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MCQOPTIONS
This section includes 396 Mcqs, each offering curated multiple-choice questions to sharpen your Uncategorized topics knowledge and support exam preparation. Choose a topic below to get started.
| 101. |
A 58-year-old man presents with weight loss and haemoptysis. He has smoked most of his life. On examination he is clubbed and has clinical evidence of right pleural effusion. His serum calcium is 3.2mM. Which of the following histological type of lung cancer is he most likely to suffer from? |
| A. | mesothelioma |
| B. | small cell carcinoma |
| C. | large cell carcinoma |
| D. | squamous cell carcinoma |
| E. | adenocarcinoma |
| Answer» E. adenocarcinoma | |
| 102. |
Which of the following is an oncogene? |
| A. | The N-Myc gene |
| B. | The WT1 (first Wilm's tumor) gene |
| C. | The Retinoblastoma gene |
| D. | The WT2 (second Wilm's tumor) gene |
| E. | The BCRabI translocation (Philadelphia chromosome) |
| Answer» B. The WT1 (first Wilm's tumor) gene | |
| 103. |
Which of the following does not have a role in the management of chronic cancer pain? |
| A. | Carbamazepine |
| B. | Clodrinate |
| C. | Dexamethasone |
| D. | Nifedipine |
| E. | Pinavarium |
| Answer» F. | |
| 104. |
A middle-aged man has a melanoma fully excised. What is the most important reason to follow him closely? |
| A. | Local and systemic recurrence |
| B. | New site recurrence |
| C. | In transit metastasis |
| D. | Lymph nodes |
| E. | New primary |
| Answer» B. New site recurrence | |
| 105. |
A 52-year-old woman presented with hot flushes. Her last menstrual period had been 1 year previously. She was treated with ethinylestradiol and medroxyprogesterone acetate. Which potential consequence of oestrogen therapy is most reduced by co-prescription of a progestogen? |
| A. | breast cancer |
| B. | breast pain |
| C. | endometrial cancer |
| D. | mood changes |
| E. | weight gain |
| Answer» D. mood changes | |
| 106. |
What is the best treatment for malignant mesothelioma? |
| A. | Extrapleural pneumonectomy, followed by chemotherapy and adjuvant radiation therapy to a dose of 50 Gy to 60 Gy |
| B. | Pleurodesis, followed by systemic chemotherapy with subsequent external-beam radiation therapy to a dose of 60 Gy in 20 fractions |
| C. | IMRT to a localized positive margin to a radiation dose of 70 Gy |
| D. | IMRT to the entire lung to a radiation dose of 45 Gy |
| Answer» B. Pleurodesis, followed by systemic chemotherapy with subsequent external-beam radiation therapy to a dose of 60 Gy in 20 fractions | |
| 107. |
What is not true for HNPCC |
| A. | It is the most common hereditary colorectal cancer syndrome in USA |
| B. | It is associated with MMR gene mutation |
| C. | It is associated with APC mutation |
| D. | It is associated with carcinoma colon and extraintestinal cancers |
| E. | Answer C and D are correct |
| Answer» D. It is associated with carcinoma colon and extraintestinal cancers | |
| 108. |
Most valuable investigation for preoperative evaluation of extensive corrosive stricture is |
| A. | Endoscopic ultrasound |
| B. | Barium study |
| C. | CT Thorax |
| D. | Pharyngoscopy |
| Answer» B. Barium study | |
| 109. |
In asbestos related disorders which of the following statements is correct? |
| A. | basal fibrotic shadowing on CXR suggests coincidental idiopathic fibrosing alveolitis |
| B. | increased incidence of primary lung cancer |
| C. | pleural effusion develops more than 20 years after causative asbestos exposure |
| D. | pleural plaques are recognized precursors of mesothelioma |
| E. | the risk of malignant mesothelioma is greatly increased in smokers compared with non-smokers |
| Answer» C. pleural effusion develops more than 20 years after causative asbestos exposure | |
| 110. |
The following are recognized features of Pancoast's tumor except: |
| A. | ipsilateral Horner's syndrome |
| B. | wasting of the dorsal interossei |
| C. | pain in the arm radiating to the fourth and fifth fingers |
| D. | erosion of the first rib |
| E. | weakness of abduction at the shoulder |
| Answer» F. | |
| 111. |
Regarding lymphomas, all are true except: |
| A. | Mesenteric nodes are involved in HL more than in NHL |
| B. | Nodal extension is contiguous in HL |
| C. | Extranodal disease is common in NHL |
