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

Related MCQs

• A 61-year-old man with a 120-pack-year smoking history is evaluated for a persistent and worsening cough and found to have a 3-cm mass in the right upper lobe on chest radiography. CT-directed needle biopsy is positive for squamous cell carcinoma. CT scans of the abdomen and pelvis, bone scan, and MRI of the head are negative for metastatic disease. Positron emission tomography scan shows uptake only in the right upper lobe mass, and pulmonary function tests indicate that the patient has adequate pulmonary reserve to undergo resection. The patient undergoes a right upper lobectomy. All margins are clear, and all peribronchial lymph nodes are negative for tumor within the resected specimen. What is the most reasonable adjuvant therapy for this patient?
• A 70-year-old man is found to have distal rectal cancer during a screening colonoscopy. The patient undergoes preoperative staging and is found to have a 1.5-cm rectal mass that does not invade the muscularis propria of the rectal wall. There is no regional lymphadenopathy and no evidence of distant metastases. The patient is staged at T1N0M0. The patient is advised to undergo APR but refuses because it will lead to anal sphincter loss and permanent colostomy. Which of the following represents a viable alternate therapeutic option for this patient?
• A 71-year-old man with mild chronic obstructive pulmonary disease and mild hypertension is evaluated during an annual routine visit. Review of systems is notable for intermittent cough, increasing dyspnea on exertion, a 2.3-kg (5 Ib) weight loss, and fatigue. The patient takes aspirin, 81 mg/d, and hydrochlorothiazide, 50 mg/d orally. He smoked one pack of cigarettes per day for 49 years but quit smoking 2 years ago. On physical examination, distant breath sounds are audible in both lungs and there are scattered rhonchi. Chest radiograph shows a perihilar mass. Abnormal laboratory results include hemoglobin of 12.5 g/dL and a serum sodium of 127 meq/L. Endobronchial biopsy reveals small-cell lung cancer. Further staging studies suggest that the disease is limited-stage. What is the most appropriate treatment for this patient‟s hyponatremia?
• A 78-year-old woman with coronary artery disease and severe chronic obstructive pulmonary disease is admitted to the hospital with painless jaundice. CT scan reveals the presence of multiple lesions in the liver, suggestive of metastases, and a nearly obstructing upper rectal mass. Colonoscopy demonstrates a large, ulcerated tumor in the proximal rectum and a residual lumen of less than 1 cm in diameter. While in the hospital, the patient develops a large bowel obstruction. What is the best treatment modality for this patient?
• 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 68-year-old man presents to his primary care physician for a routine physical examination. The patient‟s medical history is significant for hypertension. The patient is found to have guaiac-positive stools and is subsequently referred for colonoscopy. Colonoscopy reveals a “golf ball”-size, near-obstructing tumor in the descending colon, not admitting the scope. The biopsy is positive for adenocarcinoma of the colon. Which of the following is the next step in the management of this patient?
• A 65-year-old woman with no significant past medical history presents to the emergency department with a 2-day history of left lower quadrant abdominal pain. The patient denies nausea and vomiting, although she claims decreased oral intake. She also reports a low-grade fever and mild diarrhea. She describes a milder episode several years ago, which resolved on its own. On physical examination, the patient is found to have left lower quadrant tenderness with some mild guarding, but no rebound. She is hemodynamically stable, and her heart rate is 82 per minute. In the initial management of this patient, which of the following is the most sensitive diagnostic test?
• Carcinoma of the stomach usually arises from:
• A 30-year-old woman has a right mastectomy and axillary lymph node dissection for a carcinoma diagnosed by fine needle aspiration cytology. The histologic pattern is that of a poorly differentiated carcinoma that is negative for oestrogen and progesterone receptors, but is positive for HER2/neu. One axillary lymph node demonstrates micro- metastases. Her 32 year old sister is found to have a similar lesion. Which of the following statements regarding risk factors for this lesion is the most appropriate?
• Which is most characteristic of carcinoma of the cecum or right colon (in contrast to carcinoma of the rectum)?