Devita, Hellman, and Rosenberg's Cancer

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

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

Question 6.13. Which of the following may result from the use of general anesthetics for

oncologic surgery?

A. Bone marrow depression

B. Alteration of the phagocytic activity of macrophages

C. Immunosuppression

D. All of the above

Question 6.14. A 46-year-old man underwent hemicolectomy and adjuvant chemother-

apy for stage III adenocarcinoma of the colon. 18 months after completion

of therapy, he is noted to have an elevated carcinoembryonic antigen level

on a routine follow-up visit. Imaging reveals a 2-cm lesion in the right

lobe of the liver. Ultrasound-guided biopsy demonstrates metastatic ade-

nocarcinoma, consistent with colon primary. Which of the following is

the appropriate next step?

A. Referral to a surgeon

B. Observation, as he is not symptomatic

C. Chemotherapy for metastatic disease

D. Hospice

Question 6.15. A 50-year-old man with a history of renal cell carcinoma, status post-

nephrectomy 3 years ago, presents with slurred speech and left-sided arm

weakness. Imaging of the brain reveals a right parietal mass measuring

3 cm with surrounding edema. CT scan of the chest, abdomen, and pelvis

shows postsurgical changes, with no other sites of disease. He is placed

on steroids to decrease cerebral edema. Which of the following is the

appropriate management of this patient?

A. Sorafenib therapy

B. High-dose interleukin-2 therapy

C. Resection of the brain lesion

D. Hospice

Question 6.16. A 40-year-old woman presents with weight loss, night sweats, and a 2-cm

left neck mass. She is found to have an elevated LDH of 800. Imaging

reveals extensive cervical, mediastinal, and abdominal adenopathy. You

suspect lymphoma and schedule a biopsy of the neck mass for histologic

diagnosis. Which of the following would be the most appropriate tech-

nique to obtain tissue for diagnosis?

A. Fine-needle aspiration

B. Core needle biopsy

C. Incisional biopsy

D. Excisional biopsy

Question 6.17. Which of the following conditions is associated with a high incidence of

cancer, which can be prevented by prophylactic surgery?

A. Ulcerative colitis

B. Multiple endocrine neoplasia type 2

C. Cryptorchidism

D. All of the above