Oncology Practice Questions

Q: What is the role of the HER2/neu receptor in breast cancer treatment?

Guiding treatment decisions. ***Predicting response to targeted therapies in breast cancer*** - The **HER2/neu receptor** is a key biomarker used to determine the effectiveness of targeted therapies, such as trastuzumab (Herceptin), in HER2-positive breast cancer [1]. - Presence of HER2 overexpression directly impacts treatment strategies and overall patient outcomes [1]. *Risk assessment for breast cancer screening* - While risk factors are essential for screening, **HER2/neu** is not utilized for general risk assessment. - Other factors like **family history** and **BRCA mutations** play a more significant role in this context. *Histological diagnosis of breast cancer* - Histological diagnosis primarily relies on **tissue biopsy** and specific grading systems, not HER2 status per se. - While HER2 can be evaluated histologically, it is not a key method for initial diagnosis [1]. *Prognosis and recurrence prediction in breast cancer* - HER2 positivity can indicate a worse prognosis, but it is more directly linked to **treatment response** than recurrence prediction [1]. - Other factors like **tumor size** and **lymph node status** are more traditionally used in prognosis.

Q: Carcinoid tumor is diagnosed by what means?

Measurement of urinary 5-HIAA levels.. ***Measurement of urinary 5-HIAA levels.*** - Carcinoid tumors actively produce **serotonin (5-HT)**, which is metabolized into **5-hydroxyindoleacetic acid (5-HIAA)**. - Elevated levels of **5-HIAA** in a 24-hour urine collection are highly indicative of a carcinoid tumor [1]. *Serum Chromogranin A levels.* - **Chromogranin A** is a general marker for **neuroendocrine tumors**, including carcinoids, but is less specific than **5-HIAA** [1]. - Its levels can be elevated in other conditions like **renal insufficiency, atrophic gastritis**, and with **proton pump inhibitor (PPI)** use, leading to false positives. *Serum Neuron-Specific Enolase (NSE) levels.* - **NSE** is a marker primarily used for **small cell lung cancer** and some other neuroendocrine tumors, but it is not the primary diagnostic test for carcinoid. - While it can be elevated in some carcinoid cases, it lacks the specificity and diagnostic value of **urinary 5-HIAA** for classic carcinoid syndrome. *Measurement of urinary 5-HTP levels.* - **5-hydroxytryptophan (5-HTP)** is a precursor to serotonin, and its measurement is not a standard or primary diagnostic test for carcinoid tumors. - Carcinoid tumors typically directly produce **serotonin**, which is then metabolized to **5-HIAA**, making **5-HIAA** a more direct and reliable marker.

Q: Which type of lung cancer is most commonly found in non-smokers?

Adenocarcinoma. ***Adenocarcinoma*** - It is the most common type of lung cancer among **non-smokers**, often associated with **lung scarring** and **asbestos exposure**. - Typically presents in the **peripheral** regions of the lungs and has a **glandular** pattern on histology. *Squamous cell carcinoma* - More commonly associated with **smoking** [1] and usually arises in the **central parts** of the lungs. - Known for cavitary lesions and often linked to chronic **lung disease** rather than non-smokers. *None of the above* - This oes not provide a definitive lung cancer type, which is **not relevant** when adenocarcinoma is the correct answer. - Fails to recognize the significant evidence linking adenocarcinoma as the predominant type in non-smokers. *Oat cell carcinoma* - This represents **small cell lung cancer**, which is strongly linked to **smoking** rather than being common in non-smokers [1]. - Often presents with **metastatic lesions** and is more aggressive, unlike adenocarcinoma.

Q: Which one of the following is not a tumor marker for testicular tumors?

CA-125. ***CEA*** - **Carcinoembryonic antigen (CEA)** is primarily used as a tumor marker for colorectal and other gastrointestinal cancers [1], not for testicular tumors [2]. - It lacks specificity for germ cell tumors, as the primary markers in testicular tumors are **HCG**, **AFP**, and **LDH** [2]. *HCG* - **Human chorionic gonadotropin (HCG)** is commonly elevated in the presence of germ cell tumors, especially teratomas and choriocarcinomas [2]. - It is a key marker for diagnosis and monitoring of testicular tumors. *AFP* - **Alpha-fetoprotein (AFP)** is often elevated in non-seminomatous germ cell tumors, particularly yolk sac tumors [2]. - It serves as an important marker for diagnosis and treatment response in these tumors. *LDH* - **Lactate dehydrogenase (LDH)** can be elevated in various tumors, including testicular cancer, but it is a non-specific marker. - It is used to assess tumor burden and monitor treatment response rather than for definitive diagnosis.

