Patho Neoplasia

8/3/2019 Patho Neoplasia

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* Tumour marker for ovarian cancer - CA-125

* Tumour marker for liver cancer - X-fetoprotein

* BRCA 1 and BRCA 2 - breast cancer

* EBV virus causes cancers - Burkitt lymphoma (african form), Nasopharyngeal

carcinoma, B-cell lymphoma, Hodgkin lymphoma (but not Infective mononucleosis

as its not a cancer) while Infectious mononucleaosis (non-cancerous) while Non-

hodgkin's lymphoma (not caused by EBV)

* Most commonly death occurs (both men and women) by LUNGS cancer

* Male Most common cancer - prostate

* Female Most common cancer - Breast

* Neoplasm characteristics: High N/C ratio, monoclonal, High rate of mitosis (notpolyclonal)

* Most common malignant tumour of malignancy - Leukemia

* Lung cancer caused by - Nickel, Chromium, Cadmium, Asbestos (not aflatoxin)

* Organ to which metastasis never occurs (Spleen / Muscles)

* Preneoplastic conditions: Solar keratosis, Ulcerative colitis, Leukoplakia of oral

cavity/vulva/penis, Chronic atrophic gastritis so

(not basal cell carcinoma)

* Li-Frameni syndrome caused by mutation in p53 gene

* Benign mixed tumour - pleomorphic adenoma, mature teratoma

* Malignant mixed tumour - wilms tumour, immature teratoma

* Tumour suppressor genes - NF1, NF2, P53, RB1, WT1, (not CERB)

* Presence of normal cells at abnormal location

* Venous metastasis in (hepatic and renal cancer)

* Hepatoma (hepatocellular carcinoma), Lymphoma, seminoma, mesothelioma, wilms

tumour all are malignant

* Guardian genome - p53 gene

* TNF - cachexin - causes cachexia


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* Epithelia origin tumour - Hydatidiform

* Typical pathway of spread for sarcoma - hematogenous

* Most common pathway for spread of cancer - lymphatic

* Mixed tumours - Teratoma (mature/immature), dermoid cyst, pleomorphic adenoma,

Wilm's tumour

* Most common tumour arising from more than one germ layer occurs mostly in gonads

* Benign tumour in its surrounding causes atrophy

* Human herpes virus 8 - causes kaposi's sarcoma (most common malignancy in AIDS)

* Patient with Klinefilter's syndrome have high chances of breast cancer

* A tumour is associated with (colonal expansion of single mutant cell that has inccured

the genetic change

(not radiation, chemical, viruses, germ line inheritance)

* Most common cancer predisposition syndrome related to DNA defective repair -

xeroderma pigmentosum

* BCL -2 anti.apoptotic (most important in apoptosis) p53 / BAX - apoptotic

* Liver carcinogen - vinyl chloride / aflatoxin B1

* Most potent carcinogen - polycyclic Aromatic hydrocarbons

* Hypoglycemia can be manifestation- due to hepatocellular cancer

* Most common malignant neoplasm related endocrinopathy - cushing's syndrome

* 40 year old male, having mass on left side of face below left ear, biopsy done,

microscope shows cords and groups of epithelial cells with myxoid stroma,

island of cartilage and bone - pleomorphic adenoma

* Knockout gene mutation into cells - shrunken cells with chromatin clumping and

cytoplasmic blebbing increased, survival of mutant cell line reduced,

(all signs of apoptosis) gene in which mutation occured - BCL-2 (being antiapoptotic)

* Mutator phenotype with propensity to mutation is assocaited with - defective DNA

repair


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* P53 mechanism of action - cell cycle arrest and apopotosis

* Presence of C-onc - determined by transcription of tumour derrived DNA into mouse

fibroblast cell lines

* one mutant allele of APC - thousands of adenomatous polyps in colon

* PTEN gene involved in PI3Kinase signal transuction is associated with carcinoma of

endometrium (and prostate)

* Cyclin CDK 4 complex has a critical role in cell cycle regulation by phosphorylating the

Retinoblastoma suspectibility protein

(Cyclin and CDK4 phosphorylate RB protein so that it enters S phase p53 opposes

phosphorylation) - (RB is made inactive by binding transcription factor

E2F, when phosphorylated by Cyclin 4, it is set free and cell enters S phase)

