Oncology Quiz with answers

IASO Quiz 2013

Instituted byDr Panda and Dr K Gopinath

Identify this cancer survivor

Identify this cancer survivor

Lance Armstrong

Following the 2012 USPSTF recommendation against PSA screening in

all men, which group saw a decrease in screening frequency by PCPs?

A. Men between 40-49yrsB. Men above 79 yrsC. Patients with previous highest PSA

<2.49ng/mlD. All the above

Following the 2012 USPSTF recommendation against PSA screening in

all men, which group saw a decrease in screening frequency by PCPs?

A. Men between 40-49yrsB. Men above 79 yrsC. Patients with previous highest PSA

<2.49ng/mlD. All the aboveCohn JA, et al. Urol Oncol. 2013 Aug 1. [Epub ahead of print]

http://www.mdlinx.com/oncology/sdoc-article.cfm/4837969







PSA screening is likely to reduce mortality due to prostate cancer. However the conclusion is likely to be affected by

A. Selection BiasB. Lead and length BiasC. Exposure and measurement issuesD. All the above

Urethral Cancer which invades bladder neck, single inguinal node 3cm is staged

A. T4N2M0B. T4N1M0C. T2N1M0D. T3N2M0

Micromets play an important role in the natural progression of urothelial cancer.

What percentage of organ confined node negative bladder cancers recur following

cystectomy?A. 25%B. 5%C. 40%D. 60%

Micromets play an important role in the natural progression of urothelial cancer.

What percentage of organ confined node negative bladder cancers recur following

cystectomy?A. 25%B. 5%C. 40%D. 60%Bladder cancer: Diagnosis Therapeutics and Management.

Ed.Cheryl T Lee and David P Wood. 2010 page 89.

BCG for superficial bladder cancer can be potentiated for additional benefit if combined with which of the following:

A. Mitomycin CB. Interferon C. EpirubicinD. None of the above

BCG for superficial bladder cancer can be potentiated for additional benefit if combined with which of the following:

A. Mitomycin CB. Interferon C. EpirubicinD. None of the aboveZhu S et al. BMC cancer 2013,Jul 5; 13: 322. Pooled results of a recent meta-

analysis of 21 RCT and 9 comparative studiess showed a better recurrence free survival for BCG+Epirubicin at the cost of an increase in toxicity.

Intravesical BCG for non muscle invasive bladder cancer for older

patients

A. Improves Overall SurvivalB. Improves Bladder cancer specific survivalC. Improves Os but not BCSSD. Improves OS and BCSS

Intravesical BCG for non muscle invasive bladder cancer for older

patients

A. Improves Overall SurvivalB. Improves Bladder cancer specific survivalC. Improves Os but not BCSSD. Improves OS and BCSSSpencer BA, et al. J Oncol Pract. 2013;9(2):92-98.







Name the medicinal Plant/tree/seeds

Supposed to enhance memory

Name the medicinal Plant/tree/seeds

Supposed to enhance memoryGinko biloba

The correct statement below is:

A. HPV vaccination is highly effective against development of cervical dysplasia

B. HPV vaccination is highly effective against development of anal and cervical dysplasia

C. HPV vaccination is highly effective against development of cervical, anal and oral dysplasia

The correct statement below is:

A. HPV vaccination is highly effective against development of cervical dysplasia

B. HPV vaccination is highly effective against development of anal and cervical dysplasia

C. HPV vaccination is highly effective against development of cervical, anal and oral dysplasiaPalefsky et al. NEJM 2011;365(17):1576

Vit D receptor Bsm1 polymorphism may represent a risk factor for

_______ women with ovarian cancer

A. AsianB. North AmericanC. EuropeanD. South American

Vit D receptor Bsm1 polymorphism may represent a risk factor for

_______ women with ovarian cancer

A. AsianB. North AmericanC. EuropeanD. South AmericanVDR Bsm1 polymorphism is generally no associated with Ovarian

cancer risk. However a subgroup analysis of the study by Qin X et al ( Int J Gyn Cancer 2013. 23(7): 1178-83) showed european population to be at risk.

