Neoplasia — MCQs

Neoplasia Indian Medical PG Practice Questions and MCQs

Question 871: Which of the following is NOT a recognized cause of Urothelial Carcinomas?

A. Industrial solvents
B. Exposure to thorotrast
C. Alcohol consumption (Correct Answer)
D. Smoking

Explanation: ***Alcohol consumption*** - Research does not support a direct association between **alcohol consumption** and an increased risk of urothelial carcinomas. - While excessive alcohol can lead to other forms of cancer, it is not a recognized risk factor for **bladder cancer** specifically. *Smoking* - Smoking is a well-established risk factor for **urothelial carcinomas**, significantly increasing the risk of **bladder cancer** [1]. - It is responsible for up to **50% of bladder cancer cases**, due to carcinogens in tobacco smoke [1]. *Exposure to thorotrast* - **Thorotrast**, a radiopaque contrast medium, is associated with **radiation exposure**, which is a known risk for urothelial carcinomas [3]. - Its use has been linked to increased incidence of bladder cancer due to radioactive properties [3]. *Industrial solvents* - Exposure to various **industrial solvents** such as **aromatic amines** has been linked to a higher risk of developing urothelial carcinomas [1][2]. - These chemicals are commonly found in **dyes**, **rubber**, and other manufacturing processes [2]. **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. 968-970. [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. 217-218. [3] 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. 216-217.

Question 872: Which of the following statements about MALToma is true?

A. They are primary gastric lymphomas
B. H. Pylori infection is a known risk factor (Correct Answer)
C. They are a type of T cell lymphoma
D. Exclusively seen in the gastric antrum

Explanation: ***H. Pylori infection is a risk factor*** - MALToma, or **mucosa-associated lymphoid tissue lymphoma**, is often associated with chronic **H. Pylori infection**, making it a significant risk factor [1]. - **Eradication of H. Pylori** can lead to regression of MALT lymphoma, further supporting the association. *They are a type of T cell lymphoma* - MALToma is classified as a **B-cell lymphoma**, primarily arising from **marginal zone B cells** [1]. - T-cell lymphomas differ significantly in their **pathophysiology** and typical clinical presentations. *They are secondary gastric lymphomas* - MALTomas typically arise **primarily** in the gastric mucosa rather than as secondary lymphomas from another site [1]. - Secondary lymphomas are usually related to more aggressive forms and are often associated with **systemic involvement**. *Commonly seen in gastric cardia* - MALTomas are most frequently found in the **stomach** but are not specifically concentrated in the **gastric cardia** region. - They can also manifest in other areas such as the **antrum**, making this statement misleading. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 356-358.

Question 873: Which viral proteins are known to act as carcinogens in causing carcinoma cervix?

A. P 24 - gene
B. E - gene (Correct Answer)
C. L - gene
D. H - gene

Explanation: ***E - gene*** - The **E - gene** in human papillomavirus (HPV) is known to play a crucial role in the **transformation of cervical cells**, leading to cancer development [1]. - Specifically, the **E6 and E7 proteins** encoded by this gene interfere with tumor suppressor functions, contributing to cervical carcinoma [1,2]. *L - gene* - The **L - gene** is associated with the virus's structural proteins, primarily aiding in the formation of the viral capsid. - It does not have a direct role in the oncogenic process leading to cervical cancer. *H - gene* - The **H - gene** is not specifically linked to the oncogenic effects of HPV; it is not recognized for contributing to cancer development. - It is often confused in discussions but doesn't directly influence the carcinogenic pathway like the E gene does. *P 24 - gene* - The **P 24 - gene** is not related to HPV; instead, it is associated with **HIV** and its structural components. - This gene does not play any role in the development of cervical carcinoma or transformation of cervical cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1007. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 334-335.

Question 874: Which substance plays a significant role in the tumor metastasis cascade?