* Halmark of malignancy - (Anaplasia/metastasis) - anaplasia a.c to Basis

* Smoking causes Lung cancer

* Polymorphism of P-450 loci confers inherited suspectibility to Lung cancers in

ciggarrette smokers

* commonest example of familial cancer - breast cancer

* Most assosiacted cell replication as fertile soil in malignancy - Dysplasia

* Autosomal dominant inheritance - Retinoblastoma, Melanoma, HPCC,

Neurofibromatosis

* Autosomal recessive inheritence - Xeroderma pigmentosum, Ataxia telingeictesia,

blooms syndrome, Fanconi Anemia

* Familial cancer - Breast cancer, ovarian cancer, Pancreatic cancer

* Dysplasia leads to cancer in (cervix, skin, bladder, Bladder cancer) but not in Testes

* Malignant tumour have all (Hyperchromatosis, increase mitosis, Irregular nuclei,

Polymorphism) but not Growth by compression of surrounding tissue

(as they invade rather compress the adjacent tissues)

* All are childhood neoplasm - Acute lymphocytic leukemia, osteosarcoma,

medulloblastoma, wilms tumour (but not Brenner's tumour - an ovarian tumour)


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* CEA produced by (carcinoma of colon, pancreas, stomach, lungs, heart) but not by

carcinoma of liver

* Helicobacter pylori causes all (chronic gastritis, peptic ulcer diease, gastric carcinoma,

MALToma) but not (hamartamatous polyps)

* Mass of disorganized but mature cells indigenous to particular site - hamartoma

* Uncapsulated benign tumour - hemangioma/leiomyoma

* Most resistant of all tissues to invasion - mature cartilage/elastic tissues in arteries

* Which among these is not a hereditary cancer - is Carcinoma of colon (Retinoblastoma,

Familial HPCC, MEN, Neurofibromatosis are familial)

* Betanephtylamine - bladder cancer

* Arsenic - skin cancer

* Xeroderma pigmentosum - increased incidence of Basal cell carcinoma, Squamous cellcarcinoma, Malignant melanoma

* Feature of anaplasia - (mitotic figures, Loss of polarity, tumour giant cells,

Pleomorphism) but not hypochromatosis

* Tumour without invasion of basement membrane

* Basal cell carcinoma - Rodent's ulcer

* Glioma and basal cell carcinoma - never metastasize

* Pseudomyxoma peritonei associated with Appendiceal carcinoma

* Nodal enlargement in proximity of cancer not necessarily mean dissemination of

primary lesion

* Cadmium causes prostatic carcinoma

* Asbestos cuses mesothelioma

* P53 mutation present in 50% tumours

* UV radiation of 280 - 320 nm spectrum cause cutaneous cancers most commonly(though 200-280 nm spectrum most carcinogenic but filtered thru ozone)

* HPV involving cervical cancers - HPV 16 / 18

* Migratory thrombophlebitis caused by deep seated cancers like - pancreatic carcinoma

* Nonbacterial thrombotic endocarditis - nonbacterial fibrinous vegetations on the

cardiac valve leaflets (more on left-sided valves), particularly

in patients with advanced mucin-secreting adenocarcinomas


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* Disseminated intravascular coagulation in acute promyelocytic leukemias and prostatic

adenocarcinoma

1. Tumour with more than one germ layer - dermoid cyst2. Not indicateive of anaplasia nuclear to cytoplasmic ratio 1:63. Most common pathway for spread of cancer - lymphatic4. Adenomas are showing benign glandular pattern5. Malignant transformation is indicated by metastasis

6. Uncapsulated benign tumour Hemangioma7. Kruckenbergs tumour spreads via seeding in abdominal cavity8. Malignant tumor of mesenchymal origin sarcoma9. The staging of tumour consists of all except degree of differentiation10.Lymph node enlargement near cancer due to all of above11.Following tumour invades the vein renal cell carcinoma12.Most invasive and rarely metastasizing tumour basal cell carcinoma13.Carcinogenesis need initiators and promoters14.Gene in carcinogenesis is all of above

Past Papers:

1. Tumour marker for ovarian cancer - CA-1252. Tumour marker for liver cancer - X-fetoprotein3. Radon causes lung cancer4. Asbestos causes mesothelioma5. Subacute sclerosing panenecephalitis caused rarely by resistant measles

virus6. BRCA 1 and BRCA 2 gene are involved in - breast cancer7. EBV virus causes all cancers - Burkitt lymphoma (african form),

