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EBU In-service assesment 2019-2020 > Oncology > Flashcards

Oncology Flashcards

1
Q

Which is an indication for partial cystectomy for bladder cancer?

A. Squamous cell carcinoma
B. Urachal adenocarcinoma
C. Tumours of the posterior bladder wall
D. Tumours more than 3 cm from the bladder neck

A

B. Urachal adenocarcinoma

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2
Q

Which group of prostate cancer patients may be accurately staged and thereby avoid other investigative modalities?

A. Patients with clinical stage T1-T3a with a PSA < 20 ng/ml
B. Patients with Gleason score < 7 and PSA < 12 ng/ml
C. Patients with Gleason score < 4, PSA < 10, clinical stage T1-T2c
D. Patients with PSA below 15 ng/ml, Gleason score < 7, localised clinical stages

A

C. Patients with Gleason score < 4, PSA < 10, clinical stage T1-T2c

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3
Q

Most renal cell carcinomas are nowadays detected by:

A. MRI
B. CT scan
C. Ultrasound
D. Angiography

A

C. Ultrasound

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4
Q

Cryosurgery for prostate cancer can be used as a secondary procedure after:

A. Cryosurgery
B. Brachytherapy
C. External beam radiotherapy
D. All of the above

A

D. All of the above

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5
Q

The most common early complication after nephron sparing surgery is:

A. Urinary fistula
B. Acute renal failure
C. Renal vein thrombosis
D. Post-operative bleeding

A

D. Post-operative bleeding

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6
Q

In tissue derrived from prostates of locally progressive prostate cancer (PCA) under anti-androgen treatment, the androgen receptor is:

A. Absent in line with low androgen levels
B. Present only in the reamaining BPH tissue
C. Expressed in the PCA tissue only prior to endocrine treatment
D. Over-expressed in the progressive PCA tissue in spite of castrate levels of androgens in the blood

A

D. Over-expressed in the progressive PCA tissue in spite of castrate levels of androgens in the blood

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7
Q

What is the advantage of a spectorscopic analysis in magnetic resonance imaging of prostate cancer?

A. Detection of extraprostatic disease
B. Analysis of vascularisation in prostate tissue
C. Metabolic information regarding prostate tissue
D. Improvement of morphological analysis of prostate tissue

A

C. Metabolic information regarding prostate tissue

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8
Q

How is PCA3 associated with biopsy outcome?

A. PCA3 is positive in men with biopsy proven cancer
B. PCA3 is negative in men with biopsy proven prostate cancer
C. Increasing PCA3 is associated with increasing risk of cancer on biopsy
D. Increasing PCA3 is associated with decreasing risk of cancer on biopsy

A

C. Increasing PCA3 is associated with increasing risk of cancer on biopsy

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9
Q

The recommended treatment for aptients with advanced RCC, whose disease progressed on or after treatment with VEGF-targeted therapy, is:

A. Sorafenib
B. Everolimus
C. Bevacizumab
D. Temsirolimus

A

B. Everolimus

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10
Q

Binding of a luteinizing hormone releasing hormone (LHRH) agonist, such as leuprorelin, causes a supra-physiological elevation (surge) of which hormone?

A. Testosteron
B. Luteinizing hormone (LH)
C. Follicle stimulating hormone (FSH)
D. All of the above

A

D. All of the above

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11
Q

Which complication is linked to adrenalectomy for pheocromocytoma?

A. Aortic lesion
B. Hyperglycaemia
C. Adrenal insufficiency
D. Hypertensive episodes and arrythmias

A

D. Hypertensive episodes and arrythmias

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12
Q

In which histologic subtype of renal carcinoma are mutation or deletion on chromosome 3 the most common?

A. Clear cell
B. Papillary
C. Chromophobe
D. Medullary cell

A

A. Clear cell

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13
Q

Approximately how many prostate cancer patients receiveing LHRH analogue do NOT achieve a level of testosterone < 20 ng/mol?

A. 0-10%
B. 20-40%
C. 50-70%
D. 80-90%

A

B. 20-40%

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14
Q

By how much is the risk of malignancy in an unilateral udescended testis increased?

A. 5x
B. 15x
C. 30x
D. 45x

A

A. 5x

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15
Q

Which statement is correct?

A. Currently two cycles of BEP is the standard of care for amediastinal seminoma
B. Currently two cycles of BEP is the standard of care for non-seminomatous mediastinal germ cell tumours
C. Currently four cycles of BEP coupled with radiotherapy are the standard of care for a mediastinal seminoma
D. The prognosis for patients with primary retroperitonel germ cell tumours is better than for mediastinal primary tumours

A

D. The prognosis for patients with primary retroperitonel germ cell tumours is better than for mediastinal primary tumours

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16
Q

Alfa fetoprotein (AFP) is a serum marker used in testicular cancer. What is the mean serum half-life of AFP?

