LWBK1006-41 LWW-Govindan-Review November 24, 2011 11:29
522 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology ReviewANSWERS
Answer 41.1. The answer is C.
CLL has been described in association with both warm antibody
hemolytic anemia and autoimmune hemolytic anemia, but not with
microangiopathic hemolytic anemia with its red cell fragmentation.Answer 41.2. The answer is A.
SCLC is the leading cause of ectopic ACTH production.Answer 41.3. The answer is B.
Classic hypercortisolism causes moon facies, but ectopic production usu-
ally does not.Answer 41.4. The answer is A.
Some 3% to 7% of patients with SCLC and ectopic ACTH production
will develop Cushing syndrome.Answer 41.5. The answer is C.
Myopathy with weakness, muscle wasting, weight loss, hyperpigmenta-
tion, and hypokalemia are characteristic of ectopic ACTH production
from SCLC. SCLC is the leading cause of ectopic ACTH production.Answer 41.6. The answer is C.
Ketoconazole is considered the therapy of choice because of its rapid
onset of action and favorable toxicity profile. Mitotane is rarely used
due to slow onset of activity and severe toxicities associated with its use
(allergic reaction, dizziness, blurred vision, fainting). Aminoglutethimide
has limited efficacy when used alone, and is used in combination with
metyrapone to treat ectopic ACTH production from cancer.Answer 41.7. The answer is B.
Patients have a urine osmolality greater than plasma osmolality.Answer 41.8. The answer is B.
Necrolytic migratory erythema is characterized by erythema, papules,
and pustules on the face, lower abdomen, perineum, and buttocks.
These lesions progress to form blisters and result in epidermal necrosis.
Necrolytic migratory erythema is associated solely with glucagonoma,
and clears after resection of the tumor.Answer 41.9. The answer is D.
Although all of the answers listed are associated with erythrocytosis, renal
cell carcinoma is the leading cause, followed by hepatoma. Both of these