Ad Blocker Detected
Our website is made possible by displaying online advertisements to our visitors. Please consider supporting us by disabling your ad blocker.
Select the ONE answer that is BEST in each case.
A 19-year-old man presents with multiple lymph nodes in his neck. He reports no current infectious symptoms, and his monospot test is negative. On examination, he has blanching skin lesions on his face and conjunctivae, multiple large lymph nodes in his neck, and poor coordination when tested by tandem walking. He has past history of poor coordination and walking difficulty as well as recurrent sinopulmonary infections. A biopsy of the lymph node is positive for lymphoma. He is diagnosed with a hereditary disorder that is autosomal dominant, and is associated with defective deoxyribonucleic acid (DNA) repair mechanisms. Which of the following is the most likely diagnosis?
Ataxia-telangiectasia is inherited in an autosomal recessive manner. It is associated with non-Hodgkin’s lymphoma, acute lymphocytic leukemia, and stomach cancer. Associated immunoglobulin A (IgA) (± immunoglobulin E [IgE]) deficiency predisposes to infection as well. All the other conditions listed are inherited in an autosomal dominant manner, and a positive family history is much more likely
See all quizzes of the Oncology at here:
|1. A 19-year-old man presents with multiple lymph nodes in his neck. He reports no current infectious symptoms, and his monospot test is negative. On examination, he has blanching skin lesions on his face and conjunctivae, multiple large lymph nodes in his neck, and poor coordination when tested by tandem walking. He has past history of poor coordination and walking difficulty as well as recurrent sinopulmonary infections. A biopsy of the lymph node is positive for lymphoma. He is diagnosed with a hereditary disorder that is autosomal dominant, and is associated with defective deoxyribonucleic acid (DNA) repair mechanisms. Which of the following is the most likely diagnosis?
(B) tuberous sclerosis
(D) von Hippel-Lindau syndrome
(E) Peutz-Jeghers syndrome
|2. A 33-year-old male immigrant from Taiwan presents with increasing right upper quadrant (RUQ) pain. The pain is dull, and it does not radiate or change with eating. On examination the abdomen is soft, there is a mass in the RUQ, and no ascites is clinically detected. He has aprior history of hepatitis B. His laboratory investigations reveal hepatitis B surface antigen (HBsAg) positive, hepatitis B surface antibody (HBsAb) negative, aspartate amino transferase (AST) 60 U/L, alanine amino transferase (ALT) 72 U/L, and an elevated alpha-fetoprotein level. Which of the following is the most likely diagnosis?
(B) hepatocellular carcinoma (HCC)
(C) metastatic cancer
(D) hepatic hemangioma
(E) liver cirrhosis
|3. A 42-year-old man received radiation exposure at a nuclear power plant in Eastern Europe. He is now concerned about his future cancer risk. Which of the following statements is correct?
(A) malignancies occur within 10 years of exposure
(B) leukemia has the shortest latency period of all malignancies
(C) large exposure is required to develop the most serious malignancies
(D) risk increases with advancing age at the time of exposure
(E) therapeutic radiation therapy given without chemotherapy does not increase the risk of a second malignancy
|4. A 25-year-old woman has recently moved to a new city. She comes today for her first routine visit and annual physical assessment. She asks you about screening tests for cancer at her age. Which of the following cancer screening tests are recommended for her age group?
(A) mammography every 5 years
(B) Pap smear at least every 3 years
(C) stool for occult blood
(D) chest x-ray (CXR) every 3 years
(E) physical examination of the breast by a physician
|5. A 25-year-old woman presents with intermittent double vision and fatigue. Her symptoms are worse at the end of the day. She reports no other focal muscle weakness or sensory symptoms. On examination her eye movements, motor strength, and reflexes in the upper and lower limbs are normal. Repetitive handgrip exercises cause loss of strength in the grip. ACXR reveals an anterior mediastinal mass. Which of the following is the most likely diagnosis of the anterior mediastinal mass?
(E) mediastinal cyst
|6. A 64-year-old man presents with symptoms of difficulty swallowing and weight loss of 10 lb. He has no prior history of heartburn, stomach ulcers, or difficulty swallowing. He smokes one pack a day for the past 45 years and drinks approximately 5 oz of alcohol a day. He is thin appearing, there are no oral lesions, and the remaining examination is normal. Esophagoscopy reveals a midesophageal narrowing with ragged ulcerating, and biopsies are taken. Which of the following is the most likely diagnosis?
(A) adenocarcinoma of esophagus
(B) esophageal web
(D) squamous cell carcinoma of esophagus
(E) esophageal leiomyoma
|7. A 62-year-old man presents with dark tarry stools and light-headedness. Upper endoscopy finds an ulcerating lesion in his stomach and biopsies confirm gastric cancer. Which of the following is a risk factor for carcinoma of the stomach?
(A) Helicobacter pylori infection
(B) high socioeconomic status
(C) high protein diet
(D) high alcohol consumption
(E) high fat diet
|8. A young man with leukemia is treated with methotrexate. Which of the following is the mechanism of action of this drug?
(A) preventing absorption of folic acid
(B) inhibiting dihydrofolate reductase
(C) preventing formation of messenger ribonucleic acid (mRNA)
(D) forming a cytotoxic metabolite
(E) preventing proper functioning of membrane adenosine triphosphatase (ATPase)
|9. A 52-year-old man presents with abdominal pain and weight loss. He describes a dull “gnawing” pain located in the epigastric region radiating to the back. The abdominal examination is normal with no hepatosplenomegaly or masses palpated. A computerized tomography (CT) scan of the abdomen reveals a 3-cm mass in the pancreas. Which of the following statements regarding cancer of the pancreas is true?
