Surgical Oncology Practice Set

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Practice Set of Surgical Oncology

1. A 57 year old man presents with severe back pain and bilateral leg weakness for 3 days. MRI of the spine reveals metastasis at T10 vertebral body with significant cord compression. Which of the following is the most likely primary cancer in this patient ?
(1) Lung cancer and breast cancer
(2) Lung cancer and lymphoma
(3) Colon cancer and lymphoma
(4) Colon cancer and prostate cancer

2. What is the most appropriate initial therapy for the patient with malignant spinal cord compression ?
(1) Chemotherapy
(2) Radiation therapy
(3) Dexamethasone
(4) Strontium 89

3. Which of the following tumors exhibit contrast enhancement on magnetic resonance imaging (MRI) scan ?
(1) Pilocytic astrocytoma
(2) Grade 2 oligodendroglioma
(3) Grade 2 astrocytoma
(4) Cranitopharyngioma

4. Most important prognostic factor in both high and low grade adult glioma is
(1) Age of the patient
(2) Functional status of the patient
(3) Extent of surgical resection
(4) None of the above

5. Risk of Malignancy (%) associated with Bethesda Category IV
(1) 0-3%
(2) 10-30%
(3) 25-40%
(4) 50-75%

6. Highest risk RET mutation associated with Hereditary Medullary Thyroid cancer Is
(1) RET -Codon C620F
(2) RET – Codon A883F
(3) RET-Codon M918T
(4) RET – Codon C634F

7. Earliest Manifestation of MEN 2A is usually
(1) Medullary Thyroid Cancer
(2) Pheochromocytoma
(3) Primary Hyperparathyroidism
(4) Lichen Planus Amyloidosis

8. Biochemical diagnosis of insulinoma include all except
(1) Fasting plasma glucose <45-50 mg/dl
(2) Elevated insulin level >50 uU/mL by IRMA
(3) Negative screening levels for oral hypoglycemic agents sulphonylureas or meglitinides
(4) Low Beta -Hydoxybutyrate level <2.7mmol/L

9. Adrenal tumors most commonly metastasise to :
(1) Lung
(2) Bone
(3) Brain
(4) Contralateral adrenal

10. Which of the following is true regarding a clinical trial ?
(1) The sample size of a clinical trial is fixed and determined before the trials begin
(2) Clinical trials are proportionately planned experiments involving only animals
(3) Using tumor registry data to compare the survival rate of prostate cancer patients treated with surgery to those of patients who received radiotherapy is an example of clinical trial
(4) Clinical trials test a clearly stated hypothesis using a predefined analysis plan

11. Which statement is true regarding PHASE II trials ?
(1) PHASE II trials performed in patients with a wide variety of tumor types
(2) Patient eligibility should not be restricted by biomarker testing
(3) Two stage designs allow for early elimination of ineffective drugs
(4) PHASE II cannot help develop predictive biomarkers for the study drug

12. In cancer cachexia, all are effects of tumor necrosis factor except :
(1) Lipolysis
(2) peripheral proteolysis
(3) muscle degradation
(4) increased glucose turn over

13. All are neuroablative procedures at nerve root site except :
(1) Rhizotomy
(2) dorsal root entry zone lesion
(3) myelotomy
(4) cordotomy

14. Which of the following is not true about operating room integration system ?
(1) OR Integration also involves suspending monitors and imaging modalities within the OR, removing trip-hazards caused by cabling and allowing for easy access and visibility to surgical video.
(2) Designed to simplify and streamline the access to data & video, and controls for all of these devices at a central command station, allowing the surgical staff to perform many of their tasks efficiently without needing to move around the OR.
(3) Integration provides increased mobility of the patient in and out of the OR and increases patient safety.
(4) OR Integration Systems consolidate and organize all patient data for the surgical staff during a procedure, minimizing congestion and streamlining information across multiple platforms

15. Population based cancer registry collects data from the following :
(1) Door to door collection of data & screening programs
(2) Major hospitals & laboratories in the region.
(3) Private and General Practitioners.
(4) All of the above

16. Case Control Study mean which of the following ?
(1) Comparison of cases of two types of similar diseases in a limited time.
(2) Prospective study of Normal (control) and patients (case) comparing outcomes.
(3) Retrospective study of two groups of people with and without disease to study risk factors.
(4) Interventional type of comparative study to find risk factors for causation of disease

17. Which of the following is the correct statement regarding Medical ethics ?
(1) Time and culture dependent obligations of the doctors and the hospital to the patient.
(2) Set rules applicable at all times between doctors and patients regarding treatment, taking of proper consent and conduct of clinical trials.
(3) Ethics deals with the right choices of conduct considering the patient interest in all circumstances.
(4) Ethics are global rules applicable uniformly to all groups of health professionals and health-care institutions.

18. Which of the following is not true regarding oncogenic viruses ?
(1) Human papilloma virus an etiological agent for carcinoma of cervix, vulva, vagma, bladder and base of tongue.
(2) Hepatitis C virus is enveloped single stranded DNA virus belonging to Hepadnaviridae family causing HCC.
(3) BK polyoma viruses non-enveloped circular double-stranded DNA virus resides in bladder epithelium.
(4) Epstein-Barr virus is a causative factor for Burkitt’s lymphoma.

19. Which of the following pathogen is associated with colorectal cancer ?
(1) Helicobacter pylori
(2) Salmonella typhi
(3) Human herpes virus
(4) Streptococcus bovis

20. Which wavelength of ultra-violet rays is more damaging to DNA ?
(1) UV-A
(2) UV-B
(3) UV-C
(4) All have equal damaging effect.

