Neoplasia MCQs Quiz Questions And Answers
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Do you know what term refers to the uncontrolled or abnormal growth of cells and tissues in our body? It's neoplasia. Try these neoplasia MCQs quiz questions and answers and review your knowledge of the same if you already know about it. Neoplasia is a medicinal term used to describe when new, often abnormal, and excessive tissue growth occurs within the cells of an organism in an uncontrolled manner. In this quiz, we'll give you examples of patients and see if you can figure out how to treat each case.
Questions and Answers
- 1.
A 38-year-old female undergoes a routine PAP smear examination. The smear is reported as “Atypical cell seen with a high N/C ratio, hyperchromatic and pleomorphic nuclei.” A cervical biopsy is advised. The biopsy shows a tumor composed of sheets and nests of malignant squamous cells invading the underlying stroma. Many of the malignant squamous cell nests show presence of keratin pearls at the center. Which of the following is the best description of her lesion?
- A.
Severe dysplasia
- B.
Mild dysplasia
- C.
Invasive squamous cell carcinoma, well differentiated
- D.
Invasive squamous cell carcinoma, poorly differentiated
- E.
Invasive adenocarcinoma, well differentiated
Correct Answer
C. Invasive squamous cell carcinoma, well differentiatedExplanation
The correct answer is "Invasive squamous cell carcinoma, well differentiated." This is the best description of the lesion based on the information provided. The PAP smear showed atypical cells with a high nuclear-to-cytoplasmic ratio, hyperchromatic and pleomorphic nuclei, indicating abnormal cell growth. The biopsy confirmed the presence of malignant squamous cells invading the underlying stroma, and the presence of keratin pearls further supports the diagnosis of squamous cell carcinoma. The term "well differentiated" suggests that the tumor cells still retain some resemblance to normal squamous cells, indicating a less aggressive form of carcinoma.Rate this question:
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- 2.
A 21-year-old woman presents with a painful right knee. An x-ray reveals a mass arising from the distal femur. Biopsy shows a malignant tumor arising from the bone, an osteosarcoma; the malignant tumor cells laying down osteoid. When the patient was 2 years old, a cancerous lesion was surgically removed from the right eye. Which of the following regulatory genes is most likely responsible for these eye and bone lesions?
- A.
MYC proto-oncogene
- B.
RAS proto-oncogene
- C.
RB suppressor gene
- D.
TP53 suppressor gene
- E.
BRCA1 suppressor gene
Correct Answer
C. RB suppressor geneExplanation
The RB suppressor gene is most likely responsible for these eye and bone lesions. RB stands for retinoblastoma, which is a rare type of eye cancer that typically affects young children. The RB gene is a tumor suppressor gene that helps regulate cell growth and division. Mutations in this gene can lead to the development of retinoblastoma as well as other types of cancers, including osteosarcoma. Therefore, the presence of both eye and bone lesions in this patient suggests a mutation in the RB suppressor gene.Rate this question:
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- 3.
A 4-year-old boy is brought to his pediatrician because his parents have noted some problem in the child’s vision of the left side. Physical examination shows diminished visual acuity in the left eye. Subsequent investigations reveal a malignancy of the eye. The patient is subsequently treated with radiation, but is found to have a similar malignancy in the right eye 2 years later. What is the normal function of the protein that is altered in this condition? Inhibition of apoptosis
- A.
GTPase activating protein (GAP)
- B.
Inactivation of transcription factor E2F
- C.
Facilitates DNA repair
- D.
Signal transduction by RAS oncogene
Correct Answer
C. Facilitates DNA repairExplanation
The normal function of the protein that is altered in this condition is to facilitate DNA repair. This is evident from the fact that the patient developed a malignancy in both eyes, indicating a defect in DNA repair mechanisms. The protein that is altered is likely involved in repairing DNA damage, and its dysfunction leads to the development of malignancies. This explanation is supported by the fact that the patient was treated with radiation, which suggests that the DNA damage caused by the malignancy was attempted to be repaired through radiation therapy.Rate this question:
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- 4.
A 5-year-old African boy presents with a mass in his right jaw. A biopsy from the mass shows a high grade tumor composed of lymphoid cells. The pathologist describes the tumor having a “starry-sky appearance” under the microscope. The agent causing the patient’s disorder is most strongly associated with which of the following malignancies? '
- A.
Burkitt's lymphoma
- B.
T-cell leukemia/lymphoma
- C.
Hepatocellular carcinoma
- D.
