A male patient presented with increasing weight loss and abdominal pain. He had a past history of Coeliac Disease, which up until now was asymptomatic on a gluten free diet. CT of the abdomen revealed a thickened loop of small bowel with a stricture and associated lymphadenopathy. A trucut of the nodes revealed a malignant neoplasm, Diagnosis is:

Reactive lymphoid proliferation

Enteropathic-associated T cell lymphoma

A 40 year old female presents with mediastinal hilar lymphadenopathy and she has recently noticed slight weight loss and a cough. Staging shows no other evidence of disease. A trucut biopsy reveals a lymphoma showing large cells with mirror image nuclei, lymphocytes, plasma cells and eosinophils. The following phenotype is seen; CD20 positive, CD3 negative, CLA positive, and CD15 positive

Hodgkin's lymphoma, classical type

Hodgkin's lymphoma, mixed cellularity

Hodgkin's lymphoma, classical type

Reactive lymphoid proliferation

A 50 year old male presents with widespread lymphadenopathy. He has had recent fever and weight loss. A trucut biopsy reveals a malignant tumor with the following phenotype; Cytokeratin negative, CLA positive, CD3 positive, and CD30 positive

Hodgkins disease mixed cellularity

Reactive lymphoid proliferation

Which of the following equations is used to determine a positive predictive value?

True negative / (True negative + false negative)

True positive / (True positive + false negative)

True positive / (True positive + false positive)

True negative / (True negative + false negative)

True negative / (True negative + false positive)

A 55 year old male presents with a history of chronic dyspepsia and with recent weight loss. Investigation by gastroscopy reveals a reduction in specialised gastric glands and the presence of slender giemsa staining filaments on the mucosal surface. In addition a gastric mass is seen. This is composed of large B lymphocytes which are negative for cyclin D1 and BCL2. Monoclonality is identified.

Reactive lymphoid proliferation

A 67-year-old man in previously good health is hospitalized because of a 2-day history of fever and diminished consciousness. The patient responds inconsistently to verbal commands. His temperature is 39.5 C (103.1 F); he has tachycardia, and his blood pressure is 80/58 mm Hg. There is no bleeding. His hemoglobin is 12.1 g/dL, leukocyte count is 29,000/ L with 80% neutrophils, and platelet count is 20,000/ L. Which of the following studies should be obtained in this patient?

Bone marrow aspiration and biopsy

Measurement of platelet-associated IgG

Measurements of fibrin D-dimer and total fibrinogen

A 37-year-old man is hospitalized because of fever and right-sided chest pain. He has been having fatigue and recently developed dyspnea on exertion and intermittent chills. At the age of 29 years he was diagnosed with stage III Hodgkin s disease and treated with multiagent chemotherapy and radiation therapy. A year ago, he developed mild anemia with no obvious cause. He takes thyroid hormone replacement when he remembers and has used fexofenadine as needed for allergic rhinitis for the past 5 years. On physical examination, his temperature is 38.7 C (101.7 F), pulse rate is 112/min, and blood pressure is 110/70 mmHg. There is dullness at the right lower lung and egophony. The hemoglobin is 8.5 g/dL, hematocrit is 26 %, leukocyte count is 2200/ L,and platelet count is 70,000/ L. What is the most likely diagnosis?

Drug-induced bone marrow suppression

Secondary myelodysplastic syndrome

Drug-induced bone marrow suppression

A 43-year-old man with severe acquired aplastic anemia has not responded to immunosuppressive agents. He remains neutropenic and transfusion-dependent for platelets and red cells. He has an HLA-identical brother who has been cleared as a donor for his planned allogeneic stem cell transplant.They are both cytomegalovirus-seronegative. Which of the following would be prevented by using irradiated cellular blood products for this patient?

Febrile nonhemolytic transfusion reaction

Transfusion-related graft-versus-host disease

Febrile nonhemolytic transfusion reaction

A 34-year-old woman is evaluated because of progressive fatigue and recurrent attacks of abdominal pain. She weighs 61.2 kg (135 Ib). Her pulse rate is 110/min and her blood pressure is 110/70 mm Hg. She is pale, and her spleen is palpable 4 cm below the costal margin. Laboratory studies: Hemoglobin 6 g/dLHematocrit 20% Leukocyte count 2500/ L Platelet count 80,000/ L Reticulocyte count 10%Blood smear Anisocytosis and polychromatophilia Haptoglobin 0 mg/dLSerum lactate dehydrogenase 645 U/LThere is high level of hemosiderin in the urine.What is the most likely cause of this patients pancytopenia?

