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The most common side effect of cancer chemotherapy is nausea with or without vomiting. The anticancer drugs vary in their ability to cause nausea and vomiting. Which of the following anti- cancer drugs is least likely to cause nausea and vomiting?

Chlorambucil

Cisplatin

Doxorubicin

Daunorubicin

A 36-year-old woman presents with swelling in her neck that she first noticed 3 months ago. She also complains of intermittent watery diarrhea over the same time period. Physical examination reveals a nontender nodule in the left lobe of the thyroid. The patient's mother died of thyroid cancer 8 years ago. The thyroid nodule is found to be "cold" by radioiodine scintiscan. A needle biopsy of the nodule reveals malignant cells and homogeneous eosinophilic material The tumor in the patient described in Question 38 is removed, and a section stained with Congo red reveals birefringent amyloid stroma. Genetic studies show that this patient has a familial cancer syndrome. In addition to hyperparathyroidism, the patient is advised that she is at risk of developing which of the following neoplastic diseases?

Craniopharyngioma

Follicular adenoma of thyroid

Neuroblastoma

Pheochromocytoma

Screening in general population done in cancers of -

Breast

Colon

Cervix

Ovarian

Which of the following is a precancerous condition?

Lichen Sclerosus

Condyloma acuminatum

Squamous cell hyperplasia

Vaginal adenosis

The new drug pemetrexed useful in breast cancer belongs to which of the following category of the drugs ?

Antitumor agent

Alkylating agent

Hormonal agent

Antimetabolite

The most common site of vulval cancer :

Labia majora

Labia minora

Prepuce of the clitoris

Baholin's gland

50 year old male with positive family history of prostate cancer has come to you for a screening test. The most sensitive screening test to pickup prostate cancer is:

DRE

PSA

DRE + PSA

Endorectal Coil MRI with T1W and T2W images

After laparoscopic cholecytectomy, if biopsy reveals insitu cancer of gallbladdet(Stage - I), then the appropriate management is

Follow up

Extended cholecystectomy

Excision of all po sites

Radiotherapy

All are Precancerous for carcinoma esophagus Except

Achalasia

Paterson-Brown-Kelly syndrome

Zenker's diveiculum

Ectodermal dysplasia

Which type of breast cancer is most likely to be bilateral

Infiltrating duct carcinoma

Paget's disease of breast

Lobular carcinoma of breast

Medullary carcinoma of braest

A 65 -year-old man with metastatic lung cancer sees his physician because of progressive dysahria. On examination, his tongue detes to left when he protrudes it. Which of the following structures is most likely to be damaged, assuming this is a lower motor neuron lesion?

Left Hypoglossal nerve

Right Hypoglossal nerve

Left Facial nerve

Right Facial nerve

A breast cancer patient presents with difficulty on breathing. CXR shows?

Canon ball metastasis

Pneumothorax

Pulmonary artery hypertension

Interstitial lung disease

Adenoacanthoma is which type of uterine cancer?

Poorly differentiated adenocarcinoma

Well differentiation Adenocarcinoma

Mucinous carcinoma

Papillary serous carcinoma

Base population for registered cancer study:

1-2 million

1-3 million

2-5 million

3-7 million

Which is the most reliable diagnostic method for staging the oesophageal cancer

MRI

Endoscopic ultrasound

CT scan

Thoracoscopy

As per AJCC breast cancer staging T4 is?

Distant metastasis

Satellite lesions

Spread to contralateral axillary lymph nodes

Sentinel lymph node involvement

Which of the following reduces the risk of epithelial ovarian cancer?

Oral contraceptive pills

MIRENA

Tamoxifen

Mifepristone

True about telomerase or telomere is/area) They are present at the ends of eukaryotic chromosomeb) Increased telomerase activity favours cancer cellsc) DNA dependent RNA polymerased) DNA polymerase

ac

ab

ad

bc

Nitrosoureas used in the treatment of cancer are-

a) Carmustine

5FU

Methotrexate

Cisplatin

Most common cancer in male breast is

Lobular carcinoma in situ

Ductal carcinoma in situ

Infiltrating ductal Ca

A 63-year-old woman presents to the emergency room with symptoms of sudden onset of shortness of breath. She reports no chest discomfort, cough, sputum, or fever. Her past medical history is negative for any prior heart or lung problems. She was recently diagnosed with breast cancer and is undergoing active treatment. On examination, her blood pressure is 120/80 mm Hg, pulse 100/min, and heart and lungs are normal. There are no clinical signs of deep venous thrombosis (DVT). Which of the following investigations is most likely to rule out a pulmonary embolism (PE)?

normal CXR

normal electrocardiogram (ECG)

normal ventilation-perfusion lung scan

normal ventilation scan

Most common lung cancer in non-smokers is: September 2010

Adenocarcinoma

Squamous cell carcinoma

Oat cell carcinoma

None of the above

Which of the following test is unable to differentiate between &;in situ&; breast cancer and invasive disease

Core needly biopsy

FNAC

Excisional biopsy

Which of the following anticancer drugs can cross blood brain barrier?

