MCQs on circulating tumor DNA

By | December 29, 2024

Basics of ctDNA

  1. What does ctDNA stand for?
    a) Circulating tumor DNA
    b) Cellular tumor DNA
    c) Complex tumor DNA
    d) Cancerous tissue DNA
    Answer: a
  2. ctDNA is a subset of:
    a) RNA fragments
    b) Cell-free DNA (cfDNA)
    c) Genomic DNA
    d) Mitochondrial DNA
    Answer: b
  3. ctDNA originates from:
    a) Healthy cells
    b) Immune cells
    c) Tumor cells
    d) Bone marrow
    Answer: c
  4. The primary method of obtaining ctDNA is:
    a) Tissue biopsy
    b) Liquid biopsy
    c) Endoscopy
    d) CT scan
    Answer: b
  5. ctDNA is mostly found in:
    a) Blood plasma
    b) Saliva
    c) Urine
    d) Cerebrospinal fluid
    Answer: a

Characteristics and Detection

  1. Which is a common method to detect ctDNA?
    a) Mass spectrometry
    b) PCR-based assays
    c) X-ray imaging
    d) Ultrasound
    Answer: b
  2. ctDNA typically represents:
    a) Germline mutations
    b) Somatic mutations from tumors
    c) Epigenetic modifications only
    d) RNA sequences
    Answer: b
  3. Which technique is highly sensitive for ctDNA analysis?
    a) Sanger sequencing
    b) Next-generation sequencing (NGS)
    c) Western blotting
    d) Flow cytometry
    Answer: b
  4. ctDNA fragments are generally:
    a) Long (>1,000 base pairs)
    b) Short (<200 base pairs)
    c) Equal in length to chromosomal DNA
    d) Entire chromosomes
    Answer: b
  5. The half-life of ctDNA in circulation is approximately:
    a) 1-2 hours
    b) 24 hours
    c) 1 week
    d) 1 month
    Answer: a

Clinical Applications

  1. ctDNA is most commonly used in:
    a) Imaging-based diagnosis
    b) Cancer research and management
    c) Viral infections
    d) Bone disorders
    Answer: b
  2. ctDNA can help in detecting:
    a) Tumor mutations
    b) Protein levels
    c) Hormone imbalances
    d) Viral RNA
    Answer: a
  3. ctDNA analysis is critical for assessing:
    a) Tumor burden
    b) White blood cell count
    c) Heart rate
    d) Organ weight
    Answer: a
  4. ctDNA levels correlate with:
    a) Tumor size and stage
    b) Patient’s age
    c) Radiation dose
    d) Lymphocyte count
    Answer: a
  5. One key application of ctDNA is:
    a) Glucose monitoring
    b) Treatment resistance detection
    c) Blood pressure measurement
    d) Brain imaging
    Answer: b

Advantages of ctDNA

  1. One major advantage of ctDNA testing is:
    a) High cost
    b) Non-invasive nature
    c) Requirement for large samples
    d) Infrequent utility
    Answer: b
  2. ctDNA can provide real-time information about:
    a) Tumor dynamics
    b) Muscle mass
    c) Neuronal activity
    d) Skin thickness
    Answer: a
  3. ctDNA analysis reduces the need for:
    a) Pain medication
    b) Repeated tissue biopsies
    c) Blood transfusions
    d) Chemotherapy
    Answer: b
  4. ctDNA can be used for monitoring:
    a) Treatment response
    b) Blood oxygen levels
    c) Platelet aggregation
    d) Genetic inheritance patterns
    Answer: a
  5. ctDNA is considered superior to tissue biopsy in:
    a) Sensitivity to minor genetic variations
    b) Analyzing tumor microenvironment
    c) Detecting protein expression
    d) Assessing organelle structure
    Answer: a

Challenges in ctDNA Analysis

  1. A major challenge in ctDNA analysis is:
    a) Its high concentration in blood
    b) Its low abundance in circulation
    c) Its inability to carry genetic information
    d) Lack of reliable detection methods
    Answer: b
  2. ctDNA is prone to contamination from:
    a) White blood cells
    b) cfDNA from healthy cells
    c) Platelets
    d) Hemoglobin
    Answer: b
  3. ctDNA testing can sometimes lead to:
    a) Overdiagnosis
    b) Low specificity for cancer types
    c) Underestimation of tumor burden
    d) All of the above
    Answer: d
  4. Which cancer types pose a challenge for ctDNA detection?
    a) Solid tumors with low shedding rates
    b) Blood cancers
    c) Tumors with rapid metastasis
    d) All cancer types equally
    Answer: a
  5. False negatives in ctDNA testing may occur due to:
    a) Limited tumor shedding into circulation
    b) High cfDNA background
    c) Poor sample handling
    d) All of the above
    Answer: d