Which is not a paraneoplastic syndrome associated with Lung Cancer

A. Horner’ syndromeB. Lambert-Eaton SyndromeC. Sweet’s SyndromeD. Dermatomyositis

Which is not a paraneoplastic syndrome associated with Lung Cancer

A. Horner’ syndromeB. Lambert-Eaton SyndromeC. Sweet’s SyndromeD. Dermatomyositis

The syndrome was first described in 1964 by Dr. Robert D Sweet. It was also known as Gomm-Button disease in honour of the first two patients diagnosed. It is characterized by erythematous well defined cutaneous papules associates with fever and is associated with haematologic malignancies like leukaemia, Rheumatoid Arthritis, IBD, Behcets Syndrome.

The dividing line to discriminate 2R and 4R from 2L and 4L when

staging Lung Cancer is

A. Midline of tracheaB. Right Border of TracheaC. Left border of Trachea

Nodal station not amenable to be assessed by standard cervical

mediastinoscopy for staging lung cancer

A. Station 3B. Station 6C. Station 7D. Station 5

This 62 yr old pathologist who has undergone complete resection for a lung cancer is staged

pT2 N0 M0. He asks you regarding adjuvant therapy with Geftinib. Your answer is--

A. Yes it is beneficial in stage Ib, II and IIIa lung cancer

B. Adjuvant Geftinib benefits only wild type EGFRC. Adjuvant Geftinib benefits only mutant EGFRD. No benefit of Adjuvant Geftinib

This 62 yr old pathologist who has undergone complete resection for a lung cancer is staged

pT2 N0 M0. He asks you regarding adjuvant therapy with Geftinib. Your answer is--

A. Yes it is beneficial in stage Ib, II and IIIa lung cancer

B. Adjuvant Geftinib benefits only wild type EGFRC. Adjuvant Geftinib benefits only mutant EGFRD. No benefit of Adjuvant Geftinib

Gross GD et al. JCO 2013; 31(17) 3320-26. Trial was stopped mid way due to lack of benefit

Not associated with pleural Mesothelioma

A. SV 40 infectionB. Erionite exposureC. Thorium Dioxide therapyD. HPV Infection

Not associated with pleural Mesothelioma

A. SV 40 infectionB. Erionite exposureC. Thorium Dioxide therapyD. HPV Infection

Lung Cancer : Prevention, Management and Emerging Therapies. David J Stewart Ed. 2010; page 437.

OCP and HRT use are associated with increase in breast cancer and

Lung cancerA. TrueB. False

OCP and HRT use are associated with increase in breast cancer and

Lung cancerA. TrueB. False

ILCC pooled analysis of 6 case control studies ( 1961 cases and 2609 controls) found a reduced risk of lung ca in HRT (Adeno and Small Cell) and OCP (Squamous CA)users. There was no dose response relationship with years of OCP/HRT.Pesatori AC et al. Br J Cancer 2013; 109(7) 1954-64.

Which of the following is an inhibitor of PDGFR

A. DasatinibB. VandetanibC. SorafenibD. Imatinib

Which of the following is an inhibitor of PDGFR

A. DasatinibB. Vandetanib - VEGFR-2C. Sorafenib - DS DNA break repairD. Imatinib - Bcl-2

Name the book by this Ethiopia born physician which talks of liver transplantation

A. My JourneyB. Another lifeC. Cutting for StoneD. Emperor’s Malady

Does higher UV radiation exposure of pregnant women reduce incidence of some

childhood cancers

A. Yes B. No

Does higher UV radiation exposure of pregnant women reduce incidence of some

childhood cancers

A. Yes B. NoLombardi C et al. cancer Epidemiology, Biomarkers and Prevention 2013;22(6): 1118-1128

• Results: For cases with UVR exposure of 5,111 Watt-hours/m2 or above, we estimated a reduction in odds of developing acute lymphoblastic leukemia (OR: 0.89, 95% CI: 0.81–0.99), hepatoblastoma (OR: 0.69, 95% CI: 0.48–1.00), and non-Hodgkin's lymphoma (OR: 0.71, 95% CI: 0.50–1.02) adjusting for mother's age, mother's race, and child's year of birth. We also observed a small increase in odds for intracranial/intraspinal embryonal tumors (OR: 1.29, 95% CI: 1.01–1.65).