A. 2-3 days
B. 5-7 days
C. 10-14 days
D 21-28 days

A

B. 5-7 days

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17
Q

Transperineal three-dimensional prostate mapping biopsy (3D-PMB):

A. Provides more accurate tumour localisation
B. Provides less accurate tumour localisation
C. Has increased morbidity
D. Provides less accurate Gleason grading

A

A. Provides more accurate tumour localisation

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18
Q

Which statement concerning urothelial carcinomas is correct?

A. The initial diagnosis is in most cases of an advanced stage
B. They have a weak correlation between tumour grade and tumour stage
C. They may be associated with cigarette smoking, but this is rare and can be disregarded
D. They are associated with cigarette smoking, due to carcinogenic derivatives from cigarettes that are concentrated in the urin

A

D. They are associated with cigarette smoking, due to carcinogenic derivatives from cigarettes that are concentrated in the urin

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19
Q

Endometrial cell presence in fomrations outside the uterus is called:

A. Polypus
B. Endometritis
C. Endometriosis
D. Uretral caruncle

A

C. Endometriosis

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20
Q

Patients with obstructing stones and urosepsis should undergo:

A. Conservative management with antibiotics
B. Urgent percutaneous drainage or ureteral stenting
C. Ureteroscopy, laser lithotripsy and ureteral stent insertion
D. Extracorporeal shock wave lithotripsy if the stone is below 1 cm

A

B. Urgent percutaneous drainage or ureteral stenting

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21
Q

Urinaly bladder cancer with metastasis of > 2 cm in a single common iliac aretry lyph node is:

A. N0
B. N1
C. N2
D. N3

A

D. N3

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22
Q

Renal cancer extending beyond Gerota’s fascia but not invading ipsilateral adrenal gland is:

A. T3a
B. T3b
C. T3c
D. T4

A

D. T4

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23
Q

Renal cancer with multiple regional lymph node metastases of > 5 cm is:

A. N1
B. N2
C. N3
D. M1

A

A. N1

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24
Q

Very low prostate cancer risk group includes patients with fewer than:

A. 5 prostate biopsy cores positive with less than 70% in each core, Gleason Score up to 7
B. 4 prostate biopsy cores positive with less than 60% in each core, Gleason Score up to 6
C. 3 prostate biopsy cores positive with less than 50% in each core, Gleason Score up to 6
D. 2 prostate biopsy cores positive with less than 40% in each core, Gleason Score up to 7

A

C. 3 prostate biopsy cores positive with less than 50% in each core, Gleason Score up to 6

25
Q

Which renal tumour has the lowest median survival?

A. Renal medullary carcinoma
B. Tubulocystic renal cell carcinoma
C. Multiocular clear cell renal cell carcinoma
D. Carcinoma of the collecting ducts of Bellini

A

A. Renal medullary carcinoma

26
Q

Which statement is correct for the treatment of a metastatic prostate cancer?

A. Surgical castration is a less cost effective treatment
B. Degarelix has to be combined with bicalutamide to avoid flare up phenomenon
C. Mazimum androgen blockade is associated with higher risk of side effects
D. There is a clear survival benefit in favour of intermittent therapy

A

C. Mazimum androgen blockade is associated with higher risk of side effects

27
Q

What is correct about (18) F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) in patients with muscle-invasive bladder cancer?

A. Can not be performed if GFR is <60 ml/min
B. Has a sensitivity of 75% and specificity of 90%
C. Influences the treatment in about 25% of the cases
D. Is far better than conventional CT in assessing locala T-stage

A

C. Influences the treatment in about 25% of the cases

28
Q

Which is a hereditary syndrome including renal tumours?

A. Still-Birth
B. Guillain-Barré
C. Birt-Hogg-Dubé
D. Fitz-Hugh-Curtis

A

C. Birt-Hogg-Dubé

29
Q

When would you offer active surveillance in patients with prostate cancer?

A. Low-risk disease and life expectancy of > 10 years
B. Intermediate-risk disease and life expectancy of > 10 years
C. Low and intermediate-risk disease and life expectancy of > 10 years
D. All-risk categories and life expectancy of > 10 years

A

A. Low-risk disease and life expectancy of > 10 years

30
Q

A 23-year-old man presents with a painless testicular swelling. How do you proceed?

A. afp and βhcg are the only markers that should be measured
B. Negative tumour markers exclude testicular neoplasia
C. Tumour markers should be taken before and 5-7 days after orchidectomy
D. Cytogenetic and molecular markers should be routinely done

A

C. Tumour markers should be taken before and 5-7 days after orchidectomy

31
Q

In case of stage 1 non-seminomatous testicular cancer, which is ariks factor for occult metastatic disease?

