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Most cardiotoxic anticancer drug -

Anthracycline

Alkylating agent

Platinum compound

Bisphosphonates

A patient develops a persistent macrocytic anemia. Serum folate levels are normal, but serum vitamin B12 levels are low. Oral vitamin absorption studies demonstrate that the patient is unable to absorb vitamin B12 in adequate amounts. Cancer of which of the following organs is most strongly associated with this patient's condition?

Colon

Duodenum

Esophagus

Stomach

A 50-year-old woman who has a family history of breast cancer presents with a 6-month history of increasing abdominal girth. On close questioning, she volunteers a history of vague abdominal pain dating back 1 year. She has no children and has never been pregnant. Bimanual pelvic examination reveals a 10-cm right adnexal mass. Percussion of the abdomen indicates ascites. Aspiration cytology of the ascites fluid reveals malignant papillary structures with psammoma bodies. A mutation in which of the following genes is most likely associated with this patient's malignant disease?

BRCA1

p53

Rb

VHL

Most common Site of tongue Cancer

Base of tongue

Tip of tongue

Lateral margin of tongue

Posterior attachment of tongue

Which of the following drugs has been recently approved for treatment of prostate cancer?(REPEAT)

Leuprolide

Goserelin

Abarelix

Degarelix

Which of the following cancers tends to metastatize to the lymphnodes -

Follicular Carcinoma

Pappilary carcinoma

Medullary Carcinoma

Thyroid Lymphoma

A 65 year old man has stools positive for occult blood which of the following is most likely location of bowel cancer

Sigmoid

Transverse colon

Appendix

Ascending colon

A 56-year-old woman diagnosed with cancer in her left breast underwent a mastectomy with axillary lymph node dissection. Postoperatively, she develops marked swelling of the left arm that has persisted for 6 months. Now on physical examination, her temperature is 36.9deg C. Her left arm is not tender or erythematous, and it is not painful with movement or to touch, but it is enlarged with a doughy consistency. Which of the following is the most likely mechanism for these findings?

Cellulitis

Congestive heart failure

Decreased plasma oncotic pressure

Lymphedema

Cancer cells derive nutrition from

Glycolysis

Oxidative phosphorylation

Gluconeogenesis

Glycogenolysis

Under National Cancer control Programme, oncology wings were sanctioned to -

Regional Cancer institutes

District Hospitals

Medical college Hospitals

Voluntary Agenecies treating cancer patients

The risk factor association of pancreatic cancer was studied in a case control study. The values of the odds ratio and the confidence interval for various risk factors are as below: Risk factors Odds ratio 95% confidence limit A 2.5 1 - 3 B 1.4 l .1 - 1.7 C 1.6 0.9 -1.7 Which is true:

Risk A has strongest association with pancreatic cancer

Risk B has the strongest association

Risk C has the strongest association

All three are equally associated

A 53-year-old woman who is being treated for metastatic breast cancer is noted to have some lethargy, fatigue, and an elevated serum calcium level. She is brought into the ER for near comatose state, thought to be caused by the hypercalcemia. After addressing the ABCs (airway, breathing, circulation), wof is the best therapy for this patient

Bisphosphonates

IV estrogen therapy

Saline infusion and furosemide

Vitamin D

The post-operative quality of life (QOL) scores of 200 prostate cancer patients has a mean of 60 and a standard deviation of 10. How many patients are expected to have a QOL score between 40 and 80?

190

136

120

140

Multiple liver secondaries are most common in the following cancers

Head of pancreas

Stomach

Gall bladder

Periampullary

Cancers associated with excess fat intake are/is ?

Breast

Colon

Prostate

All

Intestinal polyps that have highest potential to grow into cancer

Inflammatory polyp

Adenomatous polyp

Hyperplastic polyp

Hamaomatous polyp

Test used to differentiate between chromosomal pattern of normal cell and cancer cell?

