Quiz

Question :1 Most common histology of Carcinoma of Unknown primary is

Adenocarcinoma
Squamous cell carcinoma
Unclassified neoplasm
Carcinosarcoma

Question :2 Which of the following immunohistochemical markers is not correctly matched?

CK7+, CK20+ is seen in Urothelial tumors
CK7+, CK20- is seen in Lung adenocarcinoma
CK7-, CK20+ is seen with Colorectal carcinoma
CK7+. CK20- is seen with Squamous cell lung carcinoma

Question :3 Sipuleucel T vaccine recently approved by FDA in treatment of:

Renal cancer
Bladder cancer
Testicular cancer
Prostate cancer

Question :4 In prostate cancer, mechanism of action of ketoconazole is:

Androgen receptor antagonist
GnRH receptor antagonist
GnRH receptor agonist
Adrenal ablation

Question :5 Synovial sarcoma is associated with

t(X:18) (p11.2;q11.2)
t(X:18) (p12.1;q12.2)
t(11;14) (p17.1;q22.1)
t(11;13) (p22.3;q11.2)

Question :6 Risk factors associated with Adenocarcinoma Esophagus is

Achalasia
Caustic injury
Barrett’s esophagus
Tylosis

Question :7 Mechanism of action of Cytarabine is

Inhibits Dihydrofolate reductase
Topoisomerase inhibitor
Inhibits DNA polymerase
Depolymerise microtubules

Question :8 Fibro-epithelioma of Pinkus, a rare variant of BCC presents typically on:

Head and neck region
Torso and extremities
Sun exposed areas of face
Trunk

Question :9 False statement regarding Barretts esophagus is

10% of GERD cases develop Barretts esophagus
It has 40 fold increased risk of Addenocarcinoma
Incidence of Adenocarcinoma is 5% per year in Barretts esophagus
Intestinal metaplasia occurs

Question :10 Which of the following is not true about Small intestinal lymphoma?

Most common neoplasia in children <10 yrs
Most common site of small intestinal lymphoma is duodenum
If asymptomatic then undergo chemotherapy
Symptomatic cases should undergo surgical resection

Question :11 Not true regarding Gastric MALToma is

Early stage tumor with no high risk features require Hpylori eradication
Cases with transmural invasion suggest poor prognosis
Patients with nodal disease may have failure of H.pylori eradication
Chemoradiation alone is treatment of choice for high risk MALToma

Question :12 Which of the following is not true regarding Pancreatic cancer?

Investigation of choice in Pancreatic cancer is MDCT
Percutaneous fine needle aspiration cytology is done only for Unresectable tumors
EUS can’t differentiate between chronic pancreatitis & CA Pancreas
EUS differentiates between chronic lymphadenitis from metastatic lymph node involvement

Question :13 Most common pancreatic malignancy in children is

Pancreatic adenocarcinoma
Pancreatoblastoma
Frantz tumor
Lymphoma pancreas

Question :14 Anti Hu Antibodies are associated with which of the following Cancer induced Paraneoplastic Syndrome

Small cell lung cancer
Carcinoma Ovary
Thymoma
Hodgkin’s lymphoma

Question :15 All of the following are Contraindications to surgery in Gallbladder cancer Except?

Regional metastasis
Extension to porta hepatis
Significant Ascites
Occlusion of major vessels

Question :16 Which of the following breast pathological subtype is associated with Familial diffuse type of gastric cancer?

Medullary
Ductal adenocarcinoma – No special type
Ductal adenocarcinoma – special types
Lobular adenocarcinoma

Question :17 Which of the following is not true about Birt Hogg Dubé syndrome

Bilateral multifocal tumors
Associated with chromophobe RCC & oncocytoma
Chromosome 17p11
Associated with hepatic cysts

Question :18 Fong score & outcome of colorectal liver metastasis include all except

Number of lesions more than 1
Size of largest colorectal liver metastasis not more than 3
Time to develop CRLM>1yr
CEA>200 ng/Ml

Question :19 Which of the following is not true about Hepatoblastoma?

AFP is usually elevated in 85-90%
Associated with FAP
Most of them are Symptomatic
Patients Without metastasis should undergo Complete resection

Question :20 Spoke wheel appearance is seen with

Gastric carcinoids
Small bowel carcinoids
Appendiceal carcinoids
Rectal carcinoids

Question :21 Which of the following is not true about Mucinous tumors of Appendix?

