Paediatric surgery: neuroblastoma prognostic marker: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: neuroblastoma prognostic marker

Sample item

A 2-year-old with neuroblastoma has a biopsy sent for molecular testing. Which finding indicates the worst prognosis?

ADiagnosis before 12 months of ageBHyperdiploid tumour DNA contentCHigh TrkA expressionDMYCN gene amplification

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. MYCN gene amplification

Amplification of the MYCN oncogene is the best-known adverse biological marker in neuroblastoma, linked to rapid progression and poor survival whatever the stage. Hyperdiploidy, high TrkA expression and young age are favourable features.

Option by option

A. Diagnosis before 12 months of age
Presentation under 12 months of age is favourable and includes cases that regress spontaneously.
B. Hyperdiploid tumour DNA content
Hyperdiploid DNA content is a favourable finding, especially in infants.
C. High TrkA expression
High TrkA expression is a favourable marker associated with differentiation and regression.
D. MYCN gene amplification (correct)
Correct. MYCN amplification predicts aggressive disease and a poor outcome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, MYCN gene amplification. Amplification of the MYCN oncogene is the best-known adverse biological marker in neuroblastoma, linked to rapid progression and poor survival whatever the stage.

Why is "Diagnosis before 12 months of age" not the answer?

Presentation under 12 months of age is favourable and includes cases that regress spontaneously.

Why is "Hyperdiploid tumour DNA content" not the answer?

Hyperdiploid DNA content is a favourable finding, especially in infants.

Why is "High TrkA expression" not the answer?

High TrkA expression is a favourable marker associated with differentiation and regression.

What concept does this question test?

It tests Paediatric surgery: neuroblastoma prognostic marker in General Surgery. Hyperdiploidy, high TrkA expression and young age are favourable features.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: neuroblastoma prognostic marker?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.