Board Vitals Oncology

Question 1

What cancer most commonly metastasizes to the heart?

Answer 1

Melanoma

Question 2

Which malignancy is the most common cause of pericardial effusion?

Answer 2

Lung cancer

Question 3

Which malignancy is the most common cause of pericardial metastasis?

Answer 3

Lung cancer

Question 4

Are malignant pericardial effusions likely to recur after drainage?

Answer 4

Yes

Question 5

What is the treatment of a recurrent pericardial effusion due to malignancy in a patient who has adequate life expectancy and wishes to manage the condition?

Answer 5

Pericardial window

Question 6

Other than lung carcinoma, which most commonly causes malignant pericardial effusions, which other (two) cancers account for about 40% of malignant pericardial effusions?

Answer 6

Lymphoma
Breast cancer

Question 7

Will patients with platinum-sensitive ovarian cancer who relapse more than 6 months following treatment, respond to platinum-based therapy again?

Answer 7

Yes

Question 8

What happens to the calcium level in tumor lysis syndrome?

Answer 8

Hypocalcemia

Question 9

Hemorrhagic cystitis is caused by which chemotherapy drug?

Answer 9

Cyclophosphamide

Question 10

What is the next step after diagnosing Hodgkin’s lymphoma on biopsy?

Answer 10

FDG-PET/CT scan

Question 11

Is flow cytometry immunotyping used in Hodgkin’s lymphoma?

Answer 11

No (limited Reed Sternberg cells)

Question 12

What does the presence of Reed Sternberg cell on biopsy indicate?

Answer 12

Hodgkin’s lymphoma

Question 13

Is fluorescent in-situ hybridization (FISH) used in Hodgkin’s lymphoma?

Answer 13

No

Question 14

What hematologic condition is associated with t(15;17) fusion?

Answer 14

Acute promyelocytic leukemia

Question 15

What is the treatment of acute promyelocytic leukemia?

Answer 15

All-trans retinoic acid + another agent such as arsenic trioxide

Question 16

What is the treatment of non-promyelocytic acute myeloid leukemia?

Answer 16

Cytarabine + daunorubincin (7 + 3)

Question 17

Why is acute promyelocytic leukemia not treated with just all-trans retinoic acid?

Answer 17

Monotherapy results in short term remissions

Question 18

Patient with history of malignancy has abrupt appearance of tender or painful erythematous papules and plaques, along with fevers, myalgias, arthralgias, and leukocytosis.

Diagnosis?

Answer 18

Sweet syndrome

Question 19

Is CEA useful in diagnosing testicular cancer?

Answer 19

No

Question 20

What is the initial study in a patient with a testicular mass?

Answer 20

Testicular ultrasound

Question 21

What is the next step after flow cytometry and immunophenotype is consistent with chronic lymphocytic leukemia, in a patient with symptomatic anemia?

Answer 21

Direct antiglobulin test (DAT)

CLL is associated with various autoimmune disorders processes.

Question 22

What kind of abnormalities does FISH detect?

Answer 22

Cytogenetic abnormalities

Question 23

Which virus is associated with nasopharyngeal carcinoma (squamous cell)?

Answer 23

Epstein-Barr Virus

Question 24

What virus is associated with primary central nervous system lymphoma in immunocompromised patients?

Answer 24

Epstein-Barr Virus

Question 25

Which virus is associated with oropharyngeal squamous cell carcinoma?

Answer 25

Human papillomavirus

Question 26

Which virus is associated with mucoepidermoid carcinoma?

Answer 26

Cytomegalovirus

Question 27

Which virus is associated with T-cell leukemia or lymphoma?

Answer 27

Human T-cell leukemia retrovirus 1 (HTLV-1)

Question 28

Which virus is associated with Kaposi sarcoma?

Answer 28

Human herpesvirus 8 (HHV-8)

Question 29

What is the greatest preventable risk factor for bladder cancer (urothelial carcinoma) in the general population?

Answer 29

Smoking

Question 30

Is urothelial cancer more common in males or females?

Answer 30

Males

Question 31

Is excess alcohol a risk factor for urothelial carcinoma?

Answer 31

Maybe - it has not been proven

Question 32

Is excess alcohol a risk factor for hepatocellular carcinoma?