FISH

PCR

Karyotyping

Comparative genomic hybridization

ER Positive cases of cancer breast - drug given is

Bevacizumab

Tamoxifen

Cyclophosphamide

Adalimumab

A 74-year-old man presents to the emergency department with new symptoms of blood tinged sputum. For the past week he has noticed streaks of blood in his chronic daily sputum production. He reports no fever or chills, but has lost 10 lb in the past 6 months involuntarily. His past medical history is significant for hypertension, dyslipidemia, and a 40-pack year history of smoking.On physical examination, he has bilateral expiratory wheezes, and there is clubbing of his fingers. No lymph nodes are detected and the remaining examination is normal. A CXR reveals a left hilar mass. Which of the following suggests that the tumor is a small cell lung cancer?

syndrome of inappropriate anti diuretic hormone (SIADH) secretion

acanthosis nigricans

Cushing syndrome

leukemoid reaction

Which of the following radioisotopes is commonly used as a source for external beam radiotherapy in the treatment of cancer patients?

Strontium-89

Radium-226

Cobalt-59

Cobalt-60

Signet-ring cells are found in which type of breast cancer NOT RELATED- GYN

Papillary carcinoma

Tubular carcinoma

Invasive ductal carcinoma

Invasive lobular carcinoma

T-4d in TNM staging of breast cancer is

Involvement of skin

Involvement of chest wall

Inflammatory carcinoma

Peau'de orange appearance

Down&;s syndrome predisposes to ............ cancer

AML

CML

ALL

CLL

A sublingual cancer in a 65 year old tobacco chewer has involved the mandible. The commando surgery has been planned. All of the following in removed in commando operation except

Involved mandible

Oral cancer

Accessory nerve

Neck lymphnodes

In exocrine pancreatic, cancer, the commonest tumor marker to be elevated in

CA 125

CEA

CA 15-3

CA 19-9

Best tumor marker for pancreatic cancer?

CA 125

CA 19-9

CEA

AFP

Which of the following is given to treat thrombocytopenia secondary to anti-cancer therapy and is known to stimulate progenitor megakaryocytes

Filgrastim

Oprelvekin

Erythropoietin

Anagrelide

A 66-year-old woman presents with a 6-month history of scaling and abnormal pigmentation of the skin. Her past medical history is significant for the treatment of thyroid cancer 1 year ago. Biopsy of lesional skin shows atrophy of the epidermis and dense fibrosis of the dermis, which displays dilated superficial blood vessels. These pathologic findings are most likely caused by previous exposure to which of the following?

Chemotherapy

Corticosteroids

Organic iodine

Radiation therapy

Most common type of cancer gall bladder in a patient with gallstone-

Adenocarcinoma

Squamous carcinoma

Sarcoma

Pre-cancerous lesion of bone?

Paget disease

Chronic osteomyelitis

Benign giant cell tumor

All of above

Which one predisposes to Breast cancer-

Adenosis

Fibrosis

Blue domed cysts

Epitheliosis

According to Modified Astler-Collar Classification for colorectal cancer, lymph node invasion with penetration of the entire bowel wall is included in stage:

B1

B2

C1

C2

Precancerous condition of Ca stomach is -

Peptic ulcer

Chronic gastric atrophy

Achalasia cardia

Curling' s ulcer

Following can cause endometrial cancer:

Metropathia hemorrhagica

Gynandroblastoma

Dysgerminoma

All of the above

A study revealed lesser incidence of carcinoma colon in pure vegetarians than non-vegetarians by which it was concluded that b-carotene is protective against cancer. This may not be true because the vegetarian subjects may be consuming high fibre diet which is protective against cancer. This is an example of:

Multifactorial causation

Causal association

Confounding factor

Common association

A 70 years old man with prostate cancer was given radiotherapy. The recurrence of the cancer is monitored biochemically by:

Androgens only

Prostate specific antigen and carcinoembryonic antigen

Prostate specific antigen only

ALP and CEA

Major contribution to cachexia with advanced cancer-

Clathrin

Histamine

Nutritional demands of cancer

Tumor-necrosis-factor (TNF)

Not a carcinogen for bladder cancer -

Benzidine

Isoprospyl alcohol

Acrolein

Phenacetin

Precancerous lesions of GB are all except

Procelain GB

Typhoid carrier

ABPDJ

Biliary ascariasis

Management of stage IIB cancer cervix is?

