Multiple Choice Questions (MCQ)

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Category: Urology--->Bladder Cancer
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Question 1# Print Question

Regarding bladder cancer, the following statements are true EXCEPT?

A. The estimated male:female ratio is 2:1
B. At the initial diagnosis of bladder cancer, 75% of cases are diagnosed as non-muscle-invasive bladder cancer and approximately 25% as muscleinvasive disease
C. Approximately one-third of patients diagnosed with muscle-invasive disease have undetected metastasis at the time of treatment of the primary tumour
D. 25% of patients subjected to radical cystectomy present with lymph node involvement at the time of surgery

Question 2# Print Question

Tobacco smoking is the most wellestablished risk factor for bladder cancer, causing 50%–65% of male cases and 20%–30% of female cases. Which of the following statements regarding smoking and bladder cancer is TRUE?

A. A causal relationship has not been established between an exposure to tobacco and cancer in studies in which chance, bias and confounding factors can be ruled out with reasonable confidence
B. A meta-analysis reporting on pooled risk estimates for current and former smokers demonstrated a significant association with bladder cancer for current smokers only
C. There is no immediate decrease in the risk of bladder cancer in those who stop smoking
D. The promotion of smoking cessation would result in the incidence of bladder cancer decreasing equally in men and women

Question 3# Print Question

A 69-year-old male has undergone a radical cysto-prostatectomy for muscleinvasive bladder cancer with no histological evidence of peri-vesical invasion. Staging investigations included a CT of the chest and abdomen, which showed no metastasis. However, histology of the lymphadenectomy specimen showed that two lymph nodes in the external iliac group were positive for metastasis. What would be the correct TNM (2017) pathological staging?

A. pT2 pN1 M0
B. pT3 pN1 M0
C. pT2 pN2 M0
D. pT2 pN3 M0

Question 4# Print Question

Regarding the molecular biology of bladder cancer pathogenesis, the following are true, EXCEPT:

A. Chromosome 10 loss of heterozygosity (LOH) is found in more than 50% of all bladder tumours
B. Low-grade pTa tumours usually have alterations in the RAS-MAP kinase signal transduction pathway, the most frequent being fibroblast growth factor receptor 3 (FGFR3) mutations on chromosome 4p
C. Over-expression of the genes that encode receptor tyrosine kinases such as EGFR (epidermal growth factor receptor) and the Erb2 receptor have been reported
D. Muscle-invasive tumours and CIS frequently have alterations in the p53 and retinoblastoma (pRb) pathways that control the cell cycle

Question 5# Print Question

Which of the following statements is FALSE regarding fluorescence-guided biopsy or photodynamic diagnosis (PDD) and resection?

A. The value of fluorescence cystoscopy for improvement of the outcome in relation to progression rate or survival has not been proven
B. The additional detection rate with PDD for all tumours is about 35% and about 40% for CIS
C. False positivity can occur due to recent TUR and during the first three months after BCG instillation
D. A large, multicentre, RCT comparing hexa-aminolaevulinic acid (HAL) fluorescence guided TUR with standard TUR reported an absolute reduction of no more than 9% in the recurrence rate within 9 months in the HAL arm

Category: Urology--->Bladder Cancer
Page: 1 of 2