Paroxysmal nocturnal hemoglobinuria

Which one of the following is an accurate definition of the sensitivity of a screening test?

The probability of a diagnosis of the condition of interest after a positive screening test

The percentage of screening tests that is positive

The percentage of screening tests that is negative among patients who remain unaffected by the condition of interest after screening

The percentage of screening tests that is positive among patients who remain unaffected by the condition of interest after screening

The probability of a diagnosis of the condition of interest after a positive screening test

In an office visit for an annual checkup, a 46-year-old man reports that he has had malaise and intermittent sweats for the past few months but has been able to continue his job as a high school teacher. Two years ago he was treated for stage III diffuse large-cell non-Hodgkin s lymphoma with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and attained complete remission. He takes simvastatin for hypercholesterolemia and hydrochlorothiazide for hypertension. On physical examination, he has lymphadenopathy: a 3-cm right axillary node and a 2- cm right supraclavicular node. His spleen tip is palpable. Laboratory evaluation shows mild normochromic, normocytic anemia and an elevated serum lactate dehydrogenase level. CT scans of his chest and abdomen reveal additional mediastinal and retroperitoneal lymphadenopathy. What is the best next step in this patient s management?

A repeat physical examination and CT scans in 3 months

A 2-week course of oral antibiotics

Referral for salvage chemotherapy and autologous stem cell transplantation

A repeat physical examination and CT scans in 3 months

Referral for treatment with investigational agents

A 43-year-old man is evaluated because of crushing substernal chest pain that developed during a pickup basketball game with colleagues at work. He was treated 15 years ago for stage IIB massive mediastinal Hodgkin s disease. Treatment included doxorubicin, bleomycin, vinbiastine, and dacarbazine (ABVD) followed by mantle-field radiation therapy to a total dose of 4400 cGy. He has had no recurrence of his Hodgkin s disease. He takes thyroid medication because he developed hypothyroidism 2 years after completing his therapy for Hodgkins disease. What is the most likely diagnosis?

Anemia associated with secondary myelodysplasia evolving to acute leukemia

A 68-year-old man is evaluated because of worsening chronic epigastric pain. He now has fatigue and early satiety. He has iron deficiency anemia. Results of upper gastrointestinal endoscopy reveal diffuse gastritis, along with mucosal thickening in the gastric antrum associated with a mass lesion. Abundant Helicobacter pylon organisms are noted on biopsy, and histologic evaluation of the mass lesion shows it to be a gastric lymphoma of mucosa-associated lymphoid tissue (MALT) type. What is the most appropriate next step in the management of this patients illness?

Total gastrectomy followed by radiation therapy

Combination chemotherapy with 5-fluorouracil, doxorubicin, and mitomycin C (FAM)

Combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)

Four cycles of CHOP followed by involved-field radiation therapy

Eradication of Helicobacter pylori

Total gastrectomy followed by radiation therapy

Gardner's syndrome is associated with all the following EXCEPT:

adenomas of the mandible or skull

desmoid tumors of the abdominal wall

In women the biggest risk factor for breast cancer is:

Previous contra lateral breast cancer

DNA microsatellite - best description

Single locus 2 - 4 base pairs repeats

55 year female - breast cancer 3 yrs ago had mastectomy only Presents with lower back pains. Some neurology - mild --> equivocal plantar. MRI Shows lesions in 3- 4 different vertebra - partially compressing spinal cord.

surgical decompression and radiotherapy

Man with medullary carcinoma of thyroid, worried about his son. What do you do?

look for ret oncogene in the cancer

Median survival is defined as the:

median of the survival-time intervals.

most prevalent time to death in the sample population.

point in time a survival probability on a Kaplan-Meier curve is 50%.

median of the survival-time intervals.

mean of the survival-time intervals.

Which of the following statements about the diagnosis of inflammatory breast cancer is true?

At presentation, a patient may report having a longstanding breast mass that developed skin changes over time.

There may not be a discrete palpable mass at presentation.

