MCQ --LYNCH SYNDROME
- Which syndrome increases
colorectal cancer risk due to mismatch repair gene mutation?
- A. Peutz-Jeghers syndrome
- B. Lynch syndrome
- C. Familial adenomatous
polyposis
- D. Li-Fraumeni syndrome
- Answer: B. Lynch syndrome
- Lynch syndrome often causes
cancer in which part of the colon?
- A. Distal colon
- B. Transverse colon
- C. Proximal colon
- D. Sigmoid colon
- Answer: C. Proximal colon
- What is the recommended
colonoscopic surveillance interval for MLH1 and MSH2 mutation carriers?
- A. 1 year
- B. 2 years
- C. 5 years
- D. 10 years
- Answer: B. 2 years
- Which mutation is commonly
linked to Lynch syndrome?
- A. BRCA1
- B. APC
- C. MSH2
- D. TP53
- Answer: C. MSH2
- What criteria are used to
diagnose Lynch syndrome based on family history?
- A. Dukes’ criteria
- B. Amsterdam II criteria
- C. TNM criteria
- D. Bethesda criteria
- Answer: B. Amsterdam II criteria
6.Lynch syndrome is primarily caused by mutations
in which type of genes?
- A. Tumor suppressor genes
- B. Mismatch repair genes
- C. Oncogenes
- D. Cell cycle genes
- Answer: B. Mismatch repair genes
7.What is the lifetime risk of cancer in Lynch
syndrome carriers?
- A. 10%
- B. 50%
- C. 80%
- D. 100%
- Answer: C. 80%
8.Which of the following is NOT part of the
Amsterdam II criteria?
- A. At least two successive
affected generations
- B. Three or more family
members with related cancer
- C. Tumors confirmed by
immunohistochemistry
- D. One case diagnosed before
age 50
- Answer: C. Tumors confirmed by
immunohistochemistry
9.For PMS2 mutation carriers, what is the
recommended screening interval?
- A. Every year from age 20
- B. Every 2 years from age 25
- C. Every 3 years from age 35
- D. Every 5 years from age 40
- Answer: D. Every 5 years from age
35
10.Colorectal cancer in Lynch syndrome is most
commonly found in which colon segment?
- A. Sigmoid colon
- B. Rectum
- C. Proximal colon
- D. Descending colon
- Answer: C. Proximal colon
11.Lynch syndrome is also associated with cancers
in which organs?
o A. Liver and kidney
o B. Skin and bones
o C. Endometrium, ovary, and
stomach
o D. Brain and spinal cord
o Answer: C. Endometrium, ovary, and
stomach
12.What is the genetic basis of Lynch syndrome?
o A. Autosomal dominant mutation
o B. Autosomal recessive mutation
o C. X-linked mutation
o D. Sporadic mutation
o Answer: A. Autosomal dominant mutation
13.Which of the following is NOT a gene associated
with Lynch syndrome?
o A. MLH1
o B. MSH2
o C. PMS2
o D. BRCA1
o Answer: D. BRCA1
14.The mutations in Lynch syndrome impair the
function of which pathway?
o A. Apoptotic pathway
o B. Mismatch repair pathway
o C. Cell cycle checkpoint pathway
o D. Hormonal pathway
o Answer: B. Mismatch repair pathway
15.Individuals with Lynch syndrome are at risk of
developing which type of genetic instability?
o A. Microsatellite instability
o B. Chromosomal instability
o C. Epigenetic instability
o D. Structural instability
o Answer: A. Microsatellite instability
16.What is the risk of developing cancer by age 50
for those with Lynch syndrome?
o A. 10%
o B. 50%
o C. 80%
o D. 100%
o Answer: C. 80%
17.In Lynch syndrome, what is the range of lifetime
cancer risk of endometrial cancer in females?
o A. 10-20%
o B. 30-50%
o C. 50-70%
o D. 70-90%
o Answer: B. 30-50%
18.Which screening criteria is used for identifying
Lynch syndrome based on family history?
o A. Amsterdam II criteria
o B. Bethesda criteria
o C. Dukes’ criteria
o D. Paris criteria
o Answer: A. Amsterdam II criteria
19.The Amsterdam II criteria for Lynch syndrome
diagnosis require at least how many family members with Lynch syndrome-related
cancer?
