Surgical Oncology Quiz

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Surgical Oncology Practice Set

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Quiz on Surgical Oncology

1. Most important prognostic factor of primary melanoma is :
(1) Breslow thickness
(2) Clarke level
(3) Mitotic rate
(4) Anatomical location

2. Regarding biopsy of bone tumor, what is Incorrect ?
(1) Transverse incisions are avoided
(2) In case of soft tissue extension of bone lesion, biopsy should be avoided
(3) If a hole its made, it should be round
(4) Wide retention sutures should not be used during closure

3. Myxoid/round cell liposarcomas characteristically have
(1) t(12;16)
(2) t(11;16)
(3) t(16;16)
(4) t(113;22)

4. True about Dermatofibrosarcoma Protuberans (DFSP) is
(1) Affects females more than males
(2) Upper extremities are more frequently involved
(3) Widespread metastasis occurs during presentation
(4) Often mistaken for hypertrophic scar or keloid

5. Which of these shows Good response to chemotherapy ?
(1) Myxoid liposarcoma
(2) Pleomorphic liposarcoma
(3) Round cell liposarcoma
(4) Dedifferentiated liposarcoma

6. Tumor with best prognosis among the following :
(1) Embryonal Rhabdomyosarcoma
(2) Botyroid Rhabdomyosarcoma
(3) Sclerosing Rhabdomyosarcoma
(4) Alveolar Rhabdomyosarcoma

7. Which of the following is not a B cell disorder ?
(1) Hairy cell leukemia
(2) Lymphoplasmacytic lymphoma
(3) Anaplastic large cell lymphoma
(4) Multicentric Castleman disease

8. Cryoprecipitate contains all of the following except
(1) Factor 13
(2) Factor 9
(3) Fibrinogen
(4) VWF

9. Which among the following is not an acute complication of blood transfusion ?
(1) Febrile non hemolytic transfusion reaction
(2) Post transfusion pupura
(3) Transfusion related acute lung injury
(4) Transfusion associated circulatory overload

10. In terms of risk of blood transfusion transmitted infection, which order is correct ?

11. Granular cell tumors of the esophagus 3 are most commonly found in :
(1) Distal 1/3rd
(2) Proximal 1/3rd
(3) Middle 1/3rd
(4) Same incidence along the esophagus

12. Most common cause of death in esophageal cancer
(1) Local recurrence
(2) Post operative complications
(3) Distal recurrence
(4) Tumor biology

13. Colon transposition graft in esophageal reconstruction is most commonly based on :
(1) Ascending branch of left colic
(2) Right branch of Middle colic
(3) Ascending branch of right colic
(4) Left branch of middle colic

14. Risk factors for post operative pancreatic fistula are all except
(1) Small pancreatic duct
(2) Neoadjuvant therapy
(3) Soft texture of parenchyma
(4) Increased intraoperative blood loss

15. True about malignant transformation of anal fistula :
(1) Fistula should be present for 5 yrs before malignancy
(2) Commonly seen in crohn’s associated anal fistula
(3) Malignant transformation is common
(4) None of these

16. Which of the following is not a sign of malignant gastric ulcer on radiographic studies ?
(1) Carman sign
(2) Hampton’s line
(3) Nodular gastric ulcer mound
(4) Abrupt transition between normal and abnormal mucosa several centimeters away from ulcer

17. CLIP scoring system does not include :
(1) Tumor morphology
(2) AFP levels
(3) Portal vein thrombosis
(4) Albumin levels

18. Following are true about fibrolamellar HCC except :
(1) Occurs in younger patients
(2) Tumor is encapsulated
(3) Presence of central scar
(4) AFP positive in 80% patients

19. Number of Lymph Nodes to be sampled for adequate staging in perihilar cholangiocarcinoma :
(1) 6
(2) 7
(3) 12
(4) 15

20. Treatment of choice for multifocal HCC without portal invasion is :
(1) Radiofrequency ablation
(2) Liver transplantation
(3) Transarterial chemoembolization (TACE)
(4) Sorafenib

Practice Set MCQs
Quiz Questions and Answers

21. Least common complication after pancreaticodudenectomy.
(1) Cardiac events
(2) Delayed gastric emptying
(3) Pancreatic fistula
(4) Bile leak

22. All these are worrisome features of Intraductal papillary mucinous neoplasm (IPMN) except :
(1) Lymphadenopathy
(2) Jaundice
(3) Non enhancing mural nodule
(4) Pancreatitis

23. Cloaca divides into rectum and vagina at:
(1) 4 weeks
(2) 6 weeks
(3) 8 weeks
(4) 10 weeks

24. False regarding carcinoma of rectum :
(1) Immediate surgery following short course RT
(2) Most local recurrences are situated extra rectal
(3) Local recurrences are high after sphincter saving resection than APR
(4) 80% recurrences develop within 2 years of surgery

25. Which of the following is least commonly associated with risk of cholangiocarcinoma ?
(1) Clinorchissinensis infection
(2) Hepatolithiasis
(3) HIV infection
(4) Hepatitis C virus infection