Kaposi’s sarcoma
- E.
Cervical carcinoma
Correct Answer
A. Burkitt's lymphomaExplanation
Burkitt's lymphoma (or "Burkitt's tumor", Burkitt lymphoma or "malignant lymphoma, Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes).Rate this question:
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- 5.
A 41-year-old Caucasian woman presents with fatigue, pallor, weight loss, and intermittent diarrhea. On questioning, she reports a family history of colon carcinoma. Colonoscopy reveals three small polyps in the cecum and a 3-cm ulcerated exophytic mass in the ascending colon. Biopsy is performed and histologic examination of the exophytic mass reveals the tissue shown for your evaluation below. Which of the following is the most likely genetic mechanism of the described pathologic condition?
- A.
Microsatellite instability due to defective mismatch repair
- B.
Promoter hypermethylation of tumor suppressor genes
- C.
Defective nucleotide excision repair with formation of pyrimidine dimers
- D.
Defective homologous recombination repair due to ATM gene mutation
Correct Answer
A. Microsatellite instability due to defective mismatch repairExplanation
The most likely genetic mechanism of the described pathologic condition is microsatellite instability due to defective mismatch repair. This is indicated by the presence of three small polyps in the cecum and a 3-cm ulcerated exophytic mass in the ascending colon. Microsatellite instability is commonly associated with hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome, which is characterized by a defect in the DNA mismatch repair system. This defect leads to an accumulation of errors in DNA replication, resulting in the development of tumors.Rate this question:
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- 6.
15-year-old Caucasian girl presents to the outpatient clinic with two slow-growing nodules on her right arm. Physical examination reveals several large pigmented spots with irregular margins scattered over her body and numerous small brown nodules in her irises. The nodules on the right arm are elongated, 1 X 3 cm each, well demarcated and rubbery in consistency. Which of the following signaling pathways is most likely affected in this case?
- A.
TGF-β-induced pathway
- B.
RAS-RAF-MAP-kinase pathway
- C.
NF-kB pathway
- D.
APC/β-catenin pathway
Correct Answer
B. RAS-RAF-MAP-kinase pathwayExplanation
The presence of pigmented spots with irregular margins scattered over the body and small brown nodules in the irises suggests the possibility of neurofibromatosis type 1 (NF1). NF1 is a genetic disorder caused by mutations in the NF1 gene, which encodes for neurofibromin, a protein that negatively regulates the RAS-RAF-MAP-kinase pathway. In NF1, the loss of neurofibromin function leads to overactivation of this pathway, resulting in the development of various tumors and characteristic clinical features. Therefore, the RAS-RAF-MAP-kinase pathway is most likely affected in this case.Rate this question:
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- 7.
A 47-year-old Iraqi man presents with dysphagia. The patient reports 20-pack-year history of smoking; he also drinks very hot tea several times a day. Esophagoscopy reveals an ulcerated lesion in the middle portion of the esophagus and biopsy is taken. Histologic examination reveals the tissue shown in the picture below. Which of the following is the most likely diagnosis?
- A.
Squamous cell carcinoma
- B.
Barrett esophagus
- C.
Carcinoma in situ
- D.
Squamous cell papilloma
Correct Answer
A. Squamous cell carcinomaExplanation
The most likely diagnosis based on the clinical presentation and histologic examination is squamous cell carcinoma. The patient's risk factors, including a history of smoking and frequent consumption of hot tea, are associated with the development of squamous cell carcinoma of the esophagus. The ulcerated lesion seen on esophagoscopy and the histologic findings support this diagnosis. Barrett esophagus is characterized by metaplastic columnar epithelium in the distal esophagus, which is not consistent with the findings described. Carcinoma in situ refers to pre-invasive carcinoma and would not present as an ulcerated lesion. Squamous cell papilloma is a benign lesion and would not explain the patient's symptoms or histologic findings.Rate this question:
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- 8.
A 48-year-old man presents to the emergency room complaining of vague abdominal pain, intermittent fevers, and a 9-kg (20-lb) weight loss over the past 4 months. On physical examination, he has diffuse abdominal tenderness, hepatomegaly, and yellow sclera. CT-guided liver biopsy reveals hepatocellular carcinoma. Which of the following tumor markers is useful for monitoring recurrence of disease following surgery in this patient?
- A.
CEA
- B.
AFP
- C.
CA-125
- D.
HCG
- E.