Radiotherapy

Radiotherapy with combination with chemotherapy

Chemotherapy

Hysterectomy

The Astler-Coller modification of the Dukes classification is used to classify cancers of the

Liver

Colon

Lung

Stomach

Barrett's esophagus causes which cancer:

Adenocarcinoma

Squamous cell CA

Carcinoid tumor

Esophageal leiomyoma

In which one of the following perineural invasion in head and neck cancer is most commonly seen?

Adenocarcinoma

Adenoid cystic carcinoma

Basal cell adenoma

Squamous cell carcinoma

Drug of choice for controlling severe pain in cancer patient is:

Morphine

Diclofenac

Ibuprofen

Codiene

A 58-year-old woman undergoes excision biopsy of a tumor in the left posterior triangle of her neck. Histology suggests that this is a metastatic cancer. What is the most likely site of the primary tumor?

Ovary

Adrenal gland

Kidney

Piriform fossa

The wasting syndrome associated in cancer is

Achalasia

Cacchexia

Atelexis

Cacoguesia

A 33-year-old woman presents to the emergency depament complaining of nausea and vomiting. She states that she has been having significant nausea that has been worsening over the past 2 weeks. Over the past 2 days, she has had 2 episodes of vomiting. She also notes increased fatigue. She has no abdominal pain or vaginal bleeding. She has no other complaints. Her past medical history is significant for occasional migraine headaches. She has never had surgery. She takes acetaminophen as needed for headache, and has no known drug allergies. She works as a lawyer at a local firm and lives with her husband for three years. She has no family history of cancer or hea disease. Her vital signs are stable. Examination is significant for a bluish-appearing cervix on speculum examination. The remainder of the examination, including the abdominal examination, is benign. Laboratory evaluation shows: Urine hCG: positive Leukocytes: 9,000/mm3 Hematocrit: 41% Platelets: 250,000/mm3 Pelvic ultrasound demonstrates a gestational sac with yolk sac and fetal pole surrounded by myometrium. There is a hea rate of 154 beats per minute. Which of the following is the MOST likely diagnosis?

Appendicitis

Complete hydatidiform mole

Ectopic pregnancy

Intrauterine pregnancy

Which of the following is given to treat thrombocytopenia secondary to anticancer therapy and is known to stimulate progenitor megakaryocytes?

Filgrastim

Oprelvekin

Erythropoietin

Iron dextran

Lynch syndrome is associated with cancers of the

Breast ,colon, ovary

Breast , endometrium, ovary

Breast ,colon,endometrium

Colon,endometrium ,ovary

Pancreatic Cancer is caused by:

Fasciola

Clonorchis

Paragonimus

78 year old male, known case of prostate cancer with multiple painful veebral metastasis. Ideal management plan would be -

Androgen ablation with Orchidectomy

Palliative Chemotherapy

Radical prostatectomy

TURP

Breast cancer mainly spreads to the vertebrae via -

Arterial route

Direct Invasion

Batsons venous plexus

Via Axillary lymph nodes

Absolute contraindication of conservative breast cancer therapy is

Large pendulous breast

History of previous radiation

Axillary node involvement

Subareolar lump present

Most common subtype of thyroid cancer is ?

Medullary carcinoma

Papillary carcinoma

Follicular carcinoma

Anaplastic carcinoma

In a village of 1 lakh population, among 20, 000 exposed to smoking, 200 developed cancer, and among 40,000 people unexposed, 40 developed cancer. The relative risk of smoking in the development of cancer is -

20

10

5

15

A 64-year-old man undergoes CEA surveillance for cancer, because his brother and father both had colon cancer. What information should he be provided?

CEA is highly sensitive for diagnosis.

If CEA is elevated preoperatively, it implies unresectable disease.

Increases in CEA after resection may indicate tumor recurrence.

