Radiotherapy Quiz

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Quiz on Radiotherapy

1. Resistance of tumors to multiple chemotherapeutic agents is often due to the MDR (Multiple Drug Resistance) gene. This gene encodes a protein that acts by which of the following mechanisms ?
(1) As a Trans membrane efflux pump for chemotherapeutic agents
(2) As a DNA repair molecule
(3) As an isoform of superoxide dismutase
(4) As a membrane stabilizer

2. Which of the following systemic therapy agents can be used in the treatment of advanced or unresectable desmoid tumors ?
(1) Dasatinib
(2) Pazopanib
(3) Tamoxifen
(4) Acetaminophen

3. Which is not a common side-effect of crizotinib ?
(1) Vision disturbance
(2) Diarrhoea
(3) Oedema
(4) Thrombocytopenia

4. Which of the following are good prognostic factors in breast cancer ?
(1) Oestrogen receptor positivity
(2) Grade III tumour
(3) HER 2 receptor overexpression
(4) Lymph node involvement

5. BCG for superficial bladder cancer can be potentiated for additional benefit if combined with which of the following :
(1) Mitomycin C
(2) Interferon
(3) Epitrubicin
(4) None of the above

6. What is the appropriate surveillance plane for a patient with stage I seminoma undergoing observation after an orchiectomy ?
(1) Abdominal and Pelvic CT at 6 and 12 months
(2) Chest, Abdominal and Pelvic CT at 6 and 12 months
(3) Abdominal and Pelvic CT at 3, 6 and 12 months
(4) Chest, Abdominal and Pelvic CT at 3, 6 and 12 months

7. Which is a tumor characteristic associated with BRCA 1+ breast cancer ?
(1) Lobular histology
(2) Triple negative receptor staining (ER-, PR-, HER-2/Neu-)
(3) Tubular component
(4) HER-2/Neu amplification

8. Which solid tumor histology has the highest rate of leptomeningeal spread ?
(1) Renal cell carcinoma
(2) Non-small cell lung cancer
(3) Ovarian cancer
(4) Melanoma

9. A patient undergoes an orchiectomy for a stage I pure seminoma and then elects to undergo treatment with chemotherapy. What is the recommended chemotherapy ?
(1) Single agent cisplatin
(2) Bleomycin, etoposide and cisplatin
(3) Rituximab, cyclophosphamide, doxorubicin and vincristine
(4) Single agent carboplatin

10. In NSABP B-27, a trial of neoadjuvant chemotherapy, the addition of docetaxel to doxorubicin/cyclophosphamide improved the rate of pathologic CR from 13.7% to which percent ?
(1) 14%
(2) 26%
(3) 40%
(4) 60%

11. What is the absolute four year OS benefit of docetaxel when added to long-course ADT + RT for patients with high-risk localized prostate cancer ?
(1) None
(2) 5%
(3) 10%
(4) 15%

12. 50-year-old man with T2N2M0O EBV + Nasopharynx carcinoma is treated with 70 Gy radiation with concurrent cisplatin and has complete resolution of disease. What is the MOST appropriate next step in management ?
(1) No further treatment; PET-CT in 12 weeks
(2) Consolidative biotherapy/ immunotherapy
(3) No further treatment; CT of the neck in 6 weeks
(4) Consolidative cisplatin-based systemic chemotherapy

13. What is the AJCC 8th edition staging for pf’l-4aN1 cMO bladder cancer ?
(1) UTA
(2) IIIB
(3) TVA
(4) IVB

14. What is the MOST common site of metastases from osteosarcoma?
(1) Liver
(2) Lung
(3) Lymph nodes
(4) Muscle

15. What is recommended after tumor reductive surgery for stage IIIAI1 endometrioid ovarian carcinoma, metastatic to a single paraaortic lymph node ?
(1) Observation
(2) Chemotherapy
(3) Pelvic RT and concurrent chemotherapy
(4) Extended field RT and concurrent chemotherapy

