Neoplasia — MCQs
On this page
Which of the following statements are correct with regard to Familial Adenomatous Polyposis ? 1. It is associated with mutation of APC gene located on the long arm of chromosome 5. 2. It is inherited as an autosomal recessive condition. 3. It is associated with 100% lifetime risk for development of Colorectal carcinoma. 4. Congenital hypertrophy of retinal pigment epithelium is present in half of the cases of familial adenomatous polyposis. Select the correct answer using the code given below :
The term "Gompertzian curve" is related to which one of the following ?
The most common type of brain tumour associated with neurofibromatosis type 1 is
Which of the following genetic syndromes are associated with brain tumours? 1. Neurofibromatosis type 1 2. Neurofibromatosis type 2 3. Tuberous sclerosis 4. Wiskott-Aldrich syndrome Select the answer using the code given below.
Which of the following are correct regarding Li-Fraumeni syndrome? 1. It has autosomal dominant inheritance and is associated with P53 gene. 2. It has autosomal recessive inheritance and is associated with P53 gene. 3. It is associated with an increased risk of sarcomas and leukaemia. 4. It is associated with an increased risk of brain tumours and osteosarcomas. Select the answer using the code given below.
Which of the following are correct about glomus tumour? 1. It arises from Suquet-Hoyer canals. 2. Its usual site is nail bed. 3. It is usually a small purple nodule. 4. It is painless.
The commonest variety of peritoneal metastasis is
Which of the following statements regarding papillary thyroid cancer is correct? 1. It is the most common malignant tumour of thyroid gland. 2. It is more common in young females. 3. It has propensity for haematogenous spread. 4. Distant metastases are uncommon.
The following disorders are predisposing conditions for carcinoma of the colon except
In a patient with breast cancer, the following are poor prognostic factors except
Neoplasia Indian Medical PG Practice Questions and MCQs
Question 711: Which of the following statements are correct with regard to Familial Adenomatous Polyposis ? 1. It is associated with mutation of APC gene located on the long arm of chromosome 5. 2. It is inherited as an autosomal recessive condition. 3. It is associated with 100% lifetime risk for development of Colorectal carcinoma. 4. Congenital hypertrophy of retinal pigment epithelium is present in half of the cases of familial adenomatous polyposis. Select the correct answer using the code given below :
- A. 1, 2 and 3
- B. 1, 3 and 4 (Correct Answer)
- C. 2, 3 and 4
- D. 1, 2 and 4
Explanation: ***1, 3 and 4*** - Familial Adenomatous Polyposis is indeed associated with a mutation in the **APC gene** located on the **short arm of chromosome 5 (5q21-q22)** and carries a **nearly 100% lifetime risk** of developing colorectal carcinoma if left untreated [1]. - **Congenital hypertrophy of the retinal pigment epithelium (CHRPE)**, also known as bear claw lesions, is a characteristic extracolonic manifestation observed in approximately half of FAP patients, though it does not usually affect vision. *1, 2 and 3* - This option is incorrect because FAP is inherited as an **autosomal dominant** condition, not autosomal recessive. - Statement 2, claiming autosomal recessive inheritance, is false, rendering this combination incorrect. *2, 3 and 4* - This option incorrectly states that FAP is inherited as an **autosomal recessive** condition. It is an autosomal dominant disorder. - While statements 3 and 4 are correct, the inclusion of statement 2 makes this option invalid. *1, 2 and 4* - This option is incorrect due to the assertion that FAP is an **autosomal recessive** condition (statement 2). - FAP is correctly linked to the APC gene mutation (statement 1) and CHRPE (statement 4), but the inheritance pattern given here is wrong. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 821-822.
Question 712: The term "Gompertzian curve" is related to which one of the following ?
