The Quizzes about Oncology – Part 2 (20 test)

Ad Blocker Detected

Our website is made possible by displaying online advertisements to our visitors. Please consider supporting us by disabling your ad blocker.

The Quizzes about Oncology – Part 2 (20 test)
5 (100%) 1 vote

Select the ONE answer that is BEST in each case.

A 65-year-old man, with a 45-pack-per-year history of smoking, presents with hematuria and flank pain. He reports no fever, chills, or dysuria, but he has lost 15 lb. On examination the abdomen is soft, no mass is felt, and there is no flank tenderness on percussion. His hemoglobin (Hb) is 18.5 g/dL, and his liver enzymes are normal. A CT scan of the abdomen reveals a mass in the left kidney with involvement of the renal vein. Which of the following is the most likely diagnosis?

Age, history of smoking, and polycythemia in a patient with hematuria strongly suggests a renal cell carcinoma. The elevated hemoglobin represents increased erythropoietin production and is not related to prognosis. Involvement along the renal vein and metastases to the lungis also characteristic of renal cell carcinoma. Elevated liver enzymes and weight loss can represent nonmetastatic effects of malignancy and can reverse with resection. Almost half of patients will have a palpable abdominal mass on presentation. The CT of the thorax is a useful test because three-quarters of those with metastatic disease will have lung metastases

 

See all quizzes of  the Oncology at here:

Part 1Part 2 | Part 3 |

 

21. A 65-year-old man, with a 45-pack-per-year history of smoking, presents with hematuria and flank pain. He reports no fever, chills, or dysuria, but he has lost 15 lb. On examination the abdomen is soft, no mass is felt, and there is no flank tenderness on percussion. His hemoglobin (Hb) is 18.5 g/dL, and his liver enzymes are normal. A CT scan of the abdomen reveals a mass in the left kidney with involvement of the renal vein. Which of the following is the most likely diagnosis?
(A) renal cyst
(B) renal cell carcinoma
(C) renal metastases
(D) renal abscess
(E) lymphoma
22. A 53-year-old woman presents with a 1-cm invasive carcinoma of the breast, detected on mammography. She feels well and has no other symptoms. On examination the lump is palpable, and there are no axillary lymph nodes. Which of the following is the most appropriate local therapy for her tumor?
(A) simple mastectomy with axillary dissection
(B) radiation therapy to breast and axilla

(C) local excision plus radiation therapy
(D) local excision and axillary dissection followed by radiation therapy
(E) local excision and axillary sampling

23. A 68-year-old woman presents to her attending physician feeling unwell and having lost 10 lb. Physical examination reveals left axillary lymphadenopathy. Biopsy reveals welldifferentiated adenocarcinoma. Liver scan and bone scan suggest widespread metastases. Which statement concerning her further management is correct?
(A) the response rate for metastatic adenocarcinoma (well-differentiated) of unknown primary site is so poor that no investigation or treatment is indicated
(B) special stains might guide management
(C) extensive workup, including colonoscopy, abdominal CT scan, and mammography, will define subsets that benefit from treatment
(D) special studies of the excised lymph node are not useful in determining the site of origin
(E) metastatic breast cancer is the most common cause of adenocarcinoma of unknown primary site in women
24. A 47-year-old woman with cancer phobia comes to the office for counseling. Which of
the following statements is true?
(A) cancer is the most common cause of death in the United States
(B) cancer is the most common cause of death in middle-aged women
(C) incidence rates for cancer are generally higher in women than men
(D) colon and rectum cancers have the highest mortality rate when considering both men and women
(E) about 25% of all cancers in the United States are due to environmental factors
25. A 63-year-old man, with chronic heartburn symptoms for many years, presents for reevaluation because of increased abdominal discomfort. He is taking a proton pump inhibitor for his symptoms but experiences little relief. He undergoes upper endoscopy that reveals no masses or tumors, but there is esophagitis. Biopsy of the lower esophagus reveals columnar cells. Which of the following statements is correct?
(A) it is a major risk factor for squamous cell cancer of the esophagus
(B) it can be found in up to 20% of patients undergoing esophagoscopy for esophagitis
(C) the histologic changes include development of keratinized squamous cells
(D) medical control of reflux will decrease the likelihood of malignant changes