• Conclusions: Our findings suggest that UVR during pregnancy may decrease the odds of some childhood cancers. Future studies should explore additional factors that may be correlated with UVR exposure and possibly include biomarkers of immune function and vitamin D.

Melanoma subtype which is characterized by bland fibroblastic

appearance and often mimics a scar-

A. DesmoplasticB. Acral LetigenousC. NodularD. Lentigo maligna

Melanoma subtype which is characterized by bland fibroblastic

appearance and often mimics a scar-

A. DesmoplasticB. Acral LetigenousC. NodularD. Lentigo maligna

DM are strongly and homogeneously positive for S-100 protein but are often negative or only focally positive for melanocyte differentiation antigens such as tyrosinase, gp100, Melan-A, and microphthalmia transcription factor. DM differs from conventional melanoma in its clinical course. It is associated with a higher tendency for local recurrence, but metastases to regional lymph nodes are less common.

Wood BA. Pathology 2013; 45(5): 453-463

Who is this medical inventor

A. Dr Eric Blom. B. Dr Robert EstherC. Dr Douglas J. Schwartzentruber

Who is this medical inventor

A. Dr Eric Blom. Inventor of the Blom Singer Prosthesis for laryngectomee patients

B. Dr Robert EstherC. Dr Douglas J. Schwartzentruber

Melanoma Vaccine

Pet scan is often advised for follow-up in patients treated for HNSCC. Which of the following is correct statement

A. PET scan does not obviate the need for standard radiology

B. Two negative PET scans at 6 month intervals obviates the need for additional radiology

C. Single negative PET scan obviates the need for additional radiology

Pet scan is often advised for follow-up in patients treated for HNSCC. Which of the following is correct statement

A. PET scan does not obviate the need for standard radiology

B. Two negative PET scans at 6 month intervals obviates the need for additional radiology

C. Single negative PET scan obviates the need for additional radiologyMc Dermott et al. AJNR 2013; 34(8): 1631-36The NPV of 2 negative PET scans at 6 month intervals was 98% compared to 91% for a single negative PET scan

Most likely site of an asymptomatic recurrence of H&N cancer is

A. ThoracicB. AbdominalC. Regional nodalD. Primary site

Most likely site of an asymptomatic recurrence of H&N cancer is

A. ThoracicB. AbdominalC. Regional nodalD. Primary siteDunsky KA et al. Laryngoscope 2013; 123(9): 2161-64

H&N Liposarcomas are likely to be

A. Commonly deep and have poor outcomeB. DFS and OS poorer than conventional

liposarcomsC. Low grade and early stageD. Deep seated but low grade and stage

H&N Liposarcomas are likely to be

A. Commonly deep and have poor outcomeB. DFS and OS poorer than conventional

liposarcomsC. Low grade and early stageD. Deep seated but low grade and stageGerry D et al. Head and Neck 2013; Jun 01 Epub

Stage IVa H&N Melanoma is

A. T1 N2 M0B. T3 N1 M0C. T4b N0 M0D. T3 N2 M0

One of the following is not implicated in the development of carcinoma of

the larynx.

A. TobaccoB. Leather DustC. Strong Inorganic MistsD. Asbestos Dust and Fibre

.

One of the following is not implicated in the development of carcinoma of

the larynx.

A. TobaccoB. Leather DustC. Strong Inorganic MistsD. Asbestos Dust and Fibre

Head and Neck CA. Current Perspectives and Challenges. Ed James A Radosevich. 2013: page 58. The other 3 have a strong association. Others with limited evidence are HPV 16,18, Sulfur Mustard, Rubber production, secondary tobacco smoke. Less than 1% are due to alcohol alone.