A. TNF-alpha
B. CD99
C. NM23
D. MMP-2 (Matrix Metalloproteinase-2) (Correct Answer)

Explanation: ***Collagenase IV*** - Collagenase IV is involved in the **degradation of extracellular matrix**, facilitating tumor invasion and metastasis [1,2]. - It plays a crucial role in breaking down **type IV collagen**, a major component of the **basement membrane**, allowing cancer cells to migrate [2]. *TNF-alpha* - While TNF-alpha is a cytokine that can promote **tumor growth**, it is not directly involved in the **metastatic cascade** like collagenase IV [3,4]. - It primarily functions in **inflammation** and immune response, affecting tumor microenvironment rather than directly facilitating invasion. *NM23* - NM23 is noted for its potential role as a **tumor suppressor**, and lower levels are associated with metastasis. - However, it does not play a direct role in the *metastatic cascade* itself [3,4], as it primarily influences **tumor progression** rather than matrix degradation. *CD99* - CD99 is a cell adhesion molecule implicated in **cell migration**, but it is not a significant factor in the **enzymatic breakdown** of tissue during metastasis [1,2]. - Its expression has more to do with **cell adhesion characteristics**, rather than directly promoting invasive capabilities. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 315-316. [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. 232-233. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 314-315. [4] 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 875: Carcinoma originating from glands is called?

A. Basal cell carcinoma
B. Squamous cell carcinoma
C. Adenocarcinoma (Correct Answer)
D. Fibrosarcoma

Explanation: ***Adenocarcinoma*** - Carcinoma that arises from **glandular epithelium** is specifically classified as adenocarcinoma [1]. - It often presents in organs like the **breast**, **prostate**, and **gastrointestinal tract** [4,5]. *Fibrosarcoma* - This is a **malignant tumor** derived from **fibrous connective tissue**, not glands. - Typically occurs in **soft tissues**, and is distinct from epithelial tumors like adenocarcinoma. *Squamous cell carcinoma* - Originates from **squamous epithelial cells** and primarily affects areas such as the **skin** and **mucous membranes** [2]. - It is not associated with glandular structures, differing markedly from adenocarcinoma. *Basal cell carcinoma* - Arises from **basal cells** in the **epidermis** (skin), not from glandular tissue. - It is the most common type of skin cancer and is largely not relevant to glandular origin. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 335-336. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 336-337. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 777-778. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 348-349.

Question 876: Which histological type of lung cancer is most commonly associated with metastasis?

A. Small cell carcinoma (Correct Answer)
B. Squamous cell carcinoma
C. Adenocarcinoma
D. Large cell carcinoma

Explanation: ***Squamous cell CA*** - Known for its **aggressive nature** and propensity to metastasize, particularly in later stages. - Typically arises in the **central part of the lungs**, often associated with smoking and leads to local invasion and distant spread. *Alveolar-carcinoma* - Rarely found and tends to be **less aggressive** compared to squamous cell carcinoma. - Usually has a more localized effect without the same potential for widespread metastasis. *Small cell carcinoma* - Although it is **highly metastatic**, it is less common than squamous cell carcinoma in terms of overall lung cancer incidence. - Characterized by its rapid growth and early metastasis [1], but mostly associated with a specific subtype of lung cancer cases. *Adenocarcinoma* - Generally presents as a **peripheral lung lesion** and has **less propensity for early metastasis** compared to squamous cell carcinoma. - More common in non-smokers and tends to have a less aggressive metastatic pattern. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 337-338.

Question 877: Most common lung cancer in non-smokers is:

A. Adenocarcinoma (Correct Answer)
B. Squamous cell carcinoma
C. Oat cell carcinoma
D. Large cell carcinoma

Explanation: ***Adenocarcinoma*** - **Adenocarcinoma** is the most common type of lung cancer found in non-smokers, often associated with peripheral lung nodules. - This subtype has a rising incidence rate, particularly among women and younger individuals, often linked to factors like **environmental exposures** or **genetics**. *None of the above* - This option is incorrect since adenocarcinoma is a recognized **primary lung cancer** type in non-smokers. - The statement does not address the specific cancer types and neglects to acknowledge the commonality of adenocarcinoma. *Squamous cell carcinoma* - Generally associated with smoking [1,2] and presents centrally in the lungs, making it less common among non-smokers. - Often linked to **cavitary lesions** [1] and associated with **hypercalcemia** due to parathyroid hormone-related peptide secretion. *Oat cell carcinoma* - Also known as small cell lung cancer (SCLC), is primarily linked to smoking and has a **very aggressive** nature. - Typically arises in the central airways and is associated with **paraneoplastic syndromes**, which are not relevant to the non-smoker context. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 336-337. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 720-721.