Cisplatin

Nitrosourea

Vincristine

Vinblastine

Which anti-cancer drug affects DNA as well as RNA?

5-FU

Methotrexate

Actinomycin-D

Etoposide

Most emetogienic anticancer drugs (REAPEAT)

Cisplantin

Carboplatin

High dose cycloohosphamide

High dose Methotrexate

Drug of choice for chemotherapy of cervical cancer is?

Cisplatin

Vincristine

Cyclophosphamide

Etoposide

Group of smokers followed up for 10 years to find incidence of cancer lung. What type of study is this?

Retrospective cohort

Prospective cohort

Case control study

Randomized control trials

Which of the following anti-cancer drugs is cell cycle specific?

Ifosfamide

Melphalan

Vinblastine

Cyclophosphamide

All predisposes to oral cancer except -

Erythroplakia

Leukoplakia

Submucosal fibrosis

Lichen planus

Favorable prognostic factors for ovarian cancer: are cell except:

Young age

Mucinous tumor

Well differentiated tumor

No ascites

A cancer patient who is on cisplatin therapy develops severe vomiting on the 1st day of treatment, drug indicated to treat this is:

Aprepitant.

Ondansetron

Fosaprepitant.

All of the above.

Best level of prevention for Breast cancer

Specific protection

Early diagnosis and treatment

Disability limitation

Rehabilitation

Most important dose-limiting toxicity of cancer chemotherapy is:

Gastrointestinal toxicity

Neurotoxicity

Bone marrow suppression

Nephrotoxicity

BCG used as treatment for which cancer

Lung

Bladder

Rectum

Gall bladder

Which of the following anticancer drug can cross blood brain barrier?

Cisplatin

Nitrosourea

Vincristine

Vinblastine

Beams can be used for cancer treatment are

g-rays

a-rays

Neutrons

All

Protective factor for ovarian cancer:

Nulliparity

Bilateral Tubectomy

Dysgenetic gonads

Woker of asbestos industry

The new agent pemetrexed, useful in breast cancer, belongs to which of the following category of drugs-

Antitumor antibiotic

Alkylating agent

Hormonal agent

Antimetab olite

Based on epidemiological studies, which of the following has been found to be most protective against colon cancer?

High fiber diet

Low fat diet

Low selenium diet

Low protein diet

A 53-year-old woman presents to the clinic for evaluation of a new left breast lump that she discovered 1 week ago. The nodule is not painful; she feels well and has no other symptoms. On physical examination the lump is palpable, and there are no axillary lymph nodes. The mammogram confirms the presence of a 1-cm breast mass which on biopsy is positive for invasive breast cancer. Which of the following is the most appropriate local therapy for her tumor?

simple mastectomy with axillary dissection

radiation therapy to breast and axilla

local excision plus radiation therapy

local excision and axillary dissection followed by radiation therapy

Most common type of oesophageal cancer is:

Squamous cell carcinoma

Adenocarcinoma

Adenoid cystic carcinoma

Mucoepidermoid carcinoma

Which drug is used for pain control in cancer patients ?

Pethidine

Fentanyl

Methadone

Remifentanil

Which of the following anticancer drugs can cause a hypercoagulable state

5–FU

L–asparginase

Melphalan

Carmustine

Which of the following is precancerous lesion?

Pachydermia of larynx

Laryngitis sicca

Keratosis of larynx

Scleroma larynx

Immunity against cancer cells -

Basophills

Eosinophils

NK cells

Neutrophils

Which of the following is the most common type of vulvar cancer ?

Paget's

Squamous

Melanoma

Adenocarcinoma

In breast cancer Her-2/Neu helps by the following mechanism?

Overexpression

Suppression

Mutation

Translocation

Which of the following drugs is useful for the treatment of advanced prostate cancer?

Ganirelix

Cetrorelix

Abarelix

Goserelin

Which of the following is used in the treatment of differentiated thyroid cancer?

131I

99mTc

32p

311–mIBG

A 58-year-old woman with colon cancer presents with 3 months of increasing shoness of breath. A chest X-ray reveals numerous, bilateral, round masses in both lungs. Histologic examination of an open-lung biopsy discloses malignant gland-like structures, which are nearly identical to the colon primary. Which of the following changes in cell behavior was the first step in the process leading to tumor metastasis from the colon to the lung in this patient?

Arrest within the circulating blood or lymph

Exit from the circulation into a new tissue

Invasion of the underlying basement membrane

Penetration of vascular or lymphatic channels

Breast conservation surgery for breast cancer is indicated in which one of the following conditions?