Nasopharyngeal carcinoma, B-cell lymphoma, Hodgkin lymphoma [but notInfective mononucleosis as its not a cancer) and not Non-hodgkin's lymphoma (notcaused by EBV)

8. Most commonly death occurs (both men and women) by Lungs cancer9. Male Most common cancer - prostate10.Female Most common cancer - Breast11.Neoplasm characteristics: High N/C ratio, monoclonal, High rate of mitosis (not

polyclonal)12.Most common malignant tumour of malignancy - Leukemia13.Lung cancer caused by - Nickel, Chromium, Cadmium, Asbestos (not aflatoxin)14.Organ to which metastasis never occurs (Spleen)15.Li-Frameni syndrome caused by mutation in p53 gene16.Mixed tumours - Teratoma (mature/immature), dermoid cyst, pleomorphic

adenoma, Wilm's tumour17.Benign mixed tumour - pleomorphic adenoma, mature teratoma18.Malignant mixed tumour - Wilms tumour, immature teratoma19.Tumour suppressor genes - NF1, NF2, P53, RB1, WT1, (not CERB)20.Presence of normal cells at abnormal location - Choristoma21.Venous metastasis in - (hepatic and renal cancer)22.All tumors with suffix omas are benign but Hepatoma (hepatocellular

carcinoma), Lymphoma, seminoma, mesothelioma, wilms tumour,endothelium sinus tumour all are malignant

23.Guardian genome is name for- p53 gene


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24.Cancer cachexia is caused by (reduced food intake, anorexia, intestinalobstruction, increased basal metabolic rate, cytokines produced by tumour)(Correct - cytokines produced by tumour)

25.TNF - cachexin - causes cachexia26.Placental Epithelial origin tumour (chondroma, fibroma, hemangioma,

hydatidiform mole) (Correct - Hydatidiform mole)27.Typical pathway of spread for sarcoma - hematogenous28.Most common tumour arising from more than one germ layer occurs mostly in

gonads29.Benign tumour in its surrounding causes - atrophy30.Human herpes virus 8 - causes kaposi's sarcoma (most common malignancy

in AIDS)31.Patient with Klinefilter's syndrome have high chances of - breast cancer32.A tumour is associated with - colonal expansion of single mutant cell that

has inccured the genetic change (not radiation, chemical, viruses, germ lineinheritance)

33.Most common cancer predisposition syndrome related to DNA defective repair Hereditary non-polyposis colorectal cancer

34.(most important in apoptosis) is BCL -2 (anti.apoptotic) while p53 / BAX -

apoptotic35.Liver carcinogen - vinyl chloride / aflatoxin B136.Most potent carcinogen - polycyclic Aromatic hydrocarbons37.Hypoglycemia can be manifestation- due to hepatocellular cancer38.Most common malignant neoplasm related endocrinopathy - cushing's syndrome39.Most common paraneoplastic disease - hypercalcemia40.40 year old male, having mass on left side of face below left ear, biopsy done,

microscope shows cords and groups of epithelial cells with myxoid stroma, islandof cartilage and bone - pleomorphic adenoma

41.Knockout gene mutation into cells - shrunken cells with chromatin clumping andcytoplasmic blebbing increased, survival of mutant cell line reduced,(all signs ofapoptosis) gene in which mutation occured - BCL-2 (being antiapoptotic)

42.Mutator phenotype with propensity to mutation is assocaited with - defectiveDNA repair

43.P53 mechanism of action - cell cycle arrest and apopotosis44.Presence of C-onc - determined by transcription of tumour derrived DNA

into mouse fibroblast cell lines45.One mutant allele of APC - thousands of adenomatous polyps in colon46.PTEN gene involved in PI3Kinase signal transuction is associated with carcinoma

of endometrium (and prostate)47.Cyclin CDK 4 complex has a critical role in cell cycle regulation by

phosphorylating the Retinoblastoma suspectibility protein48.(Cyclin and CDK4 phosphorylate RB protein so that it enters S phase p53 opposes

phosphorylation) - (RB is made inactive by binding transcription factor49.E2F, when phosphorylated by Cyclin 4, it is set free and cell enters S phase)50.Halmark of malignancy - (Anaplasia/metastasis) - anaplasia a.c to Basis51.Smoking causes cancer of oral cavity, esophagus, pharynx, larynx, lungs) (Correct

Lung)52.Polymorphism of P-450 loci confers inherited suspectibility to - Lung cancers in

ciggarrette smokers53.Commonest example of familial cancer - breast cancer54.Most assosiacted cell replication as fertile soil in malignancy - Dysplasia