PSA
Correct Answer
B. AFPExplanation
AFP (alpha-fetoprotein) is a tumor marker that is useful for monitoring recurrence of hepatocellular carcinoma following surgery. Elevated levels of AFP in the blood are associated with the presence of hepatocellular carcinoma. Therefore, monitoring AFP levels can help detect recurrence of the disease after surgery. CEA (carcinoembryonic antigen), CA-125, HCG (human chorionic gonadotropin), and PSA (prostate-specific antigen) are tumor markers that are associated with other types of cancer and would not be as useful for monitoring recurrence of hepatocellular carcinoma.Rate this question:
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- 9.
A 76-year-old Caucasian man presents with dysuria and intermittent hematuria. Rectal exam does not reveal any abnormalities. Cystoscopy with subsequent biopsy is performed and reveals several granular and hyperemic spots on the bladder mucosa; no intraluminal masses are identified. Histologic examination reveals the lesion of the bladder mucosa presented for your evaluation in the picture below. Which of the following is the most likely diagnosis?
- A.
Invasive urothelial carcinoma
- B.
Acute cystitis
- C.
Urothelial papilloma
- D.
Urothelial carcinoma in situ
Correct Answer
D. Urothelial carcinoma in situExplanation
The most likely diagnosis in this case is urothelial carcinoma in situ. This is suggested by the patient's presentation with dysuria and intermittent hematuria, as well as the findings on cystoscopy of granular and hyperemic spots on the bladder mucosa. The histologic examination of the bladder mucosa confirms the diagnosis. Invasive urothelial carcinoma would typically present with intraluminal masses, which were not identified in this case. Acute cystitis would typically present with different symptoms and would not be associated with the findings on cystoscopy. Urothelial papilloma would typically present with a papillary growth pattern, which was not seen in this case.Rate this question:
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- 10.
A 76-year-old man presents with a complaint of a change in bowel habits, alternating constipation and diarrhea. A stool sample reveals occult blood. Digital rectal examination reveals a palpable mass. A biopsy was performed. Of the following microscopic findings, which of the following is most Likely to indicate that the neoplasm is malignant?
- A.
Atypia
- B.
Increased nucleus to cytoplasmic ratio
- C.
Invasion of surrounding tissue
- D.
Necrosis
- E.
Pleomorphism
Correct Answer
C. Invasion of surrounding tissueExplanation
Invasion of surrounding tissue is most likely to indicate that the neoplasm is malignant. This finding suggests that the tumor has the ability to invade and spread into nearby tissues, which is a characteristic feature of malignant tumors. Atypia, increased nucleus to cytoplasmic ratio, necrosis, and pleomorphism are also features that can be seen in malignant tumors, but invasion of surrounding tissue is a more definitive indicator of malignancy.Rate this question:
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- 11.
In a blind study, a number of biopsies are submitted with the designation of grade 1 and stage 1. Without using any other information except grading and staging, which of the following is the best interpretation for these neoplasms?
- A.
They are Most likely in situ.
- B.
They are Most Likely not malignant
- C.
They are Most Likely of epithelial origin.
- D.
They are Most likely well differentiated and localized
- E.
They Most Likely spread by lymphatics
Correct Answer
D. They are Most likely well differentiated and localizedExplanation
Based on the information provided, the best interpretation for these neoplasms is that they are most likely well differentiated and localized. This is because the biopsies are designated as grade 1 and stage 1, which suggests that the neoplasms are well differentiated and have not spread beyond their original location.Rate this question:
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- 12.
A genetic study is done on a newborn that indicates the child was born with a single functional allele of a tumor suppressor gene. At the age of five the genetic study was repeated, only to find that the remaining normal allele was lost through a point mutation. As a result, the ability to halt the transition from G1 to the S phase of the cell cycle is lost. Which of the following neoplasms is most likely to arise via this mechanism?
- A.
Choristoma
- B.
Nephroblastoma
- C.
Neuroblastoma
- D.
Retinoblastoma
- E.
Teratoma
Correct Answer
D. RetinoblastomaExplanation
This question describes a scenario where a child is born with a single functional allele of a tumor suppressor gene. At the age of five, the remaining normal allele is lost through a point mutation. This loss of the tumor suppressor gene's function leads to the inability to halt the transition from G1 to the S phase of the cell cycle. Retinoblastoma is most likely to arise via this mechanism because it is a cancer that is commonly associated with mutations in the RB1 gene, which is a tumor suppressor gene involved in regulating the cell cycle.Rate this question:
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- 13.
