Neoplasia — MCQs

A 9-year-old boy presents with polydipsia, polyuria, and a serum osmolality of 325 mOsm/L. A neurologic examination reveals bitemporal hemianopia. The lesion is believed to be derived from Rathke's pouch remnants. Which of the following is the most likely histologic finding?

A 38-year-old man presents with concerns after finding out that his father was recently diagnosed with colon cancer. Family history is only significant for his paternal grandfather who also had colon cancer. A screening colonoscopy is performed, and a polyp is found in the ascending (proximal) colon, which on biopsy shows adenocarcinoma. A mutation in a gene that is responsible for which of the following cellular functions is the most likely etiology of this patient’s cancer?

A 71-year-old man comes to the physician for a routine health maintenance examination. He has occasional fatigue but otherwise feels well. He has a history of hypertension and type 2 diabetes mellitus. He is a retired chemist. His only medication is ramipril. His temperature is 37.8°C (100°F), pulse is 72/min, respirations are 18/min, and blood pressure is 130/70 mm Hg. Physical examination shows nontender cervical and axillary lymphadenopathy. The spleen is palpated 7 cm below the costal margin. Laboratory studies show a leukocyte count of 12,000/mm3 and a platelet count of 210,000/mm3. Further evaluation is most likely to show which of the following?

A 44-year-old woman presents for her annual physical checkup. She says she first noticed a mass in her right breast while taking a shower 3 months ago, which has progressively increased in size. She denies any weight loss, fever, night sweats, discharge from or change in her nipples. Her family history is negative for breast, ovarian, and endometrial cancer. She is afebrile, and her vital signs are within normal limits. Physical examination reveals a smooth, multinodular, firm 5 cm x 5 cm mass in the right breast that is mobile and painless. The skin over the mass appears to be stretched and shiny without ulcerations, erythema, or vascular demarcation. On follow-up 6 weeks later, an interval ultrasound of the right breast reveals a well-circumscribed hypoechoic mass with some cystic components that now measures 8 cm x 7 cm. A core needle biopsy of the mass is performed. Which of the following diagnosis is most likely expected to be confirmed by the core needle biopsy in this patient?

A 27-year-old man comes to the physician because of a 4-month history of recurrent episodes of headaches, palpitations, and sweating. He was adopted shortly after birth and does not know his biological parents. His pulse is 103/min and blood pressure is 160/105 mm Hg. Physical examination shows multiple soft, yellow papules on the tip of the tongue. There is a 2-cm, firm thyroid nodule. He has long and slender upper extremities, and his elbows and knees can be hyperextended. The most likely cause of this patient's condition is a mutation in which of the following genes?

A 15-year-old male presents to the emergency department with fever, malaise, and shortness of breath for 1 week. Further history reveals that the patient experiences swelling in his face in the morning that disappears as the day progresses. Physical exam reveals hepatosplenomegaly. A complete blood count shows WBC 84,000 cells/mL. Most of this patient's leukocytes are likely to express which of the following cell surface markers?

A 58-year-old woman presents with a 2-week history of fever, fatigue, generalized weakness, and bleeding gums. Past medical history is significant for type 2 diabetes mellitus, managed with metformin. The patient is afebrile, and her vitals are within normal limits. On physical examination, she has bilateral cervical lymphadenopathy and hepatosplenomegaly. A complete blood count and peripheral blood smear reveal normocytic anemia and leukocytosis. A bone marrow biopsy is performed, which shows > 20 % myeloperoxidase positive myeloblasts with splinter-shaped structures in the cytosol. The patient is started on a vitamin A derivative. Which of the following chromosomal translocations is most likely responsible for this patient’s condition?

A 6-year-old girl is brought to the physician for pain and increasing swelling over her scalp for 1 month. She has not had any trauma to the area. There is no family or personal history of serious illness. Vital signs are within normal limits. Examination shows a 3-cm solitary, tender mass over the right parietal bone. X-ray of the skull shows a solitary osteolytic lesion. Laboratory studies show: Hemoglobin 10.9 g/dL Leukocyte count 7300/mm3 Serum Na+ 136 mEq/L K+ 3.7 mEq/L Cl- 103 mEq/L Ca2+ 9.1 mg/dL Glucose 71 mg/dL Which of the following is the most likely diagnosis?

A 72-year-old man goes to his primary care provider for a checkup after some blood work showed lymphocytosis 3 months ago. He says he has been feeling a bit more tired lately but doesn’t complain of any other symptoms. Past medical history is significant for hypertension and hyperlipidemia. He takes lisinopril, hydrochlorothiazide, and atorvastatin. Additionally, his right hip was replaced three years ago due to osteoarthritis. Family history is noncontributory. He drinks socially and does not smoke. Today, he has a heart rate of 95/min, respiratory rate of 17/min, blood pressure of 135/85 mm Hg, and temperature of 36.8°C (98.2°F). On physical exam, he looks well. His heartbeat has a regular rate and rhythm and lungs that are clear to auscultation bilaterally. Additionally, he has mild lymphadenopathy of his cervical lymph nodes. A complete blood count with differential shows the following: Leukocyte count 5,000/mm3 Red blood cell count 3.1 million/mm3 Hemoglobin 11.0 g/dL MCV 95 um3 MCH 29 pg/cell Platelet count 150,000/mm3 Neutrophils 40% Lymphocytes 40% Monocytes 5% A specimen is sent for flow cytometry that shows a population that is CD 5, 19, 20, 23 positive. Which of the following is the most likely diagnosis?

A 49-year-old man with HIV comes to the physician because of a 1-month history of intermittent diarrhea and abdominal pain. Abdominal examination shows mild, diffuse tenderness throughout the lower quadrants. His CD4+ T-lymphocyte count is 180/mm3 (normal ≥ 500/mm3). Colonoscopy shows multiple hemorrhagic nodules in the rectum and descending colon. Polymerase chain reaction of the lesions is positive for HHV-8. Histologic examination of the lesions is most likely to show which of the following findings?