Surgical Oncology Questions and Answers

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Questions and Answers on Surgical Oncology

1. The following neoplasias are an intraepithelial marker for invasive cancers except :
(1) Leukoplakia
(2) colorectal adenoma
(3) cervical ectropion
(4) actinic keratosis

2. True statement regarding tamoxifen and raloxifene is :
(1) raloxifene reduces breast cancer specific mortality rate
(2) tamoxifen reduces the risk of ER negative breast cancer
(3) tamoxifen is more effective than raloxifene in reducing breast cancer incidence
(4) both decrease the risk of in situ breast neoplasms

3. Raloxifene toxicity increases the chances of :
(1) Vertebral fracture
(2) Stroke
(3) coronary artery disease
(4) endometrial cancer

4. Side effects of varenicline (Chantix) :
(1) Anorexia
(2) Hypertension
(3) elevated liver enzymes
(4) suicidal ideation

5. Selenium supplementation in randomized clinical trials was associated with :
(1) reduced incidence of prostate cancer
(2) decreased risk of squamous cell carcinoma
(3) increased incidence of non melanoma skin cancer
(4) increased risk of prostate cancer

6. In Medullary thyroid carcinoma (MTC) which of the following preoperative basal calcitonin levels is an indication for ipsilateral and lateral neck dissection :
(1) 50 to 200 pg/ml
(2) 15 to 200 pg/ml
(3) 20 to 50 pg/ml
(4) 200 to 500 pg/ml

7. All are immunotherapy agents except
(1) Nivolumab
(2) Pembrolizumab
(3) Atezolizumab
(4) Pertuzumab

8. Which target therapy is not used in lung carcinoma ?
(1) Dabrafenib
(2) Osimertinib
(3) Ruibociclib
(4) Afatinib

9. Mechanism of action of Etoposide
(1) tree radical production
(2) Topoisomerase inhibition
(3) Microtubules inhibition
(4) Carbonic anhydrase 9 inhibition

10. Mechanism of action of Taxenes
(1) Mismatch of DNA repair
(2) Microtubules stabilization
(3) G2 phase arrest
(4) Mitochondria Inhibition

11. Mitotane inhibits following enzyme in steroid synthesis
(1) 11 Beta hydroxylase
(2) 21 Hydroxylase
(3) Aromatase
(4) 17- Hydroxylase

12. Screening tests for detection of high cortisol secretion includes all except :
(1) 24 hrs urinary cortisol
(2) Late night salivary cortisol
(3) Overnight dexamethasone suppression test
(4) CRH stimulation test

13. Pure Estrogen receptor antagonist used in treatment of breast cancer is
(1) Tamoxifen
(2) Fulvestrant
(3) Raloxifene
(4) Exemestane

14. Trial that compared use of tamoxifen for 5 yrs vs. 10 yrs as adjuvant treatment of breast cancer is
(1) ATLAS trial
(2) ATAC trial
(3) TEAM trial
(4) NSABP-B14 trial

15. “Pyrosequencing” as a sequencing method is used in which of the following Next Generation sequencing platforms ?
(1) Roche 454 GS FLX
(2) Illumina HiSeq 2000
(3) Polonator G.007
(4) Helicos BioSciences HeliScope

16. Regarding colorectal cancers, KRAS and BRAF mutations have been recently shown to impair responsiveness to which group of drugs?
(1) Anti-angiogenesis inhibitors
(2) Anti EGFR agents
(3) PDL-1 inhibitors
(4) 5-FU

17. Regulatory proteins used as “inhibitors of apoptosis” by cancer cells are :
(1) Bel-2
(2) Bcl-XL
(3) Bcl-W
(4) All of the above

18. Which of the following triggers suppressive signals that can counteract proangiogenic stimult ?
(1) TSP-1
(2) VEGF
(3) AANG-44
(4) All of the above

19. Which of the following diagnostic tests is most useful for determining the tumor stage of esophageal cancer ?
(1) Esophagogastroduodenoscopy
(2) Endoscopic ultrasound
(3) PET scan
(4) CTscan

20. Which of the following is true with regard to the investigation of oral/ oropharyngeal cancer ?
(1) Artifacts from dental amalgam limit the usefulness of MRI.
(2) The sensitivity of MRI for detecting nodal metastasis greatly exceeds that of CT.
(3) MRI allows for better visualisation of soft-tissue infiltration than CT.
(4) MRI is more widely available than CT; it tends to be used for convenience.

21. Which of the following radiations are used for imaging purposes ?
(1) Alpha
(2) Beta
(3) Gamma
(4) Delta

22. The smallest unit in the reconstruction/projection of an MRI image is called as
(1) Pixel
(2) Voxel
(3) binary unit
(4) dot

23. ACS guidelines recommendation of MRI screening for ca breast is
(1) BRDAI or BRCA2 mutation.
(2) Lifetime risk more than or equal to 20%
(3) History of radiation to chest
(4) All of the above

24. Which of the following statements about video-assisted thoracic surgery for patients with lung cancer is FALSE ?
(1) The postoperative period is shorter.
(2) It decreases the risk of intraoperative bleeding.
(3) It is a viable alternative to thoracotomy in patients who are frail.
(4) Locoregional recurrence is increased.