A 75-year-old man has had a chronic cough for the past 10 years. He has a long cigarette smoking history and has begun to lose weight during the past year. No abnormal findings are noted on physical examination but a chest radiograph reveals a right hilar mass. Sputum cytology shows atypical, hyperchromatic squamous cells. Of the following, which is the most common pathway by which this neoplasm will metastasize?
- A.
Blood stream
- B.
Bronchi
- C.
Contiguous spread to pleural
- D.
Lymphatics
- E.
Pleura to peritoneum
Correct Answer
D. LymphaticsExplanation
The most common pathway for metastasis of this neoplasm is through the lymphatics. This is suggested by the presence of atypical, hyperchromatic squamous cells in the sputum cytology, which is indicative of a squamous cell carcinoma. Squamous cell carcinomas of the lung commonly spread through the lymphatic system to regional lymph nodes before spreading to distant sites. The absence of abnormal findings on physical examination and the presence of a right hilar mass on chest radiograph further support the possibility of lymphatic spread.Rate this question:
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- 14.
A 40-year-old woman had a firm palpable mass on the dome of her uterus which was discovered six years ago on a routine physical examination. The mass has slowly increased in size and is now about twice the size it was when first discovered. She remains asymptomatic. Which of the following neoplasms is she most likely to have?
- A.
A metastatic tumor from the colon
- B.
Adenocarcinoma
- C.
Hematoma
- D.
Leiomyoma
- E.
Leiomyosarcoma
Correct Answer
D. LeiomyomaExplanation
The correct answer is Leiomyoma. A leiomyoma is a benign neoplasm of smooth muscle cells, commonly known as a fibroid. It is the most likely diagnosis in this case because the patient is asymptomatic and the mass has slowly increased in size over time. Leiomyomas are common in women of reproductive age and are frequently discovered incidentally during routine physical examinations. They are typically firm and palpable masses on the uterus. Metastatic tumors from the colon, adenocarcinoma, hematoma, and leiomyosarcoma would be less likely in this case, as they would typically present with different symptoms and clinical findings.Rate this question:
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- 15.
A 55-year-old male, a chronic smoker, develops a productive cough with hemoptysis, anorexia and significant weight loss. Subsequent investigations reveal a squamous cell carcinoma of the lung. Laboratory investigations show elevated serum calcium levels. This phenomenon is best explained by which of the following?
- A.
Ectopic production of PTH
- B.
Ectopic production of ACTH
- C.
Ectopic production of ADH
- D.
Ectopic production of PTH-related peptide
- E.
Metastatic deposits in bone
Correct Answer
D. Ectopic production of PTH-related peptideExplanation
The elevated serum calcium levels in this patient can be best explained by ectopic production of PTH-related peptide. This peptide is produced by certain tumors, including squamous cell carcinoma of the lung, and acts similarly to parathyroid hormone (PTH). It increases the release of calcium from bones and reduces calcium excretion by the kidneys, leading to hypercalcemia. The other options, such as ectopic production of PTH, ACTH, or ADH, are not typically associated with squamous cell carcinoma of the lung. Metastatic deposits in bone can also cause hypercalcemia, but ectopic production of PTH-related peptide is a more likely explanation in this case.Rate this question:
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- 16.
A 23-year-old woman presents to her physician with a lump in her left breast. She has no family history of cancer and is taking low-dose oral contraceptives. On examination, she has a 2-cm rubbery, round, freely mobile mass. An ultrasound is performed showing a solid mass. Core needle biopsy is reported as a fibroadenoma. Which of the following characteristics was most likely seen on the sample?
- A.
High nucleus to cytoplasm ratio
- B.
High fraction of cells with mitotic spindles
- C.
Cellular hyperplasia with glandular architecture
- D.
Loss of glandular architecture
- E.
Anaplastic cells
Correct Answer
C. Cellular hyperplasia with glandular architectureExplanation
The most likely characteristic seen on the sample is cellular hyperplasia with glandular architecture. Fibroadenomas are benign breast tumors that are composed of both glandular and fibrous tissue. The presence of cellular hyperplasia indicates an increase in the number of cells in the glandular component, while the preservation of glandular architecture suggests that the cells are still organized in a normal pattern. This finding is consistent with fibroadenoma and helps to differentiate it from other breast masses, such as breast cancer.Rate this question:
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- 17.
Postmortem examination of a 73-year-old Caucasian woman reveals multiple well-circumscribed nodules in the liver. The gross and microscopic appearance of the liver is shown for your evaluation below. Which of the following is the most likely location of the primary pathologic process affecting the patient?
