(1)
University of Miami Sylvester Cancer Center, Miami, Florida, USA
11.7 Children (Questions)
11.9 The Skin (Questions)
11.11 Extras (Questions)
11.12 The Brain (Answers)
11.14 The Thorax (Answers)
11.15 The Abdomen (Answers)
11.16 The Pelvis (Answers)
11.18 Children (Answers)
11.20 The Skin (Answers)
11.22 Extras (Answers)
11.1 The Brain (Questions)
The Brain, Brainstem, and Cerebellum
1.
Some of the clinical presentations of a brain neoplasm are:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Edema
II.
Focal neurological dysfunction
III.
Intracranial pressure
IV.
Hydrocephalus
2.
Tumors of the cranial and spinal nerves include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Schwannoma
II.
Malignant lymphomas
III.
Neurofibroma
IV.
Pituitary adenoma
3.
Which of the following will decrease cerebral edema preoperatively, postoperatively, and during irradiation? Administration of:
A.
Glucocorticoid (dexamethasone)
B.
Phenytoin (Dilantin)
C.
Carbamazepine (Tegretol)
D.
Phenobarbital
4.
Which of the following modalities are used to deliver radiation to CNS patients?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
External beam radiation therapy
II.
Radiosurgery (stereotactic irradiation)
III.
Interstitial brachytherapy
IV.
LDR brachytherapy
5.
Criteria for CNS brachytherapy include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Tumor confined to one hemisphere
II.
No transcallosal or subependymal spread
III.
Tumor size less than 5–6 cm
IV.
Tumor well circumscribed on CT or MRI
6.
Which of the following anatomic landmarks can be used for cranial radiation therapy techniques?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The external acoustic meatus
II.
The sella turcica
III.
The cribriform plate
IV.
The mandibular angle
7.
The sella turcica is used as a landmark for:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The inferior border of whole-brain irradiation fields
II.
The hypothalamus
III.
The pineal body
IV.
The optic canal
8.
The most common error in head and neck treatment setup is:
A.
Head rotation and/or tilting
B.
Head rotation and/or in/out position
C.
Tilting and/or anterior/posterior position
D.
Anterior/posterior and/or in/out position
9.
Irradiation techniques of the entire intracranial contents include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Parallel-opposed lateral portals
II.
Inferior border 0.5–1 cm inferior to the cribriform plate, middle cranial fossa, and foramen magnum
III.
Anterior border 3 cm posterior to the ipsilateral eyelid
IV.
Superior and posterior flash
10.
Which of the following tumor locations in the brain is best treated with parallel-opposed lateral portals?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Bilateral or medial cerebral hemispheric tumors
II.
Brainstem, posterior parietal, occipital, or frontal lesions/tumors
III.
Midcerebral tumors
IV.
Craniopharyngiomas and pituitary, optic nerve, hypothalamic, and brainstem tumors
11.
When irradiating brain tumor on a pregnant patient:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The fetal exposure should be less than 0.10 Gy.
II.
Brain irradiation should be avoid due to the high risk of fetal death.
III.
Leukemia risk in the child must be considered.
IV.
The fetal exposure can exceed 20 Gy when high doses are used.
12.
Which of the following statements is true about CNS irradiation?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The patient may be irradiated with a helmet field and one or two spine fields followed by a brain boost.
II.
Patients can be treated supine or prone.
III.
Collimator and couch angles are critical for setup reproducibility.
IV.
Couch angle must be used on helmet brain and collimator angles on spine fields.
13.
Which of the following statements is true about CNS irradiation?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The junctions are moved every 20 Gy of tumor dose.
II.
The junctions are moved every 10 Gy of tumor dose.
III.
The gap used should be located between the helmet brain and superior spine field.
IV.
Three or four junctions are typically used on CNS cases.
14.
The most serious late reaction to irradiation of CNS is:
A.
Nausea and vomiting
B.
Alopecia
C.
Mucositis and esophagitis
D.
Necrosis
15.
Most brainstem gliomas are:
A.
High-grade astrocytomas
B.
Ependymoma
C.
Medulloblastoma
D.
Meningiomas
16.
