1. Which of the following concerning diamorphine elixir for the relief of pain in terminal patients is corrcet?
Correct : B. Constipation is a characteristic sequel to treatment
2. In a case of Dysgerminoma of ovary tumor markers is likely to be raised.one of the following
Correct : C. Serum lactate dehydrogenase
3. The most common pure germ cell tumor of the ovary is:
Correct : B. Dysgerminoma
4. The highest incidence of Gestational Trophoblastic Disease is in:
Correct : B. Asia
5. According to the FIGO staging of gestational trophoblastic tumors, a lady with choriocarcinoma having lung metastasis will belong to which stage
Correct : C. lll
6. A patient with non-metastatic gestational trophoblastic disease can be treated with weekly intramuscular injections of which of the following agents?
Correct : E. Methotrexate
7. Five-year survival rates of patients with low-risk, non-metastatic gestational trophoblastic disease approaches?
Correct : A. 100%
8. Comparing complete hydatidiform moles gestations, complete hydatidiform mole gestations are more likely than partial moles to demonstrate all of these characteristics except?
Correct : D. more likely to 'have focal rather than diffuse trophoblastic proliferation
9. A woman experiencing a molar pregnancy has an increased risk of which of the following in subsequent gestations ?
Correct : D. Recurrent molar gestation
10. The most likely karyotype of patient with a complete mole would be ?
Correct : A. 46, XX
11. The most likely karyotype for patient with a partial mole would be ?
Correct : C. Diandric triploidy
12. A woman with a complete mole is most likely to present with which of the symptoms?
Correct : A. Vaginal Bleeding
13. A patient with a complete mole is found to have sizeable ovarian cysts that are presumed to be theca lutein cysts. All of the following are true about theca lutein cysts EXCEPT?
Correct : D. Often require active management with surgical intervention
14. Regarding gestational trophoblastic disease (GTD),all are true except
Correct : A. Incomplete moles are more likely to undergo malignant change than the complete moles
15. Risk of Malignancy in Adenomatous polyp is related to all except
Correct : B. Number
16. Polyps are generally managed endoscopically. Which of the following is not an indication for resectional surgery
Correct : D. Lesion in upper 1/3rd of submucosa
17. Which of the following is not true for malignancy of Familial Adenomatous Polyposis
Correct : C. Astrocytomas
18. What is not true for HNPCC
Correct : C. It is associated with APC mutation
19. True about Ulcerative Colitis with malignancy
Correct : C. Is related to duration of ulcerative colitis
20. In ulcerative coilitis with toxic megacolon lowest rate of recurrence is seen in
Correct : A. Complete proctocolectomy and Brook's ileostomy
21. All are precancerous for carcinoma colon except
Correct : D. Carotene
22. Which of these genetic risk factors has the highest association with colon cancers
Correct : A. Sporadic
23. After total proctocolectomy with ileal pouch anal anastomoses what is the most common cause of death in patients with Familial Adenomatous Polyposis (FAP)
Correct : B. Periampullary carcinoma
24. Most valuable investigation for preoperative evaluation of extensive corrosive stricture is
Correct : A. Endoscopic ultrasound
25. Not an association between (PSC) Primary sclerosing cholangitis and Ulcerative colitis (UC)
Correct : C. Colitis is severe in patients with both PSC And UC as compared to UC alone
26. Which is the most accurate method of detecting colon cancer
Correct : D. Colonoscopy
27. What is the most appropriate treatment for T3 colon cancer
Correct : D. Surgery plus chemotherapy
28. Radiotherapy is indicated in
Correct : C. T3 rectal cancer
29. Concerning small intestinal fistulae, all the following are true EXCEPT:
Correct : E. The lower the fistula the higher the fluid and nutrient loss.
30. Concerning colonic polyps:
Correct : E. Most adenocarcinomas arise within pre-existing adenomas.