26. True about spermatocytic tumor :
(1) Metastatic potential is high
(2) Seen generally in older men
(3) Express placental alkaline phosphatase
(4) Secretes high amount of AFP

27. A patient underwent orchidectomy and was diagnosed as a case of seminoma. No further treatment was given and patient was kept on a regular tollow up. On follow up, a retroperitoneal lymph node was found to be enlarged measuring 2 cm. What is the next step of management ?
(1) Dog leg field radiotherapy
(2) Observation
(3) Chemotherapy

28. Regarding partial nephrectomy true statement is :
(1) In patients with an absolute indication for nephron-sparing surgery, Partial nephrectomy can even be performed for tumors that deeply invest the renal vascular structures or with limited venous thrombus.
(2) Margin clearance is not required.
(3) Posterior segmental arteries are not end arteries.
(4) Transplant backup is necessary.

29. Which of the following is the most common molecular abnormality seen in patients with prostate cancer ?
(1) KRAS mutation
(2) BRAF mutation
(3) Chromosomal translocations involving TMPRSS2
(4) P53 mutation

30. Hereditary papillary renal cancer syndrome is an autosomal dominant hereditary cancer syndrome, leading to increased risk of bilateral papillary type 1 kidney cancer. The disease locus is on chromosome 7q. The mutation responsible for this disorder involves :
(1) RET
(2) MET
(3) RAS
(4) RAF

31. A 45 yr old patient presented with neck swelling. On examination, multiple level TV lymph nodes were enlarged and fixed. FNA from the node revealed poorly differentiated histology. Even after complete evaluation including triple endoscopy, site of primary could not be identified. What is the preferred management in such a scenario ?
(1) Neck dissection f/b Chemotherapy
(2) CTRT
(3) Neck dissection alone
(4) Chemotherapy

32. In case of a metastatic lymphadenopathy, if the site of the primary tumor is unknown, then it is staged as TO if the site of primary on clinical suspicion belongs to all of the following sites except
(1) Breast
(2) Lung
(3) Hypopharynx
(4) None of the above

33. In case of a metastatic lymphadenopathy, if the site of the primary tumor is unknown, then it is staged as TO if the site of primary on clinical suspicion belongs to which of the following sites ?
(1) HPV — Oropharynx
(2) HPV + Oropharynx
(3) EBV — nasopharynx
(4) Hypopharynx

34. A 62 yr old patient presented with multiple bilateral inguinal lymphadenopathy. FNA revealed squamous cell carcinoma. Even after complete evaluation, site of primary could not be identified. What is the preferred management in such a case ?
(1) Bilateral lymph node dissection alone
(2) Bilateral lymph node dissection3 fib RT
(3) Bilateral lymph node dissection f/b CT
(4) Bilateral lymph node dissection f/b RT + CT

35. Most common leukaemia in children with Down’s syndrome is
(1) CML
(2) AML-M3
(3) AML-M7
(4) CLL

36. All-trans-retinoic acid (ATRA) is a major component of preferred chemotherapy regime in which type of leukaemia ?
(1) AML-M3
(2) ALL
(3) CLL
(4) CML

37. What is the peak incidence of radiation pneumonitis while treating lung cancer by radiation therapy ?
(1) 2 weeks
(2) 4 weeks
(3) 2 months
(4) 4 months

38. Which is the drug of choice for radiation pneumonitis ?
(1) Glucocorticoids
(2) Pentoxifylin
(3) Captopril
(4) Amifostine

39. What is the incidence of second primary lung cancer after the primary tumor has been successfully cured ?
(1) 1%
(2) 2%
(3) 5%
(4) 10%

40. Most common cause of blood stream of infection in early course of neutropenia during the first week is :
(1) Gram positive bacteria
(2) Gram positive and Gram negative bacteria
(3) Gram negative bacteria
(4) Candidiasis

41. Which of the following malignancies is considered to be an acquired immunodeficiency syndrome (AIDS) -defining cancer in an HIV infected patient ?
(1) Colon cancer
(2) Penile cancer
(3) Anal cancer
(4) Cervical cancer

42. In asplenia patients, the common infective agent in cancer patients is all except :
(1) Streptococcus pneumoniae
(2) Haemophilus influenza
(3) Clostridium botulinum
(4) Babesia microti

43. Drug of choice for prophylaxis in neutropenic patients is :
(1) Penicillin
(2) Levofloxacin
(3) Cefuroxime
(4) Amoxicillin+clavulinic acid

44. Earliest fundoscopic sign of increased intracranial pressure is
(1) Papilledema with blurring of disc margin
(2) Foster Keneddy syndrome
(3) Disc hemorrhage
(4) Absence of venous pulsation within the centre of optic disc

45. What is the mechanism of action of denosumab ?
(1) Inhibits active form of vitamin D 1, 25 dihidroxy vitamin D and prevents intestinal absorption
(2) Inhibits osteoclasts by binding RANKL (receptors activates of nuclear factor KB ligand) to prevent RANKL. activation by RANK
(3) Activates osteoblasts by binding RANKL
(4) Impedes protein prenylation and bans resorption by osteoclasts by inhibiting the mevalonate pathway