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55.Autosomal dominant inheritance - Retinoblastoma, Melanoma, HPCC,Neurofibromatosis

56.Autosomal recessive inheritence - Xeroderma pigmentosum, Ataxiatelingeictesia, blooms syndrome, Fanconi Anemia

57.Familial cancers - Breast cancer, ovarian cancer, Pancreatic cancer58.Dysplasia leads to cancer in (cervix, skin, bladder, bronchial epithelium) (but not

in Testes)59.Malignant tumour have all (Hyperchromatosis, increase mitosis, Irregular nuclei,

Polymorphism) but not Growth by compression of surrounding tissue (asthey invade rather compress the adjacent tissues)

60.All are childhood neoplasm - Acute lymphocytic leukemia, osteosarcoma,medulloblastoma, wilms tumour (but not Brenner's tumour - an ovariantumour)

61.CEA produced by (carcinoma of colon, pancreas, stomach, lungs, heart) but notby carcinoma of liver

62.Helicobacter pylori causes all (chronic gastritis, peptic ulcer diease, gastriccarcinoma, MALToma) but not (hamartamatous polyps)

63.Mass of disorganized but mature cells indigenous to particular site - hamartoma64.Most resistant of all tissues to invasion - mature cartilage65.Which among these is not a hereditary cancer - is Carcinoma of colon,

Retinoblastoma, Familial HPCC, MEN, Neurofibromatosis are familial) (Correct -Carcinoma of colon)

66.Betanephtylamine causes - bladder cancer67.Arsenic causes- skin cancer68.Xeroderma pigmentosum - increased incidence of all 3 - Basal cell carcinoma,

Squamous cell carcinoma, Malignant melanoma69.Feature of anaplasia - (mitotic figures, Loss of polarity, tumour giant cells,

Pleomorphism) but not hypochromatosis70.Tumour without invasion of basement membrane Carcinoma in situ71.Basal cell carcinoma - Rodent's ulcer72.Glioma and basal cell carcinoma - never metastasize73.Pseudomyxoma peritonei associated with Appendiceal carcinoma74.Nodal enlargement in proximity of cancer - not necessarily mean

dissemination of primary lesion (may be reactive hyperplasia or infectionresponse lymphagenitis )

75.Not an autosomal dominant inherited cancer (retinoblastoma, melanoma,neurofibromatosis, MEN 1 and 2, Xeroderma pigmentosum) (correct xerodermapigmentosum)

76.Cadmium causes prostatic carcinoma77.Asbestos cuses mesothelioma78.P53 mutation present - in more than 50% tumours79.UV radiation of280 - 320 nm spectrum cause cutaneous cancers most commonly

(though 200-280 nm spectrum most carcinogenic but filtered thru ozone)80.HPV involving cervical cancers - HPV 16 / 1881.Migratory thrombophlebitis caused by deep seated cancers like - pancreatic

carcinoma82.Nonbacterial thrombotic endocarditis - nonbacterial fibrinous vegetations on

the cardiac valve leaflets (more on left-sided valves), particularly in patients withadvanced mucin-secreting adenocarcinomas

83.Disseminated intravascular coagulation in acute promyelocytic leukemias andprostatic adenocarcinoma


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84.When parenchymal cells in a neoplasm stimulate formation of abundantcollagenous stroma its called desmoplasia

85. Nevus is benign tumour which arises from melanocytes86. Cystadenomas are found in ovaries87. Following are pluiripotent cell neoplasm retinoblastoma, nephroblastoma,terratoma, medulloblastoma, neuroblastoma (Correct - terratoma)88. Following are totipotent neoplasms except (seminoma, malignantmelanoma, embryonal carcinoma, yolk sac carcinoma, choriocarcinoma) (Correct

