Neoplasia Practice Questions

Q: Breast carcinoma is associated with all except?

ATR. **Explanation:** Breast carcinoma is a genetically heterogeneous disease [1]. The question asks for the gene **not** typically associated with a significantly increased risk of breast cancer. **1. Why ATR is the Correct Answer:** **ATR (Ataxia Telangiectasia and Rad3-related)** is a protein kinase involved in DNA damage signaling, specifically responding to replication stress and single-strand breaks. While it belongs to the same family as ATM, mutations in ATR are primarily associated with **Seckel Syndrome** (microcephaly and growth retardation), not breast carcinoma. In contrast, mutations in **ATM** (Ataxia-Telangiectasia Mutated) are well-documented risk factors for breast cancer. **2. Analysis of Incorrect Options:** * **BRCA1 & BRCA2:** These are the most common high-penetrance susceptibility genes [1]. They are involved in homologous recombination repair of double-strand DNA breaks. BRCA1 is strongly linked to Triple Negative Breast Cancer (TNBC) and ovarian cancer, while BRCA2 is associated with male breast cancer and prostate cancer. * **TP53:** Mutations in the TP53 gene cause **Li-Fraumeni Syndrome** [1]. This syndrome carries a very high lifetime risk of early-onset breast cancer, along with sarcomas, leukemia, and adrenocortical tumors. **3. Clinical Pearls for NEET-PG:** * **Li-Fraumeni Syndrome:** Think "SBLA" syndrome (Sarcoma, Breast, Leukemia, Adrenal). * **Cowden Syndrome:** Associated with **PTEN** mutations; presents with breast cancer, thyroid cancer (follicular), and endometrial cancer. * **Peutz-Jeghers Syndrome:** Associated with **STK11** mutations; carries an increased risk of breast and gastrointestinal cancers. * **CHEK2:** A moderate-penetrance gene also associated with increased breast cancer risk. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1058-1060.

Q: Gleason's scoring is performed for which of the following malignancies?

Prostate cancer. **Explanation:** **Gleason’s scoring** is the gold standard grading system used to determine the prognosis of **Prostate Adenocarcinoma** [1]. Unlike many other grading systems that rely on cellular atypia, the Gleason system is based solely on the **architectural patterns** of the tumor glands under low-power magnification. 1. **Why Option A is Correct:** The Gleason score is calculated by identifying the most common (primary) and second most common (secondary) architectural patterns, each graded from 1 to 5 [1]. The sum (e.g., 3+4=7) provides the score. In modern practice, the **ISUP Grade Groups (1–5)** are used to further categorize these scores for clinical decision-making. 2. **Why Other Options are Incorrect:** * **Lung Cancer:** Graded based on histological type (Small cell vs. Non-small cell) and differentiation (Well, moderately, or poorly differentiated). * **Bladder Cancer:** Primarily graded using the **WHO/ISUP classification**, which categorizes tumors into Low-grade or High-grade papillary urothelial carcinomas. * **Hodgkin’s Lymphoma:** This is **staged** (Ann Arbor Staging) rather than graded, as the prognosis depends on the anatomical extent of the disease rather than the degree of cellular differentiation. **High-Yield Clinical Pearls for NEET-PG:** * **Gleason Grade 1:** Small, uniform glands (closest to normal). * **Gleason Grade 5:** No gland formation; solid sheets, cords, or single cells (most aggressive). * **Prostate Specific Antigen (PSA):** Used for screening and monitoring, but Gleason score is the best predictor of prognosis following radical prostatectomy [1]. * **Site:** Most prostate cancers arise in the **Peripheral Zone** [1]. **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, pp. 989-994.

Question 1

All of the following statements are true about tumour markers except?

Accepted Answer

confirmation of cancer

Answer

screening of a cancer

Answer

follow up of a cancer patient

Answer

for knowing about recurrence

Question 2

Which of the following statements about carcinogenesis is false?

Accepted Answer

Papilloma viruses produce tumors in animals but not in humans

Answer

Asbestos exposure increases the incidence of lung cancer

Answer

Exposure to aniline dyes predisposes to cancer of the urinary bladder

Answer

Hepatitis B virus has been implicated in hepatocellular carcinoma

Question 3

Predominant osteoblastic secondaries are seen in which of the following malignancies?

Accepted Answer

Prostate carcinoma

Answer

Breast carcinoma

Answer

Bone carcinoma

Answer

Stomach carcinoma

Question 4

Breast carcinoma is associated with all except?

Accepted Answer

ATR

Answer

BRCA1

Answer

BRCA2

Answer

TP53

Question 5

Which of the following is known as the guardian of the genes?

Accepted Answer

p53

Answer

Rb

Answer

p16

Answer

p73

Question 6

A 50-year-old female presented with a lump in the right breast and was diagnosed with Luminal A carcinoma. Which of the following statements about this cancer is FALSE?

Accepted Answer

Estrogen receptor/Progesterone receptor negative

Answer

Most common subtype

Answer

Best prognosis

Answer

Poor response to paclitaxel

Question 7

Gleason's scoring is performed for which of the following malignancies?

Accepted Answer

Prostate cancer

Answer

Lung cancer

Answer

Bladder cancer

Answer

Hodgkin's lymphoma

Question 8

Which enzymatic mutation is responsible for immortality of cancer cells?

Accepted Answer

Telomerase

Answer

DNA reverse transcriptase

Answer

RNA polymerase

Answer

DNA polymerase

Question 9

Blood-borne spread is a characteristic feature of which of the following?

Accepted Answer

Sarcoma

Answer

Carcinoma

Answer

Dysplasia

Answer

Metaplasia

Question 10

Cancer cachexia is due to which of the following cytokines?

Accepted Answer

TNF-α

Answer

IL-5

Answer

IL-8

Answer

Phospholipase A2

Neoplasia — MCQs

Neoplasia — MCQs

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