soalan onco 2009

8/9/2019 Soalan Onco 2009

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1. A 36 y/o man has been hospitalized for Nasopharyngeal Carcinoma. The tumor is

quiet large as he had salloing difficulty for solid food. Anthropometric e!am

re"ealed his height 16#cm$ eight %&'g. ()AC *1.% cm. blood assay shoed +b

1,.# g/dl$ serum Albumin *.#g/dl$ total lymphocyte count 11-&mol/mm3

hich of the folloing statements is correctA. N0T is needed for enteral feeding

. Total paraenteral nutrition is required to increase eight

C. +is (2 is 1#.

4. 5o T5C is due to decrease serum Albumin

. 2ron 7upplementation ould normalize +b

*. A omen aged 66 is admitted to hospital for late stage colon cancer. 4ietary e!am

re"eals she is se"erely undernourished (2 13.- ith inta'e less that 898 of calorie

requirement. 7he gi"es history of inadequate "eges and fruit inta'e

hich of the folloing statements regarding her dietary management is correctA. The patient needs peripheral :arenteral nutrition

$ Total calorie requirement can be achie"ed through nutrition per oral

C. Total calorie requirement can be achie"ed through enteral nutrition

4. :arenteral nutrition is to gi"e as the main source calorie

. 4ietary treatments goal is to attain ma!imum inta'e of -,8 calorie requirement

3. A 6- year old oman is seen in hospital ard for late stage of o"ary carcinoma

ith ascites. Anthropo e!am shos height 1-6cm$ eight after correction ascites is 36

;0 and ()AC is 1#cm. 4ietary e!am re"eals her inta'e is only %3-;cal T?$ 70:T$ albumin@ *.& g/dl. and +b 1,.- g/dl

hich of the folloing dietary management for this patient are correct

A. increase fat inta'e

. 7upplemented oth (CT


2/15

-. ood :lays role in pre"ention of carcinogenesis in hich of the folloing stage

A. 2nitiation

. :romotion

C. :rogression

4. 2nitiation and progression

. 2nitiations$ promotion and progression

6. (ineral as a strong antio!idant and in"ol"es in a cancer pre"ention and probably

also in particularly in early stage of cancer is

A. (agnesium

. Natrium

C. 7elenium

4. ;alium

. :hosphor

&. +ypernephroma arises from

A. Beneal tubular epithelium. Benal capsule

C. 2nta=renal adrenal rests

4. Benal medula

. Benal pel"is

#. hich of the folloing is N>T a ad"isable in patients suspected of ha"ing upper

tract transitional cell carcinoma

A. )70

. ;)/2)

C. Betrograde pyelography

4. Antegrade pyelography

. CT scan

. hich is the most common cancer of the urinary ladder.

A. 7arcoma.

. TCC

C. Adenocarcinoma

4.7CC

. Clear cell carcinoma

1,. The folloing are not high ris' factors for de"elopment of carcinoma urinarybladder

A. Chemical Carcinogens

. Cigarette smo'ing

C. Artificial 7eeteners

4. Coffee drin'ing

. Tea drin'ing

A. *1 years old man presented ith the history of chronic retention of urine ith

o"erflo incontinence. +e had dysuria and frequency of urinated since last many

years. +is blood urea as 1,,mgr8 and serum creatineine as %$- mgr8. There is no

history of any systemic disease


3/15

11. hich of the folloing is the most probable diagnosis

A. 7tricture urethra

. enign prostatic hyperplasia

C. Carcinoma bladder

4. esical calculus

. esical di"erticulum

1*. hich of the folloing us the in"estigation of choice

A. ;)/2)

. )70

C. Benal 7can

4. )roflometry

. (B2

13. hich of the folloing is the biomar'er in"estigation of choice

A. A:

.CAC. :7A

4. =+C0

. 54+

13 years old girl come to hospital because there is lump at right shoulder hich notice

since 'indergarten. :hysical e!am the consistency of the lump is firm and ell

defined border. The finger can put in beteen the lump and the humerus and from !=

ray lump groth from metaphysic to diaphysis.