T1 breast tumor

Multicentric tumor

Extensive in situ cancer

T4b breast tumor

Multiple liver secondaries are most common in the following cancers -

Head of pancreas

Stomach

Gall bladder

Periampullary

Which of the following is associated with nasopharyngeal cancer?

HHV 1

HHV 2

HHV 3

HHV 4

Endometrial cancer involving >50% of myometrium, extending to vagina, no pelvic extension, no pre and para aortic lymph nodes. Peritoneal lavage was positive staged as -

III a

III b

III cl

III c2

Incidence rate of lung cancer among smokers is 8 per 1000 and among non-smokers is 1 per 1000. Population attributable risk is -

89%

95%

10%

100%

Most common lung cancer in non-smokers is:

Adenocarcinoma

Squamous cell carcinoma

Oat cell carcinoma

None of the above

Breast Cancer which involves both breasts is:

Lobular Carcinoma

Mucoid carcinoma

Ductal carcinoma

Ductal carcinoma in situ

In a prospoective study comprising 10,000 subjects, 6000 subjects were put in beta carotene and 4000 were not. 3 out of the first 6000 developed lung cancer and 2 out of the second 4000 developed lung cancer. What is the interpretation of the above results?

Beta carotene is protective in lung cancer

Beta carotene and Lung cancer have no relation to each other

The study design is not sufficient to draw any meaningful conclusions

Beta corotene is carcinogenic

A total of 3500 patient with thyroid cancer are identified and surveyed by patient interviews with reference to past exposure to radiation. The study design most appropriately illustrates -

Case series report

Case control study

Case report

Clinical trial

Multiple liver secondaries are most common in the following cancers:

Head of pancreas

Stomach

Gallbladder

Periampullary

A 65-year-old man undergoes a low anterior resection for rectal cancer. On the fifth day in hospital, his physical examination shows a temperature of 39degC (102degF), blood pressure of 150/90 mm Hg, pulse of 110 beats per minute and regular, and respiratory rate of 28 breaths per minute. A computed tomography (CT) scan of the abdomen reveals an abscess in the pelvis. Which of the following most accurately describes his present condition?

Systemic inflammatory response syndrome (SIRS)

Sepsis

Severe sepsis

Septic shock

Traetment of breast cancer with pregnant lady in first trimester

Neoadjuvent chemotherapy + Surgery

Breast conservation

MTP followed by treatment according to protocol

Radiotherapy

Which of the following is the source of nutrition for the cancer cells?

Glycolysis

Oxidative phosphorylation

Increase in mitochondria

From a fast food joint

Which cancer has maximum propensity to spread to cervical lymph nodes -

Nasopharyngal carcinoma

Carcinoma of hard palate

Carcinoma of soft palate

Carcinoma of mandible

Depression is most common in patients suffering from which of the following cancer?

Brain

Pancreas

Lungs

Kidney

Gleason Score is used to grade which cancer -

Prostate Cancer

Transitional Cell CA

Penile Cancer

Anal Cancer

A screening test applied for colon cancer. Total population taken is 1000. Test is positive in 320 and test is negative in 680. 60 people actually had the disease among 320 and 20 had disease among the 680. Calculate positive predictive value.

12%

81%

75%

28%

A 54-year-old woman is on tamoxifen for the prevention of breast cancer on the basis of her strong family history, nulliparity, and early age at menarche. Her gen. physical and gynaecological examination is within normal limits. Which of the following is this patient most likely to develop while on tamoxifen?

Breast cancer

Elevated LDL cholesterol

Endometrial changes

Myocardial infarction

Breast conservation surgery for breast cancer is indicated in one of the following conditions:

T1 breast tumor

Multicentric tumor

Extensive in situ cancer

T4b breast tumor

In a patient with breast cancer, the following are poor prognostic factors except

High grade

Absence of estrogen receptor

Aneuploid status

Age less than 35 years

Which one of the following condition is considered to be definitely precancerous in the larynx -

Vocal nodules

Angioma of vocal cords

Leukoplakia

None of the above

36 year old woman is found tested positive for BRCA 1 mutation. Her mother died due to ovarian cancer. She wishes to lower risk of ovarian cancer. Her general condition is otherwise normal. Which surgery would you recommend

Bilateral oophorectomy

Subtotal hysterectomy and bilateral oophorectomy

Bilateral salpingo oophorectomy

Total hysterectomy and BSO.