Q: Trousseau's syndrome is classically seen with:

Pancreatic carcinoma. ***Pancreatic carcinoma*** - **Trousseau's syndrome**, or migratory thrombophlebitis, is a paraneoplastic syndrome characterized by recurrent, migratory episodes of **venous thrombosis** in unusual sites. - It is often associated with adenocarcinomas, particularly those of the **pancreas**, lung, stomach, and prostate, due to the tumor's ability to activate clotting [1]. *Carcinoma of the stomach* - While stomach carcinoma can be associated with Trousseau's syndrome, it is **less common** than with pancreatic carcinoma. - Trousseau's syndrome in gastric cancer may also involve other paraneoplastic phenomena like **acanthosis nigricans**. *Multiple Endocrine Neoplasia type II* - This syndrome is associated with tumors such as **medullary thyroid carcinoma**, pheochromocytoma, and parathyroid adenomas. - It does not typically present with **Trousseau's syndrome** but instead has a distinct set of paraneoplastic manifestations related to hormone overexpression [1]. *Neuroendocrine tumors of the pancreas* - These tumors often manifest with symptoms related to hormone overproduction, such as **insulinomas** (hypoglycemia) or **gastrinomas** (Zollinger-Ellison syndrome) [2]. - While any malignancy can theoretically predispose to thrombosis, they are **not classically associated** with Trousseau's syndrome, which is more typical of exocrine pancreatic adenocarcinoma.

Q: Most common malignancy in post-transplant individuals:

Squamous cell carcinoma of skin. Most common malignancy in post-transplant individuals: ***Squamous cell carcinoma of skin*** - **Squamous cell carcinoma (SCC) of the skin** is the most common malignancy in post-transplant individuals, largely due to **immunosuppression** which impairs immune surveillance against oncogenic viruses and sunlight-induced mutations [1]. - The risk of SCC is significantly increased (up to 65-fold) in transplant recipients, often presenting as **multiple tumors** and exhibiting a more aggressive course than in the general population [2]. *Kaposi sarcoma* - **Kaposi sarcoma (KS)** is associated with **human herpesvirus 8 (HHV-8)** infection and is more common in transplant recipients compared to the general population, but it is not the *most common* malignancy [1]. - While its incidence is increased, it remains less frequent than skin cancers like SCC. *PTLD* - **Post-transplant lymphoproliferative disorder (PTLD)** is a significant complication of organ transplantation, primarily driven by **Epstein-Barr virus (EBV)** infection in the setting of immunosuppression [1]. - PTLD is a serious malignancy, but its overall incidence is less than that of skin cancers. *CNS lymphoma* - **CNS lymphoma** can occur in post-transplant patients, often linked to **EBV infection** and immunosuppression [1]. - Although it is a severe complication, its incidence is considerably lower than that of skin cancers in this population.

Question 1

What is the role of the HER2/neu receptor in breast cancer treatment?

Accepted Answer

Guiding treatment decisions

Answer

Screening for breast cancer risk

Answer

Assessing tumor recurrence risk

Answer

Diagnosis of breast cancer based on HER2 status

Question 2

Carcinoid tumor is diagnosed by what means?

Accepted Answer

Measurement of urinary 5-HIAA levels.

Answer

Serum Chromogranin A levels.

Answer

Serum Neuron-Specific Enolase (NSE) levels.

Answer

Measurement of urinary 5-HTP levels.

Question 3

Which type of lung cancer is most commonly found in non-smokers?

Accepted Answer

Adenocarcinoma

Answer

Squamous cell carcinoma (associated with smoking)

Answer

Oat cell carcinoma (small cell lung cancer)

Answer

None of the options

Question 4

Which one of the following is not a tumor marker for testicular tumors?

Accepted Answer

CA-125

Answer

AFP

Answer

LDH

Answer

HCG

Question 5

Trousseau's syndrome is classically seen with:

Accepted Answer

Pancreatic carcinoma

Answer

Carcinoma of the stomach

Answer

Multiple Endocrine Neoplasia type II

Answer

Neuroendocrine tumors of the pancreas

Question 6

Most common malignancy in post-transplant individuals:

Accepted Answer

Squamous cell carcinoma of skin

Answer

Kaposi sarcoma

Answer

PTLD

Answer

CNS lymphoma

Oncology — MCQs

Oncology — MCQs

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