MCQ Quiz-Oncology

MCQ Quiz: Oncology

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Oncology pharmacy is a rapidly evolving field where pharmacists play a critical role in managing complex medication regimens, supportive care, and patient education. From understanding the mechanism of novel immunotherapies to applying pharmacogenomics to prevent toxicity, a deep knowledge base is essential. This quiz, designed for PharmD students, will test your understanding of foundational oncology principles, key therapeutic agents, and the clinical evaluation of cancer treatments.

1. The process by which cancer cells spread from the primary site to other parts of the body is known as:

  • Apoptosis
  • Angiogenesis
  • Metastasis
  • Differentiation

Answer: Metastasis

2. Which of the following is a key principle of cancer immunotherapy?

  • Directly killing cancer cells with cytotoxic chemicals.
  • Using the body’s own immune system to fight cancer.
  • Blocking hormone receptors on cancer cells.
  • Inhibiting a specific enzyme within the cancer cell.

Answer: Using the body’s own immune system to fight cancer.

3. A patient is receiving chemotherapy and develops severe nausea and vomiting. Which class of medication is a cornerstone for preventing Chemotherapy-Induced Nausea and Vomiting (CINV)?

  • Proton pump inhibitors
  • 5-HT3 receptor antagonists (e.g., ondansetron)
  • H1 antihistamines
  • Benzodiazepines

Answer: 5-HT3 receptor antagonists (e.g., ondansetron)

4. In a clinical trial for a new cancer drug, “Overall Survival” (OS) is considered what type of endpoint?

  • A surrogate endpoint
  • A biomarker endpoint
  • A clinical endpoint.
  • A pharmacodynamic endpoint

Answer: A clinical endpoint.

5. “Progression-Free Survival” (PFS) is a measure of the time a patient lives with the disease without it getting worse. In clinical trials, it is often used as a(n):

  • Surrogate endpoint for overall survival.
  • Measure of drug toxicity.
  • Indicator of patient quality of life.
  • Direct measure of cure.

Answer: Surrogate endpoint for overall survival.

6. Testing for DPYD gene variants is recommended before initiating therapy with fluoropyrimidines (like 5-FU) to prevent the risk of:

  • Severe, life-threatening toxicity.
  • A severe infusion reaction.
  • Cardiotoxicity.
  • Therapeutic failure.

Answer: Severe, life-threatening toxicity.

7. A “basket trial” is a type of clinical trial design where:

  • Patients with one type of cancer are assigned to multiple different treatment arms.
  • Patients with different types of cancer that share the same genetic mutation are treated with one targeted drug.
  • A new drug is compared to a placebo.
  • The study is open to any patient regardless of cancer type or mutation.

Answer: Patients with different types of cancer that share the same genetic mutation are treated with one targeted drug.

8. For a patient with hormone receptor-positive breast cancer, which of the following therapies would be a primary treatment modality?

  • High-dose chemotherapy
  • Immunotherapy
  • Endocrine (hormone) therapy like tamoxifen or an aromatase inhibitor.
  • Radiation therapy only

Answer: Endocrine (hormone) therapy like tamoxifen or an aromatase inhibitor.

9. Myelosuppression is a common side effect of many chemotherapy agents. This refers to the suppression of:

  • The central nervous system.
  • The adrenal gland.
  • The bone marrow, leading to neutropenia, anemia, and thrombocytopenia.
  • The gastrointestinal tract.

Answer: The bone marrow, leading to neutropenia, anemia, and thrombocytopenia.

10. What is the primary role of a pharmacist in managing CINV?

  • To recommend and manage prophylactic antiemetic regimens based on the emetogenicity of the chemotherapy.
  • To administer the chemotherapy.
  • To diagnose the cause of the nausea.
  • To prescribe the antiemetics.

Answer: To recommend and manage prophylactic antiemetic regimens based on the emetogenicity of the chemotherapy.

11. A targeted therapy ending in “-mab” (e.g., trastuzumab) is typically what type of drug?

  • A small molecule kinase inhibitor
  • A traditional cytotoxic agent
  • A monoclonal antibody
  • A hormonal agent

Answer: A monoclonal antibody

12. A targeted therapy ending in “-ib” (e.g., imatinib) is typically what type of drug?

  • A monoclonal antibody
  • A small molecule inhibitor (e.g., tyrosine kinase inhibitor)
  • A chemotherapy prodrug
  • An immune checkpoint inhibitor

Answer: A small molecule inhibitor (e.g., tyrosine kinase inhibitor)

13. A patient with non-Hodgkin lymphoma is likely to be treated with a regimen containing which type of targeted therapy?