Specific Techniques

  1. Which sequencing method is used for broad mutation analysis in ctDNA?
    a) Sanger sequencing
    b) Whole-genome sequencing
    c) qPCR
    d) Immunohistochemistry
    Answer: b
  2. Digital droplet PCR is particularly effective for:
    a) Quantifying low levels of ctDNA
    b) Imaging tumor sites
    c) Measuring RNA expression
    d) Counting white blood cells
    Answer: a
  3. Epigenetic modifications in ctDNA include:
    a) Methylation changes
    b) Protein folding alterations
    c) Lipid modifications
    d) DNA replication errors
    Answer: a
  4. Hotspot mutation panels for ctDNA testing target:
    a) Commonly mutated oncogenes
    b) Entire genomes
    c) Non-coding RNA regions
    d) Mitochondrial DNA
    Answer: a
  5. Bioinformatics tools in ctDNA analysis help with:
    a) Data interpretation and visualization
    b) Blood sample collection
    c) Physical tumor excision
    d) Radiation therapy administration
    Answer: a

Emerging Applications

  1. ctDNA is being explored for early detection of:
    a) Diabetes
    b) Alzheimer’s disease
    c) Cancer
    d) Hypertension
    Answer: c
  2. ctDNA-based tests for minimal residual disease (MRD) monitor:
    a) Recurrence risk after treatment
    b) White blood cell counts
    c) Normal tissue repair
    d) Hormone fluctuations
    Answer: a
  3. Liquid biopsy using ctDNA can identify:
    a) Metastatic cancer
    b) Cardiovascular disease
    c) Vitamin deficiencies
    d) Bacterial infections
    Answer: a
  4. ctDNA testing is particularly helpful in identifying:
    a) Targetable mutations for therapy
    b) Heart failure risks
    c) Liver enzyme levels
    d) Lung capacity changes
    Answer: a
  5. ctDNA-guided precision oncology improves:
    a) Treatment personalization
    b) Radiation tolerance
    c) Tissue biopsy frequency
    d) Organ transplantation rates
    Answer: a

Miscellaneous

  1. ctDNA reflects:
    a) Germline alterations only
    b) Tumor-specific genetic alterations
    c) Dietary influences
    d) Immune responses
    Answer: b
  2. ctDNA may detect resistance to:
    a) Targeted therapies
    b) Radiation therapy
    c) Vitamin supplements
    d) Physical activity programs
    Answer: a
  3. A high ctDNA level during treatment often indicates:
    a) Treatment failure
    b) Tumor shrinkage
    c) Improved prognosis
    d) Normal aging
    Answer: a
  4. ctDNA mutations commonly target:
    a) Oncogenes and tumor suppressor genes
    b) Ribosomal RNA
    c) Mitochondrial DNA exclusively
    d) Viral DNA
    Answer: a
  5. ctDNA is being developed as a biomarker for:
    a) Personalized oncology
    b) Cardiovascular health
    c) Neurological disorders
    d) Genetic ancestry
    Answer: a

Future Directions

  1. ctDNA holds potential for screening:
    a) Multiple cancer types simultaneously
    b) Only late-stage cancers
    c) Nutrient deficiencies
    d) Heart diseases exclusively
    Answer: a
  2. Advanced ctDNA assays aim to improve:
    a) Sensitivity and specificity
    b) Bone density analysis
    c) Respiratory monitoring
    d) Insulin secretion analysis
    Answer: a
  3. ctDNA analysis is integrated with:
    a) Immunotherapy strategies
    b) Renal function tests
    c) Cardiovascular imaging
    d) Pulmonary function tests
    Answer: a
  4. ctDNA is least suitable for:
    a) Non-tumor conditions
    b) Monitoring cancer recurrence
    c) Identifying drug resistance mutations
    d) Early cancer detection
    Answer: a
  5. Emerging technologies in ctDNA aim to:
    a) Detect cancer at preclinical stages
    b) Replace tissue histology
    c) Eliminate all tumor burden
    d) Predict mental health outcomes
    Answer: a
  6. ctDNA methylation analysis is being explored for:
    a) Cancer type classification
    b) Determining heart rate
    c) Measuring oxygen uptake
    d) Diagnosing viral infections
    Answer: a
  7. ctDNA provides insights into:
    a) Tumor heterogeneity
    b) Bone structure
    c) Neuronal communication
    d) Protein folding defects
    Answer: a
  8. ctDNA is crucial in tracking:
    a) Clonal evolution of tumors
    b) Hemoglobin levels
    c) Cardiac output
    d) Muscle fatigue
    Answer: a
  9. Multi-cancer early detection (MCED) tests utilize:
    a) ctDNA profiles
    b) Endoscopic imaging
    c) EEG readings
    d) PET scans exclusively
    Answer: a
  10. ctDNA is a promising tool for:
    a) The future of precision oncology
    b) Agricultural engineering
    c) Urban planning
    d) Meteorological studies
    Answer: a

This comprehensive set covers foundational and advanced knowledge about ctDNA, suitable for academic and clinical settings.