The most common primary brain tumor is:
A.
Astrocytomas
B.
Gliomas
C.
Medulloblastoma
D.
Meningiomas
17.
Which of the following are considered benign brain tumors?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Astrocytomas
II.
Acoustic neuroma
III.
Glioblastomas
IV.
Meningiomas
18.
An acoustic neuroma is also called:
A.
Astrocytomas
B.
Gliomas
C.
Schwannoma
D.
Meningiomas
The Pituitary
1.
The pituitary gland:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Is connected to the hypothalamus
II.
Is located in the sella turcica
III.
Secretes nine hormones that regulate homeostasis
IV.
Produces a hormone that modulates the wake/sleep pattern
2.
A patient treated for a pituitary tumor requires periodic assessment of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Gonadal function
II.
Thyroid function
III.
Adrenal function
IV.
Lacrimal gland function
3.
Which of the following is true about pituitary radiation therapy techniques?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Lateral portals of 5 × 5 to 6 × 6 cm or shaped fields are used.
II.
If photon energies below 10 MV are used, a vertex field is recommended to decrease the irradiation dose to the temporal lobes.
III.
Special care must be taken to avoid exposure to the eyes.
IV.
Bilateral coaxial wedge fields plus a coronal field, moving arc fields, and 360° rotational fields can be used.
4.
In order to obtain a more homogeneous dose distribution and in decreasing the dose delivered to the optic chiasm:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Two parallel-opposed fields must be used with 40° wedges with heel placed posteriorly.
II.
Two parallel-opposed fields and a vertex field must be used.
III.
Two parallel-opposed fields must be used with 60° wedges with heel placed posteriorly.
IV.
Two parallel-opposed fields must be used with 15° wedges with heel placed anteriorly.
5.
Which of the following structures must be considered as critical when irradiating a pituitary tumor?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The optic chiasm
II.
The temporal lobes
III.
The brain stem
IV.
The hypothalamus
6.
The pituitary gland:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Is a middle structure situated in the body of the sphenoid bone
II.
Is located superior to the sphenoid sinus and nasopharynx
III.
Is composed of two lobes
IV.
Is an endocrine gland
7.
Which of the following hormones is produced by the pituitary gland?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Growth hormone
II.
Thyroid-stimulating hormone
III.
Prolactin
IV.
Insulin
11.2 The Head and Neck Region (Questions)
The Hypopharynx
1.
The hypopharynx is divided into:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The pyriform sinuses
II.
The posterolateral pharyngeal wall
III.
The postcricoid region
IV.
Supraglottic
2.
Which of the following parts of the hypopharynx has the highest incidence of tumor occurrence in the United States?
A.
The pyriform fossa
B.
The posterolateral pharyngeal wall
C.
The postcricoid region
D.
The pyriform sinuses
3.
Most hypopharynx tumors are:
A.
Carcinoma in situ
B.
Squamous cell carcinoma
C.
Malignant melanoma
D.
Sarcoma
4.
Preoperative irradiation of the hypopharynx is on the order of:
A.
65 to 70 Gy in 7–8 weeks
B.
60 to 66 Gy
C.
45 to 50 Gy in 4.5–5 weeks
D.
70 to 80 Gy in 10 weeks
5.
If irradiation is given alone, the irradiated volume of the hypopharynx should encompass:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The nasopharynx
II.
The oropharynx
III.
The hypopharynx
IV.
The upper cervical esophagus
6.
Hypopharynx radiation treatment consists of:
A.
Two parallel-opposed upper-neck lateral beams and one anterior photon field encompassing the lower neck plus a boost to the gross tumor
B.
Two parallel-opposed upper-neck lateral beams and one anterior electron field encompassing the lower neck
C.
Four oblique-field techniques (RAO, LAO, RPO, LPO) treating the upper and lower neck
D.
PA/PA beams encompassing the upper and lower neck
7.
The hypopharynx extends from:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The level of the hyoid bone to the lower border of the cricoid cartilage.
II.
The level of the thyroid to the lower esophagus
III.
From cervical vertebra 4 to cervical vertebra 6
IV.
From cervical vertebra 1 to cervical vertebra 2
The Larynx
1.
