300+ TOP ONCOLOGY Objective Questions and Answers

ONCOLOGY Multiple Choice Questions :-

1. Cytotoxic T cells (CTL) are capable of recognizing:
A. Peptide antigens associated with major histocompatibility complex (MHC) molecules.
B. Membrane-bound antigens.
C. Cytoplasmic antigens.
D. Nuclear antigens.
E. All of the above.
Answer: E

2. Adoptive immunotherapy with lymphokine activated killer cells (LAK) and tumor infiltrate (TIL) cells are characterized by:
A. Nonspecific stimulation of effector cells.
B. Expansion ex vivo of large numbers of lymphocytes.
C. Infusion with interleukin 2 (IL-2).
D. Significant toxicity at high doses.
E. All of the above.
Answer: E

3. Previous clinical studies with cancer vaccines have:
A. Clearly demonstrated induction of tumor-specific immune response.
B. Repeatedly demonstrated clinical response to large tumor burden.
C. Not clearly demonstrated induction of tumor-specific immune response.
D. Not been performed to date.
Answer: C

4. Which of the following statements is/are true of the epidemiology and etiology of melanoma?
A. Most patients are diagnosed after age 60 years.
B. Skin color has no association with risk of melanoma.
C. Sun exposure is the only risk factor for melanoma.
D. The per capita incidence of melanoma is highest in Australia.
Answer: D

5. Which of the following variables best predicts prognosis for patients with a recent diagnosis of cutaneous melanoma and no clinical evidence of metastatic disease?
A. Breslow thickness.
B. Clark’s level.
C. Ulceration.
D. Gender.
E. Celtic complexion.
Answer: A

6. A 38-year-old man presents with a melanoma on the skin of the right calf measuring 5 mm. in thickness. Several large nodes are palpable in the right inguinal region. Which of the following statements about the appropriate management of this clinical problem is false?
A. In the absence of systemic disease, the primary melanoma of the right calf should be excised with at least a 2-cm. margin.
B. Complete right inguinal node dissection should be performed if there is no evidence of systemic metastasis.
C. If further work-up reveals multiple lung metastases of melanoma, they should be excised as soon as possible.
D. Chemotherapy for melanoma is primarily palliative; so surgical therapy is preferred if there is no evidence of metastatic disease beyond the inguinal region.
E. If the nodes do not contain metastatic disease but are simply reactive, the chance of 5-year survival is 50% or less.
Answer: C

7. A 42-year-old woman presents with an 8 cm. × 6 cm. × 4 cm. mass in the posterior thigh. Incisional biopsy reveals a high-grade liposarcoma. Her management should include:
A. High thigh amputation.
B. Extracompartment excision with negative margins.
C. Complete excision with negative margins.
D. Adjuvant radiation therapy.
E. Adjuvant chemotherapy.
Answer: CD

8. Biologic features of adult soft tissue sarcomas include the following:
A. Mutations of p53 in metastatic liposarcoma.
B. A low (less than 1%) risk of metastasis for small, low-grade lesions.
C. Recurrent disease in at least 33% of patients.
D. Lymph node metastasis in less than 3% of patients.
E. Mutations of p53 in Li-Fraumeni syndrome.
Answer: BCDE

9. Which of the following statements describes an ideal tumor marker?
A. The ideal tumor marker should be tumor specific; that is, in the normal population or patients with benign diseases, false-positive test results are rare.
B. The ideal marker must have a low false-negative rate; that means that all patients with a particular type of cancer should test positive.
C. The circulating level of an ideal tumor marker should correlate directly with the amount of viable tumor and be a measure of the response to therapy.
D. The ideal tumor marker should act as a prognostic indicator.
E. All of the above.
Answer: E

10. A marker for the diagnosis of pancreatic cancer is:
A. CA 15-3.
B. CA 19-9.
C. Alphafetoprotein (AFP).
D. Carcinoembryonic antigen (CEA).
E. CYFRA 21-1.
Answer: B

11. Which of the following tumors may cause elevated CEA levels?
A. Breast cancer.
B. Colorectal cancer.
C. Gastric cancer.
D. Lung cancer.
E. All of the above.
Answer: E

12. The presence of which marker is a significant poor prognosis variable for patients with breast cancer:
A. CEA.
B. C-erb B-2.
C. AFP.
D. Human chorionic gonadotropin (hCG).
E. RB-1.
Answer: B

13. The most useful circulating marker for patients with hepatocellular carcinoma is:
A. CA 50.
B. Levels of vitamin B 12.
C. CEA.
D. AFP.
E. hCG.
Answer: D