1%. The folloing signs are benign tumor e!cept@

A. The size tumor a marble size

. The size tumor a tennis ball size

C. 7lo groth

4. 2ll define

. No pain

1-. rom the history abo"e$ other information should get from !=ray to support

diagnose@

A. Caulifloer appearances

. 7unburst appearances

C. >nion s'in appearances4. Codman triangle

. Nidus

16.The diagnosis is

A. >steogenic 7arcoma

. ingDs sarcoma

C. >steoid osteoma

4. >steochindroma

. Condroma

1& All the folloing are indication of operation e!cept@A. Compression to neuro"ascular bundle


4/15

. Cosmetic

C. (alignant danger

4. The doctor ant operate

. The patient need

1* year old boy came to hospital because of right tibia fracture as a result of slip andfell. The boy already felt some pain since a ee' ago and especially at night. The

result of biopsy is Bound cell tumor. rom physical e!amination there is sellingat

tibia ith ill define border and increase of temperature compare to the noral site.

rom E=ray shon there is fracture at the middle of tibia and onion s'in appearances

1#. :athologic fracture because of

A. 2t happen at 1* years old

. ecause of chronic osteomyelitis

C. ecause tri"ial trauma

4. :ossibility of bone TC

. 2t happens at a boy

1. The folloing signs are (alignant tumor e!cept@

A. The size tumor a marble size

. The size tumor a tennis ball size

C. 7lo groth

4. 2ll define

. No pain

*,. The diagnosis is

A. >steogenic sarcoma

. ingDs sarcoma

C. >steod oesteoma

4. >steochondroma

. Chondroma

1- years old came to the hospital because of selling at her right 'nee hich she

suffers for 3 months. At the beginning the size li'e a marble ball and increasing until

the size li'e a ta'ra ball. rom physical e!am there are "enectasis at the mass$ the

colour dar'er and temperature armer than adFacent side. Consistency is bony hard$

ill define and pain on palpation. E=ray shon the tumour at the metaphysic of the

fermur ith osteolytic and osteoblastic area.

*1. 2nformation that e should be found to confirm the diagnosis is

A. Caulifloer appearaces

. 7unburst appearance

C. >nion s'in appearance

4. Codman triangle

. Nidus

**. The lab findings hich can support the diagnosis

A. Al'ali phosphate increase

. Al'ali phosphate decreaseC. Acid phosphate increase


5/15

4. Acid phosphate decrease

. rythrocyte sediment rate increase

*3 The diagnosis is

A. >steogenic sarcoma

. ingDs sarcomaC. >stiod oestoma

4. >steochondroma

. Chondroma

3-.....

A. :aracetamol$ codeine and bisacodyl

$ :aracetamol and tramadol

C. ;etorolac$ tramadol and bisacodyl

4. :aracetamol$ morphine and bisacodyl

. ;etorolac and morphine

36. (ale$ &-yo has been diagnosed :rostatic Carcinoma by 7urgeon came to public

health centre ith loer abdomen pain. There is problem ith communication as

cogniti"e disorder ith the old patient.

hich pain assessment tool can be used for measurement pain intensity of this

patient

A. Numerical Bating 7cale

. isual analogue scale

C. erbal Bating scale

4. ace pain rating scale

. (c 0rill pain questionnaire

3&. (orphine as analgesic drug@

A. 2s the ea' opiod of choice in cancer pain

. :oorly absorbed after oral admin

C. Amount required is determined by pain relief

4. +as inacti"e metabolites that can be accumulated

. (odified release preparation for brea'through pain

3#. Clinical characteristic of neuropathic pain in cancer patients

A. Aching$ Throbbing. 0naing$ cramping

C. burning$ electric li'e

4. ell localized

. hyperalgesia

3. 4isad"antages of tramadol as cancer G in equitable dosage

A. more respiratory depression

. associated ith seizure

C. a controlled drug

4. more constipation

. more sedation


6/15


7/15

A. e!ternal beam radiation

. surgical

C. brachyteraphy

4. all abo"e correct

. a and c correct

%#. Cancer that has radio responsi"e character

A. (alignum 5ymphoma

. ings sarcoma

C. 7CC

4. 7oft tissue carcinoma

. none correct

%. :erioperati"e radiation mean@

A. Badiation gi"en -=6 after surgically

. 0enerally in brachytheraphy form

C. Applicator is installation done in operating room4. All abo"e correct

. A and C correct

-,. A 1% year old boy came to the eye clinic ith the complain of proptosis of the