16. Sino-nasal undifferentiated carcinoma (SNUC) arises from which tissue ?
(1) Salivary glands
(2) Notocord remnant
(3) Olfactory epithelium
(4) Schneiderian mucosa

17. In the RTOG 91-11 randomized trial for locally advanced larynx cancer, what was the 10 year rate of larynx preservation with concurrent chemo RT ?
(1) 92%
(2) 82%
(3) 72%
(4) 62%

18. Which salivary tumor of the parotid gland is MOST likely to present with nodal metastases ?
(1) Pleomorphic adenoma
(2) Salivary ductal carcinoma
(3) Adenoid cystic carcinoma
(4) Low-grade mucoepidermoid carcinoma

19. Why are cancer stem cells important targets of anti-cancer treatment ?
(1) Support the development of secondary cancers
(2) Responsible for chemo radiation toxicities
(3) Able to repair normal tissue damage
(4) Resistance to radiation therapy

20. Which is a radio-immunotherapy agent used to treat NHL ?
(1) Brentuximab Vedotin
(2) Bendamustine
(3) Ibritumomab
(4) Nivolumab

21. Regarding the use of durvalumab after chemo-RT in the management of stage III NSCLC :
(1) PD-L1 staining >50% is needed.
(2) Improved OS and increased grade 3 pneumonitis is seen.
(3) Improved OS and PFS without increase in grade 3 pneumonitis is seen.
(4) Shorter time to death or distant metastases Is seen.

22. What is the recommended treatment for a 45-year-old patient with refractory Hodgkin lymphoma involving the mediastinum, who has a complete response by PET/CT scan to 2nd line chemotherapy ?
(1) Surgery alone
(2) Radiation alone
(3) High dose chemotherapy + allogeneic SCT
(4) High dose chemotherapy + autologous SCT

23. The likelihood of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) transforming to higher grade DLBCL is in the range of :
(1) 0-5%
(2) 10-15%
(3) 20-25%
(4) 30-35%

24. What is the risk of progression of solitary bone plasmacytoma to multiple myeloma in 10 years ?
(1) 10-25%
(2) 30-50%
(3) 65-85%
(4) >90%

25. Which is a KEY difference between breast cancers in women versus men ?
(1) Use of mammography as initial imaging test
(2) Use of sentinel node biopsy for axillary staging
(3) Use of the TMN staging system
(4) Use of single agent aromatase inhibitors in the adjuvant setting

26. What is the most appropriate chemotherapy for a patient who presents with distant metastases from newly diagnosed oropharyngeal SCC ?
(1) Nivolumab
(2) Pembrolizumab
(3) Paclitaxel/Cisplatin/SFU (TPF)
(4) Cisplatin/SFU/Cetuxitmab (CCF)

27. For patients with newly diagnosed primary CNS lymphoma, the recommended chemotherapy includes :
(1) CHOP
(2) Methotrexate
(3) BEACOPP
(4) ABVD

28. What is the most effective adjuvant chemotherapy regimen for resectable pancreatic cancer ?
(1) FOLFOX
(2) Gemcitabine/capecitabine
(3) Gemcitabine/abraxane
(4) FOLFIRINOX

29. What is the principle mechanism of action of gemcitabine ?
(1) Induction of DNA dsbs
(2) Induction of interstrand crosslinks
(3) Inhibition of DNA synthesis and repair
(4) Inhibition of mRNA polyadenylation

30. What is a contraindication to the use of bevacizumab in-patients with metastatic non-small cell lung cancer ?
(1) Previous history of haemoptysis
(2) Brain metastasis
(3) On Anticoagulation pharmacotherapy
(4) All of the above

31. The lowest risk for Cardiac toxicity is to be expected with which Anthracycline and its cumulative dose ?
(1) Doxorubicin > 500 m2
(2) Epirubicin >720 m2
(3) Idaurabicin >90m2
(4) Liposomal doxorubicin >600m2