The larynx is divided into:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Supraglottic area
II.
Glottis
III.
Subglottic area
IV.
The pyriform sinuses
2.
Which of the following is true about the subglottic area?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The subglottic area begins 5 mm below the vocal cord.
II.
The subglottic area begins 5 cm below the vocal cord.
III.
The subglottic area ends at the inferior border of the cricoid cartilage and the beginning of the trachea.
IV.
The subglottic area ends at the inferior border of the true vocal cord.
3.
The most common head and neck cancer occurs in the:
A.
Hypopharynx
B.
Larynx
C.
Nasopharynx
D.
Parotids
4.
Cancer of the larynx is strongly related to:
A.
Poor exercise
B.
Alcohol
C.
Cigarette smoking
D.
Poor healthy food intake
5.
Most of subglottic laryngeal lesions are:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Ipsilateral
II.
Bilateral
III.
Diagnosed early
IV.
Diagnosed late
6.
Some procedures to eradicate carcinoma of the larynx include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Irradiation
II.
Hemilaryngectomy
III.
Cordectomy
IV.
Total laryngectomy
7.
Radiation therapy techniques for T1 laryngeal lesions generally include:
A.
Field sizes from 10 cm × 10 cm to 15 cm × 15 cm.
B.
Lateral field sizes extend from the thyroid notch superiorly to the inferior border of the cricoid cartilage and fall off anteriorly.
C.
Lateral field sizes including the jugulodigastric and middle jugular lymph nodes.
D.
Four oblique-field techniques (RAO, LAO, RPO, LPO) from 4 cm × 4 cm to 6 cm × 6 cm each.
8.
Most laryngeal tumors are:
A.
Carcinoma in situ
B.
Squamous cell carcinoma
C.
Malignant melanoma
D.
Sarcoma
9.
Which of the following nodes are mainly involved in carcinoma of the larynx?
A.
The jugulodigastric nodes
B.
The middle jugular nodes
C.
The subdigastric nodes
D.
The inferior jugular nodes
The Nasal Cavity and Paranasal Sinuses
1.
A stage III nasal cavity or paranasal sinus has:
A.
No extension out of the site of origin
B.
Extension to orbit, nasopharynx, and paranasal sinuses
C.
Extension to skin and pterygomaxillary fossa
D.
Extension to the base of the skull or pterygoid plate and destruction and intracranial extension
2.
The most common malignancy of the nasal cavity and paranasal sinuses is:
A.
Carcinoma in situ
B.
Squamous cell carcinoma
C.
Malignant melanoma
D.
Lymphoma
3.
The preferred treatment for the nasal vestibule is:
A.
Surgery
B.
Chemotherapy
C.
Radiation therapy
D.
Chemoradiation
4.
Nasal cavity and paranasal sinuses radiation therapy techniques include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
An anterior portal only
II.
An anterior portal with one or two posterior tilted lateral portals, frequently using wedges
III.
An anterior portal electron field and two opposed lateral fields, frequently using wedges
IV.
A wedge-pair technique if the disease is ipsilateral only
5.
When treating the nasal cavity and paranasal sinuses, complications of irradiation include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Central nervous system damage
II.
Unilateral or bilateral vision loss
III.
Otitis media
IV.
Chronic sinusitis
6.
Which of the following statements is true about tumors in the nasal cavity and paranasal sinuses?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
They are twice as common in males than in females.
II.
They show a bimodal age distribution of 10–20 and 50–60 years of age.
III.
They are considered rare tumors.
IV.
Most tumors present at advance stage.
7.
Which of the following nodes are mainly involved in nasal cavity and paranasal sinuses tumors?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Jugulodigastric nodes
II.
Submandibular nodes
III.
Inferior jugular nodes
IV.
Subdigastric nodes
8.
Which of the following areas of the nasal cavity and paranasal sinuses uses primary surgery followed by radiation therapy as the treatment of choice?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The nasal vestibule
II.
The nasal cavity
III.
The sphenoid sinus
IV.
The maxillary sinus
The Nasopharynx
1.
The most common site of distant metastasis from nasopharyngeal cancer is:
A.