21. According to GLOBOCAN 20/68, most common site of new cancer in females in India is :
(1) Carcinoma lip and oral cavity
(2) Carcinoma cervix
(3) Carcinoma breast
(4) Carcinoma lung

22. Cellular loss of which molecule leads to decreased cellular attachment and enhanced tumor invasion / mobility ?
(1) E-cadherin
(2) β-catenin
(3) α-tubulin
(4) ankyrin

23. Which of the following statement is correct about the association of primary sclerosing cholangitis-inflammatory bowel disease (PSC-IBD) and colorectal cancer ?
(1) PSC-IBD confers nearly a 5 fold increased risk of colorectal cancer compared to IBD alone.
(2) PSC alone is also a well established risk factor for colorectal cancer.
(3) Urso-deoxycholic acid has no chemopreventive role in colorectal cancer in PSC-IBD.
(4) All of the above.

24. Which of the following is incorrect statement ?
(1) Adenoma is precursor lesion in sporadic colorectal cancer.
(2) Early mutation in sporadic colorectal cancer is APC gene mutation whereas TP53 mutation is late event.
(3) Flat dysplasia is precursor lesion in colitis associated cancer in which TP53 mutation is early event.
(4) SMAD4 mutation is associated with conversion from early adenoma to intermediate adenoma in Vogelstein adenoma carcinoma sequence.

25. All of the following are tumor suppressor gene except
(1) PTEN
(2) STK 11
(3) SMAD4
(4) K-RAS

26. Which of the following statement is correct regarding endometrial cancer ?
(1) Type 2 endometrial cancer exhibit microsatellite instability more frequently than type I.
(2) Microsatellite stable/copy number low endometrial cancer exhibit high frequency of beta catenin (CTNNB1) mutation.
(3) Microsatellite stable/copy number high endometrial cancer have infrequent TP53 mutation.
(4) Type 2 endometrial cancer has favourable prognosis

27. All of the following are molecular subtype of gastric carcinoma except :
(1) Epstein-Barr virus positive
(2) Microsatellite instability
(3) Genomically instability
(4) Chromosomal instability

28. Most common mutation in hereditary ovarian cancer is
(1) BRCAI
(2) BRCA2
(3) TP53
(4) RADSIC

29. Which of the following will induce a quiescent state ?
(1) Telomere shortening
(2) Prolonged DMA damage
(3) High-density growth
(4) Oncogene activation

30. Interferon o is used in the treatment of
(1) Metastatic renal cell carcinoma
(2) AIDS related Kaposi sarcoma
(3) Chronic myeloid leukaemia
(4) All of the above

31. Which of the following result in inhibition of T-cell ?
(1) CTLA-4
(2) CD-28
(3) B7-1
(4) B7-2

32. Which of the following have antitumor effect ?
(1) Cytotoxic T lymphocyte
(2) Natural killer cells
(3) Macrophage
(4) All of the above

33. Which of the following types of immunity is most responsible for the host response to tumor development ?
(1) Humoral immunity
(2) B-cell-mediated immunity
(3) T-cell-mediated immunity
(4) Antibody-mediated immunity

34. What is the cost of one tobacco related cancer treatment in India ?
(1) 1,50,000
(2) 3,50,000
(3) 5,00,000
(4) None of the above

35. Most cost effective cervical cancer screening test is :
(1) Pap smear
(2) VIA test
(3) Colposcopy examination
(4) Cervical biopsy

36. All statements regarding HPV cervical cancer vaccine are true except
(1) Bivalent-HPV 16/18
(2) Quadrivalent HPV 6/12/16/18
(3) Recommended for ages 9 to 26
(4) Does not eliminate the need for the cervical cytology screening

37. In analyzing a randomized control trial of a screening test, which is the best indicator of effectiveness ?
(1) Absolute reduction in mortality
(2) Evidence of stage shift
(3) Increased 5 year survival
(4) Relative reduction in mortality

38. Inhibitory activity in cell cycle is by :
(1) E2F
(2) pl6/INK4A
(3) Cyclin dependent kinase 4
(4) Cyclin D1

39. Invasion and metastasis are prevented by :
(1) Angiogenesis
(2) Senescence
(3) evasion of apoptosis
(4) self sufficiency in growth signals

40. Interindividual pharmacokinetic / pharmacodynamic variability can be a result of which of the following principles ?
(1) Sex dependence
(2) Dose proportionality
(3) Feedback-controlled dosing
(4) Therapeutic drug monitoring

41. Which one is the receptor tyrosine kinase ?
(1) Platelet derived growth factor
(2) Insulin like growth factor
(3) cKIT
(4) all of the above

42. What is the definition of Never Smoker category ?
(1) Never smoked in lifetime
(2) Smoked less than 100 cigarettes in a person’s lifetime
(3) Smoked less than 50 cigarettes in a person’s lifetime
(4) No current cigarette use having quit for more than 10 years

43. Mechanism of Bupropion for treatment of nicotine dependency
(1) Dopaminergic reward and partial nicotinic receptor antagonist
(2) Short term nicotinic replacement therapy
(3) Blocks nicotinic receptor and reduces reward
(4) None of the above

44. The following genes are association with hereditary breast cancer except :
(1) BRCAI
(2) p53
(3) PALB2
(4) SMARCA4

45. The lifetime penetrance of medullary thyroid cancer in carriers of RET mutation associated MEN2 syndrome is:
(1) 20%
(2) 80%
(3) 50%
(4) 100%