25. Which of the following is an advantage of a tracheostomy ?
(1) Decrease in alveolar ventilation
(2) Increase in the work of breathing
(3) Increased rate of moisture exchange from the upper airway
(4) Reduction of anatomical dead space

26. 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 MRI scan of pelvis showed an anterior tumor abutting the prostate gland, radiologically staged as a T3, N1, MO cancer. What is the most appropriate next step in management ?
(1) Abdomtnoperineal resection
(2) Total mesorectal excision
(3) Long-course chemoradiation
(4) Short-course radiotherapy

27. The most common organism responsible for central line associated blood stream infection (CLABSI) is
(1) Staphylococcus epidermidis
(2) Staphylococcus aureus
(3) Candida
(4) Streptococcus

28. Radiotherapy has its most severe effects on which tissues ?
(1) Liver
(2) Kidney
(3) Lung
(4) Bone marrow

29. Hypoxia adversely affects the treatment and management of cancers because It :
(1) increases blood flow to the tumor.
(2) tmpedes adequate blood flow to the tumor.
(3) activates molecular pathways contributing to resistance.
(4) causes dyspnea and tachypnea in the patient.

30. Which of the following statements about radiation-induced fibrosis is true ?
(1) It is usually irreversible.
(2) It can be easily managed by surgical excision.
(3) It can be effectively treated using hyperbaric oxygen.
(4) The severity is reduced with concurrent chemotherapy.

31. Which of the following cell cycle phase is most radiosensitive ?
(1) M
(2) S
(3) GI
(4) GO

32. Young male with germ cell cancer. He is on bleomycin, etoposide and cisplatinum. What side effect would make you stop the treatment ?
(1) Peripheral neuropathy
(2) Neutropenic septicaemia
(3) Interstitial lung disease
(4) High tone hearing loss

33. Which of the following chemotherapy agents is most effective against soft lissue sarcoma ?
(1) Thiotepa
(2) Cyclophosphamide
(3) Dactinomycin
(4) Doxorubicin

34. Which of the following chemotherapy agents recently has been shown to be effective in treating hormone refractory prostate cancer ?
(1) Docetaxel
(2) Gemcitabine
(3) Oxaliplatin
(4) Topotecan

35. Taxane derivatives elicit cytotoxic effects mainly by which of the following mechanisms ?
(1) Stabilization of microtubules and prevention of their disassembly
(2) Intercalation into DNA and inhibition of DNA replication
(3) Inhibition of topoisomerases
(4) Inhibition of DNA repair

36. Which is an example of humanized monoclonal antibody ?
(1) Rituximab
(2) Denosumab
(3) Bevacizumab
(4) Ramucirumab

37. Regarding G-CSF the best description of its mechanism of action and role in chemotherapy is
(1) reduced PMN nadir when used as prophylaxis
(2) reduced duration of neutropenia when used as prophylaxis
(3) not useful unless already neutropenic
(4) reduce thrombocytopenia severity

38. Male with bone pain from metastatic prostate cancer will be started on LHRH antagonist. He refuses orchidectomy. His illness will show
(1) immediate improvement
(2) initially worse than improvement
(3) immediate improvement than decline
(4) slow improvement

39. Which of the following has been associated with death in trials of Nivolumab for lung cancer ?
(1) Hepatitis
(2) Neutropenia
(3) Pneumonitis
(4) Hypophysitis

40. Vaccination against HPV uses :
(1) Killed HPV
(2) Live attenuated HPV
(3) LI proteins from the viral capsid
(4) Bioengineered synthetic viral ribonucleic acid.

41. A 45 yr old male smoker presented with a 1.5 x 1.5 cm lesion on the lateral border of the tongue having 6 mm thickness. Clinically no enlarged neck nodes. Punch biopsy was done which revealed squamous cell carcinoma. What is the next step of management ?
(1) Partial glossectomy
(2) Partial glossectomy + level I-IV lymph node dissection
(3) Partial glossectomy + level I-V lymph node dissection
(4) Partial glossectomy followed by RT

42. A 39 yr old male patient with history of tobacco chewing underwent surgery followed by RT for a T3N2aM0 lesion of the buccal mucosa. After the surgery, patient was given retinoids. What is the use of retinoids in such a scenario ?
(1) Used as a maintenance therapy
(2) To decrease the nodal recurrence
(3) To prevent the recurrence of the primary
(4) To decrease the second primary after RT

43. All of the following regarding nasopharyngeal carcinoma (NPC) are true except
(1) Fossae of Rosenmuller is the most common site
(2) Skip metastasis is common in NPC
(3) Bilateral metastasis in cervical lymph node(s), none more than 6 cm in greatest dimension is considered as N2.
(4) All are true statements.

44. Cranial nerve most commonly involved in nasopharyngeal carcinoma (NPC)
(1) Cranial nerve V
(2) Cranial nerve VI
(3) Cranial nerve IV
(4) None of the above

45. Which among the following is not considered as high grade tumor in carcinoma parotid ?
(1) Acinic cell carcinoma
(2) SCC
(3) Adenocarcinoma
(4) Malignant pleomorphic adenoma