Fcm Flashcards Block Iv Questions

Front 1

1-75 y/o man w/ CHF & dementia w/ colon cancer; 3 out of 10 lymph nodes; he’s on simvastin & hydrochlorathiazide….otherwise living a good life. What additional treatment would u recommend?

Back 1

ANS: Fluorouracil & Leucovorin

Front 2

2-65 y/o man w/ Fe deficiency anemia….What would u do next?

Back 2

ANS: Colonoscopy

Front 3

3-Risk factor of osteoarthritis:

Back 3

ANS: Obesity

Front 4

4-Patient w/ blood in stool, 20lbs weight loss, decreased caliber of stool….

Back 4

ANS: recommend colonoscopy

Front 5

5-Patient w/ long standing Fe-deficiency, you would see: chelosis, smooth painful tongue, increase RDW, decrease serum ferritin

Back 5

ANS: NOT increased retic count

Front 6

6-Least common osteoarthritis joint affected:

Back 6

ANS: MCP joint of hand

Front 7

7-Risk factors of colorectal cancer are: obesity, inflammatory bowel disease, smoking, diabetes…

Back 7

ANS: NOT folic acid supplementation

Front 8

8-Function of normal synovium are: joint lubrication, antigen processing, removing debris, and cytokine production….

Back 8

ANS: NOT structural support

Front 9

9-Anemia of chronic disease:

Back 9

ANS: low serum Fe, decreased TIBC, increased serum ferritin, low retic count

Front 10

10-Genetic changes in colorectal cancer: p53 of chrom 17, APC of chrom 5, DCC of chrom 18, Ras gene mutations…

Back 10

ANS: NOT long arm of chrom 21

Front 11

11-Osteoarthritis characteristics: females affected more than males, can occur at site of previous trauma, osteophyte, joint narrowing on X-ray

Back 11

ANS: NOT inflammatory process

Front 12

12-See increased retic count in: SCA, acute blood loss, TTP, G6PD deficiency…

Back 12

ANS: NOT pernicious anemia

Front 13

13-Small cell lung cancer:

Back 13

ANS: Brain radiation in extensive stage

Front 14

14-Uric acid…

Back 14

ANS: is excreted via kidneys

Front 15

15-Schizocytes

Back 15

ANS: Microangiopathic Hemolytic Anemia

Front 16

16-Hypersegmented neutrophils:

Back 16

ANS: Pernicious anemia

Front 17

17-Most important prognostic factor in response to therapy & survival in stage IV non-small cell lung cancer:

Back 17

ANS: Performance status

Front 18

18-Hyperuricemia develops in majority of patients with which of the following?

Back 18

ANS: Under excretion of uric acid

Front 19

19-Risk factors for developing DVT are: obesity, sedentary lifestyle, pregnancy, cancer….

Back 19

ANS: NOT diabetes

Front 20

20-Common paraneoplastic syndrome encountered in lung cancer: Lambert-Eaton, SIADH, Hypercalcemia, hypertrophic osteoarthropathy…

Back 20

ANS: NOT hyperkalemia

Front 21

Q: 20 y/o man presents with pain and swelling of one knee and pain in
his heels of two week duration. He recalls having a recent diarrheal
illness which resolved without incident, now presents with "pink eye"
conjunctivitis

Back 21

A: Reactive Arthritis (Reiter's)

Front 22

Q: 66 y/o female with a hx of Coronary artery disease and high lipids
has acute MI. She was placed on continuous infusion of unfractionated
heparin and Abciximab. Despite being placed on heparin,on Day 7,
tender swollen left leg was noted. Doppler ultrasound confirms DVTE
of femoral vein. Intern notices platelet 40000 --- decreased from
300000.... what's the next step

Back 22

A. STOP heparin immediately!

Front 23

Q: Previously healthy 44 y/o male needs advice about his chances of
getting cancer. Hx: smoker for past 22 years, rarely exercises, 1
glass of wine daily, diet high in animal meats and cholesterol, no
family hx of cancer... you should advice the patient to do all of the
following EXCEPT..

