EGF-(R) = (Receptor) ER = HER = HPV = PR = VEGF (R) = (Receptor) TKI = ALK = CRC = MCA =
According to WHO data by 2030, malignancies will be the leading cause of mortality. What place do they occupy now?
third
fourth
second
first
Which are the most often occurring tumors in children up to 10 years of age?
neuroblastoma, leukemias, gastrointestinal tumors
acute leukemias, brain tumors, Wilms tumor
retinoblastoma, nephroblastoma, gastrointestinal tumors
lymphomas, leukemias, brain tumors
What are the most common neoplasias in the 2nd and 3rd decades of life?
soft tissue tumors, testicular carcinoma
mesenchymal tumors, breast cancer
gastrointestinal tumors, osteosarcoma
lung cancer, head and neck tumors
What are the most common neoplasias in the 3rd and 4th decades of life?
female genital tract tumors, male genital tract tumors
breast cancer, uterine cancer, CRC
lung cancer, breast cancer, CNS tumors
head and neck tumors, sarcomas
What are the most common neoplasias after the 5th decade of life?
Lung carcinoma, prostate gland carcinoma
Tumors of GIT, bladder carcinoma
CRC, prostate and lung carcinoma
Head and neck tumors, lung cancer
There are differences In cancer morbidity and mortality between males and females. What is the gender predominance of CRC and stomach cancer?
Men
Women
There is no gender predominance
Age-based sex division
Depending on geographic latitudes there is differential endemic Spread of neoplasms. Gastric carcinoma occurs predominantly in:
USA, Europe, Japan
Asia, Europe
Latin America, Eastern Europe, Japan
Southeast Asia and Africa
CRC occurs with the highest frequency in:
Europe
Asia
The USA
Australia and New Zealand
Mammary carcinoma is rare in:
The United States, Asia
Europe, Latin America
Africa, Asia
The Epstein-Barr virus is associated with infectious mononucleosis nasopharyngeal carcinoma, and Burkitt's lymphoma. The latter has marked endemic spread:
The Scandinavian countries, Mongolia
Malaysia, Uganda, New Guinea
Japan, the Philippines
What is screening?
testing a group of people for the detection of early-stage cancers
examining a group of people when certain symptoms and complaints are present
detection of unplanned disease by tests and procedures that can be applied quickly
evidence of disease’s initial symptoms
What types of cancer screenings are available?
Lung carcinoma, colon carcinoma, breast cancer
CRC, prostate, stomach
Breast cancer, prostate, cervical carcinoma
CRC, breast cancer, lung carcinoma
Which of the following cancers affect predominantly men
lung, prostate, colorectal carcinoma
melanoma, pancreas, lung
colon, prostate, melanoma
lung, pancreas, brain
Which tumors in women confer the lowest five-year survival rate?
breast
ovary
corpus uteri
lung
Areas with the highest oncological morbidity at present are
Americas
Africa
Europe and Americas
Which tumors in males confer the lowest five-year survival rate?
testicular carcinoma
lung cancer
prostate cancer
colon cancer
The most common Malignant tumor in Women is
Mammary Carcinoma
Cervical Carcinoma
Skin carcinoma
Ovarian Carcinoma
What is the most accurate definition of carcinogenesis?
The occurrence of mutations in more than one locus leading to the appearance of a transformed cell
Multistage and prolonged process leading to transformed cells with subsequent clonal selection and expansion
Multistage process of transformation and development of neoplastic clone
There is no correct answer
Tumorigenesis occurs in three stages
Proliferation, promotion, metastasis
Initiation, promotion, proliferation
Proliferation, promotion, progression
All answers are correct
Neoangiogenesis
the ability of cancer cells to metastasize via the blood and to form new vessels
uncontrolled growth of tissue that can deliver distant metastasize via the blood and the lymphatics
uncontrolled development of tissue with the ability to grow and metastasize by forming new vessels
there is no correct answer
Key features of the tumor cell are
ability to proliferate, metastasize, form new vessels and the possibility of apoptosis, invasion
loss of apoptosis, endless division, invasion and metastasis
generates signals for growth and development, ability to form new vessels and metastasize via the blood
all answers are correct
What is the definition of benign tumors?