CEA is highly specific for the presence of colon cancer.

A 35-year-old man undergoes gastrectomy for gastric carcinoma. Gross examination of the resected stomach reveals diffuse thickening without a discrete mass lesion. Microscopic exam shows an infiltration of signet-ring cells dispersed singly. Family history reveals that his father had a similar cancer at a young age. What gene is most likely to be mutated in this patient and his father?

APC

CDH1

PMS2

p53

Best diagnosis of pancreatic cancer (head) is by:

Ultrasound

ERCP

CT scan

Angiography

Which of the following anti-cancer drug is not anti-inflammatory or immunosuppressive

Methotrexate

Azathioprine

L-Asparginase

Cyclopohosphamide

All of the following constitute supraglottic cancer except:

Vallecula

Lower border of cricoid

Posterior commisure

All

True about small cell lung cancer -a) Bone marrow is uncommonly involvedb) Destruction of alveolar cellsc) Peripheral in locationd) Treatment is chemotherapy

c

d

bd

ac

Which of the following is TRUE/FALSE about weight loss? a) Psychiatric disorders are a major cause of involuntary weight loss. b) Up to 20% of all cancer deaths are caused directly by cachexia. c) Connective tissue diseases decreases metabolic demand. d) Hypehyroidism in the elderly have more prominent sympathomimetic features. e) Involuntary weight loss may be one of the earliest manifestations of Alzheimer's dementia.

a,b,c,d,e-True None-False

a,b,c-True & d,e-False

a,b,c,d-True & e-False

a,b,e-True & c,d,-False

Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage

C1

C2

D1

D2

Recurrent or residual cancer of nasopharynx after super voltage radiotherapy is treated by:

Intracavitary radioactive implants

Cryotherapy

Surgery

All of the above

Most common thyroid Cancer is -

Papillary carcinoma

Follicular carcinoma

Medullary carcinoma

Anaplastic carcinoma

All are true about colon-rectal cancers except

Tumours of the left side of the colon usually present with a change in bowel habit

Tumours of the right side of the colon present with iron deficiency anaemia

Right present earlier then left sided cancers

Left sided cancers are more common than right

Pulmonary fibrosis is an adverse effect of which of the following anti-cancer drugs?

Mitomycin C

Hydroxyurea

Bleomycin

Cisplatin

A female patient with breast cancer presenting with altered sensorium. The following MRI suggests:

Herpes simplex encephalitis

Gliomatosis cerebri

Limbic encephalitis

Metastasis

Which of the following antifungal is used in cancer chemotherapy?

Flucytosine

Amphotericin B

Voriconazole

Ketoconazole

Cancer cachexia is due to?

TNF-a

IL-5

IL-8

Phopholipase A2

Which of the following anti-cancer drug comes under monoclonal antibodies: March 2013

Di-ethyl-stilbestrol

Tamoxifen

Ritumixab

Boezomib

A 49-year-old man suffering from carcinoma of the prostate was x -rayed. He showed areas of sclerosis and collapse of T10 and T11 vertebrae in x-ray. The spread of this cancer to the above vertebrae was through -

Sacral canal

Lymphatic vessels

Internal vertebral plexus of veins

Superior rectal vein

Histopathology of a lung cancer shows 'Clara cells' probable diagnosis is -

Squamous cell cancer

Bronchio alveolar cancer

Large cell cancer

Papillary carcinoma

Use of tamoxifen for breast cancer can cause all ofthe following adverse effects, exceptaEUR'

>Thromboembolism

Endometrial carcinoma

>Carcinoma in contralateral breast

>Cataract

In which TNM staging of glottis carcinoma, cancer limited to larynx w ith vocal cord fixation? (D. REPEAT 2012)

T1

T2

T3

T4

Which enzymatic mutation is responsible for immoality of cancer cells :

DNA reverse transciptase

RNA polymerase

Telomerase

DNA polymerase

A high prevalence of CA cervix was found to be there in one of the tribal area of Pakistan. It was planned to have free facility of pap smear taken in the concerned rural health centre to screen the local population for the particular cancer. The program showed a lot of resistance as it lacked

Acceptability

Affordability

Accessibility

Effectiveness

The first change in precancerous lesion on colposcopy is

Mosaics

Puntation

Acetowhite lesions

Cork-screw vessels

In a case of endometrial cancer, if metastasis is seen in the vagina, what FIGO stage it would be :

Stage III a

Stage III b

Stage III c

Stage IV a

Smoking is most strongly associated with which type of lung cancer?

