Neoplasia Practice Questions

Q: Which among the following is a marker for testicular carcinoma?

b-HCG. **Explanation:** **Why b-HCG is the correct answer:** Beta-human chorionic gonadotropin (b-HCG) is a glycoprotein hormone normally produced by syncytiotrophoblasts in the placenta. In the context of testicular neoplasia, it serves as a vital serum tumor marker. It is most characteristically elevated in **Choriocarcinoma** (100% of cases) [1] and is also found in approximately 10–15% of **Seminomas** (specifically those containing syncytiotrophoblastic giant cells) [2]. Monitoring b-HCG levels is essential for diagnosis, staging, and assessing treatment response or recurrence. **Analysis of Incorrect Options:** * **A. PSA (Prostate-Specific Antigen):** This is a highly specific marker for **Prostate Cancer** and benign prostatic hyperplasia (BPH). It has no diagnostic value for testicular malignancies. * **C & D. LH and FSH:** Luteinizing Hormone and Follicle-Stimulating Hormone are gonadotropins produced by the anterior pituitary. While they are involved in the hypothalamic-pituitary-gonadal axis, they are not secreted by testicular tumors and are not used as oncological markers. **High-Yield Clinical Pearls for NEET-PG:** * **Alpha-Fetoprotein (AFP):** Another crucial testicular marker. It is elevated in **Yolk Sac Tumors** (Endodermal sinus tumors) but is **never** elevated in pure Seminomas. * **LDH (Lactate Dehydrogenase):** A non-specific marker used to assess the overall tumor burden and growth rate in germ cell tumors. * **Schiller-Duval Bodies:** The characteristic histological finding in Yolk Sac Tumors. * **Reinke Crystals:** Pathognomonic histological finding in **Leydig Cell Tumors** (non-germ cell tumors). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, p. 982. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 980-982.

Q: What is the most common site of metastasis for lung carcinoma?

Brain. **Explanation:** Lung carcinoma is notorious for its early and widespread hematogenous dissemination. While it can spread to various organs, the **Brain** is considered the most common site of metastasis for lung cancer (specifically Small Cell Lung Cancer and Adenocarcinoma) [2]. Approximately 20–40% of patients with lung cancer will develop brain metastases during the course of their disease. This occurs because cancer cells enter the pulmonary veins, reach the left heart, and are pumped directly into the systemic circulation, where the brain receives a high proportion of cardiac output. **Analysis of Options:** * **Adrenals (Option D):** This is a high-yield distractor. The adrenals are the **most characteristic** or "favorite" site of metastasis for lung cancer (often found incidentally on autopsy), but in terms of absolute frequency in clinical practice, the brain is more common [1]. * **Liver (Option A):** The liver is a very common site for many visceral malignancies (like GI tract cancers) due to portal circulation, but it ranks behind the brain and adrenals for primary lung malignancies [1]. * **Kidney (Option B):** While lung cancer can spread to the kidneys, it is significantly less frequent than the brain, liver, or bone [1, 2]. **NEET-PG High-Yield Pearls:** * **Most common site of metastasis for Lung Cancer:** Brain. * **Most common site of metastasis *to* the Brain:** Lung Cancer (followed by Breast and Melanoma) [2]. * **Most common site for "Silent" metastasis in Lung Cancer:** Adrenal glands [1]. * **Sentinel finding:** If a patient presents with a new-onset seizure and a cough, always suspect lung carcinoma with brain metastasis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 724-725. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1317-1318.

Question 1

Which among the following is a marker for testicular carcinoma?

Accepted Answer

b-HCG

Answer

PSA

Answer

LH

Answer

FSH

Question 2

If DNA is damaged in the cell cycle, which gene causes cell cycle arrest?

Accepted Answer

p53

Answer

Rb

Answer

MYC

Answer

K-RAS

Question 3

Regarding oncogenesis, which of the following is false?

Accepted Answer

An increase in telomerase activity promotes anti-tumor effects.

Answer

Proto-oncogenes can be activated by chromosomal translocation.

Answer

Malignant transformation involves the accumulation of mutations in proto-oncogenes and tumor suppressor genes.

Answer

Point mutations can occur in somatic cells.

Question 4

All of the following tumors may be malignant except?

Accepted Answer

Hemangioblastoma

Answer

Glioma

Answer

Astrocytoma

Answer

Ependymoma

Question 5

Carcinoembryonic antigen is raised in which of the following non-neoplastic conditions?

Accepted Answer

Pancreatitis

Answer

Hepatitis

Answer

Hemolytic anemia

Answer

Ulcerative colitis

Question 6

An 8-year-old African boy presents with swelling in his jaw and massive facial disfiguration. Biopsy reveals a tumor invading the bone marrow of the jaw. The pathogenesis of this malignant neoplasm is associated with a virus that exhibits a tropism for which of the following cells?

Accepted Answer

Lymphocytes

Answer

Chondrocytes

Answer

Fibroblasts

Answer

Macrophages

Question 7

Homer Wright rosettes are seen in which of the following neoplasms?

Accepted Answer

Neuroblastoma

Answer

Nephroblastoma

Answer

Ependymoma

Answer

Rhabdomyosarcoma

Question 8

Which neoplasm is associated with pure red cell aplasia?

Accepted Answer

Thymus

Answer

Breast

Answer

Hepatocellular carcinoma

Answer

Bronchogenic carcinoma

Question 9

Cancer suppressor genes are important in which of the following malignancies?

Accepted Answer

Retinoblastoma

Answer

Malignant melanoma

Answer

Liver carcinoma

Answer

Lung cancer

Question 10

What is the most common site of metastasis for lung carcinoma?

Accepted Answer

Brain

Answer

Liver

Answer

Kidney

Answer

Adrenals

Neoplasia — MCQs

Neoplasia — MCQs

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