(A) tumors of the pancreas are divided almost equally between those arising from the exocrine portion and those arising from the endocrine portion
(B) most endocrine tumors of the pancreas are malignant
(C) the body of the pancreas is the most common site of malignancy
(D) adenocarcinoma is the most common pancreatic cancer
(E) extension is through local invasion; metastases are a late manifestation
|10. A73-year-old man was born in Taiwan and came to the United States 3 years ago. He is known to be HBsAg positive. Which of the following findings suggests the development of HCC?
(B) hepatic bruits
(E) all of the above
|11. A 47-year-old man presents with dark black stools and vague crampy abdominal pain. On examination he is pale, blood pressure 100/70 mm Hg, pulse 110/min, and the abdomen is soft and nontender. Rectal examination confirms melena, and the patient is transfused 2 units of packed red blood cells. Upper endoscopy does not identify the source of bleeding, so a small bowel barium study is ordered. It reveals a small bowel tumor. Which of the following statements concerning small bowel tumors is correct?
(A) carcinoid is a common cause of small bowel tumors
|12. A 58-year-old man is newly diagnosed with colon cancer and undergoes surgical resection of the tumor. The pathology result reports no lymph node involvement, the lesion is 4 cm in size and involves the muscularis layer. His preoperative evaluation for distal metastases was negative. Which of the following factors is most important in predicting prognosis and survival in patients with colon cancer?
(A) age under 40
(B) male gender
(C) rectal bleeding
(D) small tumor size
(E) depth of tumor penetration
|13. A 64-year-old woman presents with abnormal vaginal discharge and postmenopausal bleeding. Pelvic examination reveals a bulky uterus and no adnexal masses. She undergoes a dilation and curettage (D&C), and the pathology is positive for adenocarcinoma. Which of the following is correct about carcinoma of the uterine endometrium?
(A) not associated with diabetes mellitus and obesity
(B) most common in postmenopausal woman
(C) associated with multiparity
(D) common in Jews and Muslims
(E) associated with herpes simplex virus type 2 (HSV-2) infection
|14. You are seeing a 62-year-old woman with a family history of breast cancer. She is worried about her future risk of breast cancer, since her mother died of breast cancer at the age of 63. Which of the following features is also a recognized risk factor for breast cancer?
(A) early onset of menopause
(B) early onset of menarche
(C) late-life radiation exposure
(E) early full-term pregnancy
|15. A 67-year-old man complains of shortness of breath on exertion and right-sided chest pain. The pain is constant in nature; he has no fever or chills and no sputum production. On examination, air entry to the left lower lobe is reduced and the area is dull on percussion. The CXR reveals left lower lobe pleural effusion, pleural thickening with calcification (plaques), and lower lobe fibrosis. Further history from the patient is significant in that he is a lifetime nonsmoker, and that he worked as a pipe fitter until retiring 2 years ago. Which of the following is the most likely diagnosis?
(B) squamous cell carcinoma
|16. A 23-year-old notices left leg pain after returning from a ski trip. The pain persists for 2 months, and he presents for medical evaluation after noticing a lump on his calf. On examination, there is a 2-cm nonmobile mass in his anterior shin. A magnetic resonance imaging (MRI) scan suggests the lesion is arising from the tibia, and a biopsy reveals bone sarcoma. Which of the following statements about bone sarcoma is correct?
(A) distal bone sarcomas have a better prognosis
(B) lung metastases are a late sign
(C) local lymph node involvement is very common
(D) articular cartilage is a common plane for tumor spread
|17. A 19-year-old woman notices axillary lymphadenopathy and presents for evaluation. She has noticed the lymph nodes for over a month. She has no fever, chills, weight loss, or night sweats. On examination, she has multiple mobile nontender lymph nodes in both axilla, and no cervical or inguinal lymph nodes. No spleen is palpable, and the rest of the examination is normal. A monospot test is negative, and a complete blood count (CBC) and biochemistry are normal. A biopsy of one lymph node reveals Hodgkin’s disease (HD), nodular sclerosing variety. A bone marrow biopsy is arranged. Which of the following tests is also part of the routine staging evaluation for patients with HD?
(A) positron emission tomography (PET) scan
(B) gallium scan
(C) CT of chest, abdomen, and pelvis
(D) staging laparotomy
(E) bone scan
|18. A 23-year-old man is newly diagnosed with Hodgkin’s lymphoma. Which of the following is the most likely presenting symptom of this type of lymphoma?
(A) coincidentally detected mediastinal mass
(B) fixed tender inguinal lymph node involvement
(C) mobile nontender cervical lymph nodes
(D) fixed nontender axillary nodes
(E) mobile tender axillary nodes
|19. A 68-year-old man presents with left axillary adenopathy that on biopsy reveals a low-grade lymphocytic lymphoma. Which of the following statements is correct?
(A) staging in this type of disorder is not relevant
(B) if disease is widespread, early aggressive chemotherapy will result in an improved prognosis for survival
(C) the disease is likely to be widespread at the time of diagnosis
|20. A 63-year-old man presents with a new skin rash on his chest. The lesions are well-defined red-colored plaques. A skin biopsy of the lesion reveals lymphoma. Further diagnostic evaluation does not reveal any evidence of a visceral malignancy. Which of the following characteristics about this disease is correct?
(A) it is invariably a precursor to leukemia
(B) it is of T-cell origin
(C) it has no specific geographic distribution
(D) it has a high likelihood of cure
(E) it is related to sun exposure