Small cell cancer

Squamous cell carcinoma

Adenocarcinoma

Carcinoid tumor

Which of the following cancer makes up the majority in reproductive tract neoplasms during pregnancy?

Vaginal

Cervical

Uterine

Ovarian

Which enzymatic mutation is responsible for immortaity of cancer cells

DNA reverse transcipatase

RNA polymerase

Telomerase

DNA polymerase

50 yr old female presented with lump in right breast. She was diagnosed having Luminal A carcinoma. All are true about this cancer except ?

M/C subtype

Best prognosis

ER/ PR negative

Response poor to paclitaxel

Which of the following is an increased risk of breast cancer?

Sclerosing adenosis

Atypical hyperplasia

Fibroadenoma

Florid hyperplasia

All are true about rectal cancer except:

Most common symptom is hematochezia

Precise location of tumor is done with rigid proctosigmoidoscopy

Dissection lateral to endopelvic fascia investing the mesorectum causes local recurrence

Radiation dose is 60 Gray

Locally invasive gastric carcinoma. Investigation of choice to know depth of cancer invasion:

CECT

MRI

Barium

EUS

Overall most common cancer in wold

Lung cancer

Colon cancer

Breast cancer

Thyroid carcinoma

Polycythemia is associated with all the following cancers except

Stomach cancer

Liver cancer

Prostrate cancer

Renal cell cancer

Predisposing factors for skin cancer are-a) Smokingb) U-V-light c) Chronic ulcerd) Infrared light

bc

c

ac

ad

A patient with cancer received extreme degree of radiation toxicity. Fuher history revealed that the dose adjustment of a paicular drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment in that patient during radiotherapy in order to prevent radiation toxicity -

Vincristine

Dactinomycin

Cyclophosphamide

6-Mercaptopurine

Tumor marker for Breast cancer?

CA 15-3

CA 19-9

CA 125

CEA

Because of positive biopsy findings and negative workup, he undergoes a radical prostatectomy. The pathology report reveals Gleason score 9/10 and involvement of several pelvic lymph nodes. Which is the most likely site for prostatic cancer metastasis?

Liver

Kidney

Lung

Bone

If stage lb cervical cancer is diagnosed in a young woman, while performing radical hysterectomy which structure would you not remove

Uterosacral and uterovesical ligament

Pelvic Lymph nodes

periureteral tissues

Upper third of vagina

Following is associated with maximum risk of invasive cervical cancer:-

LGSIL

HPV associated koilocytosis

High grade squamous intraepithelial lesion (HGSIL)

HSV related changes

A 50 year old breast cancer patient presents with breathlessness. What does the ECG show?

Normal tracing

AV dissociation

Electrical Alternans

Electromechanical dissociation

For the following findings, select the most likely type of lung cancer.Has the best prognosis of all malignant lung cancers.

cancer metastatic to the lung

squamous cell cancer of the lung

adenocarcinoma of the lung

small cell cancer of the lung

Most important dose-limiting toxicity of cancer chemotherapy is :

Gastrointestinal toxicity

Neurotoxicity

Bone marrow suppression

Nephrotoxicity

All the following are hormonal agents used against breast cancer except

Letrozole

Exemestane

Taxol

Tamoxifen

Screening test for cervical cancer is:

Biopsy

Papaniculaou smear

Visual inspection

Colposcopy

The phenomenon of cancer cells switching to glycolysis even in the presence of adequate oxygen for oxidative phosphorylation is known as:

Tyndall effect

Warburg effect

Hawthorne effect

None of the above