Risk of Malignancy in Adenomatous polyp is related to all except

Related MCQs

• A 76-year-old male was admitted for symptoms including constipation, change in stool character and weight loss. Colonoscopy revealed multiple polyps in the rectosigmoid area. An adenomatous polyp was removed. Another colonic tumor was seen in the same patient which was flat with irregular “shaggy rug” surface. A biopsy showed frond-like glandular architecture. Atypical epithelial cells in clusters were seen beneath the muscularis mucosae. The most likely diagnosis is:
• Which of the following is not true for malignancy of Familial Adenomatous Polyposis
• A 59-year-old man was referred because of a change in bowel habit. He had noticed no alteration in stool calibre, gastrointestinal bleeding or unintended weight loss. There was no family history of colonic polyps or gastrointestinal malignancy. Physical examination was normal. A rectal examination revealed no masses. A sigmoidoscopy revealed a 4-mm polyp in the mid-rectum, which was removed with forceps, and histology revealed a tubular adenoma. What is the most appropriate next step in management?
• Concerning adenomatous polyps, all the following are true EXCEPT:
• After total proctocolectomy with ileal pouch anal anastomoses what is the most common cause of death in patients with Familial Adenomatous Polyposis (FAP)
• Which type of polyp is most LIKELY in a patient presenting with watery mucoid diarrhea?
• A 58-year-old postmenopausal woman has been taking hormone replacement therapy with combined estrogen and progestin for the past 4 years because she was told it would decrease her risk for heart disease. Her father died at age 65 years of heart disease, and she is concerned that she is also at risk. Recently, her sister has been diagnosed with breast cancer. Her mother died of breast cancer. Three years ago, the patient had a breast biopsy that showed atypical hyperplasia. She has not had a hysterectomy. The patient is considering chemoprevention for breast cancer, but is nonetheless concerned about heart disease. Her calculated risk of breast cancer is 10.4% over the next 5 years. Which of the following options is reasonable to consider for this patient?
• A 62-year-old postmenopausal woman with a family history of breast cancer in two first-degree relatives wishes to consider taking tamoxifen to reduce her risk of breast cancer. Her baseline risk of breast cancer qualifies her for consideration of tamoxifen (i.e., an absolute risk of at least 1.66% over the next 5 years). She has had a prior hysterectomy, but her ovaries are intact. Which of the following effects of tamoxifen are relevant to the decision?
• A 69-year old black man is evaluated because of a history of steadily increasing upper abdominal pain, loss of appetite, and a 4.6-kg (1 0-Ib) weight loss over the past several months. He recently noticed that the color of his urine was darker than usual. The patient had a 40-pack-year history of cigarette smoking, but quit smoking 4 years ago. He has hypertension that is controlled by medical management. Laboratory studies: Hemoglobin 11.5 g/dL Serum total bilirubin 3.3 g/dL Serum albumin 3.2 g/dL Serum aspartate aminotransferase 105 U/L Serum alanine aminotransferase 95 U/L Urinalysis shows elevated bilirubin. CT scan of the abdomen shows dilation of the common bile and pancreatic ducts, a 5.2-cm mass in the head of the pancreas, and compression of the superior mesenteric vein. A fine-needle aspirate of the mass reveals atypical cells that are suspicious for malignancy. What is the most appropriate course of action?
• A 52-year-old woman who is a nonsmoker has a 3-cm right inguinal lymph node.Biopsy specimen shows a poorly differentiated malignancy that is difficult to characterize by light microscopy. The biopsy specimen is negative for leukocyte common antigen, cytokeratin, and estrogen receptors. Which of the following additional tests would best establish the source of this tumor?