Q 1 All of the following statements regarding tobacco
usage and cessation are correct except
A. Most Americans who quit do so on their own without
involvement in an organized cessation program.
B. Over 80% of adult Americans who smoke began before
the age of 18.
C. Smokeless tobacco is associated with gum and dental
disease, not cancer.
D. Tobacco cessation messages and programs are more
effective for light smokers than for heavy smokers.
E. Tobacco use is the most modifiable cancer risk factor.
Answer C
Q 2 . A 29-year-old male is found on routine chest radiography
for life insurance to have right hilar adenopathy.
He is otherwise healthy. Besides biopsy of the lymph
nodes, which of the following is indicated?
A. Angiotensin-converting enzyme (ACE) level
B. β-hCG
C. Thyroid stimulating hormone (TSH)
D. PSA
E. C-reactive protein
Answer B
Q 3 . Which of the following is correct regarding small-cell
lung cancer compared with non-small cell lung cancer?
A. Small-cell lung cancer is more radiosensitive.
B. Small-cell lung cancer is less chemosensitive.
C. Small-cell lung cancer is more likely to present peripherally
in the lung.
D. Small-cell lung cancer is derived from an alveolar cell.
E. Bone marrow involvement is more common in nonsmall
cell lung cancer.
Answer A
Q 4 . Which of the following statements regarding esophageal
cancer is true?
A. Cigarette smoking and heavy alcohol intake are synergistic
risk factors for adenocarcinoma.
B. Chronic gastric reflux is a risk factor for development
of esophageal squamous cell carcinoma.
C. Esophageal cancer is most common in the middle
third of the esophagus.
D. Incidence of squamous cell carcinoma has decreased
over the past 30 years while adenocarcinoma continues
to increase.
E. The prognosis for patients with adenocarcinoma is
consistently better than for those with squamous
cell carcinoma.
F. All of the above are true.
Answer D
Q 5 . All the following conditions are associated with an
increased incidence of cancer except
A. Down’s syndrome
B. Fanconi’s anemia
C. Von Hippel–Lindau syndrome
D. neurofibromatosis
E. fragile X syndrome
Answer E
Q 6 . A 50-year-old female presents to your clinic for
evaluation of an elevated platelet count. The latest complete
blood count is white blood cells (WBC) 7,000/mm 3,
hematocrit 34%, and platelets 600,000/mm 3. All the following
are common causes of thrombocytosis except
A. iron-deficiency anemia
B. essential thrombocytosis
C. chronic myeloid leukemia
D. myelodysplasia
E. pernicious anemia
Answer E
Q 7 . A 76-year-old man presents to an urgent care
clinic with pain in his left leg for 4 days. He also describes
swelling in his left ankle, which has made it difficult
for him to ambulate. He is an active smoker and has
a medical history remarkable for gastroesophageal reflux
disease, prior deep venous thrombosis (DVT) 9
months ago that resolved, and well-controlled hypertension.
Physical examination is revealing for 2+ edema in
his left ankle. A D-dimer is ordered and is elevated.
Which of the following makes D-dimer less predictive of
DVT in this patient?
A. Age >70
B. History of active tobacco use
C. Lack of suggestive clinical symptoms
D. Negative Homan’s sign on examination
E. Previous DVT in the past year
Answer A
Q 8 . A patient with longstanding HIV infection, alcoholism,
and asthma is seen in the emergency room for 1–2
days of severe wheezing. He has not been taking any medicines
for months. He is admitted to the hospital and
treated with nebulized therapy and systemic glucocorticoids.
His CD4 count is 8 and viral load is >750,000. His
total white blood cell (WBC) count is 3200 cells / μL with
90% neutrophils. He is accepted into an inpatient substance
abuse rehabilitation program and before discharge
is started on opportunistic infection prophylaxis, bronchodilators,
a prednisone taper over 2 weeks, ranitidine,
and highly-active antiretroviral therapy. The rehabilitation
center pages you 2 weeks later; a routine laboratory
check reveals a total WBC count of 900 cells/ μL with 5%
neutrophils. Which of the following new drugs would
most likely explain this patient’s neutropenia?
A. Darunavir
B. Efavirenz
C. Ranitidine
D. Prednisone
E. Trimethoprim-sulfamethoxazole
answer E
Q 9 . Which of the following symptoms is most suggestive
of an esophageal mass?
A. Early satiety
B. Liquid phase dysphagia only
C. Odynophagia with chest pain
D. Oropharyngeal dysphagia
E. Solid phase dysphagia progressing to liquid phase
dysphagia
Answer E
Q 10 . All of the following have been associated with development
of a lymphoid malignancy except
A. celiac sprue
B. Helicobacter pylori infection
C. hepatitis B infection
D. HIV infection
E. human herpes virus 8 (HHV8) infection
F. inherited immunodeficiency syndromes
Answer C
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