Back 23

A. Undergo colorectal cancer screening via colonoscopy immediately
other answers: advice to continue drinking wine with dinner, stop
smoking, increase amount of daily exercise, increase intake of fruit
and veggies

Front 24

worse prognosis for breast cancer

Back 24

increased HER-2 neu copies

Front 25

most common malignant

Back 25

infiltrating ductal (intraductal) carcinoma

Front 26

old man with stroke and chondrocalcinosis

Back 26

• pseudogout (old test question)

Front 27

which is NOT vit K dependent

Back 27

XIII

Front 28

18 year old girl, camping with bf, monogamous for 2 years, 102F, acute pn, swelling of L wrist and R knee

Back 28

N. gonorrhea

Front 29

Most specific antibody for drug induced lupus

Back 29

histone

Front 30

Which has the highest risk

Back 30

• 44F with maternal grandmother with breast cancer

Front 31

allopurinol to treat acute gout?

Back 31

NO allopurinol to treat acute gout

Front 32

Connective tissue disorder with decreased complements (c3 and c4)

Back 32

SLE

Front 33

(pancreatic tumor marker?

Back 33

Markers CA-19/9

Front 34

ovarian tumor marker?

Back 34

CA-125

Front 35

gastric or breast tumor marker?

Back 35

CEA

Front 36

Which cause of VTE is NOT inherited?

Back 36

antiphospolipid

Front 37

Which cause of VTE IS inherited?

Back 37

(Factor V leiden, antithrombin III, protein C/S, and prothrombin G20210A mutation are inherited)

Front 38

T OR F? • Epstein-barr cause gain of function of oncogene

Back 38

true
o Oncogenes can cause genetic mutation
o Tumor suppressor genes  negative growth regulation
o Cancer caused by loss of function of tumor supp genes

Front 39

T OR F? o papilloma virus cause cancer by inactivating tumor supp gene

Back 39

false

Front 40

OA common cause of inflammatory joint disease?

Back 40

false

Front 41

- ideal tumor markers?

Back 41

o sensitive and specific
o indicate tumor burden
o predict prognostic outcomes
o predict recurrence
o does NOT have to be able to predict metastatic site

Front 42

HIV guy with purpuric rash on leg, fever, hypotension, anemia, increased retic count, plt 20,000, normal PT/PTT, acute renal failure, uncontrolled seizure

Back 42

- TTP

Front 43

Wegener’s positive for cANCA?

Back 43

YES

Front 44

EBV, alkylating chemicals, ionizing radiation, H pylori ASSOCIATED WITH CANCER?

Back 44

YES

Front 45

PROGESTERONE ASSOCIATED WITH CANCER?

Back 45

NO

Front 46

Disrupt plug formation by affecting primary hemostasis?

Back 46

- scurvy, glanzman, Bernard, ttp (NOT hemophilia A)

Front 47

56M, sob, cough, dec breath sound, wheezes R lung, XR

Back 47

- large R effusion with complete opacification lower lobe, mass R upper lobe suggesting malignant neoplasia. CT  large suprahilar mass 5x4x3cm with calcification. 2 ipsilateral paratracheal nodes enlarged with 1 >2cm. Pleural tap positive for poorly differentiated adenocarcinoma in fluid. Bronchoscopy biopsy show RUL necrosis and adenocarcinoma. In addition to LYMPHATICS, will NOT metastasize to ESOPHAGUS.
-

Front 48

Lung cancer ranks as the number ______ cause of cancer-related deaths the United States each year.

Back 48

One

Front 49

Non-small cell lung cancer accounts for 80 percent of all lung cancer cases.

Back 49

True

Front 50

Smokers are __________ times more likely to develop lung cancer     than nonsmokers.

