Stats
Physics
DCIS
Esophagus
HPV
100
Which measure of central tendency equals the sum of observations divided by the number of observations? A) Percentile B) Mean C) Median D) Mode
B) Mean
100
I-125 and I-131 are examples of A) Isobars B) Isomers C) Isotones D) Isotopes
D Isotopes have same number of protons but different number of neutrons.
100
Oncotype DX DCIS score A) predicts risk of DCIS only B) predicts risk of invasive recurrence C) is validated from NSABP B-17 and B-24 D) includes ER and Her-2 in the gene analysis
B Validated with ECOG 5194 Predicts for both invasive and non-invasive disease PR is included in 12 gene analysis (not ER or Her-2)
100
TNM Stage for a 3cm distal esophagus adenocarcinoma that invades the muscularis mucosa and is found to have 2 involved regional lymph nodes with no evidence of distant metastatic disease?
T2N1, stage IIB
100
Which two types of HPV are linked to cervical cancer?
HPV 16 and 18
200
Which study design starts with an exposure and moves forward to the outcome of interest, even if the data are collected retrospectively? A) Cohort B) Phase III C) Phase IV D) Case-control
A) Cohort Case Control starts with outcome of interest and works backward to determine exposure;
200
An electron passes through a potential difference of 120 V, causing the electron to acquire a kinetic energy equal to A) 120 J B) 120 eV C) 120 MV D) 120 kVp
B
200
Results of ECOG 5194 (Local excision alone without irradiation for DCIS of the Breast) indicated a higher risk of ipsilateral breast events associated with which findings? A) lesion size and margin width B) nuclear grade and lesion size C) nuclear grade and patient age D) clinical mass vs. mammographic detection
C Grade significantly related to risk of IBE. Age also a significant variable (in this study, lesion size, margin width, age at last surgery, tamoxifen use were not analyzed)
200
In the CROSS study, what was the neoadjuvant chemoradiation treatment regimen? A) 41.4 Gy with 5-fu/cisplatin B) 50.4 Gy with 5-fu/cisplatin C) 41.4 Gy with carbo/taxol D) 50.4 Gy with carbo/taxol
C
200
According to RTOG 0129, which patient related characteristics of oropharyngeal cancer correlates with lowest overall survival? A) HPV negative, 10 or less years of smoking, T2N1M0 B) HPV negative, 10 or less years of smoking, T4N0M0 C) HPV positive, 10 or less years of smoking, T2N2bM0 D) HPV positive, 10 or more years of smoking, T2N2aM0
B Low: HPV+ <10 years smoking HPV+ 10+ years smoking N2b HPV- <10 years smoking T2-3 High HPV- <10 years smoking T4 HPV- 10+ years smoking;
300
What type of trial is used to investigate the efficacy of a new drug? A) Phase I B) Phase II C) Phase III D) Phase IV
B) Phase II I: safety II: efficacy III Side effects/compare to standard IV after marketing of drug; side effects, effect on population
300
For a TBI treatment, a 75cm x 50cm field is required. The maximum field size setting on the accelerator is 40cm x 40cm. What is the minimum SSD needed? A) 155cm B) 164 cm C) 188 cm D) 210 cm
C. (40 x 40 is defined at 100cm SSD) (75cm/40cm) x 100cm = 187.5cm
300
What is the 15 year risk for death from breast cancer for a woman with DCIS treated with breast conserving surgery and radiation therapy? A) 2-5% B) 8-10% C) 12-15% D) 18-20%
A NSABP B-17: BCS + XRT: 4.7% 15 year Breast Cancer Death (vs. 3.1% BCS alone) NSABP B-24: BCS + XRT + placebo: 2.7% (vs 2.3% +tamox)
300
What was the observed rate of pathologic complete response after chemoradiation for esophageal cancer? A) 10-15% B) 25-30% C) 40-45% D) 55-60%
B Overall pCR was 29% in CROSS trial
300
Based on RTOG 0129, what is expected 3 year OS for the following patient? HPV negative, <10 year smoking history A) 96% B) 93% C) 90% D) 87% E) 84%
B) 93%
400
If the sample mean of a data set is 200 and the sample standard deviation is 20, between what range of values would you expect 95% of the data values to fall between? (assuming a normal distribution) A) 180 - 220 B) 170 - 230 C) 160 - 240 D) 150 - 250 E) 140 - 260
C) 160 - 240 (2 standard deviations)
400
The dose in the build up region in an electron beam will increase due to: A) an increase in SSD B) a decrease in beam energy C) a significant increase in field size D) a significant reduction in field size
C Decreasing beam energy results in lower dose in build up region. Increasing the SSD results in a lower dose.
400
Regarding NSABP B-24, all of the following are true, except: A) Approximately one-quarter of patients had positive margins B) ER status was unknown C) Tamoxifen was given at 20mg daily x 5 years D) Overall mortality decreased with the addition of tamoxifen
D 1804 patients randomized after lumpectomy and radiation (50 Gy) for DCIS to placebo or tamoxifen. 25% had positive margins. ER status was unknown. 32% reduction in risk of invasive IBTR with addition of tamoxifen Contralateral events reduced by 32% Tamoxifen did not change overall mortality.
400
For squamous cell carcinoma of the esophagus, what is the expected benefit of surgical resection after achieving clinical response to concurrent chemoradiation? A) Decreased LR, Improved OS B) Decreased LR, Unchanged OS C) Unchanged LR, Improved OS D) Unchanged LR, Unchanged OS
B Bedenne trial (mostly squamous carcinoma) Stahl trial (only squamous)
400
Based on RTOG 0129, what is expected 3 year OS for the following patient? HPV negative, >10 year smoking history, 2 ipsilateral positive lymph nodes (<6cm) A) 96% B) 93% C) 75% D) 71% E) 67% F) 50% G) 46% H) 42%
D) 71%
500
Which statistical values are influenced by the prevalence of disease in the population being tested? A) Sensitivity B) Specificity C) True positive and True negative test D) Positive and Negative predictive values
D Testing for disease with higher prevalence yields higher positive predictive values.
500
If the temperature is 2% higher and the pressure is 1% lower than the standard conditions, the reading of an open-air ion chamber will be: A) 3% lower B) 1% lower C) 1% higher D) 3% higher
A) Increasing the temperature and decreasing the air pressure both serve to reduce the number of air molecules in the chamber, reducing the reading from the ion chamber proportionally
500
Pick two and state Van Nuys Prognostic Index score correctly. A) <0.1cm margin B) 2 cm tumor size C) age 41 years old D) Grade 3 with comedonecrosis
A) 3 points B) 2 points C) 2 points D) 3 points Score 1-3: Age: >60 40-60 <40 Margins: 1cm+ 0.1-0.9cm <0.1cm Tumor size: 1.5cm or less 1.5 - 4.0cm 4.1cm+ grade: (1) no necrosis/not high grade (2) necrosis/not high grade (3) high grade
500
Based on the CROSS study, what is the pathologic complete response rate for patients with squamous cell carcinoma of the esophagus treated with neoadjuvant chemoradiation? (within 10%)
Answer: 49% complete response in SqCC associated with 81.6 month median survival (23% for Adeno; 27.1 months) (29% overall; 24 months)
500
Which protein binds to p53 to promote carcinogenesis?
E6 E6 stimulates ubiquitin-mediated degradation of p53 inhibiting apoptosis E7 binds to Rb and disrupts ability to stall cells at the G1/S restriction point Rb inactivation leads to upregulation of p16
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