malignant melanoma)89. Following is not a tumour suppressor gene (SIS, P53, BRCA 1, APC, MSH)(Correct SIS a siminan virus oncogen)90. Clinical expansion of cell is largely determined by (decreased apoptosis,upregulated cell proliferation, angiogenesis, escape from immunity, additionalmutation) (Correct escape from immunity )91. In a clinical trial, chemotherapeutic agent is given to patient with breastcancer metastasis, sample of cancer cells are obtained and assessed for presenceof death of tumour cells by apoptosis, mutational inactivation of which of followingproduct is most likely to render tumour cell resistant to (BCL-2, P53, NF-KB,cytochrome p450, granyzymes) (Correct P53)92. Mutation in germ cell produces (cancer, congenital malformation, inheriteddisease, aneuploidy, extrauterine fetal death) (Correct inherited disease)93. Metaplasia at molecular genetic level is related to reprogramming ofstem cells94. Changes in oral cavity predisposing to oral carcinoma - Hairy leukoplakia95. Cancer most likely to enter_______, after venous metastasis - liver96. Hemangioma most commonly found on head97. EB virus may lead to following cancers except (African Burkitt lymphoma,Nasopharyngeal carcinoma, B-cell lymphoma, Hodgkin lymphoma, Infectiousmononucleosis) (correct infectious mononucleosis as its a disease rathera cancer)98. Most common tumour of oral cavity squamous cell carcinoma99. Malignant neoplasm that are composed of undifferentiated cells represent anaplasia100. The mutation of both alleles is one of the most common genetic mutation inhuman cancer (P53, K-RAS, RB, BCL2, BRCA1) (Correct p53)101. Which of fllowing diagnostic screening techniques used in health care is mostlikely to have had the greatest impact on reduction in cancer death in developednations - (chest radiograph, stool test, pap smear, chromosomal study, tumormarkers) (Correct Pap smear)102. Care taker genes - Genes that do not directly control tumor growth butaffect genomic stability103. Direct acting carcinogens include (polycyclic aromatic hydrocarbons,aromatic amines, natural plants, alkylating agent, insecticides) (Correct alkylating agents)104. Role of HBV in pathogenesis of liver cell cancer is largely related to (viralintegration into host genome, clonality, insertional mutagenesis, regulatoryelement HBX protein, chronic liver cell injury and regenerative hyperplasia)(Correct chronic liver cell injury and regeneratie hyperplasia)105. The most reliable method for cancer diagnosis is Biopsy?106. Procarcinogens are (pro-oncogenes, ultimate carcinogens, regulated bypolymorphism in p-450 genes, indirect acting compounds which require chemical


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transformation, highly reactive electrophiles) (Correct - indirect actingcompounds which require chemical transformation)107. Telomere/s are specialized structures at end of chromosomes, shortening istumour suppressor mechanism, function loss leads to cell death, shorteningaccelerated by telomerase, telomerase abundant in somatic cells (Correct - arespecialized structure at end of chromosome )108. Helicobacter pylori linked to causation of gastric (Gastric B-Cell lymphoma,Gastric adenocarcinoma, MALTomas, Marginal zona lymphomas, Burkitts

lymphoma) (Correct - Gastric adenocarcinoma being most common)109. Genes that regulate the apoptosis include BCL-2110. Chromosomal translocation is characteristic of Burkitts lymphoma111. Polyvinyl chloride causes - liver angiosarcoma112. Normal p53 can be rendered non-functional by human papilloma virus113. Preneoplastic conditions: Solar keratosis, Ulcerative colitis, Leukoplakia oforal cavity/vulva/penis, Chronic atrophic gastritis so (not basal cell carcinoma/not epidermal naevus)114. Proto-oncogenes are normal genes which make genes and regulate celldivision (have potential to undergo mutation and become oncogen thatproduce neoplasia)

115. In HPV virus E6 protein inhibits P53 gene, while E7 inhibits RB protein116. CDKN2A codes for protein called p16, which acts as G1-S checkpoint ofcycle117. Renal cell carcinoma has tendency to spread to bone118. 66 years old man has noted dark urine for past two weeks. A urine analysisshows hematuria, cells of this neoplasm will show single mutation causing (SIS,ERB2, ABL, RAS, N-MYC) (correct RAS (HRAS causes bladder and kidneycancer)119. A 70 years old man has episode of hematamesis, upper GIT endoscopyreveals irregular 4 cm gastric antral ulceration. Biopsies are performed andmicroscopically reveal adenocarcinoma. Molecular analysis shows DNAhypermethylation of CDKN2 complex, which of following mechanism has abnormalgene expression most likely (Amplification, Epigenetic alternation, Growth factorbinding, point mutation, Reduced miRNA expression) (Correct Epigeneticalternation)120. Some preexisting conditions are observed to procrede development ofmalignant neoplasm while others do not, which of following condition is most likelyto be statistically unrelated to subsequent malignancy (Endometrial atypicalhyperplasia, cervical squamous dysplasia, chronic ulcerative colitis, uterineleiomyomas, alcoholism related cirrhosis) (correct uterine leiomyomas)121. A 66 years old woman has observed increased abdominal girth, for 3 monthson exam, there is a fluid wave pancreatitis which of following best determinesprogression of tumour (doubling time, extent of apoptosis, gene amplification,growth fraction, telomerase expression at bottom of form) (Correct - Growthfraction)122. A clinical study was performed with the patient who was diagnosed breastcancer, malignancy grade, stage, molecular biology, and history types areanalyzed, which of the following is most likely to be associated with best prognosisof patient (decreased nuclear to cytoplasmic ratio, decreased doubling time,increased lambi receptor expression, increased cathepsin expression, decreasedapoptosis) (Correct - decreased nuclear to cytoplasmic ratio)