Back 50

More than ten

Front 51

56 year old man presented with shortness of breath and cough. Physical examination of the chest revealed decreased breast sounds and wheezes on right. Chest X-ray revealed a large right pleural effusion with complete opacification of lower lobe of the right lung and a mass in R upper lobe, probable malignant neoplasm. CT chest showed a large suprahilar mass = 5.0 x 4 x 3 cm on right with some calcifications. Two ipsilateral paratracheal nodes were enlarged,1 of which is greater than 2 cm in diameter .A Pleural tap was done and cytology was positive for undifferentiated adenocarcinoma in pleural fluid. Bronchoscopic biopsy of the RUL showed small fragment of R upper lobe with necrosis and anaplastic adenoca.

What is the stage of this cancer:

Back 51

Stage IIIB

Front 52

The most important determinant in deciding response to therapy and survival for patients with stage IV NSCLC is :

Back 52

Performance status

Front 53

Bronchorrhea

Back 53

Bronchioalveolar Ca

Front 54

Squamous Cell Ca

Back 54

SIADH

Front 55

Eaten-Lambert Syndrome

Back 55

Small cell Ca

Front 56

Peripheral mass

Back 56

Adenocarcinoma

Front 57

A 36-year-old man comes to your office for your opinion concerning adjuvant therapy for stage III (T3N1M0) colon cancer. He was in good health until two months ago when he was found to have occult blood in his stool on a routine pre-employment physical examination. He underwent surgery without complications three weeks ago and has now established normal bowel habits. He is taking no routine medications, and neither smokes nor drinks. His paternal grandfather died of rectal cancer at age 49 years, and two paternal aunts had colon cancer. After review of his pathology, you conclude that he is a candidate for adjuvant therapy.
Which one of the following statements about this patient’s prognosis and surveillance is true?

Back 57

If he develops a new primary colon cancer, he should undergo a complete colectomy.

Front 58

Genetic changes in colorectal cancer include chromosomal aberrations in all the following except:

Back 58

long arm of chromosome 21

Front 59

A 36-year-old white woman comes to your office to discuss her risk of developing colon cancer. She has had symptomatic ulcerative colitis, which involves the majority of the colon, for 15 years.Which of the following statements is most characteristic of this patient’s condition?

Back 59

The absence of extensive dysplasia on colonoscopic biopsies is associated with reduced risk of developing invasive cancer.

Front 60

A 25-year-old white graduate student is referred to you one week after she underwent right hemicolectomy for adenocarcinoma of the cecum. Her medical history is unremarkable. Her mother had a hysterectomy for uterine cancer at age 38, and her maternal grandmother was found to have colon cancer at age 49. The patient has four sisters and two brothers who range in age from 15 to 34. All are in excellent health.Which of the following diagnoses is most consistent with this patient’s family history?

Back 60

Lynch syndrome II

Front 61

A 59-year-old white woman asks your advice concerning follow-up after removal of a 7mm adenomatous polyp detected during screening sigmoidoscopy. She has no family history of colorectal cancer.
In addition to recommending annual examination of stool for occult blood and repeat flexible sigmoidoscopy every three to five years, you should recommend that which of the following be done now?

Back 61

Colonoscopy

Front 62

Genes implicated in the genetic susceptibility to HNPCC are:

Back 62

Mismatch repair genes

Front 63

A 68-year-old woman is referred to you for additional treatment four weeks after surgical resection for a tumor in the ascending colon that was determined on pathologic evaluation to be a moderately differentiated adenocarcinoma of the colon arising from a villous adenoma. The tumor had penetrated through the serosa, and three of 12 lymph nodes were positive for metastatic cancer. No other disease was seen at the time of surgery. Preoperatively, the CEA level was 1.2 ng/mL, and CT of the chest, abdomen, and pelvis demonstrated no metastasis.Her history includes diabetes controlled with a beta-blocker and a diuretic, and a hysterectomy for fibroids. She lives with her husband, is active, and is able to drive and maintain her own household. Which of the following would you recommend?

Back 63

Six months of treatment with fluorouracil, leucovorin and oxaliplatin