right eye that had been undergone for 6 months$ sloly$ accompanied by ptosis

symptoms. ye mo"ement as bloc'ed for all direction. rom the slit lamp e!am

clear hite hyperaemic conFuncti"a$ pupil and dilation$ clear lens$ >4 *,/%, >7

*,/*, no history of trauma and infection

hat is the best diagnose for the case abo"e

A. Betinoblastoma 4. Bhamdomyosarcoma

. Adenocystic carcinoma . (elagnoma (aligna

C. asal cell carcinoma

-1. A6, yo omen is complaining the lump at the superior palpebra ith the size

!!!! cm$ lumpy surface$ easily bleed$ attachH ith the surrounding tissue. The result

of biopsy is 7CC

hat is the best management for the case abo"e

A. ide e!cision ith rozen 7ection 4. Chemo

. Tumor e!tirpation . BadiotherapyC. ye ball surgery

-*. A * yo child ith hite spot on the left pupil that has been appeared since 1 year.

The result of e!am of eye ball anterior segment oblique illumination is normal.

olloing target


8/15

-3. 2n the case abo"e$ the result of enucleation in"aded the optic ner"e.

hat is the appropriate ad"ance management for this patient

A. Badiotheraphy 4. Cryoteraphy

. Chemotherapy . A"astion

C. rachiotheraphy

-%. A 6- yo man$ farmer came to the dermatology clinic ith the complain of pimple

around right chic' that et bigger e"eryday. This had been e!perienced for 3 year.

leed if scratches and there as ulcer un the mid of the lesion. 4ermatology appeared

erythematic papule ith ulcer at the central lesion$ blac' crest$ lesion on the right

chic'.

hat is the diagnosis

A. asal Cell carcinoma nodular type 4. CC (orpheus type

. 7CC . 4ermal ne"us

C. (elanoma maligna

--. Boden ulcer is included in basal cell carcinoma type

A. 7uperficial 4. ulcer

. (orpheus . Nodular

C. :igmented

-6. A boy hospitalized ith the diagnosis of ilmDs tumor. The complaint hile

entering the hospital as enlarge abdomens since # months ago accompanied by

hematuria and reducement of body eight.

hat data that finds to be completed to help confirming the dianogsis

A. +unger 4. eeling full of abdomen

. eeling hot at the abdomen . Abdominal pain

C. eeling thic' at the abdomen

-&. !am that can be perform confirming the diagnosis of the cancer abo"e is

A. C7 4. 2:

. C0 . 0

C. Ioint fluid

-#. (anagement that can be performed to the diagnosis of the case abo"e

A. Chemo J 7urgery J antimicrobial J blood transfusion

. Chemo J Badiotherapy J 7urgeryC. Badiotherapy J Chemo J 2mmunotherapy

4. 7urgery J Badiotherapy J lood transfusions

. 7urgery J Benal Transplantation J Badiotherapy

-. A %,yo man came to the hospital ith the complaint of seizure. The patient as a

hea"y smo'er. The result of (B2 e!am is there is a multinodal mass at the lobes

temporalis sometimes that absorbed the contrast and creat a se"ere oedema to the

brain. This tumor is suspected not a primer tumor so e performs complete blood

e!am and thora! and abdominal CT scan that re"ised normal result.

hat diagnostic e!am that is ad"ised for this caseA. 5umbar punction 4. 0


9/15

. 0astroscopy and colonoscopy . Conser"ati"e K obser"e (B2

C. !cision biopsy

6,. 33 yo man comes ith the complaint of repeated seizure that is usually controlled

by standard seizure therapy. The e!am re"eal -cm temporal mass in (B2. (B2 T1

hipodens and not accompanied by contrast enhance or mass effect. Thehistopathology e!am re"eal an oliga osteositoma +> grade 22. hat is the best

management for this case

A. 7trict >bser"ation

. Badiotherapy

C. Chemo

4. Badiotherphy J adFu"ant chemotherapy


10/15

4. CryGG transfusion

A -6 years old oman ith colon cancer is being consulted to the haematology

oncology department for chemo. The patient has undergone chemo and the result is

colon cancer stadium 222. The result of physical e!am is : 11,/#,$ pulse #,/mins.