| D. | Testicular lymphoma is the most common testicular tumor in people aged over 60 years |
| E. | Bone marrow is common extranodal site for lymphomatous involvement |
| Answer» B. Nodal extension is contiguous in HL | |
| 112. |
A 64-year-old man is evaluated because of fatigue and shortness of breath on exertion. He has had three episodes of urinary tract infection in the past 7 months. On physical examination, he has pallor but is otherwise normal. He denies blood loss, and his stool is negative for occult blood on three measurements. He is anemic (hemoglobin 8.4 g/dL) with normochromic, normocytic indices, and his serum creatinine level is 2.9 mg/dL. The total serum protein level is elevated, and the serum albumin level is low normal. His serum calcium level is 11.8 mg/dL.What is the most likely cause of his symptoms? |
| A. | Multiple myeloma |
| B. | Chronic pyelonephritis |
| C. | Iron deficiency anemia |
| D. | Colon cancer |
| E. | Small-cell lung cancer |
| Answer» B. Chronic pyelonephritis | |
| 113. |
Which one of the following statements is true of B cell CLL? |
| A. | Autoimmune thrombocytopenia is uncommon |
| B. | Reduced immunoglobulins a risk of recurrent viral infections |
| C. | Stage A disease should be treated with chemotherapy |
| D. | Late transformation to ALL occur in the majority of patients |
| E. | Diffuse infiltration of bone marrow indicates good prognosis |
| Answer» B. Reduced immunoglobulins a risk of recurrent viral infections | |
| 114. |
B cell CLL |
| A. | thrombocytopenia often autoimmune |
| B. | reduced immunoglobulins are a risk for recurrent bacterial infections |
| C. | Stage A disease should be treated with chemotherapy |
| D. | late transformation to ALL occur in the majority of patients |
| E. | diffuse infiltration of bone marrow indicates good prognosis |
| Answer» C. Stage A disease should be treated with chemotherapy | |
| 115. |
Which of the following associations is correct? |
| A. | Renal transplantation and Non-Hodgkin's lymphoma |
| B. | Hepatitis B and aplastic anaemia |
| C. | Turner's syndrome and acute myeloid leukaemia |
| D. | Basophilia and chronic myeloid leukaemia |
| E. | Crohn's disease and TB |
| Answer» C. Turner's syndrome and acute myeloid leukaemia | |
| 116. |
A 70-year-old man with an 80-pack-year smoking history is evaluated because of a chronic cough of 6 months duration. Chest radiograph shows a 3-cm mass in the left perihilar region, and bronchoscopic biopsy confirms poorly differentiated adenocarcinoma. There are no significant findings on physical examination, and all blood studies are normal. Bone scan and CT scan of the head are normal, but CT scans of the chest and abdomen show the mass and two 1-cm nodules in the right lobe of the liver. Intravenous contrast perfusion of the two nodules during the CT scan is not suspicious for hemangioma. Positron emission tomography scan shows distinct uptake in the left perihilar mass but only faint focal activity in the right lobe of the liver.Pulmonary function tests show mild obstructive disease. What is the best next step in this patient s management? |
| A. | Radiation therapy |
| B. | Chemotherapy |
| C. | CT-directed liver biopsy |
| D. | Serum carcinoembryonic antigen test |
| E. | Surgery |
| Answer» D. Serum carcinoembryonic antigen test | |
| 117. |
Which of the following statements regarding lymphomas in childhood is correct? |
| A. | Hodgkin's disease is more common than non-Hodgkin's under the age of 5 years. |
| B. | Hodgkin's disease has equal sex incidence. |
| C. | Lymphocyte-predominant Hodgkin's disease has the worse prognosis. |
| D. | The nodular sclerosing variety is the most common form of Hodgkin's disease. |
| E. | The most common presenting clinical sign is splenomegaly. |
| Answer» E. The most common presenting clinical sign is splenomegaly. | |
| 118. |
Malignant melanoma:- |
| A. | is the commonest form of skin cancer |
| B. | is always related to acute sun exposure |
| C. | always arises in a pre-existing pigmented naevus |
| D. | is common in the pre-pubertal age group |
| E. | typically shows metastases to regional lymph nodes |
| Answer» F. | |
| 119. |
