Medicine
Oncology
Which symptom cluster is compatible with significant hypercalcemia?
A. Wheeze, urticaria and stridor
B. Hemoptysis and pleuritic pain only
C. Constipation, polyuria, dehydration and confusion
D. Photophobia and neck stiffness
Correct Answer: C
Hypercalcemia commonly produces gastrointestinal, renal and neuropsychiatric symptoms.
Medicine
Oncology
Which complication or major adverse outcome is particularly associated with Hypercalcemia of malignancy?
A. Superior vena cava syndrome
B. Acute kidney injury and arrhythmia
C. Large-bowel obstruction
D. Osteoblastic bone metastases
Correct Answer: B
Severe hypercalcemia causes dehydration, nephrocalcinosis, renal dysfunction and electrical instability.
Medicine
Oncology
A patient is diagnosed with Hypercalcemia of malignancy. Which is the most appropriate management principle?
A. Start intravenous isotonic fluid resuscitation and use calcium-lowering therapy according to severity and cause
B. Refer to a multidisciplinary breast team for stage- and receptor-directed local and systemic therapy
C. Use multidisciplinary stage- and histology-directed surgery, radiotherapy and/or systemic therapy
D. Use stage-directed surgical and oncologic management
Correct Answer: A
Restoring volume is an early priority; antiresorptive and rapid-acting agents are used as appropriate.
Medicine
Oncology
In a patient with suspected Hypercalcemia of malignancy, which investigation or diagnostic approach is most appropriate at this stage?
A. Serial potassium, phosphate, calcium, uric acid and kidney-function monitoring
B. Triple assessment with clinical examination, breast imaging and tissue diagnosis
C. Diagnostic chest CT followed by tissue sampling of an appropriate lesion or node
D. Repeat or confirm calcium with renal function and targeted evaluation of the mechanism
Correct Answer: D
Severity, kidney function and cause guide emergency management.
Medicine
Oncology
A patient has cancer with dehydration, constipation, confusion and a markedly elevated corrected calcium. What is the most likely diagnosis?
A. Malignant spinal cord compression
B. Tumor lysis syndrome
C. Hypercalcemia of malignancy
D. Breast cancer
Correct Answer: C
Neurocognitive and gastrointestinal symptoms with marked hypercalcemia are typical of hypercalcemic crisis.
Medicine
Oncology
Which symptom in a cancer patient with back pain is especially concerning for cord compression?
A. Mild seasonal rhinitis
B. New urinary retention with leg weakness
C. Stable myopia
D. Occasional dyspepsia
Correct Answer: B
Motor weakness, sensory changes and bladder or bowel dysfunction are neurologic red flags.
Medicine
Oncology
Which complication or major adverse outcome is particularly associated with Malignant spinal cord compression?
A. Permanent paraplegia
B. Osteoblastic bone metastases
C. Septic shock
D. Acute kidney injury and arrhythmia
Correct Answer: A
Delayed treatment can cause irreversible spinal cord injury and sphincter dysfunction.
Medicine
Oncology
A patient is diagnosed with Malignant spinal cord compression. Which is the most appropriate management principle?
A. Use stage-directed surgical and oncologic management
B. Use risk- and stage-based active surveillance, surgery, radiotherapy and/or systemic hormonal therapy
C. Start prompt empiric broad-spectrum antipseudomonal antibiotics
D. Give urgent corticosteroid therapy when appropriate and arrange immediate oncology or neurosurgical management
Correct Answer: D
Rapid decompressive or radiation planning is essential to preserve neurologic function.
Medicine
Oncology
In a patient with suspected Malignant spinal cord compression, which investigation or diagnostic approach is most appropriate at this stage?
A. Diagnostic chest CT followed by tissue sampling of an appropriate lesion or node
B. Colonoscopy with biopsy
C. Urgent MRI of the spine
D. PSA-based risk assessment followed by prostate imaging and biopsy when clinically indicated
Correct Answer: C
MRI defines the level and extent of epidural disease and guides urgent treatment.
Medicine
Oncology
A patient has known cancer with new severe back pain, leg weakness and bladder dysfunction. What is the most likely diagnosis?
A. Breast cancer
B. Malignant spinal cord compression
C. Lung cancer
D. Colorectal cancer
Correct Answer: B
Back pain with neurologic deficits in a patient with cancer is spinal cord compression until proven otherwise.
Medicine
Oncology
What is the key management principle in high-risk febrile neutropenia?