At presentation, a patient may report having a longstanding breast mass that developed skin changes over time.

A biopsy is not required, since the diagnosis is clinically established.

Dermal lymph node involvement must be demonstrated.

Which of the following statements about metastasis of breast cancer to the bone is true?

Compression of the epidural spinal cord associated with breast cancer most commonly has a single site of vertebral metastasis.

Metastasis to the epidural spine is most commonly associated with worsening back pain in the supine position or with the Valsalva maneuver.

Compression of the epidural spinal cord associated with breast cancer most commonly has a single site of vertebral metastasis.

Radicular pain in the thoracic spine is typically unilateral.

Pain from T12, L1 vertebral lesions is not associated with a referred pain pattern to the bilateral iliac crests or to the bilateral sacroiliac joints.

A 50-year-old woman with early breast cancer presented with fatigue to the accident and emergency department on day 7 of her first adjuvant chemotherapy cycle. On examination, her temperature was 38.5 C, her pulse was 110 beats per minute and her blood pressure was 110/70 mmHg. A full blood count was requested. What is the most appropriate next step?

intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factor (G-CSF)

intravenous broad-spectrum antibiotics

intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factor (G-CSF)

oral broad-spectrum antibiotics

oral broad-spectrum antibiotics and G-CSF

Which of the following statements about the effectiveness of cancer is true? for treating thyroid

Tall cell carcinoma is treated more effectively than the follicular variant of papillary carcinoma.

Medullary carcinoma is treated more effectively than H rthle cell carcinoma.

The follicular variant of papillary carcinoma is treated more effectively than H rthle cell carcinoma.

Tall cell carcinoma is treated more effectively than the follicular variant of papillary carcinoma.

Insular carcinoma is treated more effectively than the follicular variant of papillary carcinoma.

Lymphoma of the stomach:

may be primary or secondary in the stomach

has a better prognosis than carcinoma of the stomach

A 40-year-old male is operated on for a medullary carcinoma of the thyroid. He expresses concern about his 10 years son getting the disease. The best test:

yearly pentagastrin-stimulated calcitonin in son

DNA analysis for RET proto-oncogene in tumor

DNA analysis for RET proto-oncogene in peripheral blood

Which of the following tumor stages is correctly matched to the appropriate prostate cancer involvement or invasion?

Stage T2c is associated with nonpalpable tumor involvement of both lobes of the prostate via needle biopsy.

Stage T2b is associated with tumor involvement of more than one half of one lobe but not both lobes of the prostate.

Stage T2c is associated with nonpalpable tumor involvement of both lobes of the prostate via needle biopsy.

Stage T3a is associated with tumor invasion of the prostate apex.

Stage T4 is associated with tumor invasion of the seminal vesicles.

What is a major criterion for the diagnosis of multiple myeloma?

Lytic bone lesions on skeletal survey

Which of the following factors increases a patient's risk for the development of leukemia?

Occupational exposure to aluminum

Occupational exposure to benzene

Occupational exposure to aluminum

Which of the following processes is NOT commonly involved in the development of bone metastases?

Chemotaxis of metastatic cancer cells

Which of the following findings is most likely to be caused by loss of function of right cranial nerve XII?

Loss of sweet taste on the right side of the tongue

Deviation of the tongue to the left side with protrusion

Deviation of the tongue to the right side with protrusion

Loss of sweet taste on the right side of the tongue

Loss of salty taste on the right side of the tongue

396 + Mcqs in Important Questions Repeated in MD Exams in Uncategorized topics Page 1 McqOptions

1.	A male patient presented with increasing weight loss and abdominal pain. He had a past history of Coeliac Disease, which up until now was asymptomatic on a gluten free diet. CT of the abdomen revealed a thickened loop of small bowel with a stricture and associated lymphadenopathy. A trucut of the nodes revealed a malignant neoplasm, Diagnosis is:
A.	Maltoma
B.	Reactive lymphoid proliferation
C.	High grade B cell lymphom
D.	Enteropathic-associated T cell lymphoma
E.	Anaplastic large cell lymphoma
Answer» E. Anaplastic large cell lymphoma