A 68-year-old woman is evaluated because of a lump on her chest wall. Seventeen years ago she developed stage I ductal adenocarcinoma (estrogen receptor-positive) of the left breast; her disease was managed with lumpectomy, breast radiation therapy, and 5 years of tamoxifen therapy. The lump she now has is separate from the breast, subcutaneous in location, fixed to the underlying 4th rib, and nontender. The mass is excised and found to be a fibrosarcoma. What is the relationship of this fibroscarcoma to her original cancer and its treatment? |
| A. | It is not related to the original cancer or its treatment |
| B. | It is related to the radiation therapy given to control the breast cancer |
| C. | It is related to the tamoxifen given to control the breast cancer |
| D. | It is related to the primary estrogen receptor-positive breast cancer |
| Answer» C. It is related to the tamoxifen given to control the breast cancer | |
| 120. |
A 25-year-old woman has her first routine check-up. Her mother died of lung cancer at the age of 60 years, and her father has had a head and neck cancer. She is very worried about getting cancer and wants to know what she can do to reduce her risk, as much as possible, of getting either of these cancers. In addition to avoidance of tobacco, which of the following approaches has been demonstrated to decrease risk for one or both of these cancers? |
| A. | Avoidance of alcohol abuse |
| B. | Daily intake of antioxidant vitamins |
| C. | Avoidance of exposure to benzene |
| D. | Daily intake of -carotene |
| Answer» B. Daily intake of antioxidant vitamins | |
| 121. |
A 69-year old black man is evaluated because of a history of steadily increasing upper abdominal pain, loss of appetite, and a 4.6-kg (1 0-Ib) weight loss over the past several months. He recently noticed that the color of his urine was darker than usual. The patient had a 40-pack-year history of cigarette smoking, but quit smoking 4 years ago. He has hypertension that is controlled by medical management. Laboratory studies: Hemoglobin 11.5 g/dL Serum total bilirubin 3.3 g/dL Serum albumin 3.2 g/dL Serum aspartate aminotransferase 105 U/L Serum alanine aminotransferase 95 U/L Urinalysis shows elevated bilirubin. CT scan of the abdomen shows dilation of the common bile and pancreatic ducts, a 5.2-cm mass in the head of the pancreas, and compression of the superior mesenteric vein. A fine-needle aspirate of the mass reveals atypical cells that are suspicious for malignancy. What is the most appropriate course of action? |
| A. | Refer the patient for exploratory laparotomy, biopsy, and biliary bypass |
| B. | Request a CT-guided biopsy of the mass in the head of the pancreas to establish a diagnosis |
| C. | Obtain a consultation for endoscopic retrograde cholangiopancreatography and possible biopsy and biliary stent placement |
| D. | Refer the patient to a tertiary-care center with surgical expertise in the management of patients with pancreatic and hepatobiliary disease |
| Answer» E. | |
| 122. |
Hypoxia adversely affects the treatment and management of cancers because it: |
| A. | increases blood flow to the tumor. |
| B. | impedes adequate blood flow to the tumor. |
| C. | activates molecular pathways contributing to resistance. |
| D. | causes dyspnea and tachypnea in the patient. |
| Answer» D. causes dyspnea and tachypnea in the patient. | |
| 123. |
Which of the following complications is NOT associated with a radical prostatectomy? |
| A. | Proctitis |
| B. | Erectile dysfunction |
| C. | Urinary incontinence |
| D. | Anastomotic stricture |
| Answer» B. Erectile dysfunction | |
| 124. |
A 56-year-old man from Thailand presented with abdominal pain and a mass in the right upper quadrant. He reported that he had been diagnosed with viral hepatitis several years previously. Investigations showed: Serum alpha-fetoprotein 13,500 IU/L (< 10) What is the most likely underlying viral infection? |
| A. | Hepatitis A virus |
| B. | Hepatitis B virus |
| C. | Hepatitis C virus |
| D. | Hepatitis D virus |
| E. | Hepatitis E virus |
| Answer» C. Hepatitis C virus | |
| 125. |
Where is vulvar carcinoma most commonly located? |
| A. | Clitoris |
| B. | Mons pubis |
| C. | Vaginal vestibule |
| D. | Labia |
| Answer» E. | |
| 126. |
Which of the following statements about patients who are diagnosed with breast cancer and have supraclavicular lymph node involvement is true? |
