MCQs on Radiotherapy - 8

1:-65 year old female presented with vulvar pruritus and a lump in the left groin for further evaluation in gynecology. During the gynecological examination, a fixed 1×1 cm left groin lymphadenopathy was detected as well as a mobile 1×1.5 cm vulvar lesion at the labia minora. In her pelvic MRI, the labia minora lesion was 1.2×1.9 cm without extension to the lower urethra and the lower third of the vagina or anus, in addition to no gross lymphadenopathy except a left inguinal single lumphadenopathy measuring 1×1.5 cm in size. PET CT workup defined the tumor in the vulva and a left-sided single inguinal node without distant metastasis. The biopsy of the vulvar lesion revealed squamous cell carcinoma. What is her FIGO staging ?

A:-Stage IIB
B:-Stage IIA
C:-Stage IIIB
D:-Stage IIIA

Correct Answer:- Option-D

2:-The estimated risk of sub-clinical cervical lymph node metastasis is between 20-30% for all the following EXCEPT

A:-T2 floor of mouth
B:-T1 soft palate
C:-T1 pharyngeal wall
D:-T2 supra-glottic larynx

Correct Answer:- Option-D

3:-Which of the following do not belong to papillary variant of thyroid cancer classification ?

A:-Insular variant
B:-Encapsulated variant
C:-Follicular variant
D:-Diffuse sclerosing

Correct Answer:- Option-A

4:-Which among the following is false with respect of HPV in oropharyngeal cancer ?

A:-HPV-associated oropharyngeal cancers are more likely to occur among men than women (3 : 1)
B:-Most of whom (80%) will not have a smoking history
C:-These Cancers are more common among white individuals than other races, are diagnosed in individuals who are 5 to 10 years younger than HPV-unassociated oropharyngeal cancers
D:-HPV-associated oropharyngeal cancers are characterized frequently as well differentiated non-keratinizing or basaloid in histopathology

Correct Answer:- Option-D

5:-Which of the following margin matches is not correct for radiotherapeutic planning for skin cancer ?

A:-Recurrent BCC : 0.5 - 1 cm
B:-Morpheaform BCC : 0.5 - 1 cm
C:-Tm > 3 cm SCC : 3 cm
D:-Ulcerative SCC : 2cm

Correct Answer:- Option-C

6:-What is the optimal total radiation dose required for immunosuppression and tumoral cell eradication in fractionated TBI regimes ?

A:-2-4 Gy
B:-4-6 Gy
C:-6-8 Gy
D:-8-12 Gy

Correct Answer:- Option-D

7:-A 7 year old boy was admitted to the emergency with severe headaches, nausea, and vomiting. His examination revealed decreased upward gaze in addition to inability to focus on objects and double vision. There was abnormal light response during accommodation. He had an MRI demonstrating hydrocephalus with a pineal region mass obstructing the aqueduct of Sylvius. What syndrome is this ?

A:-Parinaud syndrome
B:-Ventral midbrain syndrome
C:-Benedict syndrome
D:-None of these

Correct Answer:- Option-A

8:-4 years old boy was brought to the attention of an ophthalmologist because of strabismus and right-sided leukocoria. He was clinically diagnosed as having retinoblastoma and the intraocular mass workup revealed a 13-mm diameter and 11 mm thick tumor with vitreous seeding, as well as sub-retinal seeding more than 4 mm from the tumor. The tumor did not touch the lens and did not involve anterior segment structures such as the ciliary body. He had no neo-vascular glaucoma or opaque media from hemorrhage. His tumor has only caused a minor loss of vision. Which is false?

A:-The international classification for intraocular retinobalstoma in this case is "C"

B:-Lumbar puncture for CSF evaluation, bone marrow biopsy and a bone scan if the tumor is not confined to the globe are mandatory investigations

C:-This patient is out of brachytherapy limits with vitreous seeding and sub-retinal seeding

D:-Vincristine/Carboplatin/Etoposide (VCE) times 6 cycles and then external beam radiotherapy is the treatment

Correct Answer:- Option-A

9:-45-year-old woman with a long history of hyperthyroiditis presents with eyelid retraction, exophthalmos, diplopia and periorbital edema. In her history of illness, she specifically notes that she has had deterioration in her vision over the last 10 days accompanied by diplopia 1 day ago. She has not experienced any loss of color vision or demonstrated corneal involvement, but she has minor visual field defects with blurred vision. She is diagnosed with Graves' disease and thyroid ophthalmopathy. Which of the statement is false ?

A:-There is a threat of impending visual loss, although the color vision is protected. She does not seem to require decompressive surgery, but orbital radiotherapy could be recommended in addition to systemic immunosuppression with oral or IV steroids.

B:-With radiotherapy there is improvement in proptosis, eyelid retraction , or soft tissued chnages which has not been clearly defined

C:-Radiotherapy has been recommended for its efficacy for compressive optic neuropathy, which has not yet been clearly determined

D:-The current recomended external beam radiotherapy dose is 20 Gy (2 Gy/fraction/d)

Correct Answer:- Option-B

10:-38 years old male with complaints of non-specific headaches for almost 6 months has been evaluated by neurology. His brain MRI has demonstrated a recent bleeding and a dark flow void surrounding the nidus of an arteriovenous malformation in the thalamus, which was 1.5 cm in size. The angiography confirmed this diagnosis in addition to showing no deep venous drainage. He currently has no neurological symptoms. What is the rough risk of bleeding in his lifetime ?

A:-62%
B:-52%
C:-67%
D:-57%

Correct Answer:- Option-C
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