Discussion

2.	A 40 year old female presents with mediastinal hilar lymphadenopathy and she has recently noticed slight weight loss and a cough. Staging shows no other evidence of disease. A trucut biopsy reveals a lymphoma showing large cells with mirror image nuclei, lymphocytes, plasma cells and eosinophils. The following phenotype is seen; CD20 positive, CD3 negative, CLA positive, and CD15 positive
A.	Hodgkin's lymphoma, mixed cellularity
B.	Hodgkin's lymphoma, classical type
C.	Anaplastic large cell lymphoma
D.	Maltoma
E.	Reactive lymphoid proliferation
Answer» B. Hodgkin's lymphoma, classical type

Discussion

3.	A 50 year old male presents with widespread lymphadenopathy. He has had recent fever and weight loss. A trucut biopsy reveals a malignant tumor with the following phenotype; Cytokeratin negative, CLA positive, CD3 positive, and CD30 positive
A.	Hodgkins disease mixed cellularity
B.	T-cell lymphoma
C.	Anaplastic large cell lymphoma
D.	Maltoma
E.	Reactive lymphoid proliferation
Answer» C. Anaplastic large cell lymphoma

Discussion

4.	Which of the following equations is used to determine a positive predictive value?
A.	True positive / (True positive + false negative)
B.	True positive / (True positive + false positive)
C.	True negative / (True negative + false negative)
D.	True negative / (True negative + false positive)
Answer» C. True negative / (True negative + false negative)

Discussion

5.	A 55 year old male presents with a history of chronic dyspepsia and with recent weight loss. Investigation by gastroscopy reveals a reduction in specialised gastric glands and the presence of slender giemsa staining filaments on the mucosal surface. In addition a gastric mass is seen. This is composed of large B lymphocytes which are negative for cyclin D1 and BCL2. Monoclonality is identified.
A.	Gastric DLBCL
B.	Anaplastic large cell lymphoma
C.	Maltoma
D.	Reactive lymphoid proliferation
E.	T-cell lymphoma.
Answer» B. Anaplastic large cell lymphoma

Discussion

6.	A 28-year-old woman was found to have stage IV Burkitt s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0 C with rigors and was treated with imipenem. Investigations (the following day):serum sodium 138 mmol/L (137 144)serum potassium 6.2 mmol/L (3.5 4.9)serum creatinine 215 mol/L (60 110)serum corrected calcium 1.60 mmol/L (2.20 2.60)serum phosphate 1.52 mmol/L (0.8 1.4)serum lactate dehydrogenase 1238 U/L (10 250)serum urate 0.69 mmol/L (0.19 0.36)What is the most likely cause of the renal impairment?
A.	imipenem toxicity
B.	intravenous contrast toxicity
C.	kidney infiltration
D.	septic shock
E.	tumor lysis syndrome
Answer» F.

Discussion

7.	A 67-year-old man in previously good health is hospitalized because of a 2-day history of fever and diminished consciousness. The patient responds inconsistently to verbal commands. His temperature is 39.5 C (103.1 F); he has tachycardia, and his blood pressure is 80/58 mm Hg. There is no bleeding. His hemoglobin is 12.1 g/dL, leukocyte count is 29,000/ L with 80% neutrophils, and platelet count is 20,000/ L. Which of the following studies should be obtained in this patient?
A.	Bone marrow aspiration and biopsy
B.	Factor VIII level
C.	Measurement of platelet-associated IgG
D.	Measurements of fibrin D-dimer and total fibrinogen
E.	Bleeding time
Answer» E. Bleeding time

Discussion

8.	A 37-year-old man is hospitalized because of fever and right-sided chest pain. He has been having fatigue and recently developed dyspnea on exertion and intermittent chills. At the age of 29 years he was diagnosed with stage III Hodgkin s disease and treated with multiagent chemotherapy and radiation therapy. A year ago, he developed mild anemia with no obvious cause. He takes thyroid hormone replacement when he remembers and has used fexofenadine as needed for allergic rhinitis for the past 5 years. On physical examination, his temperature is 38.7 C (101.7 F), pulse rate is 112/min, and blood pressure is 110/70 mmHg. There is dullness at the right lower lung and egophony. The hemoglobin is 8.5 g/dL, hematocrit is 26 %, leukocyte count is 2200/ L,and platelet count is 70,000/ L. What is the most likely diagnosis?
A.	Relapsed Hodgkin s disease
B.	Sepsis
C.	Hypothyroidism
D.	Secondary myelodysplastic syndrome
E.	Drug-induced bone marrow suppression
Answer» E. Drug-induced bone marrow suppression

