Hemato-oncology 2007

1. What are the main differences in the distribution of the disease at the initial
estimation of Hodgkin's lymphoma (HD) compared to Non-Hodgkin's
lymphoma (NHL)?
a. In HD the disease is significantly distributed in the urinary system, as
opposed to NHL
b. HD presents in higher percents at thoracic lymph nodes, and in lower
percents at mesenteric lymph nodes, compared to NHL
c. In HD there is a significant distribution at the gastrointestinal tract, as
opposed to NHL
d. NHL presents in higher percents at thoracic lymph nodes, and in lower
percents at mesenteric lymph nodes, compared to HD

2. Calcification of lymph nodes:

a. Is rare before treatment
b. Happens in non aggressive disease
c. Calcifications may appear following treatment
d. Common before treatment
e. a + c are correct
f. b + d are correct

3. Which of the following statements is correct?

a. The BCL2 protein acts inside the cell nucleus as a transcription factor,
enhancing the rate of cell division
b. Errors at the gene rearrangement process in the genes for
immunoglobulin contribute to the development of lymphomas
c. Mutations at both alleles of a proto-oncogene must happen in order for
it to contribute to the malignant process
d. The p53 gene provokes apoptosis in cells in any case of DNA damage
e. The drug ATRA given to APL patients encourages apoptosis through
release of cytochrome C from the mitochondria

4. All of the following are correct, except:

a. In Burkitt's lymphoma, the myc oncogene is activated through
translocation to one of the immunoglobulin genes
b. The protein Bcr/Abl has higher tyrosine kinase activity compared to
the protein Abl
c. For a normal cell to become malignant - several biochemical
mechanisms should be damaged, so that the cell becomes independent
of external proliferation signals, insensible to growth inhibition,
gaining unlimited replication potential, and able to evade apoptosis
d. Methilation is an important epigenetic mechanism in cancer
development, through inactivation of many tumor suppressor genes
e. In lymphomas, there are translocations causing the production of a
chimeric-oncogenic protein

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5. What is correct regarding diffuse large B cell lymphoma?
a. Comprises a small part of all the lymphomas
b. Is characterized by multiple recurrences along many years
c. Rarely involves different systems, such as gastrointestinal system, etc.
d. Can develop at the spinal cord area and cause spinal cord compression
e. The prognosis is worse in patients older than 60 years

6. What is correct regarding opioid drugs in oncologic patients?

a. Most oncologic patients develop tolerance to the analgesic effect of the
opioid drugs
b. Opioid drugs are only given to terminal oncologic patients
c. Constipation is a common side effect in oncologic patients treated by
opioid drugs
d. Opioid drugs are the "corner stone" of treatment in oncologic patients
who experience pain
e. c and d are correct

7. All is correct regarding bevacizumam (avastin), except:

a. The drug is a monoclonal antibody
b. It acts through binding to VEGF
c. It is not accepted to use this drug along with cytotoxic drugs
d. The efficacy of the drug was proved in metastatic cancer of the colon

8. What is the mechanism of action of tamoxifen in patients with metastatic

breast cancer?
a. Inhibition of estrogen production by the ovaries
b. Inhibition of gonadotropic hormones secretion by the hypophysis
c. Binding to estrogen receptors inside the nuclei of the malignant cells
d. Inhibition of the conversion of androgens produced in the adrenal
gland into estrogens
e. Enhancement of the metabolic degradation of estrogen by the liver

9. The most efficient treatment for vomiting due to chemotherapy is:

a. Psychological and psychiatric treatment
b. Preventive therapy given before the chemotherapy and up to 5 days
afterwards
c. Therapy given 24 hours after accomplishing the chemotherapy
d. Therapy given 5 days after accomplishing the chemotherapy

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10. Look at picture number 2:

What is your diagnosis?

a. Follicular lymphoma
b. Mantle cell lymphoma
c. Nodular lymphocytic predominana Hodgkin's lymphoma
d. Nodal marginal zone lymphoma
e. Burkitt's lymphoma

11. What is correct regarding Burkitt's lymphoma?

a. "Starry sky pattern" is diagnostic to this malignancy
b. The tumor is characterized by 100% growth fraction
c. The malignant cells are T lymphocytes
d. The characteristic genetic defect for this malignancy is t(11,18)
e. In more than 80% of cases, there is a relation between the disease and
the HIV virus

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 12. Look at picture number 3:

What is your diagnosis?

a. Follicular lymphoma
b. Malt lymphoma
c. Mixed cellular HL
d. Mantle lymphoma
e. Plasma cell myeloma

13. Which marker goes with the cells at picture number 3?

a. CD5
b. CD10
c. CD20
d. CD138
e. LAP

14. Which translocation is characteristic of follicular lymphoma?

a. 14/18
b. 8/14
c. 11/14
d. 22/9

Possible answers:
8. c 1. b
9. b 2. e
10. a 3. b
11. b 4. e
12. d 5. e
13. d 6. e
14. a 7. d

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