ABIM Medical Oncology

Question 1

Which electrolyte pattern is characteristic of tumor lysis syndrome?

Accepted Answer

Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia

Answer

When tumor cells lyse they release potassium, phosphate, and nucleic acids, which are metabolized to uric acid. The excess phosphate binds calcium, which causes hypocalcemia.

Question 2

Per USPSTF (2021), at what age should average-risk adults begin colorectal cancer screening?

Accepted Answer

45

Answer

In 2021 the USPSTF lowered the starting age for average-risk colorectal cancer screening from 50 to 45 because incidence is rising in younger adults.

Question 3

Which patient meets USPSTF (2021) criteria for annual low-dose CT lung cancer screening?

Accepted Answer

A 62-year-old with a 25 pack-year history who quit 5 years ago

Answer

USPSTF recommends annual LDCT for adults aged 50–80 with at least a 20 pack-year history who currently smoke or quit within the past 15 years. Only the 62-year-old meets all three criteria.

Question 4

A patient with metastatic prostate cancer has new back pain, leg weakness, and urinary retention. Which step should come first?

Accepted Answer

High-dose IV dexamethasone and emergent whole-spine MRI

Answer

Suspected malignant spinal cord compression is an emergency. Glucocorticoids should be given promptly and an urgent MRI of the entire spine obtained, followed by radiation and/or surgery. Neurologic status at treatment strongly predicts outcome.

Question 5

A patient on chemotherapy has a temperature of 38.5°C and an ANC of 300/µL, and is hemodynamically stable. Which is the most appropriate empiric therapy?

Accepted Answer

IV cefepime

Answer

Febrile neutropenia needs immediate empiric antipseudomonal beta-lactam monotherapy, such as cefepime, piperacillin-tazobactam, or meropenem, after cultures are drawn. Vancomycin is added only for specific indications.

ABIM - American Board of Internal Medicine Practice Test

ABIM - American Board of Internal Medicine Practice Test

ABIM Medical Oncology