Deck 7: Understanding Carcinoma and Other Neoplasms in the Gastrointestinal Tract: Part A

Question 1

Carcinoma of the esophagus has a poor prognosis because:

A)metastases to liver or lung are usually present before the diagnosis is made
B)the lesion is not accessible to surgery
C)local spread usually prevents complete removal
D)the tumor is radioresistant

Answer 1

local spread usually prevents complete removal

Question 2

All of the following correctly describe carcinoma of the esophagus except:

A)male predominance
B)most frequently involves adenocarcinoma
C)patients usually over 50 years of age
D)most frequently of the squamous cell type
E)symptoms may occur late in the disease

Answer 2

most frequently involves adenocarcinoma

Question 3

Which of the following is most characteristic of carcinoma of the esophagus?

A)produces symptoms early and is more curable than cancer of the stomach
B)difficult to cure because of local spread
C)characterized by widespread and early metastases
D)has a good response to chemotherapy and therefore is rarely excised or radiated

Answer 3

difficult to cure because of local spread

Question 4

The most common type of esophageal cancer in the United States is:

A)adenocarcinoma
B)leiomyosarcoma
C)lymphoma
D)squamous cell carcinoma

Question 5

What is the significance of intestinal metaplasia in the stomach or colon?

A)It has no significance.
B)It is frequently associated with mildly precancerous inflammatory disease.
C)It is highly precancerous.
D)It is usually associated with heterotopic pancreas.

Question 6

Multiple recurrent ulcers in proximal and distal duodenum for several years are likely to be associated with:

A)heavy aspirin intake
B)islet cell adenoma of pancreas
C)smoking
D)excessive bile secretion

Question 7

In a patient with a chronic peptic ulcer of the stomach, the chance that carcinoma will develop in the ulcer is:

A)over 80%
B)about 50%
C)about 30%
D)very small

Question 8

Carcinoma of the stomach usually arises from:

A)smooth muscle cells
B)acid producing cells
C)pepsinogen producing cells
D)mucus producing cells
E)argentaffin cells

Question 9

Which presents as a bulky mass lesion often with deep central ulceration?

A)leiomyoma of stomach
B)leiomyosarcoma of stomach
C)both
D)neither

Question 10

Lymphoma of the stomach:

A)may be primary or secondary in the stomach
B)has a better prognosis than carcinoma of the stomach
C)both
D)neither

Question 11

Which neoplasm is most FREQUENTLY found in the appendix?

A)carcinoid
B)villous adenoma
C)lymphoma
D)adenomatous polyp
E)adenocarcinoma

Question 12

The most benign examples of carcinoid tumor usually are found in the:

A)colon
B)appendix
C)ileum
D)stomach

Question 13

Which type of polyp is most LIKELY in a patient presenting with watery mucoid diarrhea?

A)juvenile polyp
B)adenomatous polyp
C)villous adenoma
D)carcinomatous polyp

Question 14

Familial breast cancer is characterized by

A)Account for about 20% of all breast cancer
B)A BRCA1 mutation is the most common genetic changes.
C)Associated cancers tend to be more aggressive, of a higher grade, and hormone receptor negative.
D)Follow the same rules of screening as non-familial breast cancer.
E)All of above.

Question 15

A bulky tumor of the rectum exhibits a delicate, velvety, easily bleeding surface. It has no pedicel and its base appears to be as wide as its apex. The process is most probably:

A)inflammatory polyp
B)villous adenoma
C)mucinous adenocarcinoma
D)lymphoid polyp
E)leiomyoma

Question 16

Which is characterized by small size?

A)adenomatous polyp
B)hyperplastic polyp
C)villous adenoma
D)juvenile polyp

Question 17

Which best characterizes Peutz-Jeghers polyps?

A)solitary, hamartomatous, not premalignant
B)multiple, hamartomatous, not premalignant
C)solitary, neoplastic, premalignant
D)multiple, neoplastic, not premalignant

Question 18

Which of the following factors is most valuable in predicting the biologic behavior of carcinoma of the colon?

A)age of the patient
B)duration of symptoms
C)region of the colon affected
D)diameter of the cancer
E)lymph node metastasis

Question 19

Which of the following is most strongly predisposing to colon cancer?

A)ulcerative colitis
B)familial polyposis
C)Crohn"s disease
D)Peutz-Jegher"s syndrome

Question 20

Adenocarcinoma of the ascending colon is more likely than adenocarcinoma of the sigmoid colon to:

A)encircle the bowel, causing a stricture or obstruction
B)be bulky
C)both
D)neither

Question 21

Persistent elevation of serum carcinoembryonic antigen following surgical resection of a carcinoma of the colon suggests:

A)a poorly differentiated neoplasm
B)a second cancer
C)cirrhosis
D)metastases
E)peritonitis

Question 22

In contrast to carcinoma of the right colon, carcinoma of the left colon tends to be associated with:

A)anemia
B)diverticulosis
C)malabsorption
D)obstruction
E)no symptoms

Question 23

Which of the following lesions of the colon has the least tendency to undergo malignant transformation?

A)ulcerative colitis
B)juvenile polyp
C)villous adenoma
D)polyp of Gardner"s syndrome

Question 24

Predisposes to adenocarcinoma:

A)Barrett"s esophagus
B)achalasia, esophagus
C)both
D)neither

Question 25

Predisposes to squamous cell carcinoma:

A)Barrett"s esophagus
B)achalasia, esophagus
C)both
D)neither