Gastroenterology and hepatology: gastrointestinal stromal tumour: practice question

A General Medicine 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 Medicine · Gastroenterology and hepatology: gastrointestinal stromal tumour

Sample item

A 58-year-old man presents with melaena. CT shows a 6 cm exophytic gastric mass. Histology shows spindle cells positive for CD117 and DOG1. Which drug is appropriate for unresectable disease?

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

The answer and the reasoning

B. Imatinib

Most gastrointestinal stromal tumours arise from the interstitial cells of Cajal and carry activating mutations of KIT (CD117) or PDGFRA. Imatinib inhibits these tyrosine kinases and is the standard drug for unresectable, metastatic or high-risk resected disease.

Option by option

  • A. Trastuzumab

    Trastuzumab targets HER2, which is not the driver in these tumours.

  • B. Imatinib (correct)

    Correct. Imatinib blocks the KIT tyrosine kinase that drives the tumour.

  • C. Rituximab

    Rituximab targets CD20 on B cells and has no role in stromal tumours.

  • D. Cetuximab

    Cetuximab targets EGFR and is used in colorectal and head and neck cancers.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Imatinib. Most gastrointestinal stromal tumours arise from the interstitial cells of Cajal and carry activating mutations of KIT (CD117) or PDGFRA.

Why is "Trastuzumab" not the answer?

Trastuzumab targets HER2, which is not the driver in these tumours.

Why is "Rituximab" not the answer?

Rituximab targets CD20 on B cells and has no role in stromal tumours.

Why is "Cetuximab" not the answer?

Cetuximab targets EGFR and is used in colorectal and head and neck cancers.

What concept does this question test?

It tests Gastroenterology and hepatology: gastrointestinal stromal tumour in General Medicine. Imatinib inhibits these tyrosine kinases and is the standard drug for unresectable, metastatic or high-risk resected disease.

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 Gastroenterology and hepatology: gastrointestinal stromal tumour?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.