- A. One
- B. Two
- C. Three
- D. Four
- Answer: C. Three
20.How many generations need to be affected
according to the Amsterdam II criteria?
- A. One
- B. Two
- C. Three
- D. Four
- Answer: B. Two
21.For a Lynch syndrome diagnosis, at least one
case of cancer should be diagnosed before what age?
- A. 30
- B. 40
- C. 50
- D. 60
- Answer: C. 50
22.What is recommended for MLH1 and MSH2 carriers
in terms of colorectal surveillance?
- A. Annual colonoscopy
starting at age 20
- B. 2-yearly colonoscopy
starting at age 25
- C. 5-yearly colonoscopy
starting at age 30
- D. 3-yearly colonoscopy
starting at age 35
- Answer: B. 2-yearly colonoscopy
starting at age 25
23.What type of genetic change is a feature of
Lynch syndrome-related tumors?
- A. Somatic mutations
- B. Microsatellite
instability
- C. Germline mutations
- D. Chromosomal rearrangements
24.Lynch syndrome primarily increases the risk of
which type of cancer?
- A. Breast cancer
- B. Prostate cancer
- C. Colorectal cancer
- D. Liver cancer
- Answer: C. Colorectal cancer
25.Which organs, aside from the colon, are
associated with an increased risk of cancer in Lynch syndrome?
- A. Kidney, lung, and
bladder
- B. Endometrium, ovary, and
stomach
- C. Pancreas, brain, and
liver
- D. Skin, bone, and muscle
- Answer: B. Endometrium, ovary,
and stomach
26.What is the inheritance pattern of Lynch
syndrome?
- A. Autosomal dominant
- B. Autosomal recessive
- C. X-linked dominant
- D. X-linked recessive
- Answer: A. Autosomal dominant
27.Which gene is NOT typically involved in Lynch
syndrome?
- A. MLH1
- B. MSH2
- C. PMS2
- D. BRCA2
- Answer: D. BRCA2
28.What is the primary role of the genes affected
in Lynch syndrome?
- A. DNA repair in the
mismatch repair pathway
- B. Regulating cell cycle
checkpoints
- C. Inducing apoptosis
- D. Controlling hormonal
pathways
- Answer: A. DNA repair in the
mismatch repair pathway
29.What type of genetic instability is
characteristic of Lynch syndrome?
- A. Microsatellite
instability (MSI)
- B. Chromosomal instability
(CIN)
- C. Epigenetic instability
- D. Telomere instability
- Answer: A. Microsatellite
instability (MSI)
30.Lynch syndrome-related cancers often follow an
accelerated pathway from adenoma to carcinoma, especially for which type of
polyps?
- A. Hyperplastic polyps
- B. Sessile serrated polyps
- C. Tubular adenomas
- D. Small adenomatous polyps
- Answer: D. Small adenomatous
polyps
31.What is the estimated lifetime risk of
developing colorectal cancer in individuals with Lynch syndrome?
- A. 10%
- B. 50%
- C. 80%
- D. 90%
- Answer: C. 80%
32.In Lynch syndrome, which part of the colon is
most commonly affected by cancer?
- A. Distal colon
- B. Transverse colon
- C. Proximal colon
- D. Sigmoid colon
- Answer: C. Proximal colon
33.In addition to colorectal cancer, females with
Lynch syndrome are at risk for which other cancer with a 30-50% lifetime risk?
- A. Breast cancer
- B. Endometrial cancer
- C. Ovarian cancer
- D. Cervical cancer
- Answer: B. Endometrial cancer
34.What is the recommended colonoscopic screening
interval for individuals with MLH1 or MSH2 mutations?
- A. Annual from age 20
- B. Every 2 years from age
25
- C. Every 3 years from age
30
- D. Every 5 years from age
35
- Answer: B. Every 2 years from age
25
35.The Amsterdam II criteria for diagnosing Lynch
syndrome require how many family members to have Lynch syndrome-related cancer?
- A. One
- B. Two
- C. Three
- D. Four
- Answer: C. Three
36.For a diagnosis of Lynch syndrome under the
Amsterdam II criteria, cases must involve at least how many successive
generations?
