Oncology Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Oncology. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Oncology Indian Medical PG Question 1: Radiotherapy is most useful in:
- A. Melanoma
- B. Pancreatic carcinoma
- C. Osteosarcoma
- D. Seminoma (Correct Answer)
Oncology Explanation: ***Seminoma***
- **Seminoma** is a highly **radiosensitive** tumor, making radiotherapy a cornerstone of its treatment, especially for localized disease and in adjuvant settings.
- Due to its chemosensitivity and radiosensitivity, even advanced seminoma often responds well to treatment, leading to **high cure rates**.
*Melanoma*
- **Melanoma** is generally considered **radioresistant**, meaning that it does not respond well to conventional doses of radiation.
- Treatment primarily involves **surgical excision**, immunotherapy, and targeted therapies.
*Pancreatic carcinoma*
- **Pancreatic carcinoma** is notoriously **radioresistant** and has a poor prognosis, with limited effectiveness of standalone radiation therapy.
- Treatment often involves a combination of **surgery**, chemotherapy, and sometimes concurrent chemoradiation, though outcomes remain challenging.
*Osteosarcoma*
- **Osteosarcoma** is primarily managed with **surgical resection** and **neoadjuvant/adjuvant chemotherapy**, as it is relatively radioresistant.
- Radiotherapy is typically reserved for unresectable tumors, palliative care, or when surgery is contraindicated.
Oncology Indian Medical PG Question 2: Which among the following drugs is the new FDA approved immune checkpoint inhibitor for endometrial carcinoma?
- A. Ipilimumab
- B. Pembrolizumab (Correct Answer)
- C. Trastuzumab
- D. Nivolumab
Oncology Explanation: **Pembrolizumab**
* **Pembrolizumab** (Keytruda), a **PD-1 inhibitor**, received accelerated FDA approval for patients with **advanced endometrial carcinoma** that is mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H), and has progressed following prior systemic therapy or is not a candidate for curative surgery or radiation.
* This approval was based on data from the KEYNOTE-158 study, demonstrating **durable responses** in these specific subsets of endometrial cancer, highlighting its role in precision oncology.
*Ipilimumab*
* **Ipilimumab** (Yervoy) is a **CTLA-4 inhibitor** primarily approved for the treatment of **melanoma** and renal cell carcinoma, often in combination with nivolumab.
* While it is an immune checkpoint inhibitor, its primary indications and specific FDA approvals do not include **endometrial carcinoma**.
*Trastuzumab*
* **Trastuzumab** (Herceptin) is a **monoclonal antibody** that targets the **HER2 protein**, commonly used in the treatment of **HER2-positive breast cancer** and certain types of gastric cancer.
* It is not an immune checkpoint inhibitor and its mechanism of action is distinct from blocking immune checkpoints like PD-1 or CTLA-4.
*Nivolumab*
* **Nivolumab** (Opdivo) is a **PD-1 inhibitor** with broad FDA approvals for various cancers, including melanoma, non-small cell lung cancer, renal cell carcinoma, classical Hodgkin lymphoma, and others.
* While a potent immune checkpoint inhibitor, **pembrolizumab** received the specific accelerated approval for advanced endometrial carcinoma in the context described, making it the most direct answer for the "new FDA approved" status in this specific indication.
Oncology Indian Medical PG Question 3: Radiation exposure can lead to which type of thyroid carcinoma?
- A. Lymphoma
- B. Papillary carcinoma (Correct Answer)
- C. Medullary carcinoma
- D. Follicular carcinoma
Oncology Explanation: ***Papillary carcinoma***
- Papillary thyroid carcinoma is strongly associated with **radiation exposure**, particularly during childhood [1].
- It is the most prevalent type of thyroid cancer and typically has a **good prognosis** [1].
*Lymphoma*
- Thyroid lymphoma is rare and generally not linked to **radiation exposure**; it often presents as a **rapidly enlarging goiter**.
- It is more commonly associated with **autoimmune thyroiditis**, not primary radiation effects.
*Follicular carcinoma*
- Follicular carcinoma shows a correlation with **iodine deficiency** rather than radiation exposure [1].
- Its presentation is more subtle, compared to the classical association of **radiation with papillary carcinoma**.
*Medullary carcinoma*
- Medullary thyroid carcinoma is primarily linked to **familial syndromes** like MEN 2 and not radiation exposure.
- It arises from **parafollicular C cells**, making it clinically distinct from radiation-related types.
**References:**
[1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1098-1099.
Oncology Indian Medical PG Question 4: Which of the following is true?
1. BRCA1 is an oncogene
2. HER2neu is amplified only in a fraction of breast cancer
3. EGFR (+) is seen in non-small cell lung cancer
4. N-MYC is a tumor suppressor gene
- A. 1,3
- B. 1,2
- C. 2,3 (Correct Answer)
- D. All of the options
Oncology Explanation: ***Correct Option: 2,3***
- **Statement 2 is TRUE**: HER2neu amplification occurs in only a fraction (~15-20%) of breast cancers, making it a specific subset requiring targeted therapy with trastuzumab (Herceptin) [1].
- **Statement 3 is TRUE**: EGFR (epidermal growth factor receptor) mutations or overexpression are commonly seen in non-small cell lung cancer (NSCLC) and serve as important therapeutic targets for tyrosine kinase inhibitors.
*Incorrect Option: 1,3*
- Statement 1 is **FALSE**: BRCA1 is a **tumor suppressor gene**, not an oncogene. It functions in DNA double-strand break repair, and loss-of-function mutations increase the risk of breast and ovarian cancers.
- Statement 3 is TRUE, but the inclusion of the false statement about BRCA1 makes this option incorrect.
*Incorrect Option: 1,2*
- Statement 1 is **FALSE**: BRCA1 is a **tumor suppressor gene**, not an oncogene.
- Statement 2 is TRUE [1], but the false classification of BRCA1 invalidates this option.
*Incorrect Option: All of the options*
- Statement 1 is **FALSE**: BRCA1 is a tumor suppressor gene, not an oncogene.
- Statement 4 is **FALSE**: N-MYC is an **oncogene** that is amplified in neuroblastoma and other cancers, not a tumor suppressor gene.
- Since two of the four statements are incorrect, "All of the options" cannot be true.
**References:**
[1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1059-1060.
Oncology Indian Medical PG Question 5: Most frequently altered oncogene in pancreatic cancer is:
- A. K-RAS (Correct Answer)
- B. CDKN2A
- C. SMAD4
- D. TP53
Oncology Explanation: ***K-RAS***
- **K-RAS** mutations are present in approximately **90%** of pancreatic adenocarcinomas, making it the most frequently altered oncogene in this cancer type [1].
- It plays a major role in the **Ras signaling pathway**, which is crucial for cell proliferation and survival.
*TP53*
- While **TP53** mutations are also common in various cancers, they are not the most prevalent in pancreatic cancer, where K-RAS is more frequently mutated [1].
- Typically associated with **tumor progression**, rather than initiating changes seen in pancreatic carcinogenesis [1].
*SMAD4*
- **SMAD4** mutations occur in about **55%** of pancreatic cancers but are generally involved in the later stages of tumor progression, rather than being an initiating oncogenic event [1].
- Primarily functions in the **TGF-beta signaling pathway**, which is different from the K-RAS pathway.
*CDKN2A*
- Although **CDKN2A** deletions are implicated in pancreatic cancer, they are not as frequently altered as K-RAS mutations [1].
- This gene is related to the regulation of the **cell cycle**, but its alterations are secondary in the context of pancreatic oncogenesis [1].
**References:**
[1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Pancreas, pp. 897-898.
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