A. Tumour size >4 cm
B. Invasion of rete testis
C. Proliferation rate >45%
D. Vascular invasion

A

D. Vascular invasion

32
Q

What sould be done in cas of Non-seminaomatous Germ Cell Tumours (NSGCT) clinical stage IIA-B (retroperitoneal enlarged lymph nodes with negative tumour markers?

A. Monitor markers weekly
B. Repeat staging after 3 months
C. Initiate treatment with chemotherapy (BEPx3)
D. RPLND or follow up after 6 weeks

A

D. RPLND or follow up after 6 weeks

33
Q

What is the recommended postoperative treatment after radical nephroureterectomy?

A. A single bladder instillation of chemotherapy
B. A cystography before removing the catheter
C. To continue the antibiotic for at least three days
D. The removal of the abdominal drainage on the first postoperative day

A

A. A single bladder instillation of chemotherapy

34
Q

How can the left renal vein be accessed during a laparoscopic radical nephrectomy?

A. Incising the ligament of Treitz
B. Indentifying the superior mesenteric artery
C. Tracing the adrenal vein to the renal vein
D. Dissecting the gonadal vein until it enters the renal vein

A

D. Dissecting the gonadal vein until it enters the renal vein

35
Q

Radium Ra 223 dichloride injections have been proven to be a treatment option in patients with castration-resistant prostate cancer and:

A. Lymph node metastasis
B. Skeletal metastases
C. Liver metastasis
D. Lung metastases

A

B. Skeletal metastases

36
Q

When discussing treatment for muscle-invasive bladder cancer (cT2N0M0) in a previously healthy 66-year-old man with multifocal carcinoma in situ in the trigone and prostatic ducts, the standart treatment recommendation should be:

A. Radical cystectomy, extended pelvic lymphadenectomy and orthotopic neobladder
B. Radical cystectomy, extended pelvic lymphadenectomy and urinary diversion
C. Neoadjuvant chemotherapy followed by radical cystectomy, extended pelvic lymphadenectomy and urinary diversion
D. Neoadjuvant chemotherapy followed by radical cystectomy and urethrectomy with extended pelvic lymphadenectomy and urinary diversion

A

D. Neoadjuvant chemotherapy followed by radical cystectomy and urethrectomy with extended pelvic lymphadenectomy and urinary diversion

37
Q

Which is the recommended first-line treatment for favourable risk metastatic clear cell renal carcinoma?

A. Sunitinib or Pazopanib
B. Bevacizumab
C. Everolimus
D. Ipilimumab

A

A. Sunitinib or Pazopanib

38
Q

What is NOT an absolute contraindication for intarvesical BCG immunotherapy?

A. Presence of macroscopic hematuria
B. Within two weeks of TUR of bladder tumour
C. History of lung tuberculosis
D. Traumatic catheterisation of the urethra

A

C. History of lung tuberculosis

39
Q

What combination of T, N, M and S-stages defines Stage IIIB testicular cancer?

A. Any patient/Tx; any N, M1a; S1
B. Any patient/Tx; any N M1a; S2
C. Any patient/Tx; N1-3; M0; S3
D. Any patient/Tx; N3; M0; S1

A

B. Any patient/Tx; any N M1a; S2

40
Q

Which additional staging is currently recommended for low-risk prostate cancer?

A. Prostate mpMRI
B. Tc-Bone scan
C. None
D. Transrectal ultrasound

A

C. None

41
Q

What is the optimal PSA cut-off level for imaging in patients with biochemical recurrence after radical prostatectomy with a PSMA PET/CT scan?

A. 0,2 ng/mL
B. 1 ng/mL
C. 4 ng/mL
D. 10 ng/mL

A

B. 1 ng/mL

42
Q

What is the treatment regime with Docetaxel?

A. Once every day
B. Once every three months
C. Once every week
D. Once every 3 weeks

A

D. Once every 3 weeks

43
Q

Oaparib is effective in a phase 2 trial against a specific group M+ CRPC patients. What is the mechanism of action of Olaparib?

A. PARP inhibitor
B. Androgen receptor blocker
C. Cyp-17 inhibitor
D. Androgen biosynthesis inhibitor

A

A. PARP inhibitor

44
Q

A new version of the TNM-classification was published in December 2016. What has changed for bladder carcinoma?

A. Thera are no changes for bladder carcinoma
B. The M catergory is subdivided in M1a and M1b
C. The T1 a-b-c subclassifiction is now in use
D. Only the WHO 2004 grading is used

A

B. The M catergory is subdivided in M1a and M1b

45
Q

What is a contraindication for cytoreductive nephrectomy?