varying degrees of cellular and structural differentiation, do not metastasize
highly differentiated tumors whose cells resemble those from which they originated
a high degree of cell differentiation, the presence of functional activity and metastatic ability
answers a+c
Which statement about malignant tumors is wrong?
varying degrees of cell differentiation and structural organization
cells are organized in monolayers with signs of anaplasia
have an infiltrative growth
What is relapse?
a newly emerging tumor
the reappearance of a tumor following its surgical removal
the appearance of a tumor at the same site as the one removed
the appearance of regional lymph nodes
Malignant tumors have infiltrative growth, cellular atypism, are encapsulated capsule and have the ability to give regional and distant metastases. This statement is
true
untrue
incomplete
ambiguous
Mesenchymal tumors metastasize
Via lymphatics
Via blood
Canalicularly
Intracavitary
The tumors of __________ metastasize in Intravascular fashion
lung, stomach, intestine
ovaries, uterus, bladder
head and neck, lung and prostate
Which of the following statements are characteristic of the cancer cell biology
cellular "immortality"
angiogenic ability
altogether
ability to invade and metastasize
Indicate which factors are associated with tumor progression
IL-1, IL-6, TNF-α
EGF / R, VEGF / R, HER-2, PDGF
OPG, RANK, RANKL
a+b
Paraneoplastic syndrome is due to
tumor progression
ectopic secretion of hormone-like peptides and immune response to the tumor
metastasis
the intoxication of the organism
Which tumors are hormone-dependent in their development
breast carcinoma
colon carcinoma
endometrial carcinoma
all listed
Genetic changes leading to carcinogenesis are
Spontaneous mutations in cell cycle regulating genes
Mutations in genes regulating the replication and repair of DNA
Multiple mutations
Characteristics of neoplastic cells are
loss of apoptosis
high proliferative potential
tendency for invasion
each indicated
The most common primary brain tumors are
anaplastic astrocytomas
glioblastomas
oligodendrogliomas
there is no true answer
The mean survival rate for malignant CNS tumors is
5-10 months
15-18 months
2 years
One year
A radical method for the treatment of solitary («3 cm) CNS tumors is
radiotherapy of the brain
radiosurgery
operative treatment
chemotherapy
Radiation is an important part of the complex treatment. The total dose of craniotherapy is
40 Gy
60 Gy
80 Gy
There is no true answer
Chemotherapy incorporates
Cisplatin
Gemcitabine
Temozolamide
Medulloblastoma is predominantly located in the rear cranial well and occurs most commonly in
The 3rd and 4th decades of life
Childhood
2nd and 3rd decade of life
Newborns
The main methods of diagnosis and follow-up of treatment effect in CNS tumors are
CT and MRI
MRI and PET scan
CT and PET scan
Symptomatic therapy in CNS tumors includes
dexamethasone, tranquilizers, diuretics
anxiolytics, diuretics
anticonvulsants, diuretics, dexamethasone
Brain metastases are yielded most commonly by
Prostate and lung carcinoma
Thyroid and gastric carcinoma
Carcinoma of the mammary gland and lung carcinoma
Kidney and GIT carcinoma
Which treatment method will be preferred for solitary brain metastasis
Brachytherapy
Percutaneous external irradiation
Operational extirpation
Radiosurgery
Temozolamide used to treat brain tumors belongs to which group of cytostatics based on its mechanism of action
anthracycline
antimetabolite
an alkylating agent
atyrosine kinase inhibitor
Methods for the treatment of multiple brain metastases are
surgery
radiotherapy
b+c
List the symptoms of increased intracranial pressure behaviour Feeling less alert than usual Lack of energy or sleepiness Weakness or problems with moving or talking
Risk factors for head and neck tumors are
chronic etilism, 3rd and 4th decade of life, male Sex, tobacco chewing
smoking, systemic use of alcohol and mutation in p53 gene
female sex, smoking, alcohol abuse
The most common head and neck tumors metastasize
Ref. a+b
Neighborhood invasion/ local invasion
Head and neck tumors occur with the highest frequency at which anatomic sites
The oral cavity
Oropharynx
Larynx
Sinus
The characteristic clinical picture includes
pain, fever, soore, difficulty swallowing
ulcer. dysphagia, otalgia
dysphagia, dyspnoea, swelling in the neck, soor
The most common histology of head and neck tumors is
adenocarcinomas
epidermoid carcinomas
squamous cell carcinomas
A leading treatment approach for head and neck tumors is
chemoradiotherapy
The most common early radiation reactions are
dysphagia and oropharyngeal mucositis
reduced hearing and odinophagia
larynx edema
a+c
Late radiation complications are
trismus, reduced hearing
oropharyngeal mucositis and dysphagia
radiographic fibrosis
The gold standard for nasopharyngeal carcinoma is
surgery, radiation, chemotherapy
operative intervention and subsequent radiotherapy
combined chemoradiotherapy
all the options listed
Targeted therapy for head and neck tumors is performed with