The Least common quadrant in cancer breast is

Superior outer

Inferior outer

Sub areolar

Lower inner quadrant

Which anticancer drug prevents spindle formation is -

Busulfan

Vinca alkaloids

5 - FU

Methotrexate

All the following indicates early gastric cancer except:

Involvement of mucosa

Involvement of mucosa and submucosa

Involvement of mucosa, submucosa and muscularis

Involvement of mucosa, submucosa and adjacent lymph nodes

Which one is not the pre cancerous condition

Crohn's disease

Ulcerative colitis

Leukoplakia

Xeroderma pigmentosum

Aspirin should be given for the treatment of which cancer

Pancreatic cancer

Liver cancer

Colon cancer

Stomach cancer

FNAC is not useful in which thyroid cancer -

Follicular Carcinoma

Pappilary carcinoma

Medullary Carcinoma

Thyroid Lymphoma

A woman of age 34 yrs has been taking large quantities of vitamins in hope that it would prevent many infections & cancers. Now she came with complaint of sleep disturbances, increased hair fall, anorexia, nausea, fissures & dryness of lips. What is the most likely cause of these symptoms?

Chronic Vitamin A toxicity

Chronic Vitamin K toxicity

Chronic Vitamin E toxicity

Chronic Vitamin D toxicity

A terminally ill patient with Ca pancreas is on IV Diamorphine 10 mg/day in a cancer institute in Kerala. He is being discharged from the hospital and would like to conve it to Oral Morphine. What is the approximate dose of oral Morphine needed in this patient?

20 mg

30 mg

40 mg

5 mg

A cell cycle specific anticancer drug that acts mainly in the M phase of the cell cycle is

Bleomycin

Cisplatin

Etoposide

Paclitaxel

Which of the following anticancer drug is cell cycle specific?

Dactinomycin

Mitomycin C

Daunorubicin

Bleomycin

A 56-year-old lady, who is a known case of lung cancer, presents with vomiting, headache and seizures. Investigations reveal serum osmolarity of 265 mosm/L (normal is 285-295 mosm/L) and a serum sodium level of 125 mEq/L (normal value is 136-152 mEq/L). Urine osmolarity is greater than 100 mOsm/L She has normal water intake. Which of the following drugs is useful for this patient?

Acetazolamide

Hydrochlorothiazide

Triamterene

Tolvaptan

Four days after undergoing subtotal gastrectomy for stomach cancer, a 58-year-old woman complains of right leg and thigh pain, swelling and redness, and has tenderness on examination. The diagnosis of deep vein thrombosis is entertained. What is the initial test to establish the diagnosis?

Venography

Venous duplex ultrasound

Impedance plethysmography

Radio-labeled fibrinogen

Cytomegalovirus causes what cancer in AIDS patients -

Lymphoma

Kaposi sarcoma

Leukemia

Glioma

Testicular cancer is common in -

Ectopic testis

Undescended abdominal testis

Atrophic testis

Anteveed testis

Which of the following is not a goal of population based cancer registry?

Administrative information

Determination of cancer rates and trends

Patterns of care and outcomes

Cancer prevention

For screening of an oral precancerous condition, the test needs to have:

High sensitivity, high specificity

Low sensitivity, high specificity

High sensitivity, Low specificity

Low sensitivity, Low specificity

Most common paraneoplastic syndrome associated with small cell lung cancer?

SIADH

Cushing

Hypercalcemia

Polycythemia

A 50-year-old male with a positive family history of prostate cancer has come to you for a screening test. The most sensitive screening test to pickup prostate cancer is

DRE

PSA

DRE + PSA

Endorectal Coil MRI with T1W and T2W images

Predisposing factors for skin cancer are – a) Smokingb) UV–lightc) Chronic ulcerd) Infrared light

a

c

bc

ad

Hydroxyurea mechanism of action in cancer is by inhibiting the enzyme -

Ribonucleoside diphosphate reductase

Ribonucleotide oxidase

DNA lyase

DNA synthetase

LN involved in cervical cancer :

External Iliac LN

Obturator LN

Hypogastric LN

All

Which of the following is used to treat hormone-responsive breast cancer?

Adriamycin

Clomiphene citrate

Diethylstibestrol

Tamoxifen

Single file pattern is seen in breast cancer type?

Intraductal

Infiltrating lobular

Infiltrating ductular

All

Diagnostic test for detecting oral precancerous lesion?

High specificity and high sensitivity

High specificity and low sensitivity

Low specificity and high sensitivity

Low specificity and low sensitivity

Which of the following anticancer drugs acts by hypomeyhylation

Gemcitabine

5-FU

Decitabine

Homoharringotonine

Incidence rate of lung cancer among smokers is 8 per 1000 and among non smokers is 1 per 1000. Population attibutable risk is -

89%

95%

10%

100%

A 35-year-old male living in a southern region of Africa presents with increasing abdominal pain and jaundice. He has worked as a farmer for many years, and sometimes his grain has become moldy. Physical examination reveals a large mass involving the right side of his liver, and a biopsy specimen from this mass confirms the diagnosis of liver cancer (hepatocellular carcinoma). The pathogenesis of this tumor involves which of the following substances?

Direct-acting alkylating agents

Aflatoxin B1

Azo dyes

Vinyl chloride