  • An anti-angiogenesis agent
  • A monoclonal antibody targeting the CD20 antigen (e.g., rituximab).
  • A PARP inhibitor
  • An androgen receptor antagonist

Answer: A monoclonal antibody targeting the CD20 antigen (e.g., rituximab).

14. A key aspect of personalized medicine in oncology is:

  • Treating all patients with the same cancer in the exact same way.
  • Using the genetic profile of a patient’s tumor to guide the selection of targeted therapy.
  • Choosing the least expensive treatment option available.
  • Allowing the patient to choose their own chemotherapy regimen.

Answer: Using the genetic profile of a patient’s tumor to guide the selection of targeted therapy.

15. What is the primary mechanism of action of immune checkpoint inhibitors like pembrolizumab?

  • They directly kill tumor cells.
  • They block proteins that cancer cells use to evade the immune system, thereby restoring the T-cell response against the tumor.
  • They inhibit DNA synthesis in rapidly dividing cells.
  • They block hormone production.

Answer: They block proteins that cancer cells use to evade the immune system, thereby restoring the T-cell response against the tumor.

16. The treatment of Chronic Myeloid Leukemia (CML) was revolutionized by the development of tyrosine kinase inhibitors that target:

  • The HER2 protein
  • The CD20 antigen
  • The BCR-ABL fusion protein.
  • Vascular Endothelial Growth Factor (VEGF)

Answer: The BCR-ABL fusion protein.

17. Androgen deprivation therapy (ADT) is the cornerstone of treatment for which type of cancer?

  • Lung cancer
  • Colorectal cancer
  • Breast cancer
  • Prostate cancer.

Answer: Prostate cancer.

18. Tumor Lysis Syndrome (TLS) is an oncologic emergency caused by:

  • The rapid breakdown of tumor cells, releasing their intracellular contents into the bloodstream.
  • A severe allergic reaction to a chemotherapy drug.
  • An opportunistic infection in an immunocompromised patient.
  • The spread of cancer to the brain.

Answer: The rapid breakdown of tumor cells, releasing their intracellular contents into the bloodstream.

19. What is a primary supportive care measure to prevent Tumor Lysis Syndrome?

  • Administering a strong opioid.
  • Aggressive hydration and use of a uric acid-lowering agent like allopurinol or rasburicase.
  • Prophylactic antibiotics.
  • Blood transfusion.

Answer: Aggressive hydration and use of a uric acid-lowering agent like allopurinol or rasburicase.

20. An “umbrella trial” is a clinical trial design where:

  • Patients with a single type of cancer are screened for multiple different mutations and assigned to different targeted therapies based on their results.
  • A single drug is tested across many different cancer types.
  • Patients are observed over time with no intervention.
  • The study is designed to evaluate a non-drug therapy.

Answer: Patients with a single type of cancer are screened for multiple different mutations and assigned to different targeted therapies based on their results.

21. Cardiotoxicity is a significant dose-limiting adverse effect of which class of chemotherapy agents?

  • Taxanes (e.g., paclitaxel)
  • Platinum agents (e.g., cisplatin)
  • Anthracyclines (e.g., doxorubicin).
  • Antimetabolites (e.g., methotrexate)

Answer: Anthracyclines (e.g., doxorubicin).

22. A patient with colorectal cancer is being considered for treatment with cetuximab. Testing for the status of which gene is required because mutations can cause resistance to the drug?

  • ALK
  • BRAF
  • KRAS.
  • BCR-ABL

Answer: KRAS.

23. Which of the following is a role for a pharmacist on an oncology team?

  • Verifying chemotherapy orders for accuracy.
  • Managing supportive care medications for side effects like CINV.
  • Educating patients on their complex medication regimens.
  • All of the above.

Answer: All of the above.

24. The term “adjuvant therapy” in oncology refers to:

  • Treatment given before the primary therapy to shrink a tumor.
  • Treatment given after the primary therapy (like surgery) to eradicate any remaining micrometastatic disease.
  • The primary and only treatment for the cancer.
  • Therapy designed only to relieve symptoms.