The bone
B.
The lung
C.
The liver
D.
The brain
2.
The most common malignancy of the nasopharynx is:
A.
Rhabdomyosarcoma
B.
Lymphoma
C.
Malignant melanoma
D.
Epidermoid or undifferentiated carcinomas
3.
The preferred treatment for the nasopharynx is:
A.
Surgery
B.
Chemotherapy
C.
Radiation therapy
D.
Chemoradiation
4.
Which of the following statements is true about radiation therapy techniques for nasopharynx treatments?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The volume irradiated includes the nasopharynx, adjacent parapharyngeal tissues, and all of the cervical lymphatics.
II.
The upper neck is treated using opposing lateral fields.
III.
After 45 Gy, the lateral fields are modified to shield the spinal cord.
IV.
Lower neck involvement is treated with anterior-posterior parallel-opposed fields.
5.
Which of the following treatment modalities has been used for nasopharyngeal carcinoma?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Three-dimensional radiation therapy
II.
Stereotactic irradiation
III.
Brachytherapy
IV.
Chemotherapy
6.
Reirradiation techniques for the nasopharynx include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
External irradiation
II.
Brachytherapy
III.
Combination of external irradiation and brachytherapy
IV.
Chemotherapy
7.
Which of the following is true about nasopharyngeal carcinoma?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Children or young adults should be treated with irradiation alone.
II.
For retreatment with external beams, relatively small fields must be used.
III.
Irradiation dose depends on patient age and tumor stage.
IV.
Hypopituitarism causing significant clinical signs and symptoms is commonly reported in children.
8.
The nasopharynx is located:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
At the level of the hyoid bone to the lower border of the cricoid cartilage
II.
Anteriorly to the posterior choanae and posterior to cervical vertebrae 1 and 2 and the clivus
III.
From cervical vertebrae 4–6
IV.
Superior to the body of the sphenoid and inferior to the soft palate
9.
Which of the following are common lymph nodes involved in carcinomas of the nasopharynx?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Deep posterior cervical lymph nodes
II.
Submandibular nodes
III.
Jugulodigastric lymph nodes
IV.
Inferior jugular nodes
The Oral Cavity
1.
The oral cavity consists of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The upper and lower lips
II.
The upper and lower gingiva
III.
The hard palate
IV.
The floor of mouth
2.
The upper gingiva is composed of:
A.
The orbicularis muscle
B.
The alveolar ridge of the maxilla
C.
Mucous membrane
D.
Styloglossus, hyoglossus, and hyoid muscles
3.
The treatment of choice for patients with clinically or radiographically ipsilateral positive neck nodes is:
A.
Bilateral neck dissection followed by ipsilateral postoperative neck irradiation.
B.
Ipsilateral neck dissection followed by bilateral postoperative neck irradiation.
C.
Node removal and no further treatment is required other than observation.
D.
Contralateral prophylactic neck dissection is required.
4.
If radiation therapy is considered:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Optimal oral hygiene and pretreatment dental care must be completed.
II.
Any potential surgical procedures and tooth extractions should be carried out before initiation of radiotherapy.
III.
Approximately 8–10 days is needed for complete recovery before initiation of radiation therapy.
IV.
After a course of irradiation, caution in tooth extraction or surgical procedure involving the gums is a lifelong commitment.
5.
Which of the following statements is true about external irradiation of the oral cavity?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The most commonly used technique for carcinoma of the mobile tongue is opposed laterals.
II.
A bite block is used to keep the tongue depressed away from the palate.
III.
The radiation dose depends on the number of clonogenic cells.
IV.
Every attempt should be made to avoid an excessive dose of radiation to the mandible.
6.
The most common interstitial irradiation technique is:
A.
Percutaneous afterloading with angiocatheters and iridium-192
B.
Y-90
C.
Manchester system
D.
Surface mold
7.
The best treatment for smaller, more anteriorly situated primary lesions of the oral tongue is:
A.
External radiation alone
B.
Interstitial implant or intraoral cone radiation therapy as a boost
C.
Interstitial implant only
D.
Combined surgery and irradiation
8.
