ACCP Oncology Pharmacy Practice Exam
Question 1: Which of the following best describes the pathophysiology of acute myeloid
leukemia (AML)?
A) Uncontrolled proliferation of lymphoid blasts
B) Uncontrolled proliferation of myeloid blasts
C) Clonal proliferation of mature lymphocytes
D) Dysplastic transformation of megakaryocytes
Answer: B
Explanation: AML is characterized by the rapid, uncontrolled proliferation of myeloid precursor
cells (blasts) that fail to mature, leading to bone marrow failure.
Question 2: Which diagnostic marker is most commonly associated with acute
lymphoblastic leukemia (ALL)?
A) Myeloperoxidase positivity
B) CD10 and CD19 expression
C) BCR-ABL fusion gene
D) JAK2 mutation
Answer: B
Explanation: ALL is typically associated with the expression of B-cell markers such as CD10
and CD19, which aid in its diagnosis.
Question 3: In the management of AML, which of the following is considered the primary
induction chemotherapy regimen?
A) Hyper-CVAD
B) “7+3” regimen (cytarabine and anthracycline)
C) ICE regimen
D) R-CHOP
Answer: B
Explanation: The “7+3” regimen, which involves 7 days of cytarabine with 3 days of an
anthracycline, is standard for induction therapy in AML.
Question 4: Which cytogenetic abnormality is associated with a favorable prognosis in
AML?
A) t(15;17)
B) t(9;22)
C) inv(16)
D) del(5q)
Answer: C
Explanation: Inversion 16 [inv(16)] is linked with a favorable prognosis in AML patients.
Question 5: What is the primary treatment approach for acute promyelocytic leukemia
(APL)?
,A) High-dose chemotherapy alone
B) Allogeneic stem cell transplantation
C) All-trans retinoic acid (ATRA) combined with arsenic trioxide
D) Monoclonal antibody therapy
Answer: C
Explanation: APL is uniquely treated with ATRA and arsenic trioxide, which induce
differentiation and apoptosis of malignant cells.
Question 6: Which laboratory finding is most consistent with a diagnosis of ALL?
A) Elevated myeloperoxidase activity
B) Presence of Auer rods
C) Lymphoblasts with TdT positivity
D) Hypersegmented neutrophils
Answer: C
Explanation: Terminal deoxynucleotidyl transferase (TdT) positivity in lymphoblasts is a key
diagnostic marker in ALL.
Question 7: In chronic lymphocytic leukemia (CLL), which immunophenotypic markers
are characteristically expressed?
A) CD3, CD5, CD7
B) CD10, CD19, CD20
C) CD19, CD5, and CD23
D) CD34, HLA-DR
Answer: C
Explanation: CLL typically exhibits the expression of CD19, CD5, and CD23 on the surface of
malignant B cells.
Question 8: Which targeted therapy is commonly used in the treatment of chronic myeloid
leukemia (CML)?
A) Rituximab
B) Imatinib
C) Trastuzumab
D) Bortezomib
Answer: B
Explanation: Imatinib is a tyrosine kinase inhibitor that specifically targets the BCR-ABL fusion
protein found in CML.
Question 9: What is the hallmark genetic abnormality found in CML?
A) t(15;17)
B) t(9;22)
C) inv(16)
D) t(8;21)
Answer: B
Explanation: The Philadelphia chromosome, resulting from t(9;22), is the hallmark of CML.
,Question 10: Which of the following is most characteristic of Hodgkin lymphoma on
histopathology?
A) Auer rods
B) Reed–Sternberg cells
C) Pseudofollicular pattern
D) “Starry-sky” appearance
Answer: B
Explanation: Reed–Sternberg cells are the classic pathological finding in Hodgkin lymphoma.
Question 11: Which staging system is used for Hodgkin lymphoma?
A) Ann Arbor staging system
B) TNM classification
C) Dukes staging system
D) Rai staging system
Answer: A
Explanation: The Ann Arbor staging system is used to stage Hodgkin lymphoma based on the
number and location of involved lymph nodes.
Question 12: What is the first-line treatment for early-stage Hodgkin lymphoma?
A) Surgical resection
B) Radiation therapy alone
C) Combination chemotherapy with or without radiation
D) Targeted therapy
Answer: C
Explanation: Early-stage Hodgkin lymphoma is typically managed with combination
chemotherapy, often supplemented by radiation therapy.
Question 13: Which of the following distinguishes non-Hodgkin lymphoma (NHL) from
Hodgkin lymphoma?
