LWBK1006-20 LWW-Govindan-Review December 12, 2011 19:4
Chapter 20•Cancer of the Gastrointestinal Tract 253Question 20.3.3. Which of the following statements about staging systems for liver cancer
is TRUE?
A. The Okuda system takes into account several clinical features that
include tumor size (>50% of liver), ascites (positive or negative),
hypoalbuminemia (<3 g/dL), and hyperbilirubinemia (>3 mg/dL).
B. The Cancer of the Liver Italian Program system uses hepatic tumor
morphology and extent of liver replacement, Child-Pugh score, portal
vein thrombosis, and serum AFP levels.
C. The Barcelona Clinic Liver Cancer scoring system combines assess-
ment of tumor stage, liver function, and patient symptoms with
a treatment algorithm and has been shown to correlate well with
patient outcomes.
D. All of the above.Question 20.3.4. Which of the following biochemical abnormalities is both a paraneoplas-
tic syndrome associated with HCC, and may also be caused by end-stage
liver failure?
A. Hypoglycemia
B. Erythrocytosis
C. Hypercalcemia
D. HypercholesterolemiaQuestion 20.3.5. An increased risk of developing HCC is associated with all of the follow-
ing, EXCEPT:
A. Wilson disease
B. Hemochromatosis
C. Alpha1-antitrypsin deficiency
D. Primary biliary cirrhosisQuestion 20.3.6. Which of the following statements about screening and prevention is
INCORRECT?
A. The advent of vaccination for hepatitis B has the potential to reduce
HCC in endemic areas.
B. A combination of AFP and ultrasound screening is used in high-risk
populations.
C. Aggressive screening programs for HCC have been shown to improve
survival.
D. Detection of HCC, through surveillance of patients awaiting liver
transplantation, results in increased priority for orthotopic liver
transplantation.Question 20.3.7. Which of the following is a risk factor for developing cholangiocarci-
noma?
A. Primary sclerosing cholangitis
B. Clonorchis sinensis infestation
C. Chronic portal bacteremia and portal phlebitis
D. All of the above