题目内容

A 50-year-old woman undergoes screening colonoscopy as part of a routine health maintenance workup. An isolated l-cm pedunculated polyp is found in the sigmoid colon. The excised polyp histologically shows well-differentiated glands with no invasion of the stalk. Which of the following investigational research procedures can most clearly distinguish whether the polyp represents hyperplasia of the colonic mucosa or a tubular adenoma. _ _

A. Histochemical staining for mucin
B. Flow cytometry to determine the frequency of cells in the S phase
C. Determination of clonality by pattern of X chromosome inactivation
D. Immunoperoxidase staining for keratin
E. Immunoperoxidase staining for factor VIII

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An epidemiologic study investigates the potential cellular molecular alterations that may contribute to the development of cancers in a population. Data analyzed from resected colonic lesions show that changes are occurring that demonstrate the evolution of a sporadic colonic adenoma into an invasive carcinoma. Which of the following best describes the mechanism producing these changes.__

A. Protooncogenes can be activated by chromosomal translocation
B. Malignant transformation involves accumulation of mutations in protooncogenes and tumor suppressor genes in a step-wise fashion
C. Extensive regeneration of tissues increases the risk of cancer-causing mutations
D. Inherited defects in DNA repair increase the susceptibility to develop cancer
E. Overexpression of growth factor receptor genes is associated with poor prognosis

A 49-year old man has a lump near his right shoulder that has been increasing in size for the past 8 months. On physical examination, the physician palpates a 4-cm firm, nontender mass in the right supraclavicular region. The mass is excised, and microscopically, it is diagnosed as follicular lymphoma. Karyotypic analysis of the cells shows a chromosomal translocation, t(14;18),involving the immunoglobulin heavy-chain gene. Which of the following genes is most likely to have undergone mutation to produce these findings.__

APC (tumor suppressor gene)
BCLl (cyclin gene)
C. BCL2 (antiapoptosis gene)
D. BRCA1 (DNA repair gene)
E. C-MYC (transcription factor gene)

A 26-year-old woman has a lump in the left breast. On physical examination by the physician, there is an irregular, firm, 2-cm mass in the upper inner quadrant of the breast. No axillary adenopathy is noted. A fine-needle aspirate of the mass shows carcinoma. The patient's 30-year-old sister was recently diagnosed with ovarian cancer, and 3 years ago her maternal aunt was diagnosed with ductal carcinoma of the breast and had a mastectomy. Which of the following genes is most likely to have undergone mutation to produce these findings.__

A. BCL2 (antiapoptosis gene)
BRCAl (DNA repair gene)
C. EGF (epidermal growth factor gene)
D. ERBB2 (growth factor receptor gene)
E. HSTI (fibroblast growth factor gene)

A 51-year-old man who works in a factory that produces plastic pipe has experienced weight loss, nausea, and vomiting over the past 4 months. On physical examination, he has tenderness to palpation in the right upper quadrant of the abdomen, and the liver span is increased. Laboratory findings include serum alkaline phosphatase of 405U/L AST, 45U/L, ALT 30U/L, and total bilirubin 0.9mg/dL. An abdominal CT scan shows a 12-cm mass in the right lobe of the liver. A liver biopsy is performed, and microscopic examination shows an angiosarcoma. The patient has most likely been exposed to which of the following agents.__

Arsenic
B. Asbestos
C. Benzene
D. Beryllium
E. Vinyl chloride

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