Devita, Hellman, and Rosenberg's Cancer

LWBK1006-41 LWW-Govindan-Review November 24, 2011 11:29

524 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

activation and platelet aggregation, activation of the coagulation cas-

cade, and direct generation of thrombin all play a role in cancer-related

thrombosis.

Answer 41.20. The answer is A.

This woman’s presentation is characteristic of myasthenia gravis, in which

autoantibodies develop against the acetylcholine nicotinic postsynaptic

receptor. Myasthenia gravis is associated with thymoma in 15% of cases,

and a CT of the chest is indicated, to look for thymoma. In patients with

thymoma, myasthenia gravis may remit after thymectomy.

Answer 41.21. The answer is A.

SCLC is associated with the anti-Hu antibody, and testicular cancer is

associated with the anti-Ma2 antibody.

Answer 41.22. The answer is C.

Anti-Yo antibody causes progressive cerebellar degeneration, whereas

opsoclonus-myoclonus is caused by not one antibody, but several, includ-

ing anti-Hu, anti-Ri, and antineurofilament.

Answer 41.23. The answer is C.

LES is not a pure motor disorder because paresthesias are frequently

reported, and dry mouth and erectile dysfunction are also reported.

Answer 41.24. The answer is C.

Only rods are affected, and acquired night blindness may occur.

Answer 41.25. The answer is C.

This is likely to be a paraneoplastic leukocytosis associated with lung

cancer. In this setting, leukocytosis occurs due to hematopoietic cytokine

release from his tumor. Marrow infiltration is unlikely, as other cell lines

are normal. LAP is decreased in CML, which would also make this an

unlikely diagnosis. Infection is unlikely in the absence of any signs or

symptoms.