Answer 32

Yes

Question 33

What should you do for breast papillomas with atypical cells?

Answer 33

Excision

Question 34

What should you do for breast papillomas without atypical cells?

Answer 34

Observation

Question 35

Do breast papillomas increase the high of developing breast cancer?

Answer 35

Yes

Question 36

In what age range does intraductal papilloma occur?

Answer 36

35 - 55 years

Question 37

What age group gets Hodgkin's lymphoma?

Answer 37

15 - 35 years

Question 38

Reed-Sternberg cells. Diagnosis?

Answer 38

Hodgkin's lymphoma

Question 39

Should leukapheresis be used in patients with acute promyelocytic leukemia?

Answer 39

No (survival benefit unclear and worsens intrinsic coagulopathy)

Question 40

Can you start induction chemotherapy on a patient with acute promyelocytic leukemia who is intubated and on mechanical ventilation?

Answer 40

Yes

Question 41

When is ovarian function suppression used in hormone receptor positive breast cancer patients?

Answer 41

When there is high risk of recurrence

Question 42

Are aromatase inhibitors such as anastrozole effective as monotherapy in post-menopausal women with receptor positive breast cancer?

Answer 42

Yes

Question 43

Are aromatase inhibitors such as anastrozole effective as monotherapy in pre-menopausal women with receptor positive breast cancer?

Answer 43

No - need to be used with ovarian function suppression.

Question 44

What medication can be used as ovarian function suppression in hormone receptor positive breast cancer?

Answer 44

Leuprolide

Question 45

Which hormone therapy is recommended for premenopausal women with low-risk, early stage, resected breast cancer?

Answer 45

Tamoxifen

Question 46

Which chemotherapy drug is associated with the most nephrotoxicity?

Answer 46

Cisplatin

Question 47

What is the most common type of carcinoma in the duodenum?

Answer 47

Adenocarcinoma

Question 48

What is the most common type of carcinoma in the ileum?

Answer 48

Carcinoid

Question 49

What are atypical B lymphocytes with bilobed nuclei called?

Answer 49

Reed-Sternberg cells

Question 50

Reed-Sternberg cells are seen in which disease?

Answer 50

Hodgkin's lymphoma

Question 51

Do Reed-Sternberg cells in Hodgkin's lymphoma express CD20?

Answer 51

No

Question 52

Do Reed-Sternberg cells in Hodgkin's lymphoma express CD30?

Answer 52

Yes

Question 53

Do Reed-Sternberg cells in Hodgkin's lymphoma express CD15?

Answer 53

Yes

Question 54

What is the renal insufficiency typically from in tumor lysis syndrome?

Answer 54

Uric acid nephropathy (accumulation of uric acid crystals in the tubules)

Question 55

Does obstructive nephropathy in tumor lysis syndrome result from uric acid stone formation or crystal deposition?

Answer 55

Crystal deposition

Question 56

What is the treatment of small cell lung cancer with mediastinal lymph node involvement?

Answer 56

Etoposide + cisplatin (EP) followed by radiotherapy

Question 57

What percentage of primary lymphomas of the gastrointestinal tract occur in the stomach?

Answer 57

75%

Question 58

What percentage of small bowel neoplasms are sarcomas?

Answer 58

10%

Question 59

What the most cardiotoxic chemotherapy drug?

Answer 59

Doxorubicin

Question 60

Chromosomal arrangement: T(12,21) Diagnosis?

Answer 60

Acute lymphocytic leukemia (ALL)

Question 61

Chromosomal arrangement: T(14,18) Diagnosis?

Answer 61

Follicular lymphoma

Question 62

Chromosomal arrangement: T(8,14) Diagnosis?

Answer 62

Acute lymphocytic leukemia (ALL)

Question 63

Chromosomal arrangement: T(9,22) Diagnosis?

Answer 63

Chronic myelogenous leukemia (CML)

Question 64

Chromosomal arrangement: T(15,17) Diagnosis?

Answer 64

Acute promyelocytic leukemia (AML)

Question 65

What's the next step when a mediastinal mass is found to be causing superior vena cava syndrome?