| A. | The diagnosis should be classified as stage M1 breast cancer. |
| B. | Approximately 30% of patients will have clinically detectable internal mammary lymph nodes on CT scan of the chest. |
| C. | Over 20% of patients will have lymphedema and brachial plexopathy. |
| D. | Over 20% of patients will survive 10 years with aggressive trimodality therapy. |
| Answer» E. | |
| 127. |
Which one of the following cancers is usually associated with a moderate to high uptake of 18F-fluorodeoxyglucose (18 FFDG)? |
| A. | Bladder |
| B. | Colorectal |
| C. | Thyroid |
| D. | Testicular |
| Answer» C. Thyroid | |
| 128. |
A 44 years old female with breast lump of one year duration, slowly progressed, examination revealed right inner lower quadrant mass with normal both axillae, biopsy revealed a benign nature with average risk to develop cancer, this pathology is mostly |
| A. | Sclerosing adenosis |
| B. | Fibrocystic disease |
| C. | Hyperplasias with atypia increases the risk of developing invasive breast cancer by: |
| D. | Papillomas |
| E. | Lobular carcinoma in situ |
| Answer» C. Hyperplasias with atypia increases the risk of developing invasive breast cancer by: | |
| 129. |
Which of the following chemotherapy drug is likely to be toxic to gonads? |
| A. | Adriamycin |
| B. | Vinblastine |
| C. | Paclitaxel |
| D. | Procarbazine |
| E. | Prednisolone |
| Answer» E. Prednisolone | |
| 130. |
Which of the following statements about post-prostatectomy radiation therapy used in the EORTC 22911 Trial is true? |
| A. | It resulted in more frequent grade 2 or grade 3 late effects. |
| B. | It improved local control, biochemical progression-free survival, and overall patient survival. |
| C. | It was beneficial for patients who had prostate cancer with positive lymph nodes. |
| D. | Hormone therapy was added to the treatment regimen for patients with positive lymph nodes. |
| Answer» B. It improved local control, biochemical progression-free survival, and overall patient survival. | |
| 131. |
Which of the following laboratory tests is most appropriate for determining if a patient with acromegaly has responded favorably to radiation therapy? |
| A. | Serum glucose level |
| B. | Growth hormone (GH) |
| C. | Thyroid stimulating hormone (TSH) |
| D. | Insulin-like growth factor-1 (IGF-1) |
| Answer» E. | |
| 132. |
The carcinoid syndrome is likely to occur with carcinoid tumors: |
| A. | of the appendix |
| B. | localized to the ileum |
| C. | both |
| D. | neither |
| Answer» E. | |
| 133. |
What percent of patients diagnosed with testicular seminoma have elevated - fetoprotein serum levels? |
| A. | 00% |
| B. | 10% |
| C. | 20% |
| D. | 30% |
| Answer» C. 20% | |
| 134. |
Which stage is most appropriate for a patient who has testicular seminoma involving the spermatic cord with multiple 2- to 5-cm paraaortic lymph nodes? |
| A. | Stage IB |
| B. | Stage IIB |
| C. | Stage IIC |
| D. | Stage IIIA |
| Answer» C. Stage IIC | |
| 135. |
The most common mechanism of spread of epithelial ovarian cancer is: |
| A. | Haematogenous |
| B. | Lymphatics |
| C. | Adjacent structures |
| D. | Trans-coelomic |
| E. | Lepidic |
| Answer» D. Trans-coelomic | |
| 136. |
Most likely route of ovarian cancer spread: |
| A. | peritoneal |
| B. | direct spread to adnexae |
| C. | lymphatic |
| D. | direct spread to other organs |
| E. | none of above |
| Answer» C. lymphatic | |
| 137. |
Pre-menopausal woman found to have left axillary and supraclavicular nodes. Biopsy showed poorly differentiated cancer, oestrogen receptor poor. She has no other Symptoms, examination is otherwise normal and CXR and mammogram are normal. Next step: |
| A. | Endoscopy |
| B. | Bronchoscopy |
| C. | Local XRT |
| D. | Chemo and XRT |
| E. | Hormonal therapy |
| Answer» C. Local XRT | |
| 138. |
Which is the strongest predictor of an increased risk of breast cancer in a 40 ys woman: |
| A. | Early menarche |
| B. | Late first pregnancy > 30 years |
| C. | Previous breast carcinoma in contralateral breast |
| D. | Mother with breast cancer at age 70 |
| E. | Hormone replacement therapy |
| Answer» D. Mother with breast cancer at age 70 | |
| 139. |
Which of the following primary sites is most commonly involved in patients who are diagnosed with Ewing sarcoma? |
| A. | Pelvis |
| B. | Humerus |