- A. Intestinal obstruction
- B. Gallstone
- C. Tumour (Correct Answer)
- D. Hernia
Explanation: ***Correct Option: Tumour*** - The **Gompertzian curve** describes the growth pattern of tumors, characterized by an initial exponential growth phase followed by a deceleration of growth as the tumor size increases - This deceleration occurs due to limiting factors like **nutrient supply, oxygen availability, and accumulation of waste products** - This model is widely used in **oncology** to understand tumor kinetics, predict responses to treatment, and explain why smaller tumors respond better to chemotherapy than larger ones - The concept is fundamental in understanding **tumor doubling time** and **fractional cell kill hypothesis** in cancer therapy *Incorrect Option: Intestinal obstruction* - **Intestinal obstruction** refers to a mechanical or functional blockage in the intestine - Its clinical course is acute and does not follow a growth curve model - The progression is determined by the degree and location of obstruction, not by cellular proliferation kinetics *Incorrect Option: Gallstone* - A **gallstone** is a hardened deposit of digestive fluid that forms in the gallbladder - Gallstone formation involves bile supersaturation and precipitation of cholesterol or bilirubin, not cellular growth - Its development does not follow the Gompertzian pattern of exponential growth followed by plateau *Incorrect Option: Hernia* - A **hernia** occurs when an organ or tissue protrudes through a weakness in the surrounding muscle or connective tissue - Hernia development is a **structural/anatomical defect**, not a process involving cellular proliferation - It does not involve growth kinetics and is unrelated to the Gompertzian curve concept
Question 713: The most common type of brain tumour associated with neurofibromatosis type 1 is
- A. acoustic neuroma
- B. meningioma
- C. medulloblastoma
- D. astrocytoma (Correct Answer)
Explanation: ***Astrocytoma*** - **Pilocytic astrocytoma** is the most common brain tumor associated with **Neurofibromatosis type 1 (NF1)**, particularly in children and young adults [1]. - These tumors often occur in the **optic pathways**, **brainstem**, or **cerebellum** in patients with NF1. *Acoustic neuroma* - **Vestibular schwannomas** (acoustic neuromas) are characteristic of **Neurofibromatosis type 2 (NF2)**, not NF1 [2]. - NF2 typically involves **bilateral vestibular schwannomas** and other cranial nerve tumors [2]. *Meningioma* - Meningiomas are also more commonly associated with **NF2**, though they can occur sporadically [2]. - They are generally less common in NF1 patients and are not considered the hallmark brain tumor. *Medulloblastoma* - Medulloblastoma is a **highly malignant primary brain tumor** that occurs predominantly in children but is not specifically linked to NF1 [1]. - Its presence is not a defining feature of the NF1 syndrome. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1319-1320. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 724-728.
Question 714: Which of the following genetic syndromes are associated with brain tumours? 1. Neurofibromatosis type 1 2. Neurofibromatosis type 2 3. Tuberous sclerosis 4. Wiskott-Aldrich syndrome Select the answer using the code given below.
- A. 1, 2 and 3 (Correct Answer)
- B. 1, 3 and 4
- C. 1 and 2 only
- D. 2, 3 and 4
Explanation: ***1, 2 and 3*** - **Neurofibromatosis type 1 (NF1)**, **Neurofibromatosis type 2 (NF2)**, and **Tuberous sclerosis (TSC)** are all well-established genetic syndromes associated with an increased risk of developing various brain tumors [1]. - NF1 is linked to **optic pathway gliomas**, NF2 to **schwannomas** and **meningiomas**, and TSC to **subependymal giant cell astrocytomas (SEGAs)** [1], [2]. *1 and 2 only* - This option is incomplete as it correctly identifies NF1 and NF2 but omits Tuberous sclerosis, which is also strongly associated with brain tumours [1]. - While NF1 and NF2 are major genetic risk factors for brain tumors, excluding TSC would be an inaccurate representation of conditions linked to these abnormalities [1]. *1, 3 and 4* - This option incorrectly includes **Wiskott-Aldrich syndrome (WAS)**, which is an **immunodeficiency disorder** and not typically associated with primary brain tumours. - Although WAS can lead to an increased risk of lymphomas, these are generally not considered primary brain tumors [1] in the context of genetic syndromes predisposing to such growths. *2, 3 and 4* - This option again incorrectly includes **Wiskott-Aldrich syndrome** while omitting **Neurofibromatosis type 1**, a significant genetic syndrome linked to brain tumors [1]. - Omitting NF1, a condition known for an increased risk of gliomas, renders this option incomplete and inaccurate. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 724-725. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1318-1319.
Question 715: Which of the following are correct regarding Li-Fraumeni syndrome? 1. It has autosomal dominant inheritance and is associated with P53 gene. 2. It has autosomal recessive inheritance and is associated with P53 gene. 3. It is associated with an increased risk of sarcomas and leukaemia. 4. It is associated with an increased risk of brain tumours and osteosarcomas. Select the answer using the code given below.