Answer: Treatment given after the primary therapy (like surgery) to eradicate any remaining micrometastatic disease.

25. “Neoadjuvant therapy” refers to:

  • Treatment given after the primary therapy.
  • Treatment given to prevent cancer from ever developing.
  • The standard of care for all cancers.
  • Treatment given before the primary therapy to shrink a tumor and improve outcomes.

Answer: Treatment given before the primary therapy to shrink a tumor and improve outcomes.

26. A patient receiving high-dose methotrexate requires leucovorin rescue to:

  • Increase the efficacy of the methotrexate.
  • Prevent severe myelosuppression and mucositis by replenishing folate stores in healthy cells.
  • Treat chemotherapy-induced nausea.
  • Prevent a drug-drug interaction.

Answer: Prevent severe myelosuppression and mucositis by replenishing folate stores in healthy cells.

27. Febrile neutropenia is an oncologic emergency requiring:

  • Immediate empiric broad-spectrum antibiotics.
  • A dose reduction of the chemotherapy.
  • A blood transfusion.
  • Administration of an antiemetic.

Answer: Immediate empiric broad-spectrum antibiotics.

28. What is the purpose of using colony-stimulating factors (CSFs) like filgrastim?

  • To treat anemia.
  • To increase the platelet count.
  • To stimulate the production of neutrophils and reduce the duration of neutropenia.
  • To directly kill cancer cells.

Answer: To stimulate the production of neutrophils and reduce the duration of neutropenia.

29. The Philadelphia chromosome is a genetic abnormality associated with which cancer?

  • Acute Lymphoblastic Leukemia (ALL)
  • Chronic Myeloid Leukemia (CML).
  • Non-Hodgkin Lymphoma
  • Multiple Myeloma

Answer: Chronic Myeloid Leukemia (CML).

30. Which of the following is an example of a small molecule inhibitor?

  • Rituximab
  • Pembrolizumab
  • Erlotinib
  • Trastuzumab

Answer: Erlotinib

31. The pathophysiology of lung cancer is most strongly associated with which risk factor?

  • Alcohol consumption
  • Poor diet
  • Tobacco smoking.
  • Lack of exercise

Answer: Tobacco smoking.

32. Aromatase inhibitors are used in postmenopausal women with ER-positive breast cancer to:

  • Block estrogen receptors directly.
  • Increase the production of estrogen.
  • Block the conversion of androgens to estrogen in peripheral tissues.
  • Destroy the adrenal glands.

Answer: Block the conversion of androgens to estrogen in peripheral tissues.

33. The main difference between Hodgkin lymphoma and non-Hodgkin lymphoma is:

  • The presence of Reed-Sternberg cells in Hodgkin lymphoma.
  • The age of the patients they affect.
  • The types of chemotherapy used for treatment.
  • The location of the cancer in the body.

Answer: The presence of Reed-Sternberg cells in Hodgkin lymphoma.

34. The primary mechanism of platinum-based chemotherapy agents like cisplatin is:

  • Inhibition of topoisomerase.
  • Cross-linking of DNA strands, leading to apoptosis.
  • Blockade of microtubule function.
  • Inhibition of dihydrofolate reductase.

Answer: Cross-linking of DNA strands, leading to apoptosis.

35. A major dose-limiting toxicity of cisplatin is:

  • Cardiotoxicity
  • Mucositis
  • Nephrotoxicity.
  • Constipation

Answer: Nephrotoxicity.

36. Vinca alkaloids, like vincristine, exert their cytotoxic effect by:

  • Intercalating into DNA.
  • Inhibiting microtubule polymerization, which disrupts the mitotic spindle.
  • Blocking purine synthesis.
  • Inhibiting tyrosine kinases.

Answer: Inhibiting microtubule polymerization, which disrupts the mitotic spindle.

37. When handling and preparing cytotoxic chemotherapy agents, pharmacists and technicians must use special precautions primarily to:

  • Prevent microbial contamination of the product.
  • Minimize their own occupational exposure to these hazardous drugs.
  • Ensure the drug is stored at the correct temperature.
  • Make the drug preparation process faster.

Answer: Minimize their own occupational exposure to these hazardous drugs.

