Neoplasia Practice Questions

Q: What is used for grading of cancer?

Differentiation. **Explanation:** In oncology, **Grading** and **Staging** are two distinct methods used to evaluate a malignancy. **Why Option A is correct:** **Grading** is a histological assessment of the tumor based on the **degree of differentiation** of the tumor cells and the number of mitoses [1]. Differentiation refers to the extent to which neoplastic cells resemble their normal counterparts (morphologically and functionally) [1]. * **Grade I (Well-differentiated):** Cells closely resemble normal tissue [2]. * **Grade IV (Undifferentiated/Anaplastic):** Cells are primitive and lack resemblance to the tissue of origin [3]. Grading reflects the biological aggressiveness of the tumor. [2] **Why other options are incorrect:** * **Tumor Size (C) and Lymph Node Status (D):** These are components of **Staging** (specifically the TNM system). Staging describes the extent of spread of the cancer within the body. * **Tumor Necrosis (B):** While necrosis can be a feature of high-grade tumors (like Glioblastoma Multiforme), it is a secondary histological feature and not the primary definition of grading across all cancers [2]. **High-Yield Clinical Pearls for NEET-PG:** 1. **Staging vs. Grading:** In most clinical scenarios, **Staging is a better predictor of prognosis** than Grading. 2. **TNM System:** T (Size/Invasion), N (Regional lymph nodes), M (Distant metastasis). 3. **Anaplasia:** The hallmark of malignancy; it represents a total lack of differentiation [3]. 4. **Exceptions:** In some cancers, like Prostate Cancer, the **Gleason Scoring system** (a form of grading) is exceptionally critical for management. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 276-278. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, p. 1068. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 278.

Question 1

What is used for grading of cancer?

Accepted Answer

Differentiation

Answer

Tumor necrosis

Answer

Tumor size

Answer

Lymph node status

Question 2

Which of the following is an apoptosis inhibitor gene?

Accepted Answer

Bcl-2

Answer

p53

Answer

Rb

Answer

c-Myc

Question 3

A 59-year-old man complains of progressive weakness and reports very dark stools. Physical examination reveals fullness in the right lower quadrant. Laboratory studies show iron deficiency anemia (serum hemoglobin 7.4 g/dL) and stool occult blood. Colonoscopy discloses an ulcerating lesion of the cecum. Laboratory studies of the surgical specimen demonstrate hypermethylation of the p53 gene in neoplastic cells. Which of the following best characterizes this biochemical change?

Accepted Answer

Epigenetic modification

Answer

Gene amplification

Answer

Insertional mutagenesis

Answer

Nonreciprocal translocation

Question 4

All of the following are true about syndrome with microsatellite instability, except?

Accepted Answer

May be associated with immunodeficiency

Answer

DNA repair defects

Answer

Autosomal dominant

Answer

Increased risk of malignancy

Question 5

A 40-year-old tobacco chewer undergoes a routine oral examination. Non-scrapable white patches are noticed on the left buccal mucosa. What histological examination findings are expected?

Accepted Answer

Hyperplastic cells

Answer

Normal cells

Answer

Dysplastic cells

Answer

Aplastic cells

Question 6

A 20-year-old man presents with numerous pigmented patches and pedunculated skin tumors. Biopsy of a tumor reveals a benign neoplasm of Schwann cells. The patient has no family history of this condition. The patient is at increased risk of developing which of the following malignant neoplasms?

Accepted Answer

Neurofibrosarcoma

Answer

Ganglioneuroma

Answer

Glioblastoma multiforme

Answer

Serous cystadenocarcinoma

Question 7

All of the following are chromosomal breakage syndromes except?

Accepted Answer

Ehlers-Danlos syndrome

Answer

Fanconi's anemia

Answer

Bloom's syndrome

Answer

Ataxia telangiectasia

Question 8

Elevated AFP levels are seen in all of the following conditions, EXCEPT:

Accepted Answer

Hepatoblastoma

Answer

Seminoma

Answer

Teratoma

Answer

None of the above

Question 9

Which of the following tumor suppressor genes acts by inhibition of the Hedgehog signaling pathway?

Accepted Answer

PTCH

Answer

SDHB

Answer

BRCA1

Answer

CDKN2A

Question 10

In B-cell lymphoma, which translocation involves the bcl2 gene?

Accepted Answer

t(14:18)

Answer

t(8:14)

Answer

t(8:12)

Answer

t(14:22)

Neoplasia — MCQs

Neoplasia — MCQs

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