If ruptures it results in development of pseudomyxoma peritonei
Cytoreductive surgery combined with IPHC is Treatment of choice for PMP
Frankly malignant
Direct peritoneal seeding from appendiceal contents

Question :22 Renal cell carcinoma involving adrenal gland is staged according to AJCC 8th edition is

I
II
III
IV

Question :23 All are true about Pancoast tumors except

Occurs with tumors that invade 1st rib, subclavian vessels and brachial plexus
Standard treatment is resection for localized tumors
Originates in the superior sulcus
May present with Horner’s syndrome

Question :24 Not an etiologic factor for soft tissue sarcoma?

Viral infection
Previous radiation exposure
Scar tissue from previous injury
Retroperitoneal fibrosis

Question :25 Which of the following is not true about pancreatic endocrine tumors

VIPomas are associated with hyperkalemia
Gastrinomas are associated with ZES
Majority of insulinomas are benign
Migratory necrolytic erythema is seen in glucaganomas

Question :26 Most frequently involved anatomic location in MEN associated gastrinomas?

Head of the pancreas
Gall bladder
Gastric antrum
Duodenum

Question :27 Warburg effect describes

Sculpturing of normal tissues as a result of cell death
Inhibition of antihistone deacetylase
Paracrine signalling causing increased leakiness of basement membrane
Inefficient energy production in cancer cells by anerobic glycolysis

Question :28 A 40 yr old patient came with cough with hemoptysis & occasional chest pain. On further radiological investigation it is diagnosed to be malignant lesion. Biopsy was performed and showed small cell lung cancer. Best initial modality of treatment for this patient?

Surgery
Radiation therapy
Chemotherapy
SVC stent

Question :29 Not true about Criteria of Radiation induced sarcoma

Histology different from original lesion
Sarcoma develops away from radiation field
Latent period of 3 to 5 yrs are neede to develop sarcoma
Histology same from original lesion

Question :30 Oncotype DX Assay, recurrence score >31 denotes

Low risk
Intermediate risk
High risk
No risk

Question :31 Not true about Paget’s disease of the anal canal is:

It is a rare intraepithelial adenocarcinoma in an area of squammous epithelium
It has been proposed to be derived from pluripotent epidermal stem cells
More common in younger individuals and associated with an underlying carcinoma in 50-86% of patients
Presence of PAS positive Paget cells confirms the diagnosis

Question :32 Which of the following patients would most likely benefit from robotic-assisted versus laparoscopic surgery or colorectal cancer

A 75 year old admitted with a lower gastrointestinal bleed, ound to have a bleeding cecal tumor on colonoscopy
A 60-year-old man with a low rectal cancer Abutting prostate on EUS
A 64-year-old man with no significant medical history with a descending colon mass
A 55-year-old man admitted with obstipation with obstructing sigmoid tumor

Question :33 In Carcinoma head of pancreas, Nausea & vomiting is due to

External Compression of duodenum
Portal vein infiltration
Proliferation infiltration of tumor into duodenum
Chemotherapy related

Question :34 Which of the following is most common presenting feature of appendiceal adenocarcinoma is:

Palpable abdominal mass
Acute appendicitis
Ascites
Incidental finding during unrelated abdominal surgery

Question :35 According to AJCC 8th edition, Staging of 2cm size Pancreatic cancer if it involves portal vein is?

T1
T2
T3
T4

Question :36 Not true about Primary peritoneal serous carcinoma include

Type of adenocarcinoma
Constitutes 50% of all Epithelial ovarian carcinoma
Associated with older age at diagnosis
Obesity is also associated factor

Question :37 Which of the following is not true about Placental site trophoblastic tumor?

Arises from trophoblasts of placental bed
Associated with modestly elevated serum Beta hCG levels
Presents with vaginal bleeding
No lymphatic invasion occurs

Question :38 Indication for bone scan in carcinoma prostate

PSA >20ng/ml and biopsy Gleason score >7
T3 & T4 Stage
Symptoms Suggestive of metastatic disease
All of the above

Question :39 All are true about pragmatic classification of Carcinoma breast except

5 year survival rate of very low risk primary breast cancer is >90%
In Locally advanced breast cancer primary systemic therapy is given
Very low risk group needs locoregional and systemic treatment
In metastatic group usually primary systemic treatment

Question :40 What is the risk of malignancy when RMI (Risk of malignancy index) is >250

25%
50%
75%
100%

Question :41 A 70 years old male came with complaints of pain in the right hypochondrium. On examination the patient had a mass abdomen in the right upper quadrant. Ultrasound of the abdomen done which showed a 10 × 10 cm mass in the right lobe of liver. Which of the following tumor marker would be helpful?