Which of the following is considered a risk factor for carcinoma of the oral cavity?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Alcohol
II.
Smoking or chewing tobacco
III.
Human immunodeficiency virus (AIDS)
IV.
Vitamin deficiency
9.
The most common malignancy of the oral cavity is:
A.
Squamous cell carcinoma
B.
Lymphoma
C.
Malignant melanoma
D.
Epidermoid or undifferentiated carcinomas
10.
The level 2 lymphatic region in the head and neck includes:
A.
The submental and submandibular triangle
B.
The upper jugulodigastric
C.
Deep jugular nodes of the middle and lower third of the neck
D.
Spinal accessory and transverse cervical chains (posterior triangle)
11.
Which of the following nodes are commonly included in radiation therapy portals of the oral cavity?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The submandibular nodes
II.
The subdigastric nodes
III.
The submental nodes
IV.
The jugulodigastric nodes
The Oropharynx
1.
The oropharynx is located:
A.
From the level of the hyoid bone to the lower border of the cricoid cartilage, from cervical vertebrae 4 to 6
B.
5 mm below the vocal cord and ends at the inferior border of the cricoid cartilage and the beginning of the trachea
C.
Between the soft palate and the hyoid bone
D.
Anteriorly to the posterior choanae and posterior to cervical vertebrae 1 and 2 and the clivus. Also, superior to the body of the sphenoid and inferior to the soft palate
2.
The oropharynx is composed of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The soft palate
II.
The tonsillar region
III.
The base of the tongue
IV.
The pharyngeal wall
3.
Most oropharynx tumors are:
A.
Melanomas
B.
Sarcomas
C.
Lymphomas
D.
Keratinizing squamous cell carcinoma
4.
The most common acute irradiation sequela when treating the oropharynx is:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Oropharyngeal mucositis
II.
Fibrosis
III.
Moderate-to-severe dysphagia
IV.
Hearing loss
5.
Which of the following modalities can be used to treat the base of the tongue?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
External radiation alone (IMRT, conventional)
II.
Combined surgery and irradiation
III.
Brachytherapy
IV.
Chemotherapy
The Ear
1.
The ear is composed of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The external ear
II.
The middle ear
III.
The internal ear
IV.
The superficial ear
2.
Which of the following anatomical parts belongs to the external ear?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The bony labyrinth
II.
The tympanic membrane
III.
The auditory ossicles
IV.
The external auditory meatus (EAM)
3.
The external ear involves:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The superficial parotid nodes
II.
The retroauricular nodes
III.
The superficial cervical group nodes
IV.
No lymph node involvement
4.
Basal cell carcinoma is the most common tumor type in what part of the ear?
A.
The auditory canal
B.
The middle ear
C.
The mastoid area
D.
The external ear
5.
Tumors involving the pinna are best treated with:
A.
Orthovoltage or electron fields
B.
Chemotherapy only
C.
Surgery
D.
High-energy photons (23×)
6.
The acoustic nerve is responsible for:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Auditory function
II.
Temporal muscle function
III.
Vestibular function
IV.
Mastoid process function
7.
Which of the following part of the ear does not contain lymphatics?
A.
The external ear
B.
The middle ear
C.
The internal ear
D.
The superficial ear
The Eye
1.
The retina of the eye is located in:
A.
The outer coat
B.
The middle coat
C.
The inner layer
D.
The lens
2.
The lens is:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Located posterior to the iris
II.
Located anterior to the iris
III.
Suspended from the ciliary body
IV.
Suspended from the ocular muscles
3.
Which of the following is the treatment of choice for basal and squamous cell carcinomas of the eyelid?
A.
Surgery
B.
Chemotherapy
C.
Radiation therapy
D.
Brachytherapy
4.
The most common metastatic sites for tumors of the posterior uvea are:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
In men, the prostate or lung
II.
In men, the lung or GI track
III.
In women, the bladder or breast
IV.
In women, the breast or lung
5.
An enucleation or exenteration is done for a malignant melanoma of the posterior uvea if:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The tumor exceeds 15 mm in diameter.
II.
The tumor exceeds 10 mm in thickness.
III.
