ONCOLOGY

1.

Phase 2 trial of new cancer drug. Which is least likely to account for variation in results:

a.
b.
c.
d.
e.

Size of metastases
Site of metastases
Gender
Performance status
Prior therapy

2.

Breast cancer, least likely defect:

a)
b)
c)
d)
e)

BRCA1
BRCA2
Bcl-2
ATM
p53

3.

In women the biggest risk factor for breast cancer is:

a)
b)
c)

Family history
Previous contra lateral breast cancer
Benign breast disease

4.

Best treatment of metastatic renal cell ca:

a)
b)
c)

IL-2
Vindarabine
Palliative care

5.

Woman with recent mastectomy for breast cancer on Aminoglutathimide and Cortisone. Picture shown. Now has
erythematous rash radiating from under the arm on same side surrounding the scar, not quite dermatomal. What
is it?

a)
b)
c)
d)
e)

Herpes zoster
Fungal infection
Recurrence
Aminoglutathimide hypersensitivity
Radiation

6.

Major spread of ovarian cancer

a)
b)
c)
d)

Adnexal
Lymphatic
Blood
Peritoneal

7.

Patient gets bleomycin, etoposide, and cisplatin. Which cause for cessation of specific drug?

a)
b)
c)
d)

Infertility
Neutropaenic sepsis
Interstitial lung disease
High frequency hearing loss

8.

55 year female - breast cancer 3 yrs ago had mastectomy only Presents with lower back pains. Some
neurology - mild --> equivocal plantar.
MRI Shows lesions in 3-4 different vertebra - partially compressing spinal cord.

a)
b)
c)
d)
e)

surgical decompression and radiotherapy

chemotherapy
oestrogen therapy
NSAID
Steroids

9.

Cisplatin based chemotherapy. Which anti-emetic is most effective >24 post chemotherapy:

a)
b)
c)
d)
e)

Dexamethasone
Ondansetron
Tetracanniboids
Maxolon
Stemetil

10. Least effective for identifying an unknown primary

a)
b)
c)
d)

Axillary lymphadenopathy adenocarcinoma

Secondary hepatic metastases adenocarcinoma
Mediastinal undifferentiated carcinoma
Bone blast sec.

11. Middle aged smoker. Whole of left lung white, collapse. Bronchoscopy shows an undifferentiated carcinoma in
the left main bronchus. Presents with cough and haemoptysis. Small left clavicular lymph node palpable.
Treatment:
a)
b)
c)
d)

Surgery
Radiotherapy
Chemotherapy
Palliation

12. Smoker with carcinoma of the lung. Well until recently. Bronchoscopy shows extrinsic compression of the
bronchus. Low serum sodium. Diagnosis:
a)
b)
c)

Small cell carcinoma

Adenocarcinoma
Squamous cell carcinoma

13. In a young man testicular malignancy, how does HCG cause gynaecomastia?
a)
b)
c)
d)

By stimulating breast directly

By testosterone
By oestrogen
Action of testicular tumour

14. Young lady had radiotherapy for Hodgkins disease. 10 years later, most likely sequelae:
a)
b)
c)
d)

Thyroid carcinoma
AML
Non Hodgkins lymphoma
Carcinoma breast

15. DNA microsatellite - best description

a) Single locus 2 - 4 base pairs repeats

b) DNA fragments
c) CAG repeat
16. Which drug is least likely to affect cytokine production - especially IL-2 in T cells?

a)
b)
c)
d)
e)

Prednisone
Mycophenalate
Tacrolimus
Rapamycin
Cyclosporin A

17. Among viruses which are activated due to immunosuppression the least oncogenic virus is

a)
b)
c)
d)
e)

HHV8
CMV
Hepatitis B
EBV
Human papillomavirus

18. Disease least likely to have a family predisposition

a)Breast cancer
b)Lung cancer
c)Germ cell cancer of testes
d)Ovarian cancer
e)Prostate cancer
19. Which one of the following drugs has the least bone marrow suppression?

a)
b)
c)
d)
e)

Daunorubicin
Cisplatin
Cyclophosphamide
Etoposide
Vincristine

20. Most common mode of spread of epithelial ovarian tumours occurs to

a)
b)
c)
d)

Para aortic lymph nodes

Adnexae
Bone
Lungs

21. Changes least likely with familial colonic cancer

a)
b)
c)
d)
e)

APC gene mutation

DNA repair gene mutation
Chromosomal translocation
Microsatellite instability
Loss of heterozygosity for tumour suppressor genes

22. Small cell lung carcinoma can cause (?all of the following except)

a)
b)
c)
d)
e)

Hypercalcaemia
Cushings syndrome
Clubbing
Lambert Eaton Myasthenic syndrome
SIADH

23. BRCA-1

a)
b)
c)
d)
e)

Associated with male breast cancer

Associated with sporadic breast cancer
Predominantly associated with truncated protein
Associated with breast & ovarian carcinoma
Is an oncogene

24. Predisposing factors to oesophageal cancer include the following except

a)
b)
c)
d)
e)

Achalasia
Gastro-oesophageal reflux disease
Alcohol
Smoking
Ingestion of caustic substances

25. Young woman with amenorrhoea & large uterus. CXR shows rounded opacities. What is the best test

to monitor this condition?

a) CEA
b) HCG
c) -fetoprotein
26. How would you treat metastatic Ca Breast in a postmenopausal woman?

a)
b)
c)
d)
e)

Anti-oestrogen
Oestrogen
Progesterone
Anti-androgen
Aromatase inhibitor

27. What is the best prognostic indicator of post op survival for Ca Breast?

a)
b)
c)
d)
e)

Tumour size
Lymph node involvement
HER 2 +ve
Tumour grade/ stage
Age

28. Most consistent with G2 phase

A
B
C
D
E

DNA replication
Low
Low
Low
High
High

Microtubulin synthesis
Low
Low
High
High
High

Other protein synthesis

Low
High
Low
Low
High

29. Which malignancy is least amenable to treatment?

a)
b)
c)
d)
e)

Adeno Ca of axillary lymph nodes

Adeno Ca with sclerotic lesion in bone
Adeno Ca in liver
Squamous cell Ca in cervical lymph nodes
Poorly differentiated Ca in chest midline (?mediastinal lymph nodes) in a young man

30. Associations for 1o Ca can be made for all of the following except

a)
b)
c)
d)
e)

Adeno Ca mets in the liver in a middle aged man

Adeno Ca mets in axillary lymph nodes in a woman
Squamous Cell mets in cervical lymph nodes in a smoker
Mediastinal Adeno Ca in a young man
Skeletal sclerotic lesion in vertebrae in an elderly man

31. Mechanism of drug resistance of chemotherapeutic drugs

a) P glycoprotein
b) P53
c) Bcl 2
d) P450
32. A middle-aged man has a melanoma fully excised. What is the most important reason to follow him

closely?
a)
b)
c)
d)
e)
f)

Local recurrence
Systemic metastasis
New site recurrence
In transit metastasis
Lymph nodes
New primary