38. The concept of “palliative care” in oncology focuses on:

  • Curing the cancer at all costs.
  • Relieving symptoms and improving the quality of life for patients with serious illness.
  • Using only experimental therapies.
  • Extending life by a few days, regardless of the impact on quality of life.

Answer: Relieving symptoms and improving the quality of life for patients with serious illness.

39. A patient with metastatic melanoma has a BRAF V600E mutation. Which type of therapy would be indicated?

  • A CD20 inhibitor
  • A BRAF inhibitor like dabrafenib.
  • An aromatase inhibitor
  • A BCR-ABL inhibitor

Answer: A BRAF inhibitor like dabrafenib.

40. A common adverse effect of immune checkpoint inhibitors is:

  • Immune-related adverse events (irAEs), such as colitis, dermatitis, and endocrinopathies.
  • Severe myelosuppression.
  • Immediate anaphylaxis.
  • No side effects.

Answer: Immune-related adverse events (irAEs), such as colitis, dermatitis, and endocrinopathies.

41. Which of the following is a primary goal of supportive care in oncology?

  • To cure the cancer.
  • To manage the side effects of cancer and its treatment.
  • To test new experimental drugs.
  • To reduce the cost of treatment.

Answer: To manage the side effects of cancer and its treatment.

42. The term “complete response” in an oncology trial means:

  • The patient feels better.
  • The disappearance of all signs of cancer in response to treatment.
  • A 50% reduction in tumor size.
  • The tumor has stopped growing but is still present.

Answer: The disappearance of all signs of cancer in response to treatment.

43. A pharmacist counseling a patient on capecitabine (a prodrug of 5-FU) should advise them to watch for which common side effect?

  • Hair growth
  • Hand-foot syndrome (palmar-plantar erythrodysesthesia)
  • High blood pressure
  • Weight gain

Answer: Hand-foot syndrome (palmar-plantar erythrodysesthesia)

44. The development of new drugs that target specific molecular pathways in cancer cells is the foundation of:

  • Palliative care
  • Traditional cytotoxic chemotherapy
  • Precision medicine.
  • Surgical oncology

Answer: Precision medicine.

45. Which of the following is a key patient education point for a patient receiving immunotherapy?

  • To report any new symptoms, especially those that seem inflammatory like diarrhea or rash, to their care team promptly.
  • That the therapy has no potential side effects.
  • To stop the therapy if they miss one appointment.
  • That the therapy works by directly poisoning cancer cells.

Answer: To report any new symptoms, especially those that seem inflammatory like diarrhea or rash, to their care team promptly.

46. Tamoxifen is a selective estrogen receptor modulator (SERM) used for breast cancer. It acts as an estrogen antagonist in breast tissue, but as an agonist in which tissue, increasing the risk for endometrial cancer?

  • Bone
  • Brain
  • Endometrium.
  • Liver

Answer: Endometrium.

47. A “drug class review” performed by a P&T committee would be useful for:

  • Deciding which of several new, similar oncology drugs to add to the formulary.
  • Determining the dose of a single patient’s chemotherapy.
  • Diagnosing a patient with cancer.
  • Reporting an adverse drug reaction.

Answer: Deciding which of several new, similar oncology drugs to add to the formulary.

48. Why is it important for an oncology pharmacist to have strong patient communication skills?

  • To explain complex regimens and side effects in an understandable and empathetic way.
  • To convince patients to enroll in clinical trials.
  • To sell over-the-counter products.
  • It is not important.

Answer: To explain complex regimens and side effects in an understandable and empathetic way.

49. Bevacizumab is a monoclonal antibody that works by inhibiting:

  • The immune checkpoint protein PD-1.
  • The HER2 receptor.
  • The CD20 antigen.
  • Vascular Endothelial Growth Factor (VEGF), thereby inhibiting angiogenesis.

Answer: Vascular Endothelial Growth Factor (VEGF), thereby inhibiting angiogenesis.

50. The ultimate goal of oncology pharmacotherapy is to:

  • Increase the complexity of the treatment regimen.
  • Maximize efficacy against the cancer while minimizing toxicity for the patient.
  • Use the most expensive drugs available.
  • Ensure all patients receive the exact same treatment.

Answer: Maximize efficacy against the cancer while minimizing toxicity for the patient.

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