14. In patients with colorectal cancer the serum CEA level is a clinically useful measure for all reasons except:
A. Prognosis.
B. Detection of recurrence.
C. Guiding second-look operations.
D. Following treatment response.
E. Early diagnosis.
Answer: E

15. Which serum markers are useful in the management of patients with testicular cancer?
A. hCG.
B. AFP.
C. CA 15-3.
D. Two of the above.
E. None of the above.
Answer: D

16. Which tumor marker is useful for the management of patients with breast cancer?
A. CA 125.
B. Inhibin.
C. CA 19-9.
D. CA 15-3.
E. CEA.
Answer: D

17. A new marker that has possible utility in the management of patients with non–small-cell lung cancer (NSCLC) is:
A. Calcitonin.
B. Neuron-specific enolase.
C. CYFRA 21-1.
D. Glucagon.
E. Chromogranin A.
Answer: C

18. A circulating marker that may be useful in the management of patients with any neuroendocrine tumor is:
A. Chromogranin A.
B. Neuron-specific enolase.
C. hCG.
D. Two of the above.
E. None of the above.
Answer: D

19. A 65-year-old man is seen two years following right hemicolectomy for a Duke’s B-2 carcinoma of the cecum. Although asymptomatic, the CEA level has risen four-fold from a value obtained six months previously. Computed tomography reveals a single, 3 cm lesion in the right hepatic lobe. There is no evidence of extra-hepatic metastatic disease and the patient undergoes right hepatic lobectomy. Which of the following correctly represents the chance of overall 5 year survival?

a. 15%
b. 33%
c. 50%
d. 66%
Answer: b

20. The most serious long-term side effect of bleomycin therapy is which of the following?

a. Pulmonary fibrosis
b. Cataract formation
c. Cardiomyopathy
d. Aplastic anemia
Answer: a

21. Which of the following malignancies have declined in incidence in the United States over the past two decades?

a. Breast carcinoma
b. Gastric carcinoma
c. Endometrial carcinoma
d. Prostate cancer
e. Carcinoma of the uterine cervix
Answer: b, c, e

22. Oncogenes have been implicated in the development of a number of human neoplasms. Oncogene activation is believed to be required for oncogenesis. Which of the following potential mechanisms are relevant to these processes?

a. Chromosome translocation
b. DNA point mutation
c. Amplification
d. Gene deletion
Answer: a, b, c

23. A 45-year-old woman undergoes excision of a 1 cm breast mass. Histologic examination reveals invasive ductal carcinoma. Flow cytometric analysis is also performed which determines that a fraction of the tumor cells are “aneuploid”. The patient asks for an explanation of this term. Which of the following is/are correct?

a. The cells have a DNA content 1 times the baseline content
b. The cells have hyperchromatic nuclei
c. The cells have a DNA content 2 times the baseline content
d. The cells have squamous morphology
e. The cells have a DNA content not an even multiple of baseline content
Answer: e

24. A 45-year-old man with long-standing gastroesophageal reflux undergoes upper endoscopy that reveals patchy areas of epithelium resembling gastric mucosa extending 5 cm proximal to the esophagogastric junction. Biopsies are obtained. The pathologic report describes “Barrett’s epithelium”. Which of the following processes does this finding represent?

a. Cellular hyperplasia
b. Cellular hypertrophy
c. Metaplasia
d. Carcinoma in situ
Answer: c

25. Which of the following statements regarding the inherited form of retinoblastoma is/are correct?

a. Retinoblastoma results from amplification of the H-ras oncogene
b. Clinical disease results after chromosomal loss in a retinal cell after birth
c. Retinoblastoma results from the loss of a tumor suppressor gene
d. Clinical disease results from chromosomal translocation
Answer: b, c

ONCOLOGY Objective type Questions with Answers

26. Analysis of metastatic tumor cells has revealed expression of factors promoting tissue invasion. Which of the following is/are among such factors?

a. Collagenase
b. Plasminogen activator
c. Fibroblast growth factor
d. Interleukin-2
Answer: a, b

27. The most common complication that requires alteration of planned chemotherapy regimens is which of the following?

a. Pulmonary fibrosis
b. Gastrointestinal ulceration
c. Hematologic suppression
d. Hepatotoxicity
Answer: c

28. Resistance of tumors to multiple chemotherapeutic agents is often due to the MDR gene. This gene encodes a protein that acts by which of the following mechanisms?

a. As a transmembrane efflux pump for chemotherapeutic agents
b. As a DNA repair molecule
c. As an isoform of superoxide dismutase
d. As a membrane stabilizer
Answer: a

29. The high incidence of hepatitis B infection in Africa and parts of Asia is thought to be causally associated with increased incidence of which of the following malignancies?