A. Elevated CRP
B. Poor performance status
C. Metastasis outside of lungs
D. Low-volume metastatic disease

A

B. Poor performance status

46
Q

Cytology of voided urine is useful in the detection of which tumour?

A. Low-grade bladder tumour
B. Renal cell carcinoma
C. Grade 3 bladder tumour
D. T4a prostate tumour

A

C. Grade 3 bladder tumour

47
Q

For which procedure do the EAU guidelines recommend antibiotic prophylaxis in all patients?

A. Urodynamics
B. TURP
C. Diagnostic cystoscopy
D. Shock Wave Lithotripsy

A

B. TURP

48
Q

When should a second TurB be performed?

A. In TaLG/G1 tumours
B. In T1 tumours
C. In multiple tumours
D. In case of primary CIS

A

B. In T1 tumours

49
Q

A 57-year-male smoker is treated with TURBT for a solitary 3 cm bladder cancer located at the left lateral bladder wall. The pathological report states “High-grade urothelial carcinoma withour invasion of the lamina propria (TaG3), resection biopsies from the prostatic urethra benign”. How should thei paitent be further treated?

A. A re-resection of the previous resection site
B. BCG-induction with maintenance instillation for at least a year
C. Six weekly instillations of BCG
D. six weeklly instillations with chemotherapy

A

B. BCG-induction with maintenance instillation for at least a year

50
Q

When can radical nephroureterectomy in upper urinary tract urothelial carcinoma (UTUC) be omitted?

A. In case of multifocality
B. In case of high-risk proximal ureteric lesions
C. In case of small UTUC (<2cm)
D . Solitary low-risk UTUC

A

D . Solitary low-risk UTUC

51
Q

For which indications have atezolizumab and pembrolizumab been approved?

A. Neo-adjuvant chemotherapy of urothelial cancer
B. Adjuvant chemotherapy of urothelial cancer
C. First-line cisplatin -eligible metastatic urothelial carcinoma
D. Second-line metastatic urothelial carcinoma

A

D. Second-line metastatic urothelial carcinoma

52
Q

The best and sufficient option for staging of potential metastatic disease of renal cell carcinoma in lungs and mediastinum is:

A. Chest plain x-ray
B. Contrast enhanced CT
C. Contrast enhanced MRI
D. FDG PET CT

A

B. Contrast enhanced CT

53
Q

The RTOG-ASTRO Phoeniz Consensus Conference definition of PSA failure after primary radiation therapy is:

A. 0.02 ng/ml
B. 0.05 ng/ml
C. 2 ng/ml
D. Nadir + 2 ng/ml

A

D. Nadir + 2 ng/ml

54
Q

In case of prostate-specific antigen (PSA) recurrence after radical prostatectomy, which imaging is required?

A. Bone scan
B. CT of abdomen and pelvis
C. Whole body MRI
D. PSMA PET/CT or choline PET/CT

A

D. PSMA PET/CT or choline PET/CT

55
Q

Which is the appropriate step to prevent BCG sepsis?

A. Use antibiotic prophylaxis
B. Use Isoniazid prophylaxis
C. Postopone BCG at least 2 weeks after resection
D. Reduce BCG dose

A

C. Postopone BCG at least 2 weeks after resection

56
Q

The EAU guidelines stratify localised and locally advanced prostate cancer in different risk groups for biochemical recurrence. What characteristics define the low-risk group?

A. cT1c-2a and Gleason score < 7 and PSA < 10 ng/mL
B. cT1c-2a or Gleason score < 7 or PSA < 10 ng/mL
C. cT1c-2b and Gleason score < 7 or PSA < 10 ng/mL
D. cT1c-3 or Gleason score > 7 or PSA > 20 ng/mL

A

A. cT1c-2a and Gleason score < 7 and PSA < 10 ng/mL

57
Q

When should an extended pelvic lymphnode dissection be performed in prostate cancer?

A. In all tumour grades
B. In case the patient is followed in an active surveillance programme
C. In all patients treated with radiotherapy
D. In combination with a radical prostatectomy for a high risk tumour

A

D. In combination with a radical prostatectomy for a high risk tumour

58
Q

Which adjuvant therapy after radical nephroureterectomy for an ureteral tumour is useful?

A. Chemotherapy in combination with radiotherapy
B. Chemotherapy in case of a low risk tumour
C. Single post-operative bladder instillation with mitomycin
D. Post-operative instilllations with BCG

A

C. Single post-operative bladder instillation with mitomycin

59
Q

How is CIS (carcinoma in situ), which is detected during follow-up of patients with a previous bladder tumour that was not CIS, classified?

A. Primary CIS
B. Secondary CIS
C. Concurrent CIS
D. Urothelial dysplasia

A

B. Secondary CIS

EBU In-service assesment 2019-2020 (9 decks)

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