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123. A 37 year old woman noted a lump in her breast on self examination, hephysician palpated 2 cm firm, irregular mass in right breast, cytometery is mostlikely to show which phase, (Go, G1, S, G2, M) (Correct S phase)124. 48 years old previously healthy woman develop increased malaise over past4 months, on physical examination, there are no abnormal finding, laboratory testsshow, HB- 8.5g/dl, with WBC count 241,400 microliter. A bone marrow biopsyperformed and there is 100% cellularity normal chromosome analysis of cells frommarrow yield karyotype shows: (Chronic myelogenous leukemia, Metastatic breast

cancer, multiple myeloma, myeloid hyperplasia, granulomatous infection) (Correct Myelogenous Leukemia)125. Paraneoplastic syndrome, are heterogenous, karyotype group of disordercause symptoms independent except (Tumour invasion/metastasis, infection,ectopic hormone, metastatic/nutritional defects, tumor treatment)(Correct Ectopic Hormone)126. In the area of molecular pathology, and molecular diagnosis, (detection ofmonoclonality is essential for diagnosis of biopsy samples of breast cancers,detection of monoclonality is essential for diagnosis of biopsy samples oflymphomas, microsomal instability are helpful in diagnosing HNPCC, HER 2 genedetection by FISH test is used to diagnose inherited breast cancer, FAP is caused by

mutation in mismatch repair gene)( Correct - detection of monoclonality isessential for diagnosis of biopsy samples of lymphomas)127. Sequence of metaplasia, dysplasia, neoplasia occurs in neogenesis of: (Sq.cell carcinoma of bladder, carcinoid of small intestine, Adenocarcinoma of Barrettesophagus, sq. cell carcinoma of lungs, malignant lymphoma)(Correct -Adenocarcinoma of Barrett esophagus)128. Which of following helps in grading of tumour: (presence or absence ofmetastasis in lymph nodes, degree of differentiation, presence of tumour necrosis,mitotic activity, presence of cell in vascular space) (Correct - degree ofdifferentiation)129. Regarding bening and malignant neoplasm: (All malignant neoplasms canmetastasize, 30% of newly diagnosed patients with malignancy have metastasis,benign tumours are anaplastic, always in stomach, coexist in leukemia) (Correct -30% of newly diagnosed patients with malignancy have metastasis)130. Most common cause of cancer mortality in male aged between 15-34 is(Non-hodgkin lymphoma, lungs, brain, leukemia, prostate) (Correct - Lungs)131. Most common cause of cancer mortality in female aged between 15-34 is(brain, cervix, leukemia, non-Hodgkin lymphoma, breast) (Correct - Breast)132. Single transformed cell must go how many doubling to become clinicallydetectable lesion weighting appx 1 g (10, 30, 50, 110, 1300) (Correct - 30)133. Procarcinogens include all of following except (cyclophosphamide,benzopene, aflatoxin, betel nut, vinyl chloride) (Correct - Cyclophosphamide)134. Which of following is correct oncogen virus association: (HPV-Burkittlymphoma, HTLV nasopharyngeal carcinoma, EBV T-cell lymphoma, HPV-cervicalcancer) (Correct HPV-cervical cancer)135. Which of following malignancy is associated with acanthosis nigricans:(hepatocellular carcinoma, breast carcinoma, renal carcinoma, pancreaticcarcinoma, gastric carcinoma) (Correct Gastric carcinoma)136. Alpha fetoprotein is tumour marker for malignancy (ovarian carcinoma, coloncarcinoma, stomach cancer, breast cancer, Hepatocellular carcinoma) (Correct Heptaocellular carcinoma)


