Neoplasia Practice Questions

Q: The MYC gene product functions as which of the following?

Transcription activator. **Explanation:** The **MYC gene** (specifically c-MYC) is a proto-oncogene that encodes a protein belonging to the **transcription factor** family [1]. Once activated by mitogenic signaling pathways (like RAS/MAPK), the MYC protein translocates to the nucleus [2]. It binds to specific DNA sequences (E-box sequences) by forming a heterodimer with the **MAX protein**. This complex acts as a potent **transcription activator**, promoting the expression of genes required for cell cycle progression (e.g., Cyclin D), metabolism, and protein synthesis. **Analysis of Incorrect Options:** * **A & B (Protein kinase/Growth factor inhibitors):** These functions are characteristic of **Tumor Suppressor Genes** (like CDKN2A/p16 or APC). MYC is an oncogene; its overexpression promotes growth rather than inhibiting it. * **C (GTPase):** This is the characteristic function of the **RAS protein**. RAS acts as a molecular switch by cycling between an active GTP-bound state and an inactive GDP-bound state. **NEET-PG High-Yield Pearls:** * **Burkitt Lymphoma:** Classically associated with the **t(8;14)** translocation, which moves the c-MYC gene (Chr 8) to the IgH locus (Chr 14), leading to constitutive MYC expression [3]. * **Amplification:** **N-MYC** is commonly amplified in Neuroblastoma (correlates with poor prognosis), while **L-MYC** is associated with Small Cell Carcinoma of the Lung. * **Function:** MYC is often called a "master regulator" of metabolism (Warburg effect) and cell growth. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 292-293. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 296-297. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 324-325.

Q: Flexner-Wintersteiner rosettes in microscopy are seen in which condition?

Retinoblastoma. **Explanation:** **Flexner-Wintersteiner rosettes** are the pathognomonic histological hallmark of **Retinoblastoma**. These structures consist of a ring of cuboidal or columnar cells surrounding a central lumen. This lumen represents an attempt by the primitive tumor cells to differentiate into photoreceptor elements (rods and cones). The presence of these rosettes indicates a degree of retinal differentiation. **Analysis of Options:** * **Retinoblastoma (Correct):** It is the most common intraocular malignancy of childhood. Flexner-Wintersteiner rosettes are highly specific for this condition. Other histological features include Homer-Wright rosettes (less specific) and fleurettes (representing high differentiation). * **Retinitis Pigmentosa:** This is a degenerative (not neoplastic) disease of the photoreceptors. Histology shows "bony spicule" pigmentation and atrophy of the retinal layers, not rosette formation. * **Trauma:** Ocular trauma leads to inflammation, scarring, or hemorrhage (e.g., Commotio retinae). It does not involve the cellular proliferation required to form rosettes. * **Neuroblastoma:** While neuroblastomas also feature rosettes, they are typically **Homer-Wright rosettes** (which lack a central lumen and contain a central tangle of nerve fibers/neuropil). Flexner-Wintersteiner rosettes are not characteristic of neuroblastoma. **High-Yield Clinical Pearls for NEET-PG:** * **Homer-Wright Rosettes:** Seen in Neuroblastoma, Medulloblastoma, and Retinoblastoma (non-specific). * **Flexner-Wintersteiner Rosettes:** Specific for Retinoblastoma and Pineoblastoma. * **Fleurettes:** Represent the highest level of photoreceptor differentiation in Retinoblastoma. * **Calcification:** Retinoblastoma is a "chalky white" tumor; presence of calcification on CT scan is a key diagnostic sign.

Question 1

All of the following are angiogenic factors EXCEPT?

Accepted Answer

IFN

Answer

VEGF

Answer

PDGF

Answer

TGF-β

Question 2

The MYC gene product functions as which of the following?

Accepted Answer

Transcription activator

Answer

Protein kinase inhibitor

Answer

Growth factor inhibitor

Answer

GTPase

Question 3

Which of the following tumours are known to spontaneously regress?

Accepted Answer

Malignant melanoma

Answer

Neuroblastoma

Answer

Ewing's sarcoma

Answer

Wilm's tumour

Question 4

Which of the following is NOT associated with human papillomavirus infection?

Accepted Answer

Nasopharyngeal carcinoma

Answer

Oropharyngeal tumors

Answer

Anal canal carcinoma

Answer

Cervical carcinoma

Question 5

CEA is elevated in all of the following conditions except:

Accepted Answer

Prostatic carcinoma

Answer

Alcoholic cirrhosis

Answer

Ulcerative colitis

Answer

Carcinoma colon

Question 6

Which of the following pre-malignant conditions is associated with the highest probability of progression to malignancy?

Accepted Answer

Erythroplakia

Answer

Dysplasia

Answer

Hyperplasia

Answer

Leukoplakia

Question 7

The retinoblastoma gene regulates which phase transition?

Accepted Answer

G1 to S phase

Answer

G2 to M phase

Answer

G0 to S1 phase

Answer

S to G1 phase

Question 8

Flexner-Wintersteiner rosettes in microscopy are seen in which condition?

Accepted Answer

Retinoblastoma

Answer

Retinitis pigmentosa

Answer

Trauma

Answer

Neuroblastoma

Question 9

Rosettes typically seen in Neuroblastoma are:

Accepted Answer

Homer-wright rosettes

Answer

Flexner Wintersteiner rosettes

Answer

Perivascular rosettes

Answer

Neurocytic rosettes

Question 10

Which of the following is a cause of tumorogenesis in aging?

Accepted Answer

Telomerase reactivation

Answer

Telomerase inactivation

Answer

Increased apoptosis

Answer

Suppression of proto-oncogenes

Neoplasia — MCQs

Neoplasia — MCQs

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