Question 1

Which of the following proto-oncogenes is least likely to be associated with an increased risk of breast cancer?

Accepted Answer

Wiskott Aldrich Syndrome is primarily associated with immunodeficiency and not directly linked to an increased risk of breast cancer, unlike the other options listed which are known to have associations with breast cancer risk.

Question 2

A 40-year-old male is operated on for a medullary carcinoma of the thyroid. He expresses concern about his 10 years son getting the disease. The best test:

Accepted Answer

DNA analysis for RET proto-oncogene in peripheral blood is the best test for screening family members of patients with medullary thyroid carcinoma, as it can identify those who carry the genetic mutation responsible for the disease.

Question 3

Patient with germ cell tumor receiving BEP. Which side-effect would necessitate cessation of the responsible drug:

Accepted Answer

A

Question 4

A female presents with shortness of breath. CXR is shown with whiteout of Left lung. Told neurone-specific enolase +ve, next best step in management:

Accepted Answer

Chemotherapy is the most appropriate next step in management for a patient presenting with symptoms and findings suggestive of a small cell lung cancer (SCLC), indicated by the positive neuron-specific enolase (NSE) and the presentation on the chest X-ray. SCLC is highly aggressive and typically responds better to chemotherapy than to surgical resection, radiotherapy, or other localized treatments in the initial management.

Question 5

Which of the following best describes the incidence of colon cancer with age:

Accepted Answer

The incidence of colon cancer increases exponentially after age 50, reflecting the cumulative effect of risk factors over time and possibly the increased surveillance and screening in older populations.

Question 6

All of the following can occur in germ line leading to breast cancer except which one:

Accepted Answer

Bcl-2 is primarily associated with apoptosis regulation rather than directly with germ line mutations leading to breast cancer. BRCA1, BRCA2, p53, and the Ataxia telangiectasia gene are all known to have germ line mutations that can predispose individuals to breast cancer.

Question 7

Which of the following is the least likely to be involved in hereditary colon cancer:

Accepted Answer

Chromosomal translocations are more commonly associated with hematologic cancers and sarcomas than with hereditary colon cancer. Hereditary colon cancer is more often linked to mutations in specific genes (like APC), defects in DNA repair genes, alterations in microsatellites (as seen in microsatellite instability), and deletions of genes rather than chromosomal translocations.

Question 8

A 50 year patient presents with metastatic renal cell carcinoma. The best management would be:

Accepted Answer

The answer of A 50 year patient presents with metastatic...

Question 9

The genetic defect in hereditary non-polyposis coli lies in:

Accepted Answer

The genetic defect in hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome, lies in a DNA repair defect. This condition is characterized by mutations in mismatch repair (MMR) genes, which are crucial for correcting DNA replication errors.

Question 10

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:

Accepted Answer

The presence of nodules and plaquing over and around the scar of a previous mastectomy, with extension onto the contralateral breast, is highly suggestive of tumor recurrence. This pattern is not typical for radiation recall, fungal infection, or herpes zoster.

Question 11

Which is the strongest predictor of an increased risk of breast cancer in a 40 ys woman:

Accepted Answer

Previous breast carcinoma in the contralateral breast is a strong predictor of an increased risk of breast cancer, indicating a personal history of breast cancer increases the risk of developing a new cancer in the other breast.

Question 12

A young male has non-Hodgkin's lymphoma. The LMO starts prednisone whilst awaiting a haematology admission. He presents unwell with WCC previously 30, now 2, urate 2.3, K 8.0, phosphate 10, Cr .25. The most likely diagnosis?

Accepted Answer

Tumor lysis syndrome is the most likely diagnosis given the presentation of acute kidney injury (elevated creatinine), hyperkalemia (K 8.0), hyperphosphatemia (phosphate 10), and hyperuricemia (urate 2.3) following the initiation of chemotherapy in a patient with a high tumor burden, such as non-Hodgkin's lymphoma. These symptoms are characteristic of tumor lysis syndrome, a potentially life-threatening condition caused by the rapid release of intracellular contents from lysed cancer cells into the bloodstream.

Question 13

A young female (30 years) had mantle radiotherapy in her teens. The most likely cancer site in her now:

Accepted Answer

Mantle radiotherapy in young females, especially during adolescence, significantly increases the risk of developing breast cancer later in life.

Question 14

The most common mechanism of spread of epithelial ovarian cancer is:

Accepted Answer

The answer of The most common mechanism of spread of...

Question 15

A man with metastatic prostate cancer with increasing bone pain. The decision is made to start a GnRH agonist Your advice regarding the likely effect of this:

Accepted Answer

GnRH agonists initially cause a surge in testosterone levels, which can temporarily worsen symptoms (tumor flare) in prostate cancer patients, followed by a decrease in testosterone levels leading to symptom improvement.

Question 16

Concerning lung cancer:

Accepted Answer

The use of chemotherapy in combination with radiotherapy for patients with stage III non-small cell lung cancer (NSCLC) has been shown to improve survival, making it a standard approach for the treatment of this stage of lung cancer.

Question 17

Regarding familial breast cancer, which of the following statements is true?

Accepted Answer

Mutation of the BRCA1 gene is known to increase the risk of both breast and ovarian cancer.

Question 18

Oesophageal cancer is associated with:

Accepted Answer

The answer of Oesophageal cancer is associated with:
...

Question 19

Small cell lung cancer is more associated with ( than NSCLC)

Accepted Answer

The answer of Small cell lung cancer is more associated...

Question 20

Regarding cell kinetics of cancer:

Accepted Answer

The answer of Regarding cell kinetics of cancer:
...

Quiz 9: Cancer and Management Scenarios