A. Do not delay empiric broad-spectrum antibiotics while awaiting culture results
B. Wait for cultures to become positive before treatment
C. Use topical antibiotics only
D. Discharge every patient without assessment
Correct Answer: A
Febrile neutropenia is time-critical; cultures and empiric treatment should occur promptly.
Medicine
Oncology
Which complication or major adverse outcome is particularly associated with Febrile neutropenia?
A. Acute kidney injury and arrhythmia
B. Acute kidney injury with life-threatening hyperkalemia
C. Metastatic bone disease
D. Septic shock
Correct Answer: D
Blunted inflammatory responses can mask infection until rapid bacteremia and shock occur.
Medicine
Oncology
A patient is diagnosed with Febrile neutropenia. Which is the most appropriate management principle?
A. Give urgent corticosteroid therapy when appropriate and arrange immediate oncology or neurosurgical management
B. Start intravenous isotonic fluid resuscitation and use calcium-lowering therapy according to severity and cause
C. Start prompt empiric broad-spectrum antipseudomonal antibiotics
D. Use aggressive risk-based prophylaxis or treatment with hydration and uric-acid-lowering therapy
Correct Answer: C
Early empiric antibiotics reduce mortality because neutropenic patients can deteriorate rapidly.
Medicine
Oncology
In a patient with suspected Febrile neutropenia, which investigation or diagnostic approach is most appropriate at this stage?
A. PSA-based risk assessment followed by prostate imaging and biopsy when clinically indicated
B. Prompt cultures and focused infection evaluation while treatment is initiated
C. Urgent MRI of the spine
D. Repeat or confirm calcium with renal function and targeted evaluation of the mechanism
Correct Answer: B
Microbiologic sampling is important, but treatment must not be delayed in a high-risk neutropenic patient.
Medicine
Oncology
A patient is receiving cytotoxic chemotherapy and develops fever with a markedly reduced absolute neutrophil count. What is the most likely diagnosis?
A. Febrile neutropenia
B. Colorectal cancer
C. Prostate cancer
D. Malignant spinal cord compression
Correct Answer: A
Fever in significant neutropenia is an oncologic emergency even when no infection source is initially evident.
Medicine
Oncology
Which metastatic pattern is classically associated with prostate cancer?
A. Only cystic liver lesions
B. Isolated skin metastases as the rule
C. No bone involvement
D. Osteoblastic bone metastases
Correct Answer: D
Prostate cancer commonly spreads to the axial skeleton and classically produces osteoblastic lesions.
Medicine
Oncology
Which complication or major adverse outcome is particularly associated with Prostate cancer?
A. Metastatic bone disease
B. Superior vena cava syndrome
C. Osteoblastic bone metastases
D. Large-bowel obstruction
Correct Answer: C
Prostate cancer has a strong tendency to spread to bone and often produces osteoblastic lesions.
Medicine
Oncology
A patient is diagnosed with Prostate cancer. Which is the most appropriate management principle?
A. Use aggressive risk-based prophylaxis or treatment with hydration and uric-acid-lowering therapy
B. Use risk- and stage-based active surveillance, surgery, radiotherapy and/or systemic hormonal therapy
C. Refer to a multidisciplinary breast team for stage- and receptor-directed local and systemic therapy
D. Use multidisciplinary stage- and histology-directed surgery, radiotherapy and/or systemic therapy
Correct Answer: B
Management ranges from surveillance to multimodal therapy depending on cancer risk and patient health.
Medicine
Oncology
In a patient with suspected Prostate cancer, which investigation or diagnostic approach is most appropriate at this stage?
A. PSA-based risk assessment followed by prostate imaging and biopsy when clinically indicated
B. Repeat or confirm calcium with renal function and targeted evaluation of the mechanism
C. Serial potassium, phosphate, calcium, uric acid and kidney-function monitoring
D. Triple assessment with clinical examination, breast imaging and tissue diagnosis
Correct Answer: A
PSA is not diagnostic alone; tissue confirmation and staging are required when cancer is suspected.
Medicine
Oncology
A patient has progressive lower urinary tract symptoms, bone pain and a suspicious prostate examination. What is the most likely diagnosis?
A. Malignant spinal cord compression
B. Hypercalcemia of malignancy
C. Tumor lysis syndrome
D. Prostate cancer
Correct Answer: D
Prostate malignancy can be asymptomatic early but advanced disease may produce urinary or skeletal symptoms.