- A.
A
- B.
B
- C.
C
- D.
D
Correct Answer
D. DExplanation
The answer is D because the gross and microscopic appearance of the liver in the image shows multiple well-circumscribed nodules. This is indicative of metastatic liver lesions, suggesting that the primary pathologic process originated from another site in the body and spread to the liver.Rate this question:
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- 18.
An 18-year-old African American presents with a complaint of bloody stools that he attributes to occasional constipation. On questioning, he informs that his father died of colorectal cancer at the age of 51 years. The patient is sent to colonoscopy, the gross appearance of the colonic mucosa is shown for your evaluation below. Which of the following genes is most likely affected in this case?
- A.
Hereditary nonpolyposis colon cancer gene
- B.
Adenomatosis polyposis coli gene
- C.
Retinoblastoma gene
- D.
Ras gene
Correct Answer
B. Adenomatosis polyposis coli geneExplanation
Based on the information provided, the patient's father died of colorectal cancer at a relatively young age, suggesting a potential genetic component to the development of the disease. Adenomatosis polyposis coli (APC) gene mutations are associated with familial adenomatous polyposis (FAP), a condition characterized by the development of numerous polyps in the colon. FAP increases the risk of developing colorectal cancer at a young age, making the APC gene the most likely gene affected in this case.Rate this question:
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- 19.
A 26-year-old Caucasian man presents with dyspnea, hemoptysis, and enlarged right testicle. Chest x-ray and testicular biopsy is performed and the results are shown for your evaluation. Elevation of which of the following serum markers would be confirmatory in this case?'
- A.
Alpha –fetoprotein
- B.
Carcinoembryonic antigen
- C.
Prostate specific antigen
- D.
Calcium
Correct Answer
A. Alpha –fetoproteinExplanation
Elevation of alpha-fetoprotein (AFP) would be confirmatory in this case. AFP is a serum marker that is typically elevated in certain types of cancer, including testicular cancer. The patient's presentation with dyspnea, hemoptysis, and an enlarged right testicle, along with the results of the chest x-ray and testicular biopsy, suggest the possibility of testicular cancer. An elevated AFP level would provide further evidence to support this diagnosis.Rate this question:
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.JPG "A 5-year-old African boy presents with a mass in his right jaw. A biopsy from the mass shows a high grade tumor composed of lymphoid cells. The pathologist describes the tumor having a “starry-sky appearance” under the microscope. The agent causing the patient’s disorder is most strongly associated with which of the following malignancies?
'")
.JPG "A 41-year-old Caucasian woman presents with fatigue, pallor, weight loss, and intermittent diarrhea. On questioning, she reports a family history of colon carcinoma. Colonoscopy reveals three small polyps in the cecum and a 3-cm ulcerated exophytic mass in the ascending colon. Biopsy is performed and histologic examination of the exophytic mass reveals the tissue shown for your evaluation below. Which of the following is the most likely genetic mechanism of the described pathologic condition?")
.JPG "A 47-year-old Iraqi man presents with dysphagia. The patient reports 20-pack-year history of smoking; he also drinks very hot tea several times a day. Esophagoscopy reveals an ulcerated lesion in the middle portion of the esophagus and biopsy is taken. Histologic examination reveals the tissue shown in the picture below. Which of the following is the most likely diagnosis?")
.JPG "A 76-year-old Caucasian man presents with dysuria and intermittent hematuria. Rectal exam does not reveal any abnormalities. Cystoscopy with subsequent biopsy is performed and reveals several granular and hyperemic spots on the bladder mucosa; no intraluminal masses are identified. Histologic examination reveals the lesion of the bladder mucosa presented for your evaluation in the picture below. Which of the following is the most likely diagnosis?")
.JPG "An 18-year-old African American presents with a complaint of bloody stools that he attributes to occasional constipation. On questioning, he informs that his father died of colorectal cancer at the age of 51 years. The patient is sent to colonoscopy, the gross appearance of the colonic mucosa is shown for your evaluation below. Which of the following genes is most likely affected in this case?")
.JPG "A 26-year-old Caucasian man presents with dyspnea, hemoptysis, and enlarged right testicle. Chest x-ray and testicular biopsy is performed and the results are shown for your evaluation. Elevation of which of the following serum markers would be confirmatory in this case?'")
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Feb 28, 2024Quiz Edited by
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Expert Reviewed by
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Jun 18, 2012Quiz Created by
Chachelly
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