(E) only 10% of patients with Barrett’s esophagus may develop malignancy

26. A 59-year-old man develops jaundice and pruritus. He has no abdominal pain, and on physical examination he is icteric, the liver span is 10 cm, and no masses are felt. Ultrasound reveals dilated intrahepatic bile ducts. He undergoes endoscopic retrograde cholangiopancreatography(ERCP), which suggests a cholangiocarcinoma. Which of the following is the most likely predisposing factor for cholangiocarcinoma?
(A) smoking
(B) excess alcohol intake
(C) chronic hepatitis B virus (HBV) infection
(D) history of ulcerative colitis or sclerosing cholangitis
(E) gallstones
27. A 53-year-old woman notices a lump in her left breast. She reports no symptoms of breast discharge or previous breast disease. She is postmenopausal, menarche was at age 13, and her family history is negative for breast cancer. Examination reveals a 2-cm palpable lump, which is mobile and nontender, and there are no axillary lymph nodes. Biopsy of the lump is positive for breast cancer, and she undergoes a lumpectomy and lymph node dissection. Which of the following factors is important in deciding about adjuvant therapy for breast cancer?
(A) menopausal status
(B) tumor size
(C) endocrine receptor status
(D) lymph node status
(E) all of the above
28. A 45-year-old man is worried about a dark pigmented skin lesion on his arm. The “mole” is 3 mm wide, symmetric with a regular border and even pigmentation. He reports no change
in size or other symptoms. Which of the following is the most appropriate next step in management?
(A) observation only
(B) excisional biopsy
(C) punch biopsy
(D) chemotherapy, then surgical excision
(E) surgical excision and regional node dissection
29. A 73-year-old man presents with fatigue and multiple lymph nodes in his neck. He has multiple large nontender lymph nodes in his neck and axilla. The spleen is not palpable, and the remaining examination is normal. A biopsy of the lymph node reveals lymphocytic lymphoma. Which of the following factors predicts poor prognosis?
(A) no extranodal involvement
(B) poor performance status
(C) age <60
(D) low serum lactate dehydrogenase (LDH) levels
(E) fever and weight loss
30. An asymptomatic 74-year-old man has a high erythrocyte sedimentation rate (ESR) noted on routine blood work done in a yearly physical examination. A follow-up protein electrophoresis reveals a monoclonal immunoglobulin G (IgG) spike. Which of the statements would suggest a plasma cell myeloma, rather than a monoclonal gammopathy of unknown significance?
(A) Bence Jones protein 2 g/day
(B) normal hemoglobin
(C) M component level of 2 g/dL
(D) bone marrow plasma cells of 5%
(E) normal serum calcium level
31. Have the lowest cancer rates for both sexes.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

32. Have very high rates of melanoma.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

33. Have the highest rates for breast, corpus uteri, and ovarian cancers.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

34. Have especially high rates for cervical cancer

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

35. Have elevated rates for nasopharynx and liver cancers.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

36. Have high rates for stomach cancer.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

37. Have high cancer rates, at least partially, due to socioeconomic factors.

(A) Hispanic Americans
(B) White Americans
(C) Black Americans
(D) Native Americans
(E) Chinese Americans
(F) Japanese Americans
(G) Filipino Americans

38. A56-year-old man notices an ulcer on his tongue. The lesion persists for a month and becomes more painful and larger in size. There is a 5-mm pale lesion on the lateral border of his tongue, and the remaining examination is normal. A biopsy of the site is positive for squamous cell cancer.

(A) alcoholic beverages
(B) alkylating agents
(C) arsenic
(D) asbestos
(E) benzene
(F) ultraviolet radiation
(G) Epstein-Barr virus
(H) hepatitis B virus (HBV)
(I) human papillomavirus (HPV)
(J) vinyl chloride

39. A 68-year-old man develops shortness of breath on exertion and right-sided chest pain. Air entry is reduced to the right lower lobe and the area is dull on percussion. A CXR reveals a right pleural effusion. A CT scan of the chest reveals a pleural-based tumor in the right lower lobe, and areas of calcification on the pleura. A biopsy of the lesion is positive for mesothelioma.

(A) alcoholic beverages
(B) alkylating agents
(C) arsenic
(D) asbestos
(E) benzene
(F) ultraviolet radiation
(G) Epstein-Barr virus
(H) hepatitis B virus (HBV)
(I) human papillomavirus (HPV)
(J) vinyl chloride

40. A 64-year-old woman notices a nodule on her face that persists for more than a month. It appears as a raised lesion with small vessels on it. Excisional biopsy of the lesion confirms a diagnosis of basal cell carcinoma.

(A) alcoholic beverages
(B) alkylating agents
(C) arsenic
(D) asbestos
(E) benzene
(F) ultraviolet radiation
(G) Epstein-Barr virus
(H) hepatitis B virus (HBV)
(I) human papillomavirus (HPV)
(J) vinyl chloride

Leave a Reply