Devita, Hellman, and Rosenberg's Cancer

LWBK1006-06 LWW-Govindan-Review November 24, 2011 11:20

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

Question 6.4. An 83-year-old man presents for colon resection after evaluation for

microcytic anemia revealed a 3-cm villous adenoma in his cecum. Colon-

oscopy was performed, and the adenoma was not able to be resected.

Biopsy revealed dysplastic changes. No evidence of metastatic disease was

seen on computed tomography (CT) of the chest, abdomen, and pelvis.

Which of the following statements is TRUE?

A. Surgery should be avoided in this patient because of the prohibitive

morbidity and mortality in this octogenarian.

B. The patient’s medical history and physical examination are the best

determinants of preoperative risk.

C. The patient requires a cardiac stress test and possible cardiac catheter-

ization before surgical resection.

D. No additional testing besides routine laboratory testing is required.

Question 6.5. A 67-year-old man with poorly controlled diabetes, congestive heart fail-

ure with an ejection fraction of 14%, and Stage III chronic kidney disease

is scheduled to undergo pancreaticoduodenectomy. He should be catego-

rized as American Society of Anesthesiologists Class:

A. II

B. III

C. IV

D. V

Question 6.6. A 42-year-old woman presents with a 4-year history of a lump on her right

lateral thigh. On examination, she has a firm nodule in her right thigh,

approximately 5 cm in size. The mass appears to be in the subcutaneous

tissue but is not freely mobile. The patient has no associated neurologic

findings. The next appropriate step in management is:

A. Perform fine-needle aspiration

B. Perform core biopsy

C. Perform excisional biopsy

D. Obtain magnetic resonance imaging

Question 6.7. A 45-year-old woman with a body mass index of 34 is scheduled to

undergo Ivor Lewis esophagectomy for a T2N0M0 adenocarcinoma of

the distal esophagus. Her relative risk of pulmonary complications after

surgery compared with a nonobese patient is approximately:

A. 0.8 to 1.7

B. 1.5 to 2.0

C. 1.7 to 3.0

D. 2.0 to 4.5