31. A 45 years old male with bilateral breast cancer with his mother developed breast cancer when aged 34 years and his sister developed ovarian cancer at age 50 years. The most likely genetic mutation for this patient is/are
Correct : B. BRCA2
32. A 45 years old female with right sided breast cancer with no family history suggesting familial cancer.
The most likely genetic mutation for this patient is/are
Correct : B. BRCA2
33. Chromosomal 17 has many genes implicated in molecular criteria of breast cancer
including these genes EXCEPT:
Correct : D. ATM
34. Concerning adenomatous polyps, all the following are true EXCEPT:
Correct : C. They occur mainly in the ileum
35. Familial polyposis coli
Correct : D. polyps develop throughout the colon and rectum early in the second decade of life
36. Gardner's syndrome is associated with all the following EXCEPT:
Correct : E. no malignant potential
37. All the following may predispose to colorectal cancer EXCEPT
Correct : B. High fibre, low fat diets
38. Genes implicated in the pathogenesis of colorectal cancer include all the following
EXCEPT:
Correct : D. BRCA1 gene
39. The carcinoid syndrome is likely to occur with carcinoid tumors:
Correct : D. neither
40. Carcinoid tumors (argentaffinomas) are characterized by all of the following except:
Correct : E. appendiceal types have greatest malignant potential
41. Primary carcinoma is least common in:
Correct : C. small intestine
42. Which is most characteristic of carcinoma of the cecum or right colon (in contrast to
carcinoma of the rectum)?
Correct : A. anemia
43. In which of the following segments of the gastrointestinal tract is primary carcinoma
least common?
Correct : C. small intestine
44. Bilateral ovarian metastases presenting as tumor masses are most
characteristically associated with carcinoma of the:
Correct : B. stomach
45. The worst prognosis is associated with carcinoma of the:
Correct : A. esophagus
46. Diffuse intramural spread with extensive fibroblastic thickening is a morphologic
pattern most characteristically associated with carcinoma of the
Correct : B. stomach
47. Carcinoid tumors have a varied malignant potential. The most benign are located in the:
Correct : D. appendix
48. Which of the following characterizes the biologic nature of carcinoid tumors (argentaffinomas)?
Correct : B. production of systemic symptoms when they metastasize to the liver
49. In the colon, which is benign and has no significant tendency to undergo malignant
transformation?
Correct : B. juvenile polyp
50. Carcinoma of the esophagus:
Correct : B. is difficult to cure because of local spread
51. Carcinoma of the esophagus has a poor prognosis because:
Correct : C. local spread usually prevents complete removal
52. All of the following correctly describe carcinoma of the esophagus except:
Correct : B. most frequently involves adenocarcinoma
53. Which of the following is most characteristic of carcinoma of the esophagus?
Correct : B. difficult to cure because of local spread
54. The most common type of esophageal cancer in the United States is:
Correct : D. squamous cell carcinoma
55. What is the significance of intestinal metaplasia in the stomach or colon?
Correct : B. It is frequently associated with mildly precancerous inflammatory disease.
56. Multiple recurrent ulcers in proximal and distal duodenum for several years are
likely to be associated with:
Correct : B. islet cell adenoma of pancreas
57. In a patient with a chronic peptic ulcer of the stomach, the chance that carcinoma
will develop in the ulcer is:
Correct : D. very small
58. Carcinoma of the stomach usually arises from:
Correct : D. mucus producing cells
59. Which presents as a bulky mass lesion often with deep central ulceration?
Correct : C. both
60. Lymphoma of the stomach:
Correct : C. both
61. Which neoplasm is most FREQUENTLY found in the appendix?
Correct : A. carcinoid
62. The most benign examples of carcinoid tumor usually are found in the:
Correct : B. appendix
63. Which type of polyp is most LIKELY in a patient presenting with watery mucoid
diarrhea?
Correct : C. villous adenoma
64. Familial breast cancer is characterized by
Correct : C. Associated cancers tend to be more aggressive, of a higher grade, and hormone receptor negative.
65. A bulky tumor of the rectum exhibits a delicate, velvety, easily bleeding surface. It
has no pedicel and its base appears to be as wide as its apex. The process is most probably:
Correct : B. villous adenoma
66. Which is characterized by small size?
Correct : B. hyperplastic polyp
67. Which best characterizes Peutz-Jeghers polyps?
Correct : B. multiple, hamartomatous, not premalignant
68. Which of the following factors is most valuable in predicting the biologic behavior of carcinoma of the colon?
Correct : E. lymph node metastasis
69. Which of the following is most strongly predisposing to colon cancer?
Correct : B. familial polyposis
70. Adenocarcinoma of the ascending colon is more likely than adenocarcinoma of the sigmoid colon to:
Correct : B. be bulky
71. Persistent elevation of serum carcinoembryonic antigen following surgical resection of a carcinoma of the colon suggests:
Correct : D. metastases
72. In contrast to carcinoma of the right colon, carcinoma of the left colon tends to be associated with:
Correct : D. obstruction
73. Which of the following lesions of the colon has the least tendency to undergo malignant transformation?
Correct : B. juvenile polyp
74. Predisposes to adenocarcinoma:
Correct : A. Barrett‟s esophagus
75. Predisposes to squamous cell carcinoma:
Correct : B. achalasia, esophagus
76. A 76-year-old male was admitted for symptoms including constipation, change in stool character and weight loss. Colonoscopy revealed multiple polyps in the rectosigmoid area. An adenomatous polyp was removed. Another colonic tumor was seen in the same patient which was flat with irregular “shaggy rug” surface. A biopsy showed frond-like glandular architecture. Atypical epithelial cells in clusters were seen beneath the muscularis mucosae. The most likely diagnosis is:
Correct : C. focus of adenocarcinoma arising in villous adenoma
77. An elderly male had rectal bleeding. A flat velvety mass was observed in the
cecum. The provisional diagnosis was villous adenoma. A partial colectomy was performed. Invasion through the muscularis mucosae, but not into the muscularis propria, was observed on paraffin sections. Therefore, the final diagnosis was:
Correct : C. adenocarcinoma Dukes A
78. A male heavy smoker develops increasing difficulty in swallowing gradually over six months. Constriction of the mid-esophagus is seen on x-ray of barium swallow. The most likely diagnosis is:
Correct : D. squamous cell carcinoma
79. Which of the following chemotherapy drug is likely to be toxic to gonads?
Correct : D. Procarbazine
80. High dose chemotherapy given prior to stem cell transplant may be associated with
gonadal failure. Risk is least with the use of
Correct : D. Fludarabine + ATG
81. Incidence of Gallbladder cancer is highest in
Correct : A. Chile
82. Which of the following is least to occur as Gallbladder primary?
Correct : C. Lymphoma
83. Which of the following is less likely to be associated with Gallbladder cancer?
Correct : C. Aflatoxins
84. On immunohistochemistry, classical Hodgkin‟s lymphoma Reed sternberg cells are
likely to be
Correct : C. CD15(+), CD 30(+),CD45(-)
85. Most common site of metastasis in breast cancer is
Correct : C. bone
86. Which one of the following cancers is usually associated with a moderate to high uptake of 18F-fluorodeoxyglucose (18 FFDG)?
Correct : B. Colorectal
87. Which one of the following is an accurate definition of the sensitivity of a screening test?
Correct : C. The percentage of screening tests that is positive among patients who remain unaffected by the condition of interest after screening
88. Epstein-Barr virus-associated Hodgkin‟s lymphoma is …
Correct : B. common in young children
89. Treatment of early stage favorable Hodgkin‟s lymphoma …
Correct : C. with 4 cycles of chemotherapy and low dose involved-filed radiotherapy is the standard of care
90. Regarding G-CSF - the best description of its mechanism of action and role in chemotherapy is
Correct : A. reduced PMN nadir when used as prophylaxis
91. A 44-year-old woman presented with post-coital bleeding. Investigation revealed a 2-cm grade 1, stage IB1 squamous cell carcinoma of the cervix. There was no evidence of lymphovascular space invasion. She had completed her family.What is the most appropriate treatment?
Correct : D. radical hysterectomy
92. Mutations in which gene are least likely to be associated with breast cancer if inherited in the germ-line?
Correct : D. Bcl-2
93. The least likely to be associated with bowel cancer is
Correct : B. Der-abl gene translocation
94. 14 year old girl with Hodgkin's disease is treated with radiotherapy (mantle field).
Which is the most likely secondary carcinoma that could develop
Correct : A. breast
95. Young male with germ cell cancer. He is on bleomycin. etoposide and cisplatinum.
What side effect would make you stop the treatment?
Correct : B. neutropenic septicaemia
96. Most likely route of ovarian cancer spread:
Correct : B. direct spread to adnexae
97. Man with medullary carcinoma of thyroid, worried about his son. What do you do?
Correct : C. look for ret oncogene in blood
98. Metastatic renal cell carcinoma, symptomatic:
Correct : C. Surgery
99. An older woman with breast cancer with bony metastases who was on aminoglutamethonine. Picture of rash which covered right breast and covered left breast a little, small nodules, some dead skin and a few scaly bits. Most likely cause of rash?
Correct : D. skin recurrence
100. Male with bone pain from metastatic prostate cancer will be started on LHRH antagonist. He refuses orchidectomy. His illness will show: