac crests or to the bilateral sacroiliac joints.
Answer» A. Metastasis to the epidural spine is most commonly associated with worsening back pain in the supine position or with the Valsalva maneuver.
388.

A 62-year-old man with limited-stage small cell lung cancer and proximal muscular weakness is most likely to have which of the following conditions?

A. SIADH
B. Myasthenia gravis
C. Cerebellar degeneration
D. Eaton-Lambert syndrome
Answer» D. Eaton-Lambert syndrome
389.

A 3-year-old girl has Wilms tumor with a favorable histology and a positive surgical margin. CT scan of the chest does not reveal any pulmonary nodules. What cancer stage is most appropriate for the patient's condition?

A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Answer» C. Stage III
390.

Which of the following types of cancer is most frequently associated with isolated hepatic metastases at presentation?

A. Colorectal
B. Esophageal
C. Gastric
D. Lung
Answer» A. Colorectal
391.

Which of the following statements about the treatment of bone metastases secondary to breast cancer is true?

A. Radiation therapy will achieve partial or complete pain relief within 4 weeks.
B. Single-fraction irradiation provides equivalent results to protracted radiation treatment schedules for pain control durability and reduced risk of subsequent fracture.
C. Metastatic sites with extraosseous bone involvement should be treated with 153Sm only, because localized external-beam irradiation is not beneficial.
D. An 8-Gy dose of hemibody irradiation should be administered in a single fraction to the upper, middle, or lower hemibody regions for treatment of painful bony metastases.
Answer» A. Radiation therapy will achieve partial or complete pain relief within 4 weeks.
392.

A 35-year-old man sought advice about the increased risk of cardiac complications following chemotherapy. Eight years previously, he had been successfully treated for Hodgkin‟s disease with six cycles of doxorubicin, bleomycin, vinblastine and dacarbazine, and mediastinal radiotherapy. For how many years from the end of treatment will this increased risk persist?

A. 1–5
B. 6–10
C. 11–15
D. 16–20
E. >20
Answer» E. >20
393.

A 58-year-old man presented with haemoptysis, weight loss and worsening breathlessness. He was a lifelong heavy smoker. His chest X-ray was abnormal. A CT scan of chest and abdomen demonstrated a large mass in the right lower lobe invading into the mediastinum and pericardium, extensive mediastinal lymphadenopathy, and bone metastasis (T4, N3, M1b). Bronchoscopy and biopsy confirmed a squamous cell carcinoma. Mutation analysis revealed that EGFR and K-ras genes were both wild type. What is the most appropriate first-line therapy?

A. docetaxel
B. erlotinib
C. gefitinib
D. gemcitabine and cisplatin
E. pemetrexed and cisplatin
Answer» D. gemcitabine and cisplatin
394.

Which of the following diagnostic tests is NOT included in the staging of small cell lung cancer?

A. CT scan of the chest and upper abdomen
B. Brain imaging
C. Bone scan
D. PET scan
Answer» D. PET scan
395.

Which of the following types of cancer is most commonly associated with myasthenia gravis?

A. Small cell lung cancer
B. Non-small cell lung cancer
C. Mesothelioma
D. Thymoma
Answer» D. Thymoma
396.

A 55-year-old man underwent resection of a T2 clear cell renal carcinoma. What is the most likely pathogenesis?

A. activating mutations of the VHL gene
B. MET oncogene activity
C. mutation of p53
D. up-regulated expression of HIF-controlled genes
E. von Hippel–Lindau syndrome
Answer» D. up-regulated expression of HIF-controlled genes
397.

During evaluation of tumor biopsy specimens, which of the following markers can be used as a histochemical indicator of cell proliferation?

A. Ki-67
B. TP53
C. c-myc
D. Nuclear/cytoplasmic ratio
Answer» A. Ki-67
398.

Which of the following statements about the effectiveness of cancer is true? for treating thyroid

A. Medullary carcinoma is treated more effectively than Hürthle cell carcinoma.
B. The follicular variant of papillary carcinoma is treated more effectively than Hürthle cell carcinoma.
C. Tall cell carcinoma is treated more effectively than the follicular variant of papillary carcinoma.
D. Insular carcinoma is treated more effectively than the follicular variant of papillary carcinoma.
Answer» B. The follicular variant of papillary carcinoma is treated more effectively than Hürthle cell carcinoma.
399.

Which of the following processes is NOT commonly involved in the development of bone metastases?

A. Avascular necrosis
B. Activation of osteoclasts
C. Cell adhesion molecules
D. Chemotaxis of metastatic cancer cells
Answer» A. Avascular necrosis
400.

SBLA syndrome is another name of

A. Lynch I
B. Lynch II
C. Li- Fraumeni syndrome
D. Cowden's syndrome
E. Peutz-Jegher‟s Syndrome
Answer» C. Li- Fraumeni syndrome

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