A) Presence of Reed–Sternberg cells
B) Involvement of mediastinal nodes
C) B-cell origin in most cases
D) Early-stage treatment with ABVD regimen
Answer: A
Explanation: The absence of Reed–Sternberg cells is a key feature that distinguishes NHL from
Hodgkin lymphoma.
Question 14: What is the most common clinical presentation of multiple myeloma?
A) Lymphadenopathy
B) Bone pain and lytic lesions
C) Splenomegaly
D) Central nervous system involvement
Answer: B
Explanation: Multiple myeloma typically presents with bone pain due to lytic lesions and
skeletal involvement.
, Question 15: Which laboratory test is most indicative of multiple myeloma?
A) Elevated lactate dehydrogenase (LDH)
B) Monoclonal protein spike (M-protein) on serum protein electrophoresis
C) Elevated beta-2 microglobulin
D) Thrombocytosis
Answer: B
Explanation: The detection of an M-protein spike on serum protein electrophoresis is a hallmark
of multiple myeloma.
Question 16: What is the role of stem cell transplantation in multiple myeloma
management?
A) It is used exclusively as salvage therapy
B) It is part of consolidation therapy in eligible patients
C) It is not recommended due to high toxicity
D) It replaces chemotherapy in frontline treatment
Answer: B
Explanation: Autologous stem cell transplantation is often used as consolidation therapy in
eligible multiple myeloma patients following induction treatment.
Question 17: Which of the following best describes the mechanism of tumor lysis
syndrome?
A) Immune-mediated cell destruction
B) Rapid release of intracellular contents from lysed tumor cells
C) Progressive marrow failure
D) Chronic inflammation-induced cell death
Answer: B
Explanation: Tumor lysis syndrome results from the rapid breakdown of tumor cells, releasing
potassium, phosphate, and nucleic acids into the bloodstream.
Question 18: Which electrolyte abnormality is most frequently observed in tumor lysis
syndrome?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
Answer: B
Explanation: Hyperkalemia is a common electrolyte disturbance due to the release of
intracellular potassium during tumor cell lysis.
Question 19: Which of the following is a major indication for hematopoietic cell
transplantation?
A) Early-stage solid tumors
B) Refractory hematologic malignancies
C) Benign hematologic disorders
D) Localized lymphoma without systemic involvement
Answer: B
Question 1: Which of the following best describes the pathophysiology of acute myeloid
leukemia (AML)?
A) Uncontrolled proliferation of lymphoid blasts
B) Uncontrolled proliferation of myeloid blasts
C) Clonal proliferation of mature lymphocytes
D) Dysplastic transformation of megakaryocytes
Answer: B
Explanation: AML is characterized by the rapid, uncontrolled proliferation of myeloid precursor
cells (blasts) that fail to mature, leading to bone marrow failure.
Question 2: Which diagnostic marker is most commonly associated with acute
lymphoblastic leukemia (ALL)?
A) Myeloperoxidase positivity
B) CD10 and CD19 expression
C) BCR-ABL fusion gene
D) JAK2 mutation
Answer: B
Explanation: ALL is typically associated with the expression of B-cell markers such as CD10
and CD19, which aid in its diagnosis.
Question 3: In the management of AML, which of the following is considered the primary
induction chemotherapy regimen?
A) Hyper-CVAD
B) “7+3” regimen (cytarabine and anthracycline)
C) ICE regimen
D) R-CHOP
Answer: B
Explanation: The “7+3” regimen, which involves 7 days of cytarabine with 3 days of an
anthracycline, is standard for induction therapy in AML.
Question 4: Which cytogenetic abnormality is associated with a favorable prognosis in
AML?
A) t(15;17)
B) t(9;22)
C) inv(16)
D) del(5q)
Answer: C
Explanation: Inversion 16 [inv(16)] is linked with a favorable prognosis in AML patients.
Question 5: What is the primary treatment approach for acute promyelocytic leukemia
(APL)?
,A) High-dose chemotherapy alone
B) Allogeneic stem cell transplantation
C) All-trans retinoic acid (ATRA) combined with arsenic trioxide
D) Monoclonal antibody therapy
Answer: C
Explanation: APL is uniquely treated with ATRA and arsenic trioxide, which induce
differentiation and apoptosis of malignant cells.
Question 6: Which laboratory finding is most consistent with a diagnosis of ALL?
A) Elevated myeloperoxidase activity
B) Presence of Auer rods
C) Lymphoblasts with TdT positivity
D) Hypersegmented neutrophils
Answer: C
Explanation: Terminal deoxynucleotidyl transferase (TdT) positivity in lymphoblasts is a key
diagnostic marker in ALL.