Bevacizumab
Cetuximab
Panitumumab
Nivolumab
HPV is related to the etiology of
cervical carcinoma
anogenital carcinoma
head and neck carcinoma
Head and neck tumors include neoplasia originating from anatomical locations
salivary glands, larynx, pharynx, oral cavity, nasal cavity, maxillary, frontal, ethmoidal, sphenoidal sinus
larynx, pharynx, oral and nasal cavities, parotid gland
parotid gland, larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses
parotid gland, larynx, pharynx, oral cavity, nasal cavity, maxillary, frontal, ethmoidal sinus
Tumors of head and neck are characterized by
increased frequency in Central Asia
mainly affect female subjects
most common in the western world
Complete the term against the relevant definition of premalignant lesions that are associated with the development of squamous cell carcinoma: - hyperkeratosis + underlying epithelial hyperplasia - superficial erythema spots near to normal mucosa due to epithelial dysplasia
The therapeutic approach to advanced disease includes
protocols with combined modality (radiochemotherapy)
radical surgery
administration of platinum-based chemotherapy protocol
the combined use of surgery radiotherapy
The four major histological types of lung carcinoma are
large cell, squamous, papillary, small cell
small cell, squamous cell, adenocarcinoma, large cell
spinocellular, acinar, small cell, large cell
Which histological type has the worst prognosis?
spinocellular
acinar adenocarcinoma
small cell
What are the principal biomarkers for NSCLC?
EGFR, HER-2
K-RAS, HER-2
ALK, PDL-1
EGFR, ALK, PDL-1
The standard for ChTh in radically operated patients with NSCLC is
APCT containing taxane
APCT containing cisplatin
APCT containing vinorelbine
APCT containing anthracyclines
Target therapies for NSCLC include
Bevacizumab, Panitumumab, Nivolumab
Erlotinib, Gefitinib, Crizotinid
Pertuzumab, Cetuximab, Pembrolizumab
Malignant Mesothelioma is characterized by (one wrong answer)
The main method of treatment is chemotherapy
Origin from the pleura, pericardium, peritoneum, testicular envelopes.
A causal relationship with exposure to asbestos
There are a large percentage of patients with five years of survival
Which of the following statements about lung carcinoma is NOT correct
more prominent for developed countries
the main cause of cancer morbidity and mortality in women
there are 2 major histological types - small cell and non-small cell
has a high-sensitivity tumor marker for diagnosis
Which of the following statements for small cell lung cancer (SCLC) compared to non-small cell lung cancer (NSCLC) is true
SCLC is more radiosensitive
SCLC is less chemosensitive
SCLC is more likely to have a peripheral localization in the lung
Tendency towards early and rapid metastasis
73 years old man has an increasing pain in the lumbar segment of the spine, more pronounced at bedtime. From the history - a long-standing hypertonic; sometimes smokes 1-2 cigarettes a week. Physical status is normal. Laboratory studies have found elevated serum alkaline phosphatase levels. From radiograph of the lumbar segment - a lytic bone lesion of the third lumbar vertebra. Which of the following cancers is the most likely diagnosis:
carcinoma of the stomach
non-small cell lung carcinoma
sarcoidosis
mesothelioma
Immunotherapy in lung carcinoma is performed with
BCG vaccine
Immunomodulators
Nivolumab, Pembrolizumab
Pulmonary carcinoma metastasizes most often in
liver
pleura and mediastinal lymph nodes
brain
bones
The recommended behavior of a General Practitioner in a patient with a blood clot is
Follow-up for one month
X-ray and consultation with a pneumologist no later than two weeks
CT scan
X-ray and surgery referral
What is the significance of EGFR expression Studies, KRAS mutation and ALK in non-small cell lung carcinoma
They are prognostic markers for survival
Reference markers for surgery
EGFR-TKI response markers
Possibility for personalized treatment
Which factors are not carcinogens for lung cancer
Smoking
Radiation
A diet rich in fat
Avitaminoses
Hypertrophic pulmonary osteoarthropathy is
Symptom of Peak Lung Cancer Symptom
Complication of radiotherapy
Paraneoplastic syndrome in lung carcinoma
Paraneoplastic syndrome in ovarian cancer
Contemporary molecular genetic tests on lung cancer biopsy specimen include
EGFR mutation
PDF
ALK
Peripheral lung lesions suspect for carcinoma are indicated for further diagnostic testing with
Surgical resection
Transthoracal needle biopsy
Bronchoscopy
Mediastinoscopy
For pleural effusion suspicious of lung carcinoma indicated is
X-ray and consultation with a pulmonologist
VATS (video-assisted thoracoscopy) with a biopsy
Magnetic resonance tomography
Positron emission tomography
Palliative therapy in lung cancer is
associated with a high risk of fatal toxicity
associated with increased life expectancy at reduced quality of life
followed by a 1 year life expectancy at improved quality of life
does not change life expectancy
Which statement is true for Luminous type A?
