review 5 by akashyap


									<Q>A 45-year-old healthy woman has a routine check of her health status. She has no chest pain, cough, or fever. A chest x-ray taken and shows a peripheral 2.5 cm diameter "coin lesion" in the right mid-lung field. Which of the following biologic characteristics best distinguishes this lesion as a neoplasm, rather than a granuloma? <C>Recurrence following excision <C> Rapid increase in size <C+> Uncontrolled (autonomous) growth <C> Necrosis

<Q>A study is performed to analyze characteristics of malignant neoplasms in biopsy specimens. The biopsies were performed on patients who had palpable mass lesions on digital rectal examination. Of the following microscopic findings, which is most likely to indicate that the neoplasm is malignant? <C>Pleomorphism <C>Atypia <C+> Invasion <C> Increased nuclear/cytoplasmic ratio <C>Necrosis <Q>A child is born with a single functional allele of a tumor suppressor gene. At the age of five the remaining normal allele is lost through a point mutation. As a result, the ability to continue the transition from G1 to the S phase of cell cycle is lost. Which of the following neoplasms is most likely to arise via this mechanism? <C> Infiltrating ductal carcinoma of breast <C> Small cell anaplastic carcinoma of the lung <C+> Retinoblastoma of eye <C> Cerebral astrocytoma <C>Chronic myeloid leukemi

<Q>A 52-year-old man has had increasing fatigue for the past 6 months. On physical examination he has a palpable spleen tip. Laboratory studies show a WBC count of 189,000/microliter. The peripheral blood smear shows many mature and immature myeloid cells present. Cytogenetic analysis of cells obtained via bone marrow aspiration reveals a t (9:22) translocation. This translocation leads to formation of a hybrid gene that greatly increases tyrosine kinase activity. Which of the following genes is most likely translocated to cause these findings? <C>p53 <C> Rb <C+> c-abl <C> NF-1 <C> k-ras

<Q>A 41-year-old woman has noted a foul-smelling vaginal discharge for 3 weeks. On physical examination there is an exophytic 3 cm mass involving the ectocervix. Pap smear testing is performed; she has never had a previous Pap smear. Cytologic changes are present on this Pap smear that are consistent with squamous cell carcinoma. She is found to have a positive serologic test for syphilis. Her serum glucose is increased above normal . She has been a commercial sex worker in the past. Which of the following is the most likely risk factor for her cervical carcinoma? <C+> Human papillomavirus infection <C> Diabetes mellitus, type II <C> Heavy cigarette smoking <C> Pelvic inflammatory disease <C> Previous cancer chemotherapy

<Q>A 70-year-old healthy man is found to have a palpable firm nodule in the prostate gland on digital rectal examination. His serum prostate specific antigen (PSA) is increased to 4 times the normal. The microscopic appearance seen on biopsy of the prostate will probably be most consistent with which of the following conditions? <C> Chronic prostatitis <C+>Adenocarcinoma <C> Infarction <C> Leiomyoma <C> Rhabdomyosarcoma

<Q>In an experiment, it is observed that chronic, increased exposure to ionizing radiation results in damage to cellular DNA. As a consequence, a protein is now absent that would arrest the cell in the G1 phase of the cell cycle. Subsequent to this, the cell is transformed to acquire the property of unregulated growth. The absent protein is most likely the product of which of the following genes? <C> k-ras <C+> p53 <C> c-myc <C> c-abl <C> Bcl-2

<Q>A 44-year-old woman who has had multiple sexual partners for the past 30 years has an abnormal Pap smear with cytologic changes suggesting human papillomavirus infection. Without treatment, she is most likely to develop which of the following lesions? <C+> Squamous cell carcinoma <C> Non-Hodgkin's lymphoma <C> Kaposi's sarcoma <C> Adenocarcinoma <C> Leiomyoma

<Q>In an experiment, biologic characteristics of neoplastic and non-neoplastic cells are analyzed in culture. It is observed that cell division in cells derived from malignant neoplasms, but not in normal cells, is aided by the presence of an enzyme which repairs progressive chromosomal shortening. The lack of chromosomal shortening allows the malignant cells to undergo many more divisions than the normal cells. Which of the following enzymes is most likely to have this effect? <C> Reverse transcriptase <C> DNA polymerase <C+> Telomerase <C> Protein kinase <C> Topoisomerase

<Q>A 62-year-old man has complained of pain on urination for the past week. He is afebrile. On cystoscopy, a slightly erythematous 1 cm diameter area is seen on the bladder mucosa. This area is biopsied and on microscopic examination shows cells with marked hyperchromatism and increased nuclear/cytoplasmic ratio involving the full thickness of the epithelium. However, these changes are confined to the epithelium above the basement membrane. Which of the following terms best describes these biopsy findings? <C> Metaplasia <C> Minimal dysplasia <C> Microinvasion <C> Hyperplasia <C+> Carcinoma in situ

<Q>A 53-year-old woman feels a lump in her right breast. Her physician palpates an irregular 3 cm mass that is not movable because it appears fixed to the overlying skin, which is retracted. A mastectomy is performed and the pathologist on sectioning the breast finds a 3 x 3.5 cm ovoid mass,microscopic examination of which shows sheets of cells exhibiting marked nuclear pleomorphism,high N:C ratio,numerous mitosis Which of the following terms denotes these changes? <C> Anaplasia <C>Aplasia <C> Desmoplasia <C> Dysplasia <C+> Metaplasia

<Q>A 66-year-old man has a routine physical examination and a stool sample proves positive for the presence of occult blood. He undergoes colonoscopy and a 5 cm sessile mass is present in the sigmoid colon. Biopsy of the mass yields a diagnosis of adenocarcinoma. A chest x-ray shows multiple 1 to 3 cm nodules in both lungs. Presence of which of the following in the neoplastic cells is most likely to explain the presence of lung nodules? <C> Vimentin <C> Leukocyte common antigen <C+> Laminin receptor <C> Telomerase <C> DNA topoisomerase II

<Q>An epidemiologic study is performed involving patients with long-standing EpsteinBarr virus infection. It is observed that these patients have an increased risk for development of malignant neoplasms in adulthood. Which of the following neoplasms is most likely to be found in these patients? <C> Kaposi sarcoma <C> Small cell anaplastic carcinoma of lung <C> Osteosarcoma <C+> Nasopharyngeal carcinoma <C> Endometrial carcinoma

<Q>A study of malignant neoplasms reveals that some of them have a greater potential for invasion and metastases. Analysis of the cells of cancers that have metastasized reveals a mutation which results in decreased cell surface expression of E-cadherin. Which of the following genes is most likely mutated to produce these findings? <C+> beta-catenin <C> BRCA-2 <C>Cyclin D <C> NF-1 <C> RAS

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