The journey of this physician’s discovery and clinical application was captured in a

Hollywood movie in 2008 starring Harry Connick -

A. Living ProofB. A Gift of LifeC. Nude RatsD. The Lonely Road

Triple negative breast cancers typically demonstrate

A. Chemotherapy sensitivityB. Chemotherapy insensitivityC. Sensitive to only cisplatinD. Chemotherapy sensitivity followed shorter

durable response

The residual tumour excised at surgery following neoadjuvant therapy with

Trastuzumab and Chemotherapy is likely to have --

A. Retained Her2 expressionB. Gained Her2 point mutationsC. Lost Her2 expressionD. Lost Her2 point mutations

The residual tumour excised at surgery following neoadjuvant therapy with

Trastuzumab and Chemotherapy is likely to have --

A. Retained Her2 expressionB. Gained Her2 point mutationsC. Lost Her2 expressionD. Lost Her2 point mutations

• In a study of 167 HER2-positive breast cancer patients, participants who received neoadjuvant chemotherapy without anti-HER2 treatment were more likely to demonstrate HER2 loss within their residual disease (40% vs 14.7%, P=0.019). Additionally, HER2 loss demonstrated a trend towards higher risk of relapse (HR 2.41, P=0.063). The pCR is confirmed as a powerful predictor of long-term outcome. The rate of HER2 loss is higher in patients receiving neoadjuvant CT without anti-HER2 agents. HER2 status on residual disease after preoperative therapy can be helpful in selecting patients at different risk of relapse, to be included in prospective trial exploring further adjuvant therapy.Guarneri V, et al. Ann Oncol. 2013 Sep 7. [Epub ahead of print]







Which of the following predicts the possibility of recurrence in node

negative breast cancerA. Lymphovascular invasionB. Age of patientC. Perineural spreadD. Adjuvant radiotherapy

Which of the following predicts the possibility of recurrence in node

negative breast cancerA. Lymphovascular invasionB. Age of patientC. Perineural spreadD. Adjuvant radiotherapy

In a study of 716 patients with node-negative breast cancer, 47 ultimately recurred during 47 months of median follow-up. Lymphovascular invasion (HR 4.6) and Nottingham grade 3 (HR 4.99) tumors were independent risk factors associated with an increased risk of recurrence. Adjuvant radiotherapy (HR 0.35) decreased tumor recurrence, while adjuvant chemotherapy had no effect. Lin PH. J Surg Oncol 2013; 108(6): 352

Your 52 yr old patient treated for HR+ EBC and now on Exemestrane says she is in the pink of

health with no musculoskeletal symptoms, vasomotor or vulvovaginal symptoms.

Inference on her survival--A. She likely to have a decreased survivalB. No inference can be drawnC. She has same survival as for her stage of

cancerD. She is likely to have a better survival

Your 52 yr old patient treated for HR+ EBC and now on Exemestrane says she is in the pink of

health with no musculoskeletal symptoms, vasomotor or vulvovaginal symptoms.

Inference on her survival--A. She likely to have a decreased survivalB. No inference can be drawnC. She has same survival as for her stage of cancerD. She is likely to have a better survival

Fontein DB et al. JCO 2013; 31(18): 2257-64International Tamoxifen Exemestrane Multinational Trial

The drugs recommended for breast cancer risk reduction in a 50yr old

postmenopausal lady with family history of breast cancer and dense breasts are

A. Raloxifene or TamoxifenB. Raloxifene onlyC. Raloxifene, Tamoxifen and Exemestrane

The drugs recommended for breast cancer risk reduction in a 50yr old

postmenopausal lady with family history of breast cancer and dense breasts are

A. Raloxifene or TamoxifenB. Raloxifene onlyC. Raloxifene, Tamoxifen and Exemestrane

Moyer VA, et al. Ann Intern Med. 2013 Sep 24. USPSTF recommendations

Attachment of H Pylori to the gastric epithelium leads to activation of NF-Kb

and increased A. IL-8B. VEGFC. MMP-2D. HGF

Use of S-1 a novel drug based on 5FU with Cisplatin compared to the standard Cisplatin + 5FU for

gastric cancer reveals

A. Cis plat + S-1 is more effectiveB. Increased incidence of Stomatitis, Febrile

neutropeniaC. Lower incidence of hand foot syndromeD. Increased treatment related deaths