CA 19-9
ALP
AFP
Calcitonin

Question :42 Gall bladder carcinoma is M1 stage when which of the following lymph nodes are involved?

Superior mesenteric lymph nodes
Aortic lymph nodes
Celiac lymph nodes
Pancreato-duodenal lymph nodes

Question :43 All of the following are indications of diagnostic laparoscopy in a patient with carcinoma pancreas except:

Tumor located in the head of the pancreas
Tumor size 4 cm
CA 19-9 level 200 U/mL
Inconclusive findings on CECT abdomen

Question :44 Ideal preferred treatment for carcinoma of the gallbladder in majority is:

Radical resection that includes gallbladder in continuity with the right hepatic lobe and regional lymph node dissection
Radiation therapy
Chemotherapy
Palliative

Question :45 Following are risk factors for developing Gastric Adenocarcinoma except

Multifocal mucosal atrophy
Intestinal metaplasia
Partial gastrectomy
PGDFRA mutation

Question :46 With regard to adenocarcinoma of the small bowel, all of the following statements are correct except:

Small bowel adenocarcinoma is found in decreasing order of frequency in ileum, jejunum, and duodenum
Villous adenomas of the small bowel are commonly found in the duodenum around the Ampulla of Vater
Adenocarcinoma of the duodenum usually occurs earlier than small bowel adenocarcinoma elsewhere in the jejunum and ileum
Villous adenomas of the duodenum are frequently associated with familial adenomatous polyposis

Question :47 All the following are protective factors against Ovarian cancer Except

Use of OCP’s
Tubal ligation
Pregnancy
BRCA1/2 mutations

Question :48 Length of colon resection for colon cancer is based on

Size of primary tumor
Need to remove regional lymph nodes
Performance status
Grade of primary tumor

Question :49 Which of following skin tumours have least tendency for metastases?

Squamous cell carcinoma
Melanoma
Basal cell carcinoma
Sebaceous carcinoma

Question :50 Which of the following statements is not true

Type 1 epithelial ovarian cancers include low grade serous, endometroid, mucinous varieties
Type 2 epithelial ovarian cancers include high grade serous & endometroid varieties
Type 2 epithelial ovarian cancers are associated with P53 mutations
Type 1 epithelial ovarian cancers are more aggressive than Type 2

Question :51 Which of the following differentiates between Borderline tumours from benign cystadenomas of Ovary by all except

Epithelial budding
Single layered epithelium
Increased mitotic activity
Nuclear atypia

Question :52 Which of the following is not True about Fallopian tube cancer?

Infertility & Nulliparity are predisposing factors
OC pills & Breast feeding are protective factors
Most frequent change detected is Gains at 3q
Life time risk of Fallopian tube cancers in BRCA carriers is 30%

Question :53 Treatment of choice of Squamous cell carcinoma Anal canal with more than T1 & N+ Stage is

Wide local excision
APR
Chemoradiotherapy
Radiotherapy

Question :54 Which of the following is not True about Carcinoid tumors?

Appendiceal carcinoids are more common in females
Type 3 gastric carcinoids are more common in females
Maximum malignant potential is associated with pancreatic carcinoids
Somatostatin receptor scintigraphy with In111 labelled pantreotide has shown lesser sensitivity than CT scan

Question :55 Not True about Phase trials is

Phase I trail is conducted on Healthy volunteers
Phase I trails gives information about maximum tolerable doses
Phase II trails gives information about Establishing therapeutic efficacy
Phase IV trails confirms therapeutic efficacy

Question :56 Not true about Mesothelioma is

Most commonly seen with Pleura
Associated with asbestosis exposure
Good prognosis
20% occur in peritoneum

Question :57 Not true about Malignant mucosal melanoma is

Most common site of head and neck mucosal melanoma is sinonasal region
Most common site of laryngeal mucosal melanoma is Supraglottic region
Majority of mucosal melanomas may be associated with BRAF mutations
More advanced & Poor prognosis

Question :58 Which of the following is not true about Cyclophosphamide

Causes Carcinoma bladder
Alkylating agent
Myelosuppression that involves platelets
Causes cardiac toxicity

Question :59 Most common cancer to cause Opsoclonus in children is

Neuroblastoma
ALL
AML
Carcinoma Lung

Question :60 Translocation seen with Ewing’s sarcoma is

t(x,18)
t(11,22)
3p-
12p-

Question :61 Next line management in patients with <4cm incidentaloma with benign imaging features is

Repeat imaging in 3-6 months
Biochemical evaluation annually
Adrenalectomy
Both A & B