- A. 1 and 4 only
- B. 1 and 3 only
- C. 1 only
- D. 1, 3 and 4 (Correct Answer)
Explanation: ***1, 3 and 4*** - Li-Fraumeni syndrome is characterized by **autosomal dominant inheritance** caused by germline mutations in the **TP53 tumor suppressor gene** (statement 1 is correct) [2]. - The syndrome is associated with a significantly increased risk of multiple cancers, including **sarcomas** (osteosarcomas and soft tissue sarcomas), **acute leukemias**, **brain tumors** (gliomas, medulloblastomas), **adrenocortical carcinomas**, and **breast cancer** - often referred to as the "SBLA" spectrum [2], [3]. - Statement 3 is correct: The syndrome IS associated with both **sarcomas and leukemia** (particularly acute leukemias in children) [3]. - Statement 4 is correct: **Brain tumors and osteosarcomas** are hallmark malignancies of Li-Fraumeni syndrome. *1 and 4 only* - While statements 1 and 4 are both correct, this option incorrectly excludes statement 3. - Statement 3 is medically accurate: **leukemias** (particularly acute leukemias) ARE part of the classic Li-Fraumeni cancer spectrum and represent one of the defining malignancies of the syndrome. - Excluding leukemia from the Li-Fraumeni spectrum is a significant medical error. *1 and 3 only* - Statement 1 is correct regarding **autosomal dominant inheritance** and the **TP53 gene** [2]. - Statement 3 is also correct regarding **sarcomas and leukemia** [1]. - However, this option incorrectly excludes statement 4, which correctly identifies **brain tumors and osteosarcomas** as part of the Li-Fraumeni spectrum. *1 only* - Statement 1 correctly identifies the **autosomal dominant inheritance** and involvement of the **TP53 gene** [2]. - However, this option is incomplete as it excludes statements 3 and 4, both of which accurately describe the characteristic cancer spectrum of Li-Fraumeni syndrome. - The specific cancer risks (sarcomas, leukemias, brain tumors, osteosarcomas) are essential defining features of the syndrome [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 297-298. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 227-228. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 298-300.
Question 716: Which of the following are correct about glomus tumour? 1. It arises from Suquet-Hoyer canals. 2. Its usual site is nail bed. 3. It is usually a small purple nodule. 4. It is painless.
- A. 1, 2 and 4
- B. 2, 3 and 4
- C. 1, 3 and 4
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - Glomus tumors originate from the **Suquet-Hoyer canals**, specialized arteriovenous anastomoses involved in thermoregulation. - They are most frequently found in the **nail bed** (especially subungual region) as small, **purple** (reddish-blue) nodules and are typically very painful. - The classic triad includes severe pain, cold sensitivity, and point tenderness. *1, 2 and 4* - This option incorrectly states that glomus tumors are **painless**. In fact, they are characterized by severe pain due to their rich innervation. - While correct that they arise from Suquet-Hoyer canals and are found in the nail bed, the **painlessness** aspect is inaccurate. *2, 3 and 4* - This option incorrectly includes the statement that glomus tumors are **painless**, which contradicts a key distinguishing feature. - Although glomus tumors are typically found in the nail bed and appear as purple nodules, pain is a characteristic clinical feature, not absence of pain. *1, 3 and 4* - This option incorrectly states that glomus tumors are **painless** and omits the correct statement about the usual nail bed location. - While they do arise from Suquet-Hoyer canals and can be small purple nodules, their characteristic severe pain makes this option incorrect.
Question 717: The commonest variety of peritoneal metastasis is
- A. plaques of varying sizes
- B. drop metastasis in pelvis
- C. diffuse adhesion
- D. discrete nodules (Correct Answer)
Explanation: ***discrete nodules*** - Peritoneal metastasis most commonly manifests as **discrete nodules** scattered across the peritoneal surfaces [1]. - These nodules vary in size and distribution, often arising from the implantation of malignant cells shed from a primary tumor. *plaques of varying sizes* - While plaques can occur, they are generally less common than discrete nodules as the primary manifestation of **peritoneal carcinomatosis**. - Plaques often represent confluent growth of numerous smaller nodules rather than the initial, more frequent presentation. *drop metastasis in pelvis* - **Drop metastases** to the pelvis are a common site for peritoneal dissemination due to gravity and fluid dynamics within the peritoneal cavity. - However, referring to it as simply "drop metastasis in pelvis" describes a location rather than the morphology, which is typically **nodular**. *diffuse adhesion* - **Diffuse adhesions** typically result from chronic inflammation or surgical procedures, connecting peritoneal surfaces. - While extensive tumor growth can lead to adhesions, the initial and most common pattern of metastasis is individual **tumor cell implantation** forming **discrete nodules**, not diffuse initial adherence. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 233-234.
Question 718: Which of the following statements regarding papillary thyroid cancer is correct? 1. It is the most common malignant tumour of thyroid gland. 2. It is more common in young females. 3. It has propensity for haematogenous spread. 4. Distant metastases are uncommon.
- A. 2. It is more common in young females.
- B. 4. Distant metastases are uncommon.
- C. 3. It has propensity for haematogenous spread.