Use of S-1 a novel drug based on 5FU with Cisplatin compared to the standard Cisplatin + 5FU for

gastric cancer reveals

A. Cis plat + S-1 is more effectiveB. Increased incidence of Stomatitis, Febrile

neutropeniaC. Lower incidence of hand foot syndromeD. Increased treatment related deaths

Ajani JA et al. Eur J Cancer 2013; 49(17):3616-24. CS is noninferior to CF and has improved safety

What is not true for follow up of Stage II and III Colon Cancer

A. 80% recurrences occur in the first 2-2.5 yrsB. CT abdomen and chest recommended

annually for 3 yrsC. If surveillance colonoscopy is fine at 1 yr

colonoscopy is done every 2 yrsD. PET scan can be recommended as part of a

trial only

What is not true for follow up of Stage II and III Colon Cancer

A. 80% recurrences occur in the first 2-2.5 yrsB. CT abdomen and chest recommended

annually for 3 yrsC. If surveillance colonoscopy is fine at 1 yr

colonoscopy is done every 2 yrsD. PET scan can be recommended as part of a

trial onlyASCO endorsed the guideline prepared by CCO ( JCO Nov 2012 )

Incorrect about carcinoid tumours

A. Causes depletion of tyrosineB. Some patients may have dermatological

manifestations in sun exposed partsC. 10% secrete excessive levels of SerotoninD. May produce tricuspid stenosis

Incorrect about carcinoid tumours

A. Causes depletion of tyrosine. The aminoacid depleted is tryptophan

B. Some patients may have dermatological manifestations in sun exposed parts

C. 10% secrete excessive levels of SerotoninD. May produce tricuspid stenosis

This computer scientist and professor at Carnagie Mellon University was an author

of a best seller called

A. Alice projectB. Time managementC. Achieving your

childhood dreamsD. The last lecture

This computer scientist and professor at Carnagie Mellon University was an author

of a best seller called

A. Alice projectB. Time managementC. Achieving your

childhood dreamsD.The last lecture by

Randy Pausch

The 5 year survival of stage 1 pancreatic cancer is--

A. Less than 30%B. 50%C. 65%D. 5%

In patients with nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs), when

preoperative grading assessment is not achieved, which clinical variable is an excellent predictor of post-treatment nodal positivity?

A. Radiological tumour sizeB. BMIC. AgeD. Gender

In patients with nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs), when

preoperative grading assessment is not achieved, which clinical variable is an excellent predictor of post-treatment nodal positivity?

A. Radiological tumour sizeB. BMIC. AgeD. Gender

Partelli S, et al. JAMA Surg. 2013;148(10):932-939.





In patients with hepatocellular carcinoma (HCC) receiving transarterial

therapy (TACE/TAE), which is NOT a prognostic factor for risk of death?

A. Albumin > 3.6 g/dlB. Bilirubin > 17umol/lC. Tumour Size > 7 cmD. AFP >400ng/dl

In patients with hepatocellular carcinoma (HCC) receiving transarterial

therapy (TACE/TAE), which is NOT a prognostic factor for risk of death?

A. Albumin > 3.6 g/dlB. Bilirubin > 17umol/lC. Tumour Size > 7 cmD. AFP >400ng/dl

This is the hepatoma arterial embolization prognostic score. Kadalayil L, et al. Ann Oncol. 2013;24(10):2565-2570.




For adult survivors of childhood cancer, which organ system is the most at-risk for disease

during adulthood after exposure to treatment with potential toxicity?

A. PulmonaryB. HaematopoieticC. HepaticD. Gastrointestinal

.


For adult survivors of childhood cancer, which organ system is the most at-risk for disease

during adulthood after exposure to treatment with potential toxicity?

A. PulmonaryB. HaematopoieticC. HepaticD. Gastrointestinal

Less than 15% develop haematopoietic, hepatic, skeletal dysfunction. Other organs at risk are cardiac, neurologic, neurocognitive and endocrine.

Hudson MM, et al. JAMA. 2013;309(22):2371-2381.




