Quiz about Important Questions Repeated in MD Exams

Question 1

A male patient presented with increasing weight loss and abdominal pain. He had a past history of Coeliac Disease, which up until now was asymptomatic on a gluten free diet. CT of the abdomen revealed a thickened loop of small bowel with a stricture and associated lymphadenopathy. A trucut of the nodes revealed a malignant neoplasm, Diagnosis is:

Accepted Answer

Enteropathic-associated T cell lymphoma

Answer

Maltoma

Answer

Reactive lymphoid proliferation

Answer

High grade B cell lymphom

Answer

Anaplastic large cell lymphoma

Question 2

A 50 year old male presents with widespread lymphadenopathy. He has had recent fever and weight loss. A trucut biopsy reveals a malignant tumor with the following phenotype; Cytokeratin negative, CLA positive, CD3 positive, and CD30 positive

Accepted Answer

T-cell lymphoma

Answer

Hodgkins disease mixed cellularity

Answer

Anaplastic large cell lymphoma

Answer

Maltoma

Answer

Reactive lymphoid proliferation

Question 3

A 40 year old female presents with mediastinal hilar lymphadenopathy and she has	recently noticed slight weight loss and a cough. Staging shows no other evidence of disease. A trucut biopsy reveals a lymphoma showing large cells with mirror image nuclei, lymphocytes, plasma cells and eosinophils. The following phenotype is seen; CD20 positive, CD3 negative, CLA positive, and CD15 positive

Accepted Answer

Hodgkin's lymphoma, mixed cellularity

Answer

Hodgkin's lymphoma, classical type

Answer

Anaplastic large cell lymphoma

Answer

Maltoma

Answer

Reactive lymphoid proliferation

Question 4

A 55 year old male presents with a history of chronic dyspepsia and with recent weight loss. Investigation by gastroscopy reveals a reduction in specialised gastric glands and the presence of slender giemsa staining filaments on the mucosal surface. In addition a gastric mass is seen. This is composed of large B lymphocytes which are negative for cyclin D1 and BCL2. Monoclonality is identified.

Accepted Answer

Gastric DLBCL

Answer

Anaplastic large cell lymphoma

Answer

Maltoma

Answer

Reactive lymphoid proliferation

Answer

T-cell lymphoma.

Question 5

A 28-year-old woman was found to have stage IV Burkitt‟s lymphoma. Her renal	function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0°C with rigors and was treated with imipenem.  Investigations (the following day):
serum sodium 138 mmol/L (137–144)
serum potassium 6.2 mmol/L (3.5–4.9)
serum creatinine 215 μmol/L (60–110)
serum corrected calcium 1.60 mmol/L (2.20–2.60)
serum phosphate 1.52 mmol/L (0.8–1.4)
serum lactate dehydrogenase 1238 U/L (10–250)						
serum urate 0.69 mmol/L (0.19–0.36)						
What is the most likely cause of the renal impairment?

Accepted Answer

tumor lysis syndrome

Answer

imipenem toxicity

Answer

intravenous contrast toxicity

Answer

kidney infiltration

Answer

septic shock

Question 6

A 67-year-old man in previously good health is hospitalized because of a 2-day history of fever and diminished consciousness. The patient responds inconsistently to verbal commands. His temperature is 39.5 °C (103.1 °F); he has tachycardia, and his blood pressure is 80/58 mm Hg. There is no bleeding. His hemoglobin is 12.1 g/dL, leukocyte count is 29,000/μL with 80% neutrophils, and platelet count is 20,000/μL. Which of the following studies should be obtained in this patient?

Accepted Answer

Measurements of fibrin D-dimer and total fibrinogen

Answer

Bone marrow aspiration and biopsy

Answer

Factor VIII level

Answer

Measurement of platelet-associated IgG

Answer

Bleeding time

Question 7

A 37-year-old man is hospitalized because of fever and right-sided chest pain. He has been having fatigue and recently developed dyspnea on exertion and intermittent chills. At the age of 29 years he was diagnosed with stage III Hodgkin‟s disease and treated with multiagent chemotherapy and radiation therapy. A year ago, he developed mild anemia with no obvious cause. He takes thyroid hormone replacement when he remembers and has used fexofenadine as needed for allergic rhinitis for the past 5 years.	On physical examination, his temperature is 38.7 °C (101.7 °F), pulse rate is 112/min, and blood pressure is 110/70 mmHg. There is dullness at the right lower lung and egophony. The hemoglobin is 8.5 g/dL, hematocrit is 26 %, leukocyte count is 2200/μL,and platelet count is 70,000/μL.
What is the most likely diagnosis?

Accepted Answer

Secondary myelodysplastic syndrome

Answer

Relapsed Hodgkin‟s disease

Answer

Sepsis

Answer

Hypothyroidism

Answer

Drug-induced bone marrow suppression

Question 8

A 43-year-old man with severe acquired aplastic anemia has not responded to immunosuppressive agents. He remains neutropenic and transfusion-dependent for platelets and red cells. He has an HLA-identical brother who has been cleared as a donor for his planned allogeneic stem cell transplant.They are both cytomegalovirus-seronegative. Which of the following would be prevented by using irradiated cellular blood products for this patient?

Accepted Answer

Transfusion-related graft-versus-host disease

Answer

Cytomegalovirus disease

Answer

Alloimmunization

Answer

Febrile nonhemolytic transfusion reaction

Answer

Hemolytic transfusion reaction

Question 9

A 34-year-old woman is evaluated because of progressive fatigue and recurrent attacks of abdominal pain. She weighs 61.2 kg (135 Ib). Her pulse rate is 110/min and her blood pressure is 110/70 mm Hg. She is pale, and her spleen is palpable 4 cm below the costal margin.	Laboratory studies: Hemoglobin 6 g/dL
Hematocrit 20% Leukocyte count 2500/μL Platelet count 80,000/μL Reticulocyte count 10%
Blood smear Anisocytosis and polychromatophilia Haptoglobin 0 mg/dL
Serum lactate dehydrogenase 645 U/L	
There is high level of hemosiderin in the urine.
What is the most likely cause of this patients pancytopenia?

Accepted Answer

Paroxysmal nocturnal hemoglobinuria

Answer

Autoimmune hemolytic anemia

Answer

Aplastic anemia

Answer

Myelodysplastic syndrome

Answer

Acute myeloid leukemia

Question 10

In an office visit for an annual checkup, a 46-year-old man reports that he has had	malaise and intermittent sweats for the past few months but has been able to continue his job as a high school teacher. Two years ago he was treated for stage III diffuse large-cell non-Hodgkin‟s lymphoma with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and attained complete remission. He takes simvastatin for hypercholesterolemia and hydrochlorothiazide for hypertension. On physical examination, he has lymphadenopathy: a 3-cm right axillary node and a 2- cm right supraclavicular node. His spleen tip is palpable. Laboratory evaluation shows mild normochromic, normocytic anemia and an elevated serum lactate dehydrogenase level. CT scans of his chest and abdomen reveal additional mediastinal and retroperitoneal lymphadenopathy. What is the best next step in this patient‟s management?

Accepted Answer

Referral for salvage chemotherapy and autologous stem cell transplantation

Answer

A 2-week course of oral antibiotics

Answer

A repeat physical examination and CT scans in 3 months

Answer

Referral for treatment with investigational agents

Answer

A repeat course of CHOP

Practice Test On: Important Questions Repeated in MD Exams

Practice Test On:
Important Questions Repeated in MD Exams