a. Hepatocellular carcinoma
b. Esophageal cancer
c. Burkitt’s lymphoma
d. Gastric carcinoma
Answer: a

30. Workers exposed to asbestos are at increased risk for which of the following tumors?

a. Thoracic mesothelioma
b. Bladder carcinoma
c. Laryngeal carcinoma
d. Testicular carcinoma
e. Non-Hodgkin’s lymphoma
Answer: a, b, c

31. The Lynch Syndrome is also known as hereditary non-polyposis colorectal cancer. Which of the following is/are features of this syndrome?

a. Left sided colon cancers
b. Autosomal dominant inheritance
c. Multiple polyps beginning in adolescence
d. Multiple cutaneous nevi
Answer: b

32. A number of clinical factors have been noted to decrease sensitivity of tumors to the effects of ionizing radiation. Which of the following is most important in this regard?

a. Increased tissue vascularity
b. High tumor mitotic rate
c. Tissue hypoxia
d. Subcutaneous tumor location
Answer: c

33. Brachytherapy involves the delivery of radiation therapy locally via specially designed catheters placed in direct apposition to the treated tissue. The most common radioisotope used in this application is which of the following?

a. 125I
b. 14C
c. 3H
d. 34P
Answer: a

34. Patients that have acquired immunodeficiency syndrome are at increased risk for which of the following neoplasms?

a. Colorectal cancer
b. Meningioma
c. Kaposi’s sarcoma
d. Hepatocellular carcinoma
e. Esophageal carcinoma

Answer: c

35. DNA viruses have been implicated as etiologic agents in several human tumors. Evidence for a causative role exists for which of the following neoplasms?

a. Burkitt’s lymphoma
b. Testicular carcinoma
c. Cervical carcinoma
d. Osteogenci sarcoma
e. Esophageal carcinoma
Answer: a, c

36. When a chemotherapeutic agent is stated to have caused a partial response this implies what degree of reduction in measurable tumor volume?

a. 0–9%
b. 10–29%
c. 30–49%
d. 50–99%
Answer: d

37. Which of the following represent obstacles to the use of retroviruses in therapeutic gene transfer?

a. Viral receptors may not be present on target cell membranes
b. For integration, the host cell must undergo mitosis
c. Virus particles are labile
d. Viral purification is difficult

Answer: a, b, c, d

38. Which of the following statements regarding alpha-1-antitrypsin deficiency is/are correct?

a. Alpha-1-antitrypsin is a plasma elastase inhibitor
b. Most homozygous patients develop chronic obstructive pulmonary disease
c. The spleen is the primary site of alpha-1-antitrypsin synthesis
d. Intracellular accumulation of abnormal protein occurs in hepatocytes
Answer: a, b, d

39. Which of the following statements regarding retroviruses is/are correct?

a. The genetic material contained within a retrovirus is RNA
b. Inside the host cell the viral RNA is converted to single-stranded DNA
c. Proviral DNA is integrated into the host chromosome
d. Retroviruses can be used to transfect both replicating and non-replicating cells
Answer: a, c

40. Which of the following statements relating to adenoviruses is/are correct?

a. Adenoviral infection is a common cause of upper respiratory tract infection
b. Adenoviral genetic material consists of double-stranded DNA
c. Adenovirus can be produced in large quantity and easily purified
d. Adenoviral infection requires host cell mitosis
Answer: a, b, c

41. Which of the following statement relating to cystic fibrosis is/are correct?

a. Cystic fibrosis is inherited as an X chromosome-linked recessive trait
b. Cystic fibrosis is caused by a defective chloride channel
c. Cystic fibrosis is caused by defective acetylcholine receptors
d. Cystic fibrosis is inherited as an autosomal recessive trait
Answer: b, d

42. Hemophilia B has been treated in a pre-clinical model by gene transfer for which deficient clotting factor?

a. Factor II
b. Factor VII
c. Factor IX
d. Factor X
Answer: c

43. Familial hypercholesterolemia has been proposed as a disease to be treated by gene therapy. The molecular basis of familial hypercholesterolemia is which of the following?

a. Absence of hepatic low density lipoprotein receptors
b. Overproduction of high density lipoprotein
c. Absence of lipoprotein lipase
d. Overproduction of hepatic ornithine transcarbamylase
Answer: a

44. Antisense oligodeoxynucleotides have been proposed as agents for cancer-directed gene therapy. When delivered intracellularly, antisense molecules act to block which of the following?

a. Transcription
b. Translation
c. Post-translational processing
d. Ribosylation
Answer: b

45. Which of the following viruses is/are considered to be neurotropic?

a. Adenovirus
b. Herpes simplex virus
c. Retrovirus
d. Adeno-associated virus
Answer: b

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