What percentage of adult survivors of childhood cancer develop an adult

neoplasm (benign and or malignant)

A. 16%B. 45%C. 3%D. 0.5%

What percentage of adult survivors of childhood cancer develop an adult

neoplasm (benign and or malignant)

A. 16%B. 45%C. 3%D. 0.5%Hudson MM, et al. JAMA. 2013;309(22):2371-2381.




This actor was diagnosed with ---- in the film

A. LeukaemiaB. Brain TumourC. Lymphosarcoma

of Intestine

Risk of recurrence in GIST after surgery is high (55% or more)in all except:

A. More than 10 cm size in any locationB. 2-5cm with mitosis 5 per 50HPFC. Mucosal invasionD. Mitosis >1 per 5HPF

Most of the GIST are positive for CD117. Approximately 8% are CD117 negative but PDGFRA positive. These tumours

are-A. Clinically indolent, located in small intestineB. Clinically aggressive, located in stomach andC. Clinically indolent, located in stomach,

Most of the GIST are positive for CD117. Approximately 8% are CD117 negative but PDGFRA positive. These tumours

are-A. Clinically indolent, located in small intestineB. Clinically aggressive, located in stomach andC. Clinically indolent, located in stomach Haematology Oncology Clinics: Rare Cancers. Dec 2012.

These PDGFRA positive tumours commonly are of epithelioid morphology and the commonest mutation is on exon 18 (D842V) which makes them resistant to TKI

The expected DFS following non operative management of clinical CR of Stage I-III rectal cancer treated by

neoadjuvant CCRT is

A. 50%B. 80%C. 60%D. 40%

The expected DFS following non operative management of clinical CR of Stage I-III rectal cancer treated by

neoadjuvant CCRT is

A. 50%B. 80%C. 60%D. 40%Solanki AA et al. Onco Targets and therapy 2013; 2013(6): 1097-1110

Who is this surgeon

A.Frank H. NetterB.B FisherC.CW Lilliehei

Who is this surgeon

A. Frank H. Netter was an American surgeon and celebrated medical illustrator. The first edition of his Atlas of Human Anatomy — his "personal Sistine Chapel" — was published in 1989 and he was made a Fellow of the New York Academy of Medicine

B. B FisherC. CW Lilliehei

Statistics: the incorrect statement is

A. Type 1 error is fixed aprioriB. Increasing sample size has no effect on type 2

errorC. Doubling sample size does not affect

confidence intervalD. Sample size and effect size are inversely

related

Statistics: the incorrect statement is

A. Type 1 error is fixed aprioriB. Increasing sample size has no effect on type

2 errorC. Doubling sample size does not affect

confidence intervalD. Sample size and effect size are inversely

related

Which is not a subtypes of Chondroma

A. EctochondromaB. EnchondromaC. Perosteal chondromaD. Soft tissue Chondroma

What minimum dose of radiation is needed to produce a statistically superior response to bone pain

A. 10 GyB. 8 GyC. 15 GyD. 4 Gy

What minimum dose of radiation is needed to produce a statistically superior response to bone pain

A. 10 GyB. 8 GyC. 15 GyD. 4 Gy

Dennis K. Radiother Oncol 2013; 106(1) 5-14In this systematic analysis the authors found that the minimum dose of 8Gy was needed to reduce pain in bone mets.

Most common Uterine Sarcoma

A. CarcinosarcomaB. Endometrial stromal sarcomaC. LeiomyosarcomaD. Adenosarcoma

He hypothesised the angiogenesis theory for cancer which states that a tumor is able to

create its own blood supply. Dozens of cancer drugs were developed based on his research.

A. Dr J Michael BishopB. Dr Harold E VarmusC. Dr Judah FolkmanD. Dr Brian J Druker

He hypothesised the angiogenesis theory for cancer which states that a tumor is able to

create its own blood supply. Dozens of cancer drugs were developed based on his research.

A. Dr J Michael BishopB. Dr Harold E Varmus

Nobel for Oncogene 1989

C. Dr Judah FolkmanD. Dr Brian J Druker

Along with Nicholas B. Lydon and Charles Sawyers, Lasker for CML

Oncology Quiz with answers

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