Question 7: In chronic lymphocytic leukemia (CLL), which immunophenotypic markers
are characteristically expressed?
A) CD3, CD5, CD7
B) CD10, CD19, CD20
C) CD19, CD5, and CD23
D) CD34, HLA-DR
Answer: C
Explanation: CLL typically exhibits the expression of CD19, CD5, and CD23 on the surface of
malignant B cells.
Question 8: Which targeted therapy is commonly used in the treatment of chronic myeloid
leukemia (CML)?
A) Rituximab
B) Imatinib
C) Trastuzumab
D) Bortezomib
Answer: B
Explanation: Imatinib is a tyrosine kinase inhibitor that specifically targets the BCR-ABL fusion
protein found in CML.
Question 9: What is the hallmark genetic abnormality found in CML?
A) t(15;17)
B) t(9;22)
C) inv(16)
D) t(8;21)
Answer: B
Explanation: The Philadelphia chromosome, resulting from t(9;22), is the hallmark of CML.
,Question 10: Which of the following is most characteristic of Hodgkin lymphoma on
histopathology?
A) Auer rods
B) Reed–Sternberg cells
C) Pseudofollicular pattern
D) “Starry-sky” appearance
Answer: B
Explanation: Reed–Sternberg cells are the classic pathological finding in Hodgkin lymphoma.
Question 11: Which staging system is used for Hodgkin lymphoma?
A) Ann Arbor staging system
B) TNM classification
C) Dukes staging system
D) Rai staging system
Answer: A
Explanation: The Ann Arbor staging system is used to stage Hodgkin lymphoma based on the
number and location of involved lymph nodes.
Question 12: What is the first-line treatment for early-stage Hodgkin lymphoma?
A) Surgical resection
B) Radiation therapy alone
C) Combination chemotherapy with or without radiation
D) Targeted therapy
Answer: C
Explanation: Early-stage Hodgkin lymphoma is typically managed with combination
chemotherapy, often supplemented by radiation therapy.
Question 13: Which of the following distinguishes non-Hodgkin lymphoma (NHL) from
Hodgkin lymphoma?
A) Presence of Reed–Sternberg cells
B) Involvement of mediastinal nodes
C) B-cell origin in most cases
D) Early-stage treatment with ABVD regimen
Answer: A
Explanation: The absence of Reed–Sternberg cells is a key feature that distinguishes NHL from
Hodgkin lymphoma.
Question 14: What is the most common clinical presentation of multiple myeloma?
A) Lymphadenopathy
B) Bone pain and lytic lesions
C) Splenomegaly
D) Central nervous system involvement
Answer: B
Explanation: Multiple myeloma typically presents with bone pain due to lytic lesions and
skeletal involvement.
, Question 15: Which laboratory test is most indicative of multiple myeloma?
A) Elevated lactate dehydrogenase (LDH)
B) Monoclonal protein spike (M-protein) on serum protein electrophoresis
C) Elevated beta-2 microglobulin
D) Thrombocytosis
Answer: B
Explanation: The detection of an M-protein spike on serum protein electrophoresis is a hallmark
of multiple myeloma.
Question 16: What is the role of stem cell transplantation in multiple myeloma
management?
A) It is used exclusively as salvage therapy
B) It is part of consolidation therapy in eligible patients
C) It is not recommended due to high toxicity
D) It replaces chemotherapy in frontline treatment
Answer: B
Explanation: Autologous stem cell transplantation is often used as consolidation therapy in
eligible multiple myeloma patients following induction treatment.
Question 17: Which of the following best describes the mechanism of tumor lysis
syndrome?
A) Immune-mediated cell destruction
B) Rapid release of intracellular contents from lysed tumor cells
C) Progressive marrow failure
D) Chronic inflammation-induced cell death
Answer: B
Explanation: Tumor lysis syndrome results from the rapid breakdown of tumor cells, releasing
potassium, phosphate, and nucleic acids into the bloodstream.
Question 18: Which electrolyte abnormality is most frequently observed in tumor lysis
syndrome?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
Answer: B
Explanation: Hyperkalemia is a common electrolyte disturbance due to the release of
intracellular potassium during tumor cell lysis.
Question 19: Which of the following is a major indication for hematopoietic cell
transplantation?
A) Early-stage solid tumors
B) Refractory hematologic malignancies
C) Benign hematologic disorders
D) Localized lymphoma without systemic involvement
Answer: B