2(5 1&8 5ab +T 3,8 C 1*$,,, mm3$ :5T 1-,$,,,/mm3

6&. Chemo abo"e is an action of

A. AdFu"ant C. 7upporti"e management

. Neo adFu"ant 4. :alliati"e management

6#. The obFecti"e of chemo for the case abo"e is as

A. 7upporti"e therapy C. :alliati"e therapy

. Curati"e therapy 4. Neo adFu"ant therapy

6. >ther supporti"e management that can be performed besides for chemo for this

patient abo"e isA. Antibiotic C. +igh calorie higF protein diet

$ Analgesic 4. +igh fat diet

&,. A %# year old oman ith the diagnosis of breast cancer


11/15

&3. A %, year old man comes to the hospital ith the complaint of lump at the

mandible. +istory of GG.. and GGGG.$ position of teeth on top of the tumor is

irregular$ the tumor is felt and no pressure pain.

The possible disorder of the case abo"e

A. Neoplasma 4. Trauma

. Neo Neoplasm . 7ali"ary gland disorder C. inflammation

&%. -- years old man comes to the clinic ith the complain of ulcer at the right side of

the GG.. 7ince % months ago. "er medicated before but ne"er cured. +istory of

smo'ing$ alcohol$ 2n clinical e!am ulcer J$ indurations J

hat e!am that is ad"ises to confirm the abo"e diagnosis

A. !poliati"e cytology 4. iopsy

. :ap smear . (onoclonal antibody

C. Thlanide blue e!amination

&-. A %, year old oman comes to the clinic ith the complaint of lump at the lectchic' in front of left ear$ sloly gro$ painless and mobile.

hat is the possible diagnosis of the case abo"e

A. enign Cyst 4. athinDs tumor

. 5ymphoepithelial . >ncocytoma

C. :lemorphic Adenoma

&6. A 3, year old oman ith the complaint of right breast lump$ suspected because

of hormonal imbalance. The dominant morphologic changes are @ cyst formation and

fibrotic epithelial hyperplasia sclerosing adenosis.

hat is the disorder of the breast abo"e

A. ibrocystic disorder 4. :apiloma intraductal

. ibroadenoma . Adenoma 7clerosis

C. Tumor :hyloideus

&&. A *% year old oman come to the clinic ith complain of left breast lump since *

months ago$ round$ rubber consistency$ mobile$ painless$ diameter * cm. location the

upper lateral quadrant

hat is the disorder of the breast abo"e

A. ibrocystic disorder 4. :apiloma intraductal

. ibroadenoma . Adenoma 7clerosis

C. Tumor :hyloideus

. A %& years old oman come to the oncology clinic ith the complain of breast

lump since 6 months ago. +istory of left breast surgery 1 year ago ith

histopathology ibroadenoma. (arried but no children. 2n clinical e!am there is a

s'in color changing of the breast$ dimpling ith solid breast diameter 3.-cm attached

to the s'in. There is a regional gland enlargement.

hat is the supporti"e e!amination to confirm the diagnosis of this case

A. Try cut needle aspiration 4. 2ncision iopsy

. ine needle aspiration . !cision biopsy

C. rozen section


12/15

&. A -, year old oman comes to the hospital ith the complaint of lump and ulcer

at the left breast. )lcer is e!perienced since 3 months ago$ lump history since 1 year

ago. irst menstruation at 1* years old$ married$ one child


13/15

#%. A *6 years old oman$ parity of 1$ comes to the clinic ith the complain of

"aginal bleeding since 1 months ago. The patient has been curettage before because of

mola hidatinosa. hat is the e!am that is needed for this disease

A. =+C0 tumor mar'er e!am 4. CT

. Thora! !=ray . (B2 e!am

C. )70

#- A *6 years old oman$ parity of 1$ comes to the clinic ith the complain of

"aginal bleeding since 1 months ago. The patient has been curettage before because of

mola hidatinosa. hat is the management for this case if the diagnosis is (alignant