There is extra-sclera extension at diagnosis.
IV.
There are small growing melanomas.
6.
Which of the following is the most common intraocular malignancy in children:
A.
Malignant melanoma
B.
Retinoblastoma
C.
Rhabdomyosarcoma
D.
Optic glioma
7.
Which is the most common grouping system used for retinoblastoma?
A.
Reese-Ellsworth classification system
B.
TNM staging classification system
C.
American Joint Committee staging system
D.
Stage A, B, and C
8.
Which of the following sources has been used on radioactive plaque retinoblastoma therapy?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Cobalt-60
II.
Iodine-125
III.
Iridium-192
IV.
Ruthenium-109
9.
Which of the following sources is the most common today for radioactive plaque retinoblastoma therapy?
A.
Cobalt-60
B.
Iodine-125
C.
Iridium-192
D.
Ruthenium-109
10.
Which of the following statements is true about retinoblastoma tumors?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
It is bilateral in one-third of patients.
II.
It is unilateral in two-thirds of patients.
III.
Most patients with hereditary form have bilateral disease.
IV.
The common signs and symptoms are leukocoria (white papillary reflex) and strabismus (squint).
Salivary Glands
1.
The salivary glands consist of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The parotid gland
II.
The submandibular gland
III.
The sublingual gland
IV.
The submaxillary gland
2.
Which of the following is the largest salivary gland?
A.
The parotid gland
B.
The submandibular gland
C.
The sublingual gland
D.
The submaxillary gland
3.
The most common malignant subtype of parotid tumors in children is:
A.
Mucoepidermoid tumor
B.
Adenoid cystic carcinoma
C.
Pleomorphic adenoma
D.
Astrocytomas
The Thyroid
1.
Differentiated thyroid cancer consists of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Papillary carcinoma
II.
Mixed papillary-follicular carcinoma
III.
Follicular adenocarcinoma
IV.
Anaplastic cancer
2.
Which of the following radioactive isotope is used in the treatment of thyroid cancer?
A.
Iridium-192
B.
Iodine-131
C.
Iodine-125
D.
Palladium-103
3.
Which of the following statements about thyroid cancer is true:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Thyroid cancer is uncommon.
II.
Thyroid cancer is more common in females than males.
III.
There is higher risk after irradiation.
IV.
Incidence is lowest in children.
4.
The thyroid gland is composed of:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The right lobe
II.
The pyramidal lobe
III.
The left lobe
IV.
The isthmus
5.
Which of the following modalities best demonstrates thyroid function?
A.
Nuclear medicine
B.
CT
C.
MRI
D.
Ultrasound
Unusual Nonepithelial Tumors of the Head and Neck
1.
Which of the following tumors are considered unusual nonepithelial tumors of the head and neck?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Hemangiopericytomas
II.
Chordomas
III.
Esthesioneuroblastomas
IV.
Extramedullary plasmacytomas
11.3 The Thorax (Questions)
The Breast
1.
Which of the following is considered early-stage breast cancer?
A.
Tis, T1, and inflammatory only
B.
Tis to T3 only
C.
Tis, T1, T2 only
D.
T4 and recurrent only
2.
In the United States, the most common malignancy and the second most common cause of mortality in females is:
A.
Colorectal cancer
B.
Breast cancer
C.
Lung cancer
D.
Skin cancer
3.
Risk factors associated with breast cancer include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Sex
II.
Genetic factors
III.
Diet
IV.
Endocrine factors
4.
The mammary gland lies:
A.
Over the pectoralis major muscle from the second to the sixth rib and from the sternum to the anterior or midaxillary line
B.
Over the pectoralis minor muscle from the first to the twelfth rib and from the sternum to the anterior or midaxillary line
C.
Under the pectoralis major muscle from the second to the sixth rib and from the sternum to the midaxillary line
D.
Over the pectoralis minor muscle from the second to the sixth rib and from the sternum to the anterior or midaxillary line
5.
Which of the following statements is true about breast cancer?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The lymphatic of the breast drains mainly superiorly and laterally.
II.
The supraclavicular and internal mammary nodes are occasionally involved.
III.
