Internal-Medicine

CHAPTER 6
Oncology
Questions
DIRECTIONS (Questions 1 through 30): Each of
the numbered items in this section is followed by
answers. Select the ONE lettered answer that is
BEST in each case.
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?
prior 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?
(See Fig. 6–1.)
(A)
(B)
(C)
(D)
(E)
hepatoma
hepatocellular carcinoma (HCC)
metastatic cancer
hepatic hemangioma
liver cirrhosis
(A)
(B)
(C)
(D)
(E)
neurofibromatosis
tuberous sclerosis
ataxia-telangiectasia
von Hippel-Lindau syndrome
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 a
Figure 6–1.
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