Internal-Medicine

120 6: Oncology
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)
(B)
(C)
(D)
(E)
malignancies occur within 10 years of
exposure
leukemia has the shortest latency period
of all malignancies
large exposure is required to develop
the most serious malignancies
risk increases with advancing age at the
time of exposure
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)
(B)
(C)
(D)
(E)
mammography every 5 years
Pap smear at least every 3 years
stool for occult blood
chest x-ray (CXR) every 3 years
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?
(A)
(B)
(C)
(D)
(E)
teratoma
thyroid
thymoma
lymphoma
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)
(B)
(C)
(D)
(E)
adenocarcinoma of esophagus
esophageal web
achalasia
squamous cell carcinoma of esophagus
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)
(B)
(C)
(D)
(E)
Helicobacter pylori infection
high socioeconomic status
high protein diet
high alcohol consumption
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)