Discussion

9.	A 43-year-old man with severe acquired aplastic anemia has not responded to immunosuppressive agents. He remains neutropenic and transfusion-dependent for platelets and red cells. He has an HLA-identical brother who has been cleared as a donor for his planned allogeneic stem cell transplant.They are both cytomegalovirus-seronegative. Which of the following would be prevented by using irradiated cellular blood products for this patient?
A.	Cytomegalovirus disease
B.	Alloimmunization
C.	Transfusion-related graft-versus-host disease
D.	Febrile nonhemolytic transfusion reaction
E.	Hemolytic transfusion reaction
Answer» D. Febrile nonhemolytic transfusion reaction

Discussion

10.	A 34-year-old woman is evaluated because of progressive fatigue and recurrent attacks of abdominal pain. She weighs 61.2 kg (135 Ib). Her pulse rate is 110/min and her blood pressure is 110/70 mm Hg. She is pale, and her spleen is palpable 4 cm below the costal margin. Laboratory studies: Hemoglobin 6 g/dLHematocrit 20% Leukocyte count 2500/ L Platelet count 80,000/ L Reticulocyte count 10%Blood smear Anisocytosis and polychromatophilia Haptoglobin 0 mg/dLSerum lactate dehydrogenase 645 U/LThere is high level of hemosiderin in the urine.What is the most likely cause of this patients pancytopenia?
A.	Autoimmune hemolytic anemia
B.	Aplastic anemia
C.	Myelodysplastic syndrome
D.	Paroxysmal nocturnal hemoglobinuria
E.	Acute myeloid leukemia
Answer» E. Acute myeloid leukemia

Discussion

11.	Which one of the following is an accurate definition of the sensitivity of a screening test?
A.	The percentage of screening tests that is positive
B.	The percentage of screening tests that is negative among patients who remain unaffected by the condition of interest after screening
C.	The percentage of screening tests that is positive among patients who remain unaffected by the condition of interest after screening
D.	The probability of a diagnosis of the condition of interest after a positive screening test
Answer» D. The probability of a diagnosis of the condition of interest after a positive screening test

Discussion

12.	In an office visit for an annual checkup, a 46-year-old man reports that he has had malaise and intermittent sweats for the past few months but has been able to continue his job as a high school teacher. Two years ago he was treated for stage III diffuse large-cell non-Hodgkin s lymphoma with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and attained complete remission. He takes simvastatin for hypercholesterolemia and hydrochlorothiazide for hypertension. On physical examination, he has lymphadenopathy: a 3-cm right axillary node and a 2- cm right supraclavicular node. His spleen tip is palpable. Laboratory evaluation shows mild normochromic, normocytic anemia and an elevated serum lactate dehydrogenase level. CT scans of his chest and abdomen reveal additional mediastinal and retroperitoneal lymphadenopathy. What is the best next step in this patient s management?
A.	A 2-week course of oral antibiotics
B.	Referral for salvage chemotherapy and autologous stem cell transplantation
C.	A repeat physical examination and CT scans in 3 months
D.	Referral for treatment with investigational agents
E.	A repeat course of CHOP
Answer» C. A repeat physical examination and CT scans in 3 months

Discussion

13.	A 74-year-old woman presents for an urgent office visit. She has been experiencing epigastric discomfort over the last 3 months. Discomfort is worse during meals and prevents her from eating full portions. She has lost 5.4 kg (12 Ib). She also reports dyspnea on exertion. She has been taking ramipril, aspirin, and simvastatin. On physical examination, her pulse rate is 88/min, and her blood pressure is 155/85 mm Hg. There is mild epigastric tenderness with palpation. Her spleen is massively enlarged and palpable at the umbilicus. The edge of her liver is also palpable 6 cm below the costal margin. Her hemoglobin is 7.5 g/dL, mean corpuscular volume 89 fL, leukocyte count 11,200/ L, and platelet count 114,000/ L. Peripheral blood smear shows numerous erythroblasts, myeloid precursors, and teardrop cells. Bone marrow cannot be aspirated, and biopsy specimen shows marked fibrosis. Analysis of blood is negative for t(9;22) by fluorescent in situ hybridization (FISH). What is the most l
A.	Chronic myeloid leukemia
B.	Hairy cell leukemia
C.	Myelodysplastic syndrome
D.	Disseminated tuberculosis
E.	Myelofibrosis
Answer» F.