Metastases to the internal mammary nodes are more frequent form inner quadrant and central lesions.
IV.
Vascular invasion and hematogenous metastases to the lungs, pleura, bone, and brain occur even with small tumors.
6.
Most of the carcinomas of the breast occur in the:
A.
Upper inner quadrant
B.
Lower inner quadrant
C.
Lower outer quadrant
D.
Upper outer quadrant
7.
Breast cancer spreads via:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Lymphatic vessels
II.
Blood vessels
III.
Direct invasion
IV.
Mammary ducts
8.
The best modality in detection of breast cancer is:
A.
PET-CT
B.
MRI
C.
Mammography
D.
CT scan
9.
The most common type of breast cancer is:
A.
Ductal carcinoma in situ (DCIS)
B.
Invasive (infiltrating) ductal carcinoma
C.
Lobular carcinoma in situ (LCIS)
D.
Tubular carcinoma
10.
Strong prognostic factors of breast cancer include:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Tumor size
II.
Tumor location
III.
Clinical stage
IV.
PSA
11.
Which of the following are genes associated with hereditary breast cancer?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
BRCA3
II.
BRCA1
III.
BRCA4
IV.
BRCA2
12.
Axillary and supraclavicular nodal irradiation must be performed:
A.
In patients with more than five positive axillary lymph nodes
B.
In patients whom axillary dissection could not be performed
C.
In patients with more than two or more positive axillary lymph nodes
D.
All Tis patients
13.
Adjuvant chemotherapy for breast cancer must be given to:
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Node-negative patients with tumors less than 2 cm in diameter
II.
Postmenopausal patients with positive nodes
III.
Premenopausal patients with positive nodes
IV.
All patients with positive nodes
14.
General breast irradiation field borders include:
A.
Superior, head of clavicles; inferior, 2–3 cm below the inframammary fold; medially, 1 cm over midline; lateral, 2 cm beyond palpable breast tissue
B.
Superior, acromioclavicular joint; inferior, 1 cm below the inframammary fold; medially, 1 cm over midline; lateral, 2 cm beyond palpable breast tissue
C.
Superior, head of clavicles; inferior, 1 cm below inframammary fold; medially, midline; lateral, 2 cm beyond palpable breast tissue
D.
Superior, acromioclavicular joint; inferior, 2–3 cm below the inframammary fold, medially, 1 cm over midline; lateral, 1 cm beyond palpable breast tissue
15.
Which of the following positions is recommended when treating a large pendulous breast?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Prone
II.
Lateral decubitus
III.
Modified lateral decubitus
IV.
Supine
16.
Which of the following is used for a breast planning to obtain a uniform dose distribution?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Wedges
II.
Compensating filters
III.
Multileaf collimators
IV.
Blocks
17.
Which of the following irradiation techniques can be used for breast cancer?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
Medial and lateral tangential fields
II.
En face electron boost
III.
Interstitial brachytherapy
IV.
IMRT
18.
Physical wedges must be avoided on medial tangent breast beams because:
A.
The sternum is adjacent to the medial border.
B.
The wedge can be dropped and injure the patient.
C.
The contralateral breast will receive more doses due to scatter.
D.
It is too heavy and difficult to position.
19.
Most common intact breast, supraclavicular, and electron boost doses are:
A.
Breast, 45 Gy; SCV, 50 Gy; electron boost, 10 Gy
B.
Breast, 50 Gy; SCV, 45 Gy; electron boost, 10 Gy
C.
Breast, 80 Gy; SCV, 50 Gy; electron boost, 10 Gy
D.
Breast, 50 Gy; SCV, 45 Gy; electron boost, 45 Gy
20.
Supraclavicular fields are angled 15–20° to:
A.
Spare part of the spinal cord
B.
Spare part of the lung
C.
Properly match the breast tangents
D.
Get more homogenous dose to the supraclavicular nodes
21.
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Which of the following anatomical parts is commonly blocked during a supraclavicular field irradiation?
A.
I, II, and III only
B.
I and III only
C.
II and IV only
D.
IV only
E.
All are correct
I.
The clavicle
II.
The cord
III.
The mandible
IV.
The humeral head
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