Multiple Choice Questions (MCQ)

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Category: Medicine--->Hematology and Oncology
Page: 3

Question 11# Print Question

A 38-year-old woman presents with repeated episodes of sore throat. She is on no medications, does not use ethanol, and has no history of renal disease. Physical examination is normal. Hgb is 9.0 g/dL, MCV is 85 fL (normal), white blood cell count is 2000/µL, and platelet count is 30,000/µL.

Which of the following is the best approach to diagnosis? 

A. Erythropoietin level
B. Serum B12
C. Bone marrow biopsy
D. Liver spleen scan
E. Therapeutic trial of corticosteroids

Question 12# Print Question

A 50-year-old woman presents with abdominal fullness, vague abdominal pain, and constipation. She had colonoscopy 7 years ago that was normal. She has a 20-packyear smoking history but quit 10 years ago. She cannot recall any family history of cancer. Pelvic examination reveals left adnexal fullness. Her BMI is 40.

What is the most appropriate next step in the evaluation of this patient?

A. Pelvic ultrasound
B. CA-125 antigen levels
C. Surgery
D. CT scan of abdomen
E. Reassurance and follow-up in 6 months

Question 13# Print Question

A 52-year-old man with cirrhosis resulting from chronic hepatitis C presents with increasing right upper quadrant pain, anorexia, and 15-lb weight loss. The patient is mildly icteric and has moderate ascites. A friction rub is heard over the liver. Abdominal paracentesis reveals blood-tinged fluid, and CT scan shows a 4-cm solid mass in the right lobe of the liver.

Which of the following is the most important initial diagnostic study? 

A. Serum α-fetoprotein level
B. Colonoscopy to search for a primary neoplasm
C. Measurement of hepatitis C viral RNA
D. Upper GI endoscopy
E. Positron emission tomography scan

Question 14# Print Question

A 60-year-old man presents with dull aching pain in the right flank. Physical examination reveals a firm mass that does not move with inspiration. Laboratory studies show normal BUN, creatinine, and electrolytes. UA shows hematuria. Hemoglobin is elevated at 18 g/dL and serum calcium is 11 mg/dL.

What is the most likely diagnosis?

A. Polycystic kidney disease
B. Pheochromocytoma
C. Adrenal carcinoma
D. Renal adenomyolipoma
E. Renal cell carcinoma

Question 15# Print Question

A 64-year-old woman who is receiving chemotherapy for metastatic breast cancer has been treating midthoracic pain with acetaminophen. Over the past few days she has become weak and unsteady on her feet. On the day of admission she develops urinary incontinence. Physical examination reveals fist percussion tenderness over T8 and moderate symmetric muscle weakness in the legs. Anal sphincter tone is reduced.

Which of the following diagnostic studies is most important to order? 

A. Serum calcium
B. Bone scan
C. Plain radiographs of the thoracic spine
D. MRI scan of the spine
E. Electromyogram with nerve conduction studies

Category: Medicine--->Hematology and Oncology
Page: 3 of 8