Answer 65

Biopsy and tissue diagnosis

Question 66

What is the name of recurrent or migratory thrombophlebitis associated with visceral carcinoma?

Answer 66

Trousseau's syndrome

Question 67

What is the clonal population of bone marrow plasma cells in monoclonal gammopathy of undetermined significance (MGUS)?

Answer 67

Less than 10%

Question 68

When are TKIs used to treat CML safe to discontinue?

Answer 68

Duration of 3 or more years Complete molecular response for 2 or more years

Question 69

What is the most likely source of a HPV-related squamous cell carcinoma of the head and neck?

Answer 69

Lingual and palatine tonsils

Question 70

What the P16 positivity in squamous cell carcinoma indicate?

Answer 70

Tumorigenesis is in some way mediated by HPV

Question 71

What is the treatment of BRAF negative metastatic malignant melanoma?

Answer 71

Ipilimumab plus nivolumab

Question 72

Is dacabazine used as first line therapy in metastatic melanoma?

Answer 72

No

Question 73

What does the presence of anti-N-methyl-D-aspartate receptor (NMDAR) antibodies indicate in a patient with neurologic symptoms?

Answer 73

Paraneoplastic neurologic syndrome

Question 74

What are the most common tumors associated with anti-NMDA receptor encephalitis?

Answer 74

Ovarian teratomas

Question 75

What is the next step in a patient with known follicular lymphoma now with new constitutional symptoms and a rapidly growing lymph node?

Answer 75

Biopsy (can have histologic transformation)

Question 76

What is the treatment for progressive follicular lymphoma?

Answer 76

Rituximab

Question 77

How is staging done in non-Hodgkin's lymphoma?

Answer 77

- PET/CT - Bone marrow biopsy of FDG-avid nodal lymphomas

Question 78

Which histologic types (3) of colon cancer are associated with a poor prognosis?

Answer 78

- Signet cell adenocarcinoma - Poorly differentiated adenocarcinoma - Undifferentiated adenocarcinoma

Question 79

Does the location of the colon matter - which side has a more favorable prognosis?

Answer 79

Yes - Left sided colon cancers have a more favorable prognosis than right sided colon cancers.

Question 80

Does colon cancer with a KRAS mutation have a better or worse prognosis compared to colon cancer with the mutation?

Answer 80

Worse prognosis

Question 81

Are higher pre-operative CEA levels associated with better or worse prognosis in colon cancer?

Answer 81

Worse prognosis

Question 82

Patient's on chronic opioid therapy need to be screen with the 4 A's - what are they?

Answer 82

- Analgesia - Adverse effects - Aberrant behaviors - Activity

Question 83

Patient has multiple trichilemmomas, hamartomatous polyps throughout the gastrointestinal (GI) tract, fibrocystic breast disease, and an increased risk of breast and thyroid cancer. Diagnosis?

Answer 83

Cowden syndrome

Question 84

Patient has mucosal lentingines and hamartomatous polyps throughout the GI tract; there is an increased risk of breast, ovarian, and GI cancer. Diagnosis?

Answer 84

Peutz-Jehgers syndrome

Question 85

What syndrome is caused by a STK11 mutation?

Answer 85

Peutz-Jehgers syndrome

Question 86

A mutation in which gene causes Cowden syndrome?

Answer 86

PTEN

Question 87

What is the initial step in tumor lysis syndrome management?

Answer 87

Hydration

Question 88

The negative predicative value is the probability that the person does not have the disease when the test results are negative. True or false?

Answer 88

True

Question 89

Which virus is associated with nasopharyngeal squamous cell carcinoma?

Answer 89

Epstein-Barr virus

Question 90

Can neutropenic fever be treated outpatient?

Answer 90

Yes - if considered low risk for complications based on MASCC Risk-Index and CISNE scores

Question 91

What is the outpatient treatment of neutropenic fever?

Answer 91

Ciprofloxacin plus amoxicillin-clavulanate

Question 92

What should you do in a patient presenting with back pain and lower extremity weakness who has cancer?

Answer 92

- Glucocorticoids - Urgent spine imaging (Concern for spinal cord compression)

Question 93

Which tumor marker is associated with pancreatic cancer?

Answer 93

CA19-9