Trophoblast disease

A. >bser"ation 4. Chemo

. Curretage . Badiation

C. +ysterectomy

#6. A *- years old oman$ no parity$ comes to the clinic ith the complaint of lump at

the loer abdomen since 6 months ago. (arried 3 years ago. Bepeatedly come to thedoctor to ha"e children$ ody eight drastically decrease ithin last * months

hat is the most possible diagnosis of this case

A. Cer"ical Carcinoma C. (alignant trpophoblast

. >"arian Carcinoma 4. Tube carcinoma

. ndometrium Carcinoma

#&. A -# years old oman comes to the clinic ith post menopause bleeding.

ndometrium biopsy shos adenocarcinoma. Total hysterectomy and bilateral pel"ic

lymphadenectomy is performed. The pathology e!am result after operation re"eal

tumor has further to cer"i!. 5ymph shos no malignancy cell/

hat is the stadium of endometrial carcinoma of the case

A. 7tadium , C. 7tadium 222

. 7tadium 2 4. 7tadium 2

C. 7tadium 22

##. A 6- years old oman comes to the clinic ith the complaining of abdominal

distended for 3 month. 2n abdominal percussion there is GGG of lymph ith the

tympani sound. 2n pel"ic e!am there isGG at the G.. ith diameter of # cm nodular

and limited on the pel"ic. G.. not palpated. lood chemistry$ urinalysis$ pap smear$

and chest !=ray is normal/

hich mar'er than has to be e!amined to diagnose this case diagnosisA. CA1*- 4. =+C0

. 7CC Ag . CA

C. A:

#. To find out a ris' factor for a oman ith diagnosis of lung cancer$ e ha"e to

point out in anamnesis about

A. +o long time suffers 4. Carcinogenic food consump

. :assi"e smo'er or not


14/15

history of smo'er and has been long time or' in cement factory. Thora! photo

shoed a mass in the right lung ith diameter about - cm. :hysical e!am are normal

hich of the folloing statement is the cause of coughing

A. 7mo'e 4. 7econdary infection

. Bespiratory obstruction . :rolong cough

C. 2rritation of bronchial "ascularisations

1. A man$ 63 years old came to surgery policlinic ith abdomen pain$ history of

frequent obstipation$ frequent feeling of fullness and if flatus$ he fell getting betting.

4efecation sometimes ith fresh bloody pain$ and ne"er satisfied

The e!amination that you should do as the first appropriating diagnosis is

A. Total Colonoscopy 4. Bectal touchH

. :lain E=ray abdomen . (esentrical angiography

C. 4ouble contrast barium enema

3. The most possible diagnosus of this case abo"e is

A. 1/3 :ro!imal Bectum Carcinoma 4. Bectal. 1/3 (id Bectum Carcinoma . 4escendens Colon Carcinoma

C. 1/3 4istal Bectum Carcinoma

1* years old boy came to hospital ith chief complain diaphysis right tibia pain since

ee' ago. The result pathology e!am is round cell tumor ith malignant

charachteristics

%. The possible diagnosis

A. >steomyelitis 4. ingDs sarcoma

. >steosarcoma . >steochondroma

C. Chondrosarcoma

-. E=ray from the diagnosis abo"e@

A. Codman triangle

. 7un rays appearance

C. >nion 7'in appearance

4. Codman triangle and sun rays appearance

. Cliacha

A 6, years old oman come to doctor because pain in all the ody and feel fatigue.

:unch out lesion as found from radiologic e!am

6. 4iagnosis possible@

A. (ultiple mioloma 4. >steoporosis

. Tumor (etastases . >steochondroma

C. >steosarcoma

&. The 'ind of e!am that e need to support the diagnosis abo"e is

A. CT scan 4. ence=Iones protein

. (B2 . Al'ai :hosphate

C.

#. The type of disease abo"e included in group of


15/15

A. +ematogen 4. Bound cell tumor

. >steoporosis . Nutrition disorder

C. (etastases

. According to ;obler Boss states that - step physicologic reaction hen patient

getting cancer in stage 22A. 4enial 4.7hoc'

. 4epression . Acceptance

C. Angry

1,,. Cancer 7tage 2 is

A. 4enial 4. 7hoc'

. 4epression . Acceptance

C. Angry

soalan onco 2009

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