Question 878: Which of the following markers is specific for gastro-intestinal stromal tumor (GIST)?

A. CD117 (Correct Answer)
B. CD34
C. CD23
D. S-100

Explanation: ***CD 117*** - CD 117 (c-KIT) is the **primary marker** for gastrointestinal stromal tumors (GIST), indicating the presence of the **c-KIT gene mutation** [1]. - Its expression is crucial for diagnosing GISTs, as it is found in nearly all cases of these tumors. *CD 34* - While CD 34 is expressed in some GISTs, it is a **more general marker** associated with stem cells and not specific for GISTs. - GISTs can be negative for CD 34, making it unsuitable for definitive diagnosis. *S-100* - S-100 is typically a marker for **melanocytes** and neuroectodermal tumors, not for GISTs. - It is often used to identify **schwannomas** or **melanomas**, which are unrelated to GIST pathology. *CD 23* - CD 23 is primarily a marker for **chronic lymphocytic leukemia (CLL)** and some forms of lymphoma, not associated with GISTs. - Its presence indicates **lymphoid** lineage, further diverging from GISTs, which are **mesenchymal tumors**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 782-783.

Question 879: Which of the following is not an apoptotic gene?

A. Mcl-1
B. Bax
C. P53
D. n-myc (oncogene) (Correct Answer)

Explanation: ***n-myc*** - **n-myc** is primarily known for its role in **cell proliferation and differentiation**, not specifically associated with apoptosis [2]. - It is an **oncogene** that can contribute to tumorigenesis, but does not directly regulate apoptotic pathways [3]. *P53* - **P53** is a well-known **tumor suppressor gene** that plays a crucial role in inducing apoptosis in response to DNA damage [1]. - Activation of P53 leads to the transcription of genes that promote cell death, thus it is definitely an apoptotic gene [1]. *Bax* - **Bax** is a pro-apoptotic member of the **Bcl-2 family**, promoting apoptosis by facilitating mitochondrial outer membrane permeabilization [4,5]. - It plays a direct role in the apoptotic pathway, making it an important apoptotic gene [5]. *Mcl-1* - **Mcl-1** is an anti-apoptotic member of the **Bcl-2 family**, which helps prevent apoptosis by inhibiting pro-apoptotic factors [2,3]. - Its function is to **promote cell survival**, not apoptosis, but it is still classified as part of the apoptotic regulatory network [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 303-304. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 310. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 310-311. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death, pp. 65-67. [5] 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. 80-81.

Question 880: Which of the following is a good prognostic factor in neuroblastomas?

A. N-myc amplification
B. RAS oncogene
C. Hyperdiploidy (Correct Answer)
D. Translocations

Explanation: ***Hyperdiploidy*** - An increased number of chromosomes (hyperdiploidy) (more than diploid, typically triploid or tetraploid) is associated with a **favorable outcome** in neuroblastoma, particularly in infants [1]. - This chromosomal characteristic indicates a less aggressive tumor biology and often correlates with better response to treatment and **higher survival rates** [1]. *N-myc amplification* - Amplification of the **N-myc oncogene** is a strong indicator of **poor prognosis** in neuroblastoma, leading to rapid tumor progression and resistance to therapy [1]. - It is associated with **advanced disease stage** and is a key factor in risk stratification for treatment intensity [1]. *RAS oncogene* - While mutations in the **RAS oncogene** are found in various cancers, their specific prognostic significance in neuroblastoma is less consistently favorable than hyperdiploidy. - RAS mutations can sometimes be associated with **tumor resistance** to certain therapies. *Translocations* - **Chromosomal translocations** in general are often associated with oncogenesis and can have variable prognostic implications depending on the specific genes involved. - In neuroblastoma, specific translocations are generally not considered a good prognostic factor; instead, they can sometimes be linked to **aggressive disease** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 486-487.

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

Neoplasia — MCQs

Neoplasia — MCQs

On this page

Practice by Chapter

Want unlimited practice?