AOCNP COMPREHENSIVE BOARD
EXAM PREP (2026) QUESTIONS AND
ANSWERS
1. A patient with metastatic colorectal cancer is found to have a KRAS mutation in exon 12.
How does this finding impact the treatment plan?
A. The patient is likely to respond well to Cetuximab (Erbitux).
B. The patient should be treated with Panitumumab (Vectibix).
C. EGFR inhibitors should be avoided as they are ineffective in KRAS-mutant tumors.
D. The mutation indicates a favorable prognosis and lower risk of recurrence.
Answer: C
Conceptual Explanation: KRAS mutations are predictive of resistance to EGFR-targeted
monoclonal antibodies like cetuximab and panitumumab in colorectal cancer because the
mutation keeps the signaling pathway ‘on’ regardless of receptor blockade.
2. Which of the following electrolyte abnormalities is NOT typically associated with Tumor
Lysis Syndrome (TLS)?
A. Hypercalcemia
,B. Hyperkalemia
C. Hyperuricemia
D. Hyperphosphatemia
Answer: A
Conceptual Explanation: Tumor Lysis Syndrome is characterized by hyperuricemia,
hyperkalemia, and hyperphosphatemia. Hypocalcemia occurs as a result of calcium binding
to the excess phosphate.
3. A patient receiving Doxorubicin for breast cancer has reached a cumulative lifetime dose of
450 mg/m2. What is the primary concern for this patient?
A. Hemorrhagic cystitis
B. Congestive heart failure
C. Irreversible pulmonary fibrosis
D. Peripheral neuropathy
Answer: B
Conceptual Explanation: Anthracyclines like doxorubicin carry a risk of cumulative dose-
related cardiotoxicity, leading to permanent heart failure; the risk increases significantly
above 400-450 mg/m2.
, 4. A patient on Nivolumab (Opdivo) presents with new-onset Grade 3 diarrhea and
abdominal pain. What is the most appropriate first-line management?
A. Hold Nivolumab and initiate high-dose corticosteroids (1-2 mg/kg/day).
B. Prescribe Loperamide and continue Nivolumab.
C. Switch to an alternate checkpoint inhibitor.
D. Order a stool culture and wait for results before treating.
Answer: A
Conceptual Explanation: Immune-related adverse events (irAEs) like colitis require
prompt management. Grade 3 symptoms necessitate holding the immunotherapy and
starting systemic steroids to dampen the immune response.
5. Which molecular marker is specifically associated with the use of Trastuzumab (Herceptin)
in gastric cancer?
A. BRAF V600E
B. ALK rearrangement
C. HER2/neu overexpression
D. MSI-High status
Answer: C
EXAM PREP (2026) QUESTIONS AND
ANSWERS
1. A patient with metastatic colorectal cancer is found to have a KRAS mutation in exon 12.
How does this finding impact the treatment plan?
A. The patient is likely to respond well to Cetuximab (Erbitux).
B. The patient should be treated with Panitumumab (Vectibix).
C. EGFR inhibitors should be avoided as they are ineffective in KRAS-mutant tumors.
D. The mutation indicates a favorable prognosis and lower risk of recurrence.
Answer: C
Conceptual Explanation: KRAS mutations are predictive of resistance to EGFR-targeted
monoclonal antibodies like cetuximab and panitumumab in colorectal cancer because the
mutation keeps the signaling pathway ‘on’ regardless of receptor blockade.
2. Which of the following electrolyte abnormalities is NOT typically associated with Tumor
Lysis Syndrome (TLS)?
A. Hypercalcemia
,B. Hyperkalemia
C. Hyperuricemia
D. Hyperphosphatemia
Answer: A
Conceptual Explanation: Tumor Lysis Syndrome is characterized by hyperuricemia,
hyperkalemia, and hyperphosphatemia. Hypocalcemia occurs as a result of calcium binding
to the excess phosphate.
3. A patient receiving Doxorubicin for breast cancer has reached a cumulative lifetime dose of
450 mg/m2. What is the primary concern for this patient?
A. Hemorrhagic cystitis
B. Congestive heart failure
C. Irreversible pulmonary fibrosis
D. Peripheral neuropathy
Answer: B
Conceptual Explanation: Anthracyclines like doxorubicin carry a risk of cumulative dose-
related cardiotoxicity, leading to permanent heart failure; the risk increases significantly
above 400-450 mg/m2.
, 4. A patient on Nivolumab (Opdivo) presents with new-onset Grade 3 diarrhea and
abdominal pain. What is the most appropriate first-line management?
A. Hold Nivolumab and initiate high-dose corticosteroids (1-2 mg/kg/day).
B. Prescribe Loperamide and continue Nivolumab.
C. Switch to an alternate checkpoint inhibitor.
D. Order a stool culture and wait for results before treating.
Answer: A
Conceptual Explanation: Immune-related adverse events (irAEs) like colitis require
prompt management. Grade 3 symptoms necessitate holding the immunotherapy and
starting systemic steroids to dampen the immune response.
5. Which molecular marker is specifically associated with the use of Trastuzumab (Herceptin)
in gastric cancer?
A. BRAF V600E
B. ALK rearrangement
C. HER2/neu overexpression
D. MSI-High status
Answer: C