Discussion

14.	A 43-year-old man is evaluated because of crushing substernal chest pain that developed during a pickup basketball game with colleagues at work. He was treated 15 years ago for stage IIB massive mediastinal Hodgkin s disease. Treatment included doxorubicin, bleomycin, vinbiastine, and dacarbazine (ABVD) followed by mantle-field radiation therapy to a total dose of 4400 cGy. He has had no recurrence of his Hodgkin s disease. He takes thyroid medication because he developed hypothyroidism 2 years after completing his therapy for Hodgkins disease. What is the most likely diagnosis?
A.	Recurrent Hodgkins disease
B.	Myocardial infarction
C.	Pulmonary fibrosis
D.	Anemia associated with secondary myelodysplasia evolving to acute leukemia
E.	Constrictive pericarditis
Answer» C. Pulmonary fibrosis

Discussion

15.	Which is the most accurate method of detecting colon cancer
A.	Fecal occult blood
B.	PET/CT
C.	Sigmoidoscopy
D.	Colonoscopy
E.	Digital examination
Answer» E. Digital examination

Discussion

16.	A 68-year-old man is evaluated because of worsening chronic epigastric pain. He now has fatigue and early satiety. He has iron deficiency anemia. Results of upper gastrointestinal endoscopy reveal diffuse gastritis, along with mucosal thickening in the gastric antrum associated with a mass lesion. Abundant Helicobacter pylon organisms are noted on biopsy, and histologic evaluation of the mass lesion shows it to be a gastric lymphoma of mucosa-associated lymphoid tissue (MALT) type. What is the most appropriate next step in the management of this patients illness?
A.	Combination chemotherapy with 5-fluorouracil, doxorubicin, and mitomycin C (FAM)
B.	Combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)
C.	Four cycles of CHOP followed by involved-field radiation therapy
D.	Eradication of Helicobacter pylori
E.	Total gastrectomy followed by radiation therapy
Answer» E. Total gastrectomy followed by radiation therapy

Discussion

17.	What is the most appropriate treatment for T3 colon cancer
A.	Surgery alone
B.	Chemotherapy alone
C.	Radiotherapy alone
D.	Surgery plus chemotherapy
E.	Supportive care only
Answer» E. Supportive care only

Discussion

18.	Radiotherapy is indicated in
A.	aT3 colon cancer
B.	T2 colon cancer
C.	T3 rectal cancer
D.	T1 rectal cancer
E.	T1 colon cancer
Answer» D. T1 rectal cancer

Discussion

19.	Gardner's syndrome is associated with all the following EXCEPT:
A.	multiple colorectal adenomas
B.	sebaceous and dermoid cysts
C.	adenomas of the mandible or skull
D.	desmoid tumors of the abdominal wall
E.	no malignant potential
Answer» F.

Discussion

20.	Which of the following is more likely to result from the administration of bleomycin?
A.	sodium urate
B.	calcium pyrophosphate
C.	calcium hydroxyapatite
D.	calcium oxalate
E.	none of above
Answer» B. calcium pyrophosphate

Discussion

21.	In women the biggest risk factor for breast cancer is:
A.	Family history
B.	Previous contra lateral breast cancer
C.	Benign breast disease.
D.	Hyperplasia
E.	Breast feeding
Answer» C. Benign breast disease.

Discussion

22.	Disease least likely to have a family predisposition
A.	Breast cancer
B.	Lung cancer
C.	Germ cell cancer of testes
D.	Ovarian cancer
E.	Prostate cancer
Answer» C. Germ cell cancer of testes

Discussion

23.	DNA microsatellite - best description
A.	Single locus 2 - 4 base pairs repeats
B.	DNA fragments
C.	CAG repeat
D.	DNA folding
Answer» B. DNA fragments

Discussion

24.	Among viruses which are activated due to immunosuppression the least oncogenic virus is
A.	HHV8
B.	CMV
C.	Hepatitis B
D.	EBV
E.	Human papillomavirus
Answer» C. Hepatitis B

