Neoplasia Practice Questions

Q: The MYC gene product functions as which of the following?

Transcription activator. **Explanation:** The **MYC gene** (specifically c-MYC) is a proto-oncogene that encodes a protein belonging to the **transcription factor** family [1]. Once activated by mitogenic signaling pathways (like RAS/MAPK), the MYC protein translocates to the nucleus [2]. It binds to specific DNA sequences (E-box sequences) by forming a heterodimer with the **MAX protein**. This complex acts as a potent **transcription activator**, promoting the expression of genes required for cell cycle progression (e.g., Cyclin D), metabolism, and protein synthesis. **Analysis of Incorrect Options:** * **A & B (Protein kinase/Growth factor inhibitors):** These functions are characteristic of **Tumor Suppressor Genes** (like CDKN2A/p16 or APC). MYC is an oncogene; its overexpression promotes growth rather than inhibiting it. * **C (GTPase):** This is the characteristic function of the **RAS protein**. RAS acts as a molecular switch by cycling between an active GTP-bound state and an inactive GDP-bound state. **NEET-PG High-Yield Pearls:** * **Burkitt Lymphoma:** Classically associated with the **t(8;14)** translocation, which moves the c-MYC gene (Chr 8) to the IgH locus (Chr 14), leading to constitutive MYC expression [3]. * **Amplification:** **N-MYC** is commonly amplified in Neuroblastoma (correlates with poor prognosis), while **L-MYC** is associated with Small Cell Carcinoma of the Lung. * **Function:** MYC is often called a "master regulator" of metabolism (Warburg effect) and cell growth. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 292-293. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 296-297. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 324-325.

Q: Flexner-Wintersteiner rosettes in microscopy are seen in which condition?

Retinoblastoma. **Explanation:** **Flexner-Wintersteiner rosettes** are the pathognomonic histological hallmark of **Retinoblastoma**. These structures consist of a ring of cuboidal or columnar cells surrounding a central lumen. This lumen represents an attempt by the primitive tumor cells to differentiate into photoreceptor elements (rods and cones). The presence of these rosettes indicates a degree of retinal differentiation. **Analysis of Options:** * **Retinoblastoma (Correct):** It is the most common intraocular malignancy of childhood. Flexner-Wintersteiner rosettes are highly specific for this condition. Other histological features include Homer-Wright rosettes (less specific) and fleurettes (representing high differentiation). * **Retinitis Pigmentosa:** This is a degenerative (not neoplastic) disease of the photoreceptors. Histology shows "bony spicule" pigmentation and atrophy of the retinal layers, not rosette formation. * **Trauma:** Ocular trauma leads to inflammation, scarring, or hemorrhage (e.g., Commotio retinae). It does not involve the cellular proliferation required to form rosettes. * **Neuroblastoma:** While neuroblastomas also feature rosettes, they are typically **Homer-Wright rosettes** (which lack a central lumen and contain a central tangle of nerve fibers/neuropil). Flexner-Wintersteiner rosettes are not characteristic of neuroblastoma. **High-Yield Clinical Pearls for NEET-PG:** * **Homer-Wright Rosettes:** Seen in Neuroblastoma, Medulloblastoma, and Retinoblastoma (non-specific). * **Flexner-Wintersteiner Rosettes:** Specific for Retinoblastoma and Pineoblastoma. * **Fleurettes:** Represent the highest level of photoreceptor differentiation in Retinoblastoma. * **Calcification:** Retinoblastoma is a "chalky white" tumor; presence of calcification on CT scan is a key diagnostic sign.

Question 1

All of the following statements are true about tumor suppressor gene TP53, except?

Accepted Answer

Activity in the cells decreases following UV irradiation and stimulates cell cycle.

Answer

Regulates genes involved in cell cycle regulation.

Answer

Increased levels can induce apoptosis.

Answer

Inherited TP53 mutations give rise to Li-Fraumeni syndrome.

Question 2

All of the following are angiogenic factors EXCEPT?

Accepted Answer

IFN

Answer

VEGF

Answer

PDGF

Answer

TGF-β

Question 3

The MYC gene product functions as which of the following?

Accepted Answer

Transcription activator

Answer

Protein kinase inhibitor

Answer

Growth factor inhibitor

Answer

GTPase

Question 4

Which of the following tumours are known to spontaneously regress?

Accepted Answer

Malignant melanoma

Answer

Neuroblastoma

Answer

Ewing's sarcoma

Answer

Wilm's tumour

Question 5

Which of the following is NOT associated with human papillomavirus infection?

Accepted Answer

Nasopharyngeal carcinoma

Answer

Oropharyngeal tumors

Answer

Anal canal carcinoma

Answer

Cervical carcinoma

Question 6

CEA is elevated in all of the following conditions except:

Accepted Answer

Prostatic carcinoma

Answer

Alcoholic cirrhosis

Answer

Ulcerative colitis

Answer

Carcinoma colon

Question 7

Which of the following pre-malignant conditions is associated with the highest probability of progression to malignancy?

Accepted Answer

Erythroplakia

Answer

Dysplasia

Answer

Hyperplasia

Answer

Leukoplakia

Question 8

The retinoblastoma gene regulates which phase transition?

Accepted Answer

G1 to S phase

Answer

G2 to M phase

Answer

G0 to S1 phase

Answer

S to G1 phase

Question 9

Flexner-Wintersteiner rosettes in microscopy are seen in which condition?

Accepted Answer

Retinoblastoma

Answer

Retinitis pigmentosa

Answer

Trauma

Answer

Neuroblastoma

Question 10

Rosettes typically seen in Neuroblastoma are:

Accepted Answer

Homer-wright rosettes

Answer

Flexner Wintersteiner rosettes

Answer

Perivascular rosettes

Answer

Neurocytic rosettes

Neoplasia — MCQs

Neoplasia — MCQs

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