- D. 1. It is the most common malignant tumour of thyroid gland. (Correct Answer)
Explanation: ***1. It is the most common malignant tumour of thyroid gland.*** - **Papillary thyroid cancer (PTC)** accounts for approximately **80-85% of all thyroid cancers**, making it the most prevalent type [1]. - This is the definitive correct statement among the options provided. *2. It is more common in young females.* - While PTC is indeed **more common in females** (3:1 female-to-male ratio), the term "young" is imprecise for exam purposes [3]. - PTC typically occurs in the **3rd to 5th decades** (30-50 years), which is more accurately described as "middle-aged" rather than "young" [1], [2]. - The statement lacks specificity needed for a definitive answer. *3. It has propensity for haematogenous spread.* - This is **incorrect**. PTC primarily spreads via the **lymphatic system** to regional cervical lymph nodes [2]. - **Hematogenous spread** is characteristic of **follicular thyroid carcinoma**, not papillary type [2]. - While distant hematogenous metastases can occur in advanced PTC, it is **not** the characteristic pattern of spread. *4. Distant metastases are uncommon.* - While this statement has merit (distant metastases occur in only 5-10% at presentation), it is less definitively correct than statement 1. - The majority of PTC metastases are **locoregional lymphatic** spread rather than distant. - However, when distant metastases do occur, it affects prognosis significantly (lungs > bones). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1098-1100. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 428-430. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1095-1096.
Question 719: The following disorders are predisposing conditions for carcinoma of the colon except
- A. Villous adenoma
- B. Familial polyposis coli
- C. Escherichia coli (Correct Answer)
- D. Peutz-Jeghers syndrome
Explanation: ***Escherichia coli*** - For this 2009 examination, *Escherichia coli* was not recognized as a direct predisposing condition for **colorectal carcinoma**. - **Note for modern learners:** Recent research (post-2010) has identified that certain E. coli strains, particularly pks+ E. coli producing colibactin toxin, can cause DNA damage and are associated with increased colorectal cancer risk. However, this knowledge was not established at the time of this exam. - In the context of classic predisposing conditions, E. coli remains the correct answer for this historical question. *Villous adenoma* - **Villous adenomas** are a type of colorectal polyp with the highest malignant potential among adenomatous polyps (up to 40% risk) [1]. - These are well-established **precancerous lesions** that can progress to **colorectal cancer**, especially when large (>2 cm) or showing high-grade dysplasia [1]. - This is a major predisposing condition for colorectal carcinoma. *Familial polyposis coli* - Also known as **Familial Adenomatous Polyposis (FAP)**, this autosomal dominant disorder causes hundreds to thousands of adenomatous polyps in the colon and rectum [2]. - Nearly **100% of untreated patients** develop **colorectal cancer** by age 40-50 [2]. - This is one of the most significant hereditary predisposing conditions for colorectal carcinoma. *Peutz-Jeghers syndrome* - This **autosomal dominant** disorder features multiple **hamartomatous polyps** throughout the GI tract and characteristic mucocutaneous pigmentation [3]. - Patients have a **15-fold increased risk** of colorectal cancer and elevated risks for other malignancies (gastric, small bowel, pancreatic, breast, ovarian, lung) [3]. - This is an established hereditary predisposing condition for colorectal carcinoma. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 371-373. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 821-822. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 813-814.
Question 720: In a patient with breast cancer, the following are poor prognostic factors except
- A. Aneuploid status
- B. Age less than 35 years
- C. High grade
- D. Absence of epidermal growth factor receptor (Correct Answer)
Explanation: ***Absence of epidermal growth factor receptor*** - The **absence of epidermal growth factor receptor (EGFR/HER1) overexpression** is associated with a **better prognosis** in breast cancer. - **EGFR overexpression** is more commonly seen in aggressive breast cancers, particularly **triple-negative breast cancers** (ER-negative, PR-negative, HER2-negative), and is associated with poor outcomes [2]. - When EGFR is absent or not overexpressed, the tumor tends to have less aggressive biological behavior. *Aneuploid status* - **Aneuploid status** (abnormal chromosome number) is a well-recognized **poor prognostic factor** in breast cancer, indicating genetic instability and aggressive tumor behavior [2]. - It is associated with **increased risk of recurrence** and poorer response to therapy. *Age less than 35 years* - **Younger age** (less than 35 years) at diagnosis is a **poor prognostic factor** for breast cancer. - This is often due to more aggressive tumor biology, **higher grade tumors**, hormone receptor negativity, and delayed diagnosis in younger women. *High grade* - A **high histological grade** (Grade III) indicates a more aggressive tumor with rapid cell division, marked nuclear pleomorphism, and poor differentiation, signifying a **poor prognosis** [1]. - High-grade tumors are more likely to metastasize and have higher recurrence rates. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 458-459. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1064-1066.
Practice by Chapter
Nomenclature and Classification of Tumors
Practice Questions
Characteristics of Benign and Malignant Neoplasms
Practice Questions
Molecular Basis of Cancer
Practice Questions
Carcinogenesis and Carcinogens
Practice Questions
Tumor Progression and Metastasis
Practice Questions
Tumor Markers
Practice Questions
Paraneoplastic Syndromes
Practice Questions
Genetic Basis of Cancer
Practice Questions
Tumor Immunity
Practice Questions
Cancer Epidemiology and Prevention
Practice Questions
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free