Discussion

25.	55 year female - breast cancer 3 yrs ago had mastectomy only Presents with lower back pains. Some neurology - mild --> equivocal plantar. MRI Shows lesions in 3- 4 different vertebra - partially compressing spinal cord.
A.	surgical decompression and radiotherapy
B.	chemotherapy
C.	oestrogen therapy
D.	NSAID
E.	Steroids
Answer» B. chemotherapy

Discussion

26.	Man with medullary carcinoma of thyroid, worried about his son. What do you do?
A.	yearly calcitonin
B.	look for ret oncogene in the cancer
C.	look for ret oncogene in blood
D.	pentagastrin stimulation test
E.	reassure
Answer» D. pentagastrin stimulation test

Discussion

27.	The most common type of esophageal cancer in the United States is:
A.	adenocarcinoma
B.	leiomyosarcoma
C.	lymphoma
D.	squamous cell carcinoma
Answer» E.

Discussion

28.	Median survival is defined as the:
A.	most prevalent time to death in the sample population.
B.	point in time a survival probability on a Kaplan-Meier curve is 50%.
C.	median of the survival-time intervals.
D.	mean of the survival-time intervals.
Answer» C. median of the survival-time intervals.

Discussion

29.	Which of the following statements about the diagnosis of inflammatory breast cancer is true?
A.	There may not be a discrete palpable mass at presentation.
B.	At presentation, a patient may report having a longstanding breast mass that developed skin changes over time.
C.	A biopsy is not required, since the diagnosis is clinically established.
D.	Dermal lymph node involvement must be demonstrated.
Answer» B. At presentation, a patient may report having a longstanding breast mass that developed skin changes over time.

Discussion

30.	Which of the following statements about metastasis of breast cancer to the bone is true?
A.	Metastasis to the epidural spine is most commonly associated with worsening back pain in the supine position or with the Valsalva maneuver.
B.	Compression of the epidural spinal cord associated with breast cancer most commonly has a single site of vertebral metastasis.
C.	Radicular pain in the thoracic spine is typically unilateral.
D.	Pain from T12, L1 vertebral lesions is not associated with a referred pain pattern to the bilateral iliac crests or to the bilateral sacroiliac joints.
Answer» B. Compression of the epidural spinal cord associated with breast cancer most commonly has a single site of vertebral metastasis.

Discussion

31.	A 50-year-old woman with early breast cancer presented with fatigue to the accident and emergency department on day 7 of her first adjuvant chemotherapy cycle. On examination, her temperature was 38.5 C, her pulse was 110 beats per minute and her blood pressure was 110/70 mmHg. A full blood count was requested. What is the most appropriate next step?
A.	await full blood count result
B.	intravenous broad-spectrum antibiotics
C.	intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factor (G-CSF)
D.	oral broad-spectrum antibiotics
E.	oral broad-spectrum antibiotics and G-CSF
Answer» C. intravenous broad-spectrum antibiotics and granulocyte colony-stimulating factor (G-CSF)

Discussion

32.	Which of the following types of cancer is most commonly associated with myasthenia gravis?
A.	Small cell lung cancer
B.	Non-small cell lung cancer
C.	Mesothelioma
D.	Thymoma
Answer» E.

Discussion

33.	SBLA syndrome is another name of
A.	Lynch I
B.	Lynch II
C.	Li- Fraumeni syndrome
D.	Cowden's syndrome
E.	Peutz-Jegher s Syndrome
Answer» D. Cowden's syndrome

Discussion

34.	Which of the following statements about the effectiveness of cancer is true? for treating thyroid
A.	Medullary carcinoma is treated more effectively than H rthle cell carcinoma.
B.	The follicular variant of papillary carcinoma is treated more effectively than H rthle cell carcinoma.
C.	Tall cell carcinoma is treated more effectively than the follicular variant of papillary carcinoma.
D.	Insular carcinoma is treated more effectively than the follicular variant of papillary carcinoma.
Answer» C. Tall cell carcinoma is treated more effectively than the follicular variant of papillary carcinoma.

Discussion

35.	Multiple recurrent ulcers in proximal and distal duodenum for several years are likely to be associated with:
A.	heavy aspirin intake
B.	islet cell adenoma of pancreas
C.	smoking
D.	excessive bile secretion
Answer» C. smoking

Discussion

36.	In a patient with a chronic peptic ulcer of the stomach, the chance that carcinoma will develop in the ulcer is:
A.	over 80%
B.	about 50%
C.	about 30%
D.	very small
Answer» E.