ER, PR- positive, HER2- negative, low Ki 67
ER PR- positive, HER2-positive, low Ki 67
ER, PR- positive, HER2- negative, high Ki 67
Which statement is wrong for Luminous Type B?
ER, PR- positive, HER2- overexpression, regardless of Ki 67
ER, PR- positive, HER2- positive, low Ki 67
No wrong answer
In non-luminous type we observe?
ER, PR- negative, HER2- overexpression
ER, PR- positive, HER2-positive, Ki 67 low
ER, PR- positive, HER2- negative
Genetic mutations in breast carcinoma are
BRCA 1, BRCA 2
BRCA1, BRCA2, p53
ALK, PDL 1
All listed
Standard treatment for luminal type A breast carcinoma includes
hormone therapy
hormone therapy +/- chemotherapy at positive lymph nodes
Standard treatment for luminal type B HER 2 negative breast carcinoma includes
hormone therapy +/- chemotherapy
Standard treatment for luminal type B HER 2-positive breast carcinoma includes
chemotherapy, anti-HER 2 therapy
chemotherapy, hormone therapy, anti- HER 2 therapy
hormone therapy, chemotherapy
Treatment in triple negative breast carcinoma includes
chemotherapy + hormone therapy
chemotherapy, hormone therapy, anti- HER2
Specify the standard treatment algorithm for breast cancer T2N1M0 without hormonal expression
PCT, surgery, radiotherapy
Surgery, PCT, radiotherapy
Radiotherapy, surgery, PCT
The three answers are correct
Specify the main tumor marker for diagnosis of breast cancer
CEA
CA 15-3
HGT
CA 19-9
The biological characteristic of the "triple-negative" breast cancer requires (choose one wrong answer)?
maximum severity of therapeutic behavior
hormonal therapy
strict monitoring due to the risk of early relapse and metastasis
affects younger women
Indicate which target drugs are used in HER positive breast cancer
Avastin, Panitumumab, Cetuximab
Herceptin, Lapatinib, Perjeta
Tarceva, Iressa, Avastin
Herceptin, Nivolumab, Crisotinib
A method of early detection (screening) of breast cancer is
Echography
Mammography in 2 projections
CT
MRI
The default markers for breast cancer are
The total CEA and CA 15-3
HER, estrogen and progesterone receptors, Ki 67
Total CEA and CA 125
Serum alkaline phosphatase and LDH
In which % of cases the breast cancer has a genetic predisposition
5%
10%
25%
40%
Triple-negative breast cancer belong to which of the listed histological groups?
Luminal A
Luminal B
Basal-like
"Normal" -like
A recommended age group to start screening for early detection of breast carcinoma is
women over 60 years of age
women over 50 years of age
women aged 50-69
family-related women, regardless of age
All of these factors are associated with a decreased risk of developing breast cancer except for
Negative history of breastfeeding
First pregnancy before 18 years of age
Men after 15 years of age
Natural menopause before 42 years of age
Which of the following features is associated with an unfavorable prognosis for breast carcinoma
ER+
Low proportion of S-phase cells
Overexpression of erbB2 (HER-2)
PR+