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02.05.16
1. 46 year old woman is evaluated for irregular vaginal bleeding is found
to have invasive cervical cancer. She undergoes total abdominal
hysterectomy (ureter injury) and bilateral salpingo (FALLOPIAN
TUBES) oophorectomy. Pelvic lymphadenectomy was also
performed, during which several enlarged nodes around the pelvic
vessels were resected. A week after the surgery, the patient begins to
experience left-sided flank pain that radiates to the groin. Her
temperature is 36.1C (97F), blood pressure is 120/70 mm Hg, and
pulse is 84/min. On physical examination, there is a ballotable left
flank mass. Which of the following most likely accounts for this
physical exam finding?
A. Hydronephrosis
a. Ureter surgery water accumulating in the kidney.
b. Uterine artery cross with the ureter.
B. Interstitial nephritis
C. Renal cell carcinoma
a. Not related to cervical cancer
D. Renal cystic disease
E. Renal vein thrombosis
F. Vesicoureteral reflux
i. Fever
2. The patient has a strong family history of ovarian (breast cancer)
and uterine cancer. The cells identified by the special
immunohistochemical staining of the axillary lymph nodes are also
noted to overexpresss a 185 kD glycoprotein. This protein spans the
cell membrane and has intracellular tyrosine kinase activity. Which
of the following is the most likely function of this protein?
A. Acts as a sex hormone receptor
B. Accelerates cell proliferation
C. Governs intercellular binding
D. Induces cytokine release
E. Mediates endocytosis
3. Axillary lymph nodes excised from 36 year old female contains clumps
of cells that show positive immunohistochemical staining for
cytokeratin. These cells most likely belong to which of the following
lineages?
A. Lymphoid
B. Epithelial
C. Myeloid
D. Mesenchymal
E. Neuroendocrine
4. 57 year old man comes to ED due to fevers and painful motuh ulcers.
He recently began methotrexate(hepatic and renal injury) therapy for