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137. A clinical study is performed to determine incidence of cancer in differentcountries, the data shows person in Japan and immigrants: (Breast cancer, coloncancer, lung cancer, stomach cancer, uterine cancer) (Correct Stomach cancer)138. A 42 years old woman goes to her physician for a routine physical exam, a 4cm diameter tender mass is palpated in right breast, which appears fixed to chestwall, Another 2 cm non tender mass is palpable in left axilla, chest radiographshows multiple 0.5 to 2.0 cm nodules in both lungs, which of following classificationindicate stage of disease: (T1N1M0, T1N0M1, T2N1M0, T3N0M0, T4N1M1) (Correct

- T4N1M1)139. Which of following microscopic finding is most likely to indicate thatneoplasm is malignant: (pleomorphism, atypia, invasion, increased nuclear tocytoplasmic ratio, necrosis) (Correct invasion)140. Autosomal dominant cancer is best represented by osteogenic sarcoma,soft tissue sarcoma, retinoblastoma, leukemia, lymphoma (Correct -retinoblastoma)141. Clinically some of patients with neoplasm are found to have grade 1 disease,which of following is best interpretation of a neoplasm with these designations:(unlikely to be malignant, arising from epithelium, may spead via lymphatics andblood, has an in-situ component, well differentiated and localized) (Correct well

differentiated and localized)142. A child is born with single functional allele of tumour suppressor gene, at ageof 5, remaining allele is lost through point mutation, as a result ability to inhibit cellcycle progression until cell is ready to divide is lost, which of following neoplasm ismost likely to arise via this mechanism: (infiltrating ductal carcinoma of breast,small cell anaplastic carcinoma of lungs, Retinoblastoma of eye and osteosarcoma,cerebral astrocytoma, chronic myeloid leukemia) (Correct - Retinoblastoma ofeye and osteosarcoma)143. Presence of which neoplastic cell shows lungs nodules: (Leukocyte commonantigen, Beta-catenin, telomerase, DNA topoisomerase, vinertics) (Correct Betacatenin)144. Commonest tumour suppressor gene to be involved in human is (P53, Rb,NF-2, NF-1, p-16 ) (Correct P53) ( guardian genome, )145. A biopsy of a mass is performed and microscopic studies show modulatorydifferent adenocarcinoma which of following finding is most likely to be present inpatient: (K-RAS mutation in neoplastic cell, Neoplastic cell +ve for vimentin, +vestool culture for Shigella flaxeria, plasma HIV I RNA level of 40,000 copies/ml,increased titer DNA topoisomerase I autoantibody) (Correct K-RAS mutation inneoplastic cell)146. 60 years female has a firm mass with irregular border, felt in his left breastin routine P.E, a fine needle aspiration is performed and microscopic examinationshows malignant cell (analysis of karyotype, detection of gene, determination ofaneuploidy, distinguishing carcinoma from sarcoma, quantification of RNA content)(Correct determination of aneuploidy)147. Lack of chromosomal shortening allows malignant cell to undergo moredivisions than normal cells, because of : (reverse transcriptase, DNA polymerase,telomerase, protein kinase, topoisomerase) (Correct - Telomerase)148. A chest X-ray demonstrate 6cm palpable mass, a sputum is collected, andsputum cytology report leads Atypical cell present suggestive of squamous cellcarcinoma, which of following environmental exposure is most likely to beassociated with these findings (Asbestos, Radon, Silica, Formaldehyde, Benzene)(Correct - Radon)


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149. A 59 years old man had worsening cough with chest pain for past 6 months,on physical examination he has no remarkable finding, a chest xray shows 3 cmlump on left side of chest, molecular mechanism most likely be: (Point mutation inDNA, generation of free radical, loss of blood supply, secondary inflammation, ATPdepletion) (Correct - Point mutation in DNA)150. 60 years old man, with 80 pack years history of smoking, experience anepisode of hemoptysis, on physical examination, he has puffiness of face, pedaledema, bruises on skin, and high blood pressure, which hormone should be

detected in blood in increased amount: (PTH related peptide, erythropoietin, ACTH,insulin, Gastrin) (Correct - ACTH)151. Columnar epithelial cells from colonic mucosa, are studied to identifyabnormalities in cell signaling pathway, abnormal epithelial cells from colonicadenocarcinoma (ADP, BRC-ABL, cyclic AMD, cyclin D1, MAP kinase) (Correct MAP kinase)

