View Answer

E

Questions 8–9

A 65-year-old woman with no other significant past medical history presents with a large mass in the right breast. The mass measures approximately 6 cm in diameter and appears to be fixed to the chest wall. In addition, bulky adenopathy is present in the right axillary region. The patient states that the mass has been enlarging for the last several years.

8. Following mammography, what should be the next step in this patient's evaluation?

A Fine-needle aspiration

B Incisional or core biopsy

C Excisional biopsy

D Modified radical mastectomy

E Radical mastectomy

View Answer

B

The diagnosis for this patient is invasive ductal carcinoma. A mammogram reveals no other lesions in the right breast and no abnormalities in the left breast. A chest radiograph, bone scan, and liver function tests are normal.

9. What should the next step in the management of this patient involve?

A Neoadjuvant chemotherapy

B Radiation therapy to the breast and axilla

C Radical mastectomy

D Modified radical mastectomy

E Simple mastectomy

View Answer

A

10. A 47-year-old patient with a history of left-sided nephrectomy for trauma 20 years ago presents with right flank pain and hematuria. Laboratory studies reveal a creatinine of 2.5 mg/dL. Which of the following is the appropriate management plan?

A Hydration overnight, followed by repeat evaluation of serum creatinine

B Intravenous pyelography (IVP)

C CT scan of abdomen and pelvis with oral and intravenous contrast

D Ultrasonography followed by urgent cystoscopy

E Percutaneous nephrostomy tube placement

View Answer

D

11. Which of the following are potential sequelae of benign prostatic hyperplasia?

A Bladder stone formation

B Recurrent urinary tract infections secondary to prostatitis

C Prostate cancer

D Bladder cancer

E Organic impotence

View Answer

A

12. A 68-year-old man undergoes a CT scan of the abdomen as part of the evaluation for some mild abdominal tenderness after a motor vehicle collision. The scan reveals no evidence of trauma, but a 4-cm solid left renal mass is noted. There is evidence of thrombus in the inferior vena cava. Which of the following treatments is not indicated?

A Preoperative chemotherapy and radiation to downstage tumor

B Resection of the left adrenal gland

C Resection of the para-aortic lymph nodes

D Resection of the left kidney

E Incision of vena cave and removal of thrombus

View Answer

A

13. A 23-year-old man has a solid mass in his left testis. When it is removed, the pathology reveals an embryonal carcinoma with a teratoma. A CT scan of the chest and abdomen reveals 8 cm of lymphadenopathy in the periaortic nodes. What is the recommended treatment?

A Modified nerve-sparing retroperitoneal lymph node dissection

B Full bilateral retroperitoneal lymph node dissection

C Chemotherapy with paclitaxel (Taxol), gemcitabine, and cisplatin

D Chemotherapy with cisplatin, etoposide, and bleomycin

E Chemotherapy plus retroperitoneal radiation