32. 75 years old man receives monotherapy with oral capecitabine for colon cancer metastatic to liver. Twelve days after treatment initiation he develops grade 4 febrile neutropenia and grade 3 diarrhoea and mucositis. Which of the following drug- metabolizing enzymes is most likely to be deficient in this patients ?
(1) CYP2D6
(2) Dihydropyrimidine dehydrogenase (DPD)
(3) O6-methylguanine methyltransferase (MGMT)
(4) Thiopurine 5-methyltransferase (TPMT)

33. Which is the standard of care in first line treatment of metastatic HER2 positive breast cancer for women in good clinical condition ?
(1) Trastuzumab + epirubicin + paclitaxel
(2) Trastuzumab + pertuzumab + docetaxel
(3) Trastuzumab + lapatinib + capecitabine
(4) Trastuzumab — emtansine (T- DMI)

34. A 65-years-old man undergoes surgical excision of right temporal anaplastic oligodendroglia. Post-operatively, in addition to radiation, which biomarker suggests increased benefit from chemotherapy ?
(1) 1Ip/19q chromosomal codeletion
(2) Methylation of MGMT promoter
(3) Mutation of IDH1 and IDH2
(4) PTEN loss

35. Five-year survival rates of patients with low-risk, non-metastatic gestational trophoblastic disease approaches
(1) 100%
(2) 75%
(3) 50%
(4) 25%

36. The most likely karyotype for patient with a partial mole would be
(1) 46, XX
(2) 46, XY
(3) Triploidy
(4) Aneuploidy

37. Which lymph nodes are considered a distant disease for breast cancer Staging ?
(1) Cervical nodes
(2) Supraclavicular nodes
(3) Intramammary nodes
(4) Rotter’s nodes

38. Which of the following processes characterizes the level of disease prevention known as tertiary prevention ?
(1) Prevention of disease before its biological onset
(2) Prevention of disease progression and additional disease complications after overt clinical disease occurs
(3) Prevention of clinical illness through the early and asymptomatic detection and remediation of certain disease conditions.
(4) Prevention of illness through appropriate individual and group behavior modification designed to minimize infection risk

39. Which one of the following formulae Is commonly used to calculate the BSA for adult patients receiving chemotherapy ?
(1) Calvert
(2) Cockroft
(3) Dubois
(4) Jelliffe

40. Stewart-Treves syndrome is known to occur in patients with which of the following ?
(1) Varicose Veins
(2) Post Mastectomy lymphedema
(3) Colon Cancer
(4) Pancreatic Cancer

41. A 75-years old patient comes in with jaundice and abdominal pain. The abdominal ultrasound finds a GB region mass. A magnetic resonance cholangiopancreatography (MRCP) is ordered. The clinician diagnoses it as likely a Klatskin tumor. Where are Klatskin tumors usually located ?
(1) The distal common bile duct
(2) The junction of the left and right hepatic ducts
(3) The cystic duct origin
(4) An intrahepatic location

42. A homosexual male is seen for a routine check-up. He denies any constitutional symptoms. He expresses concern that he has some fleshy nodules around the anus and wants to get rid to them. What is the most likely cause of his anal nodules ?
(1) HPV 12
(2) HPV 32
(3) HPV 6 and 11
(4) Herpes simplex 2

43. Which of the following statements regarding mucinous breast carcinomas is true ?
(1) They account for 18% of all breast cancers
(2) Lymph node involvement is seen in 80% of the cases
(3) They are characterized by a rapid growth pattern.
(4) They carry a more favorable prognosis than invasive ductal carcinoma.

44. After neoadjuvant therapy, the primary tumor has completely disappeared on the resection specimen, the correct classification is
(1) ypTx
(2) ycT0
(3) ypT0
(4) none of the above

45. The correct statement below is :
(1) HPV vaccination is highly effective against development of cervical dysplasia
(2) HPV vaccination is highly effective against development of anal and cervical dysplasia
(3) HPV vaccination is highly effective against development of cervical, anal and oral dysplasia
(4) All the above