Important points for neoplasia:

1. Epithelial tissue origin; ectoderm, endoderm2. Connective tissue origin: mesoderm3. Terrtoma: derives from ectoderm, endoderm, mesoderm4. Carcinomas: derive from squamous, glandular (adenocarcinoma), transitional

epithelium5. Sarcomas: derive from connective tissue6. Hamartoma: nonneoplastic overgiowth of lissue7. Choristoma: normal tissue where it should not be8. Grade of cancer: to see if cancer resemble its parent tissue or not?9. Malignanl tumors: increased nuclear/cytoplasmic ralio; abnormal mitotic

spindles10.Malignanl tumors: 30 doubling times before detected11.Benign and malignant lumors: monoclonal12.Malignanl tumors: upregulation telomerase activily13.Basal cell carcinomas of skin: invade tissue but do not melastasize14.Invasion: second mosl important criterion for malignancy15.Resist invasion: cartilage,clastic lissue (choose cartilage)16.Loss of intercellular adherence > cell invasion17.Extranodal metastasis [e.g,, liver) hasas greater prognostic significance than

nodal metastasis.18.Lymph nodes: first line of defense in carcinomas19.Routes of metaslasis: lymphatic, hematogenous, seedingof body cavities20.Seeding; comnon wilh surface-derived ovarian cancers21.Bone metaslasis: vertebra most common site;paravertebral venous plexus22.Osteoblastic melastasis:T serum alkaline phosphatase23.Osteolytic metastasis: potential for hypercalcemia, pathologic fractures24.Bone metastasis;osteoblastic (radio-dense) or osteolytic (radiolucent),25.Lymph node; moslcommon tissue which are metastasized26.Cancer:2nd most common cause death in US27.Lifelime risk for cancer greater in men than women28.Blacks; greatest overall risk for cancer29.Most common tumours in childhood 1st Acute lymphoblastic leukemia (-33%),

2nd central nervous system, CNS tumors (-21%),3rd nenroblastoina (~7%),4thWilms tumor (-5%)


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30.Cancer in men: prostate, lung, colorectal31.Cancer in women: breast,lung, colorectal32.Gynecologic cancer; endometrium, ovary, cervical33.Most common cause of cancer death in adults: lung cancer34.Malignant melanoma: mosl rapidly increasing cancer35.Actinic (solar) keratosis: precursor of squamous cell carcinoma36.Cessation of smoking is most importanl factor in decreasing risk for cancer37.HBV immunization: decreased risk for hepatocellular carcinoma

38.Human papillomavirus immunization: decreased risk for cervical cancer39.Cervical cancer is the least common gynecologic cancer in lhe United Stales.40.Cervical Pap smear: most responsible for decreased incidence/mortality rale for

cervical cancer41.PSA: more seiisilive than specific42.Treatment of H. pylori Infeccion: decreased risk for developing gaslric

lymphoma/adenocarcinoma43.Treatment of GERD: decreased risk for distal adcnocircinoma of esophagus44.Point mutations: most common type of mutation in cancer45.Proto-oncogenes: involved in normal growth and repair Suppressor genes:

protect againsl unregulated cell growth46.BCL2 gene family: antiapoptosis genes47.BAX gene: apoplosis gene48.Hormone r marker: calcilmiin (rnt'dullary carcinoma of ihyroid)49.Cytotoxic CD8 T cells: most effective host defense against cancer50.Least Prognosis: M > N > T51.Cachexia: TNF- pivotal role52.Anemia of chronic disease: most common anemia in cancer53.In cancer, Hemostasis inclines towards thrombogenic54.Gram.negative sepsis: most common cause of death in cancer55.Hypercalcemia: most common paraneoplastic syndrome56.Acanthosis nigricans: may be associated with stomach cancer57.Signs of ectopic hormonc production: hypercalcemia, hyponatremia,

hypercortisolism, polycythemia58.Pathogens and cancer: viruses higher than bacteria which are parasites59.leukemia; most common cancer due to ionizing radiation60.Basal cell carcinoma: most common cancer due lo excessive UV lighl exposure61.Repair genes: correct errors in nucleotide pairing; excise pyrimidine dimers62.Enzymes involved in dimer excision; endonudcase, enonucleasc, ligase63.Tobacco is the agent most responsible for cancer and cancer deaths in the United

Slates.64.Chemical carcinogenesis: initiation , promotion, progression

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Patho Neoplasia