Q.1 What is the most common childhood cancer?
Neuroblastoma
Acute Lymphoblastic Leukemia (ALL)
Wilms Tumor
Retinoblastoma
Explanation - ALL is the most common cancer in children, accounting for about 25% of all pediatric malignancies.
Correct answer is: Acute Lymphoblastic Leukemia (ALL)
Q.2 Which genetic abnormality is commonly associated with Burkitt lymphoma?
t(9;22)
t(14;18)
t(8;14)
t(15;17)
Explanation - Burkitt lymphoma is classically associated with a translocation involving c-MYC on chromosome 8 and the IgH locus on chromosome 14.
Correct answer is: t(8;14)
Q.3 What is the typical presenting symptom of retinoblastoma?
Leukocoria
Exophthalmos
Nystagmus
Ptosis
Explanation - Leukocoria (white pupillary reflex) is the hallmark of retinoblastoma and often noticed by parents in photographs.
Correct answer is: Leukocoria
Q.4 Which tumor marker is elevated in yolk sac tumors in children?
Beta-hCG
AFP
LDH
CA-125
Explanation - Alpha-fetoprotein (AFP) is a marker for yolk sac tumors (endodermal sinus tumors).
Correct answer is: AFP
Q.5 Which pediatric cancer is associated with aniridia?
Wilms Tumor
Neuroblastoma
Hepatoblastoma
Ewing Sarcoma
Explanation - Wilms tumor can be associated with WAGR syndrome (Wilms tumor, Aniridia, Genitourinary anomalies, mental Retardation).
Correct answer is: Wilms Tumor
Q.6 What is the most common site of neuroblastoma?
Brain
Adrenal medulla
Liver
Bone marrow
Explanation - Neuroblastoma commonly arises from the adrenal medulla, although it can occur anywhere along the sympathetic chain.
Correct answer is: Adrenal medulla
Q.7 Which gene mutation is most strongly associated with retinoblastoma?
TP53
RB1
MYCN
NF1
Explanation - Retinoblastoma is caused by mutations in the RB1 tumor suppressor gene located on chromosome 13q14.
Correct answer is: RB1
Q.8 Which pediatric malignancy is classically associated with a 'starry-sky' appearance on histology?
Burkitt Lymphoma
Ewing Sarcoma
Wilms Tumor
Neuroblastoma
Explanation - Burkitt lymphoma shows interspersed macrophages giving a 'starry-sky' appearance on histology.
Correct answer is: Burkitt Lymphoma
Q.9 Which imaging modality is best for staging Wilms tumor?
CT scan
MRI
Ultrasound
X-ray
Explanation - CT scan is commonly used for staging Wilms tumor to evaluate local extension and metastasis.
Correct answer is: CT scan
Q.10 Which of the following is the most radiosensitive pediatric tumor?
Medulloblastoma
Ependymoma
Glioblastoma
Astrocytoma
Explanation - Medulloblastomas are highly radiosensitive tumors and often respond well to craniospinal irradiation.
Correct answer is: Medulloblastoma
Q.11 Which tumor is associated with elevated urine catecholamine metabolites (HVA and VMA)?
Neuroblastoma
Wilms Tumor
Rhabdomyosarcoma
Hepatoblastoma
Explanation - Neuroblastomas often secrete catecholamine metabolites such as vanillylmandelic acid (VMA) and homovanillic acid (HVA).
Correct answer is: Neuroblastoma
Q.12 What is the most common primary bone malignancy in children?
Ewing Sarcoma
Osteosarcoma
Chondrosarcoma
Fibrosarcoma
Explanation - Osteosarcoma is the most common primary bone cancer in children and adolescents, especially during growth spurts.
Correct answer is: Osteosarcoma
Q.13 Which tumor is associated with the 'onion-skin' appearance on X-ray?
Osteosarcoma
Ewing Sarcoma
Rhabdomyosarcoma
Chondrosarcoma
Explanation - Ewing sarcoma characteristically shows an onion-skin periosteal reaction on X-ray.
Correct answer is: Ewing Sarcoma
Q.14 Which chromosomal translocation is most commonly associated with Ewing sarcoma?
t(11;22)
t(8;21)
t(15;17)
t(9;22)
Explanation - Ewing sarcoma is associated with t(11;22) translocation involving the EWS-FLI1 fusion gene.
Correct answer is: t(11;22)
Q.15 Which syndrome predisposes children to medulloblastoma?
Turcot Syndrome
WAGR Syndrome
Beckwith-Wiedemann Syndrome
Li-Fraumeni Syndrome
Explanation - Turcot syndrome predisposes to medulloblastomas and glioblastomas in association with colorectal polyposis.
Correct answer is: Turcot Syndrome
Q.16 Which of the following is NOT part of Beckwith-Wiedemann syndrome?
Macroglossia
Hemihypertrophy
Wilms Tumor
Retinoblastoma
Explanation - Beckwith-Wiedemann syndrome predisposes to Wilms tumor, hepatoblastoma, and neuroblastoma but not retinoblastoma.
Correct answer is: Retinoblastoma
Q.17 Which pediatric brain tumor is most commonly located in the posterior fossa?
Medulloblastoma
Glioblastoma
Craniopharyngioma
Ependymoma
Explanation - Medulloblastomas are the most common malignant brain tumors in children and typically arise in the cerebellum (posterior fossa).
Correct answer is: Medulloblastoma
Q.18 Which of the following is a small round blue cell tumor of childhood?
Neuroblastoma
Ewing Sarcoma
Rhabdomyosarcoma
All of the above
Explanation - Neuroblastoma, Ewing sarcoma, and rhabdomyosarcoma are all classified as small round blue cell tumors.
Correct answer is: All of the above
Q.19 Which pediatric tumor is associated with opsoclonus-myoclonus syndrome?
Wilms Tumor
Neuroblastoma
Medulloblastoma
Osteosarcoma
Explanation - Opsoclonus-myoclonus (dancing eyes-dancing feet) syndrome is a paraneoplastic syndrome associated with neuroblastoma.
Correct answer is: Neuroblastoma
Q.20 Which of the following is the most common malignant liver tumor in children?
Hepatoblastoma
Hepatocellular carcinoma
Rhabdomyosarcoma
Metastasis
Explanation - Hepatoblastoma is the most common primary malignant liver tumor in children, often associated with Beckwith-Wiedemann syndrome.
Correct answer is: Hepatoblastoma
Q.21 Which cancer is associated with the Li-Fraumeni syndrome?
Osteosarcoma
Wilms Tumor
Neuroblastoma
Retinoblastoma
Explanation - Li-Fraumeni syndrome, due to TP53 mutations, predisposes to sarcomas including osteosarcoma.
Correct answer is: Osteosarcoma
Q.22 Which type of rhabdomyosarcoma is most common in children?
Embryonal
Alveolar
Pleomorphic
Undifferentiated
Explanation - Embryonal rhabdomyosarcoma is the most common histologic subtype in children.
Correct answer is: Embryonal
Q.23 Which clinical feature is most suggestive of Wilms tumor?
Hematuria
Abdominal mass
Hypertension
Abdominal pain
Explanation - Wilms tumor typically presents as a painless abdominal mass in children.
Correct answer is: Abdominal mass
Q.24 Which pediatric cancer is most associated with Down syndrome?
Acute Lymphoblastic Leukemia (ALL)
Wilms Tumor
Osteosarcoma
Medulloblastoma
Explanation - Children with Down syndrome are at increased risk of developing ALL and AML.
Correct answer is: Acute Lymphoblastic Leukemia (ALL)