Internal-Medicine

126 6: Oncology
Questions 38 through 42
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
alcoholic beverages
alkylating agents
arsenic
asbestos
benzene
ultraviolet radiation
Epstein-Barr virus
hepatitis B virus (HBV)
human papillomavirus (HPV)
vinyl chloride
For each patient with cancer, select the most likely
etiologic agent.
38. A 56-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. (SELECT ONE)
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.
(SELECT ONE)
42. A 58-year-old woman presents with RUQ
abdominal discomfort. She has no history of
gallstones, and on examination, there is a firm
mass in the RUQ. Ultrasound of the liver reveals
a 6-cm solitary lesion in the liver, and her alphafetoprotein
level is elevated. (SELECT ONE)
Questions 43 through 47
(A)
(B)
(C)
(D)
(E)
cancer metastatic to the lung
squamous cell cancer of the lung
adenocarcinoma of the lung
small cell cancer of the lung
large cell cancer of the lung
For each of the following findings, select the most
likely type of lung cancer.
43. The most common type of lung cancer in the
United States. (SELECT ONE)
44. Has the best prognosis of all malignant lung
cancers. (SELECT ONE)
45. Most likely to cause nonmetastatic hypercalcemia.
(SELECT ONE)
46. Associated with syndrome of inappropriate
antidiuretic hormone (SIADH). (SELECT ONE)
47. Associated with myasthenic syndrome (Eaton-
Lambert syndrome). (SELECT ONE)
Questions 48 through 52
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. (SELECT ONE)
41. A 54-year-old woman has postmenopausal
vaginal bleeding. There is no associated pain or
systemic symptoms, and speculum examination
reveals an irregular appearance to the
cervix, which bleeds easily when samples are
taken for a Pap smear. The diagnosis is cervical
cancer. (SELECT ONE)
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
methotrexate
cytarabine
5-fluorouracil (5-FU)
bleomycin
doxorubicin
pamidronate
cisplatin
busulfan
cyclophosphamide
vincristine