| C. | Fibula |
| D. | Tibia |
| Answer» B. Humerus | |
| 140. |
The most common mode of spread of colon cancer is |
| A. | Hematogenous |
| B. | Lymphatic |
| C. | Direct extension |
| D. | Implantation |
| Answer» C. Direct extension | |
| 141. |
What is the second most common histology associated with vulvar cancers? |
| A. | Adenocarcinoma |
| B. | Adenosquamous carcinoma |
| C. | Squamous cell carcinoma |
| D. | Melanoma |
| Answer» E. | |
| 142. |
Major spread of ovarian cancer |
| A. | Adnexal |
| B. | Lymphatic |
| C. | Blood |
| D. | Peritoneal |
| E. | Seeding |
| Answer» B. Lymphatic | |
| 143. |
Which histology is most likely in men older than 60 years with testicular cancer? |
| A. | Yolk sac tumor |
| B. | Classical seminoma |
| C. | Choriocarcinoma |
| D. | Lymphoma |
| Answer» E. | |
| 144. |
A female with a history of breast cancer removed. Examination revealed previous modified radical mastectomy scar. Diffuse erythema, with nodules and plaquing over and around scar with some extension onto contralateral breast is evident. The most likely diagnosis is: |
| A. | Radiation recall |
| B. | Fungal infection |
| C. | Tumor recurrence |
| D. | Herpes zoster |
| E. | None of above |
| Answer» D. Herpes zoster | |
| 145. |
A 42-year-old man presented with a 1-month history of altered personality and increased seizure frequency. An MR scan of brain demonstrated an enhancing lesion in the right frontal lobe. Histology revealed a grade 3 oligodendroglioma, with loss of heterozygosity of 1p/19q. What is the most appropriate treatment? |
| A. | chemoradiation with temozolomide |
| B. | cranial irradiation |
| C. | craniospinal irradiation |
| D. | procarbazine, vincristine and lomustine (PCV) |
| E. | temozolomide |
| Answer» C. craniospinal irradiation | |
| 146. |
Not an association between (PSC) Primary sclerosing cholangitis and Ulcerative colitis (UC) |
| A. | Inflammatory Bowel disease (IBD) seen in 70% of patients with PSC |
| B. | Diagnosis of IBD occurs 8-10 years before PSC |
| C. | Colitis is severe in patients with both PSC And UC as compared to UC alone |
| D. | Risk of colon cancer is more when patients have both UC and PSC as compared to UC alone |
| Answer» D. Risk of colon cancer is more when patients have both UC and PSC as compared to UC alone | |
| 147. |
In ulcerative coilitis with toxic megacolon lowest rate of recurrence is seen in |
| A. | Complete proctocolectomy and Brook's ileostomy |
| B. | Ileo rectal anastomoses |
| C. | kock's pouch |
| D. | none of above |
| Answer» B. Ileo rectal anastomoses | |
| 148. |
Which of the following statements about radiation-induced fibrosis is true? |
| A. | It is usually irreversible. |
| B. | It can be easily managed by surgical excision. |
| C. | It can be effectively treated using hyperbaric oxygen. |
| D. | The severity is reduced with concurrent chemotherapy. |
| Answer» B. It can be easily managed by surgical excision. | |
| 149. |
Which of the following proto-oncogenes is least likely to be associated with an increased risk of breast cancer? |
| A. | ATM (ataxia telangiectasia) |
| B. | BRCA-1 |
| C. | Bcl 2 |
| D. | HER-2neu |
| E. | Wiskott Aldrich Syndrome |
| Answer» F. | |
| 150. |
In which of the following cases of lung cancer would surgical resection of the tumor be a reasonable therapeutic option? |
| A. | A 56-year-old woman with an adenocarcinoma of the right lung. CT scan shows enlarged lymph nodes in the right and left hilum. PFTs show an FEV1 of 2.25 L. (55% predicted). |
| B. | A 59-year-old man who is found at bronchoscopy to have a tumor in the right mainstem bronchus extending to within 1 cm of the carina. Pulmonary Function Tests (PFTs) show an FEV1 of 2.1 liters (65% of predicted normal). |
| C. | A 62-year-old lady with a small peripheral mass who has elevated liver enzymes and a computed tomography (CT) scan showing probable metastatic deposits in the liver PFTs show an FEV1 of 3.5 Liters (80% of predicted normal). |
| D. | A 70-year-old man with a right lower lobe tumor 2 cm in diameter with no evidence of regional adenopathy or distant spread of disease. PFTs show an FEV1 of 0.8 Liters (28% predicted). |
| E. | A 71-year-old man with a 3 cm tumor obstructing the right lower lobe bronchus. PFTs show an FEV1 of 1.98 L. (43% predicted). |
| Answer» F. | |