Neoplasia Practice Questions

Q: The term "Gompertzian curve" is related to which one of the following ?

Tumour. ***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

Q: The commonest variety of peritoneal metastasis is

discrete nodules. ***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.

Q: 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.

1. It is the most common malignant tumour of thyroid gland.. ***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.

Q: Which one of the following is NOT associated with BRCA1/BRCA2 genes?

Liver cancer. ***Liver cancer*** - **BRCA1/BRCA2 mutations** are primarily associated with an increased risk of breast, ovarian, and prostate cancers, but not typically with **liver cancer**. - While liver cancer does have genetic predispositions, they are generally linked to other genes and environmental factors like chronic viral hepatitis or alcohol abuse. *Ovarian cancer* - **BRCA1/BRCA2 gene mutations** significantly increase the risk of developing **hereditary ovarian cancer**, particularly serous ovarian carcinoma [2]. - Individuals with these mutations often undergo prophylactic oophorectomy to reduce their risk [2]. *Prostate cancer* - **BRCA1/BRCA2 mutations**, especially **BRCA2**, are associated with an increased risk of developing **prostate cancer**, often an aggressive form, particularly in younger men. - Screening guidelines for men with BRCA mutations may include earlier and more frequent PSA testing. *Breast cancer* - **BRCA1 and BRCA2 genes** are tumor suppressor genes, and mutations in these genes are the most common cause of **hereditary breast cancer** [1], [2]. - Individuals with BRCA mutations have a significantly higher lifetime risk of developing breast cancer, and often have a higher incidence of bilateral breast cancer [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, p. 1058. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1058-1059.

Q: In which of the following is the term low and high grade squamous intraepithelial neoplasia used?

Bethesda classification. ***Bethesda classification*** - The Bethesda classification system is used for reporting **cervical cytology** results (Pap test) [1]. - It categorizes squamous cell abnormalities into **low-grade squamous intraepithelial lesion (LSIL)** and **high-grade squamous intraepithelial lesion (HSIL)** [1]. *Shaw's classification* - **Shaw's classification** is not a recognized system for reporting cervical cytopathology. - This term does not apply to the categorization of squamous intraepithelial neoplasia. *FIGO staging* - **FIGO (International Federation of Gynecology and Obstetrics) staging** is used for the clinical staging of **gynecologic cancers**, not for initial cytological screening results [1]. - It describes the extent of cancer progression, not intraepithelial lesions. *Papanicolaou method* - The **Papanicolaou (Pap) method** refers to the staining technique and the general cytological test for cervical cancer screening [1]. - While it's the test itself, the **interpretation and reporting** of results, including terms like LSIL and HSIL, fall under the Bethesda classification system [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1010.

Question 1

The term "Gompertzian curve" is related to which one of the following ?

Accepted Answer

Tumour

Answer

Intestinal obstruction

Answer

Gallstone

Answer

Hernia

Question 2

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.

Accepted Answer

1, 3 and 4

Answer

1 and 4 only

Answer

1 and 3 only

Answer

1 only

Question 3

The commonest variety of peritoneal metastasis is

Accepted Answer

discrete nodules

Answer

plaques of varying sizes

Answer

drop metastasis in pelvis

Answer

diffuse adhesion

Question 4

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.

Accepted Answer

1. It is the most common malignant tumour of thyroid gland.

Answer

2. It is more common in young females.

Answer

4. Distant metastases are uncommon.

Answer

3. It has propensity for haematogenous spread.

Question 5

The histological grade best correlates with the prognosis in which one of the following malignancies?

Accepted Answer

Soft tissue sarcoma

Answer

Melanoma

Answer

Colonic adenocarcinoma

Answer

Prostate cancer

Question 6

Which one of the following is NOT associated with BRCA1/BRCA2 genes?

Accepted Answer

Liver cancer

Answer

Ovarian cancer

Answer

Prostate cancer

Answer

Breast cancer

Question 7

In which of the following is the term low and high grade squamous intraepithelial neoplasia used?

Accepted Answer

Bethesda classification

Answer

Shaw's classification

Answer

FIGO staging

Answer

Papanicolaou method

Question 8

Which of the following pairs is not correctly matched?

Accepted Answer

Sister Joseph’s nodule ……… Solitary secondary deposit in the liver

Answer

Krukenberg tumour ……… Peritoneal seeding involving ovaries

Answer

Virchow’s node ……… Palpable node in left supraclavicular space

Answer

Blumer’s shelf ……… Secondary deposits in pelvic cul-de-sac

Question 9

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→4  B→1  C→2  D→3

Answer

A→3  B→2  C→1  D→4

Answer

A→3  B→1  C→2  D→4

Answer

A→4  B→2  C→1  D→3

Question 10

All of the following are major subtypes of breast cancer based on Gene array analysis EXCEPT:

Accepted Answer

Estrogen receptor positive

Answer

Luminal A and Luminal B

Answer

Triple negative

Answer

Her-2 receptor positive

Neoplasia — MCQs

Neoplasia — MCQs

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