- A. One
- B. Two
- C. Three
- D. Four
- Answer: B. Two
37.According to the Amsterdam II criteria, at least
one case of cancer should be diagnosed before which age?
- A. 40
- B. 50
- C. 60
- D. 70
- Answer: B. 50
38.Which type of mutation is commonly found in
colorectal cancers associated with Lynch syndrome?
- A. BRCA mutation
- B. Germline mutation in
mismatch repair genes
- C. Somatic mutation in TP53
- D. Chromosomal
rearrangements
- Answer: B. Germline mutation in
mismatch repair gen
39.What is Lynch syndrome primarily associated
with?
- A. Breast cancer risk
- B. Skin disorder
- C. Hereditary colorectal
cancer risk
- D. Cardiovascular disease
- Answer: C. Hereditary colorectal
cancer risk
40Which gene mutation type is commonly involved in
Lynch syndrome?
- A. Germline mutation in DNA
mismatch repair genes
- B. Somatic mutation in skin
cells
- C. Autosomal recessive
mutation
- D. X-linked mutation
- Answer: A. Germline mutation in
DNA mismatch repair genes
41.Lynch syndrome increases the risk of which other
cancers besides colorectal?
- A. Skin and bone cancers
- B. Endometrial, ovarian,
and stomach cancers
- C. Brain and spinal cord
cancers
- D. Lung and liver cancers
- Answer: B. Endometrial, ovarian,
and stomach cancers
42.Which diagnostic criteria are used to identify
Lynch syndrome based on family history?
- A. Bethesda criteria
- B. Amsterdam II criteria
- C. Dukes' staging
- D. TNM staging
- Answer: B. Amsterdam II criteria
43.According to the Amsterdam II criteria, what is
the minimum number of family members who must be affected by a Lynch
syndrome-related cancer for diagnosis?
- A. One
- B. Two
- C. Three
- D. Four
- Answer: C. Three
Lynch Syndrome
44.Lynch syndrome, a common cause of hereditary
colorectal cancer, results from mutations in which genes involved in DNA
mismatch repair?
- A. BRCA1 and BRCA2
- B. MLH1, MSH2, MSH6, and
PMS2
- C. APC and TP53
- D. EGFR and KRAS
- Answer: B. MLH1, MSH2, MSH6, and
PMS2
45.What is the main genetic feature that
differentiates Lynch syndrome from other colorectal cancer syndromes?
- A. Chromosomal instability
- B. Microsatellite
instability (MSI)
- C. Loss of heterozygosity
- D. Telomere shortening
- Answer: B. Microsatellite
instability (MSI)
- .
46.In Lynch syndrome, individuals with which
mutations should start colorectal surveillance at age 25 with 2-year intervals?
- A. MLH1 and MSH2
- B. MSH6 and PMS2
- C. TP53 and BRCA1
- D. APC and STK11
- Answer: A. MLH1 and MSH2
47.Why might females with Lynch syndrome have a
recommendation for gynecological screening?
- A. They have a risk of
early menopause.
- B. They are at higher risk
for endometrial and ovarian cancers.
- C. Hormonal imbalances are
common in Lynch syndrome.
- D. It is part of the
general screening for all cancer syndromes.
- Answer: B. They are at higher
risk for endometrial and ovarian cancers.
48.The Amsterdam II criteria are specifically used
to diagnose Lynch syndrome based on family history. Which of the following is
NOT part of these criteria?
- A. At least three family
members with Lynch syndrome-related cancers
- B. Cancer affecting at
least two successive generations
- C. At least one Lynch
syndrome-related cancer diagnosed before age 50
- D. Confirmation by genetic
testing
- Answer: D. Confirmation by
genetic testing
49.Which type of laboratory testing is often
performed to confirm Lynch syndrome in suspected cases?
- A. Immunohistochemistry for
mismatch repair proteins
- B. Cytogenetic analysis
- C. Complete blood count
- D. Serum tumor markers
- Answer: A. Immunohistochemistry
for mismatch repair proteins
50.Which of the following cancers is NOT included
in the Amsterdam II criteria for Lynch syndrome?
- A. Colorectal cancer
- B. Endometrial cancer
- C. Small bowel cancer
- D. Lung cancer
- Answer: D. Lung cancer
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