Discussion

37.	Carcinoma of the stomach usually arises from:
A.	smooth muscle cells
B.	acid producing cells
C.	pepsinogen producing cells
D.	mucus producing cells
E.	argentaffin cells
Answer» E. argentaffin cells

Discussion

38.	Which presents as a bulky mass lesion often with deep central ulceration?
A.	leiomyoma of stomach
B.	leiomyosarcoma of stomach
C.	both
D.	neither
Answer» D. neither

Discussion

39.	Lymphoma of the stomach:
A.	may be primary or secondary in the stomach
B.	has a better prognosis than carcinoma of the stomach
C.	both
D.	neither
Answer» D. neither

Discussion

40.	Which is characterized by small size?
A.	adenomatous polyp
B.	hyperplastic polyp
C.	villous adenoma
D.	juvenile polyp
Answer» C. villous adenoma

Discussion

41.	Which of the following is most strongly predisposing to colon cancer?
A.	ulcerative colitis
B.	familial polyposis
C.	Crohn s disease
D.	Peutz-Jegher s syndrome
Answer» C. Crohn s disease

Discussion

42.	Predisposes to adenocarcinoma:
A.	Barrett s esophagus
B.	achalasia, esophagus
C.	both
D.	neither
Answer» B. achalasia, esophagus

Discussion

43.	A 40-year-old male is operated on for a medullary carcinoma of the thyroid. He expresses concern about his 10 years son getting the disease. The best test:
A.	Yearly calcitonin in son
B.	yearly pentagastrin-stimulated calcitonin in son
C.	DNA analysis for RET proto-oncogene in tumor
D.	DNA analysis for RET proto-oncogene in peripheral blood
E.	Thyroid ultrasound in son
Answer» E. Thyroid ultrasound in son

Discussion

44.	Which of the following tumor stages is correctly matched to the appropriate prostate cancer involvement or invasion?
A.	Stage T2b is associated with tumor involvement of more than one half of one lobe but not both lobes of the prostate.
B.	Stage T2c is associated with nonpalpable tumor involvement of both lobes of the prostate via needle biopsy.
C.	Stage T3a is associated with tumor invasion of the prostate apex.
D.	Stage T4 is associated with tumor invasion of the seminal vesicles.
Answer» B. Stage T2c is associated with nonpalpable tumor involvement of both lobes of the prostate via needle biopsy.

Discussion

45.	Three different lung cancer radiation treatments are being assessed for maximum- tolerated dose. This study is an example of what type of clinical trial?
A.	Phase I
B.	Phase II
C.	Phase III
D.	Pilot
Answer» B. Phase II

Discussion

46.	What is the second leading cause of lung cancer?
A.	Exposure to arsenic
B.	Exposure to asbestos
C.	Exposure to benzene
D.	Exposure to radon
Answer» E.

Discussion

47.	What is a major criterion for the diagnosis of multiple myeloma?
A.	Calcium level of >12 mg/dL
B.	Hemoglobin level of 8.5 g/dL
C.	Plasmacytoma on tissue biopsy
D.	Lytic bone lesions on skeletal survey
Answer» D. Lytic bone lesions on skeletal survey

Discussion

48.	Which of the following factors increases a patient's risk for the development of leukemia?
A.	Occupational exposure to benzene
B.	Occupational exposure to aluminum
C.	Use of mitomycin C
D.	Exposure to HPV
Answer» B. Occupational exposure to aluminum

Discussion

49.	Which of the following processes is NOT commonly involved in the development of bone metastases?
A.	Avascular necrosis
B.	Activation of osteoclasts
C.	Cell adhesion molecules
D.	Chemotaxis of metastatic cancer cells
Answer» B. Activation of osteoclasts

Discussion

50.	Which of the following findings is most likely to be caused by loss of function of right cranial nerve XII?
A.	Deviation of the tongue to the left side with protrusion
B.	Deviation of the tongue to the right side with protrusion
C.	Loss of sweet taste on the right side of the tongue
D.	Loss of salty taste on the right side of the tongue
Answer» C. Loss of sweet taste on the right side of the tongue

Discussion

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