Pathology: USMLE Question No. 1

[Cardiac Arrest]

From My Collection of USMLE Qs

Choose the correct answer
correct answe will be posted after 7 days

Q1: A 52-year-old woman presents to her doctor with abdominal pain. She states that she has had the pain on and off for the last 3 months, but lately it is worse. She has no significant past medical history and does not take any medication. She has been married for 26 years and has no children. Her husband has been her only sexual partner. Physical examination reveals a distended, but nontender abdomen. Radiologic examination demonstrates ascites and multiple soft tissue masses throughout the peritoneum as well as a primary lesion. The primary lesion is biopsied and demonstrates cystic spaces lined with tall columnar cells; psammoma bodies are also identified. Additional blood tests for CEA and CA19-9 are negative. CA-125 is positive. Which of the following is the most likely primary diagnosis?

(A) Cervical cancer

(B) Colon cancer

(C) Liver cancer

(D) Ovarian cancer

(E) Pancreatic cancer

[BaBiNa]

Cardiac Arrest

It is a nice idea to put some of USMLE Qs and make memders trying to solve

:LL:

Today is my final patho exam, so I think I still have fresh information

even I hate that subject

:o:

The primary lesion is biopsied and demonstrates cystic spaces lined with tall columnar cells; psammoma bodies are also identified. Additional blood tests for CEA and CA19-9 are negative. CA-125 is positive

I think answer is >>> D

Ovarian cancer

(Serous Tumor)


I hope my answer is right

:l:




Great Work .. Keep on

:hp:

[WaLeeD]

Salam..

Yes.. me too
I think it is Overian Cancer..

Took it from BaBiNa..
:eye:


Anyway..
It is really nice work Cardiac..

I've an Idea for you..
You can write it up to the moderators..

What about if we establish a special section for USMLE here in our forum ??

I think by this we are going to build a bank for USMLE MCQ's..
This will train us more & more & we will be the WINNERS..


Waiting for your response..

:12:

[GoldenButterfly]

well i had my final pathology no. of months ago but im trying to squeeze my mind to think
(or should i say i'm just running away from studying my finals )

mid age and nulliparous (that predispose to something)
abdominal pain
soft tiss masses throughout the peritoneum
tall columnar cells( i willput aside liver and cervical ca i couldn't recall the histo of pancreatic ca and the symptoms are not likely)
cystic (which i think rule out colon ca maybe im wrong)
i couldn't recall any markers
but psammoma body i heard that name in some other tumour... thyroid maybe?!


so i'll shade the d circle, i'll choose ovarian ca


I did not take it from Babina :85:


salam

[sendrayla]

asalamualikum:12:
yes it is an ovarian ca (serus adenoma of the ovary):ya:

[BaBiNa]

GoldenButterfly

U r right about psammoma body

we can find it in other tumors:

Papillary Ca in thyroid

Meningioma in CNS

:LL:








Don`t think I`m perfect & excellent in patho to remember that thing

:o:

just today my patho OSCE

and there is Qs about Papillary Ca & Meningioma

so I still remember

:aa:

HaHaHaHaHaHa

------------------------------------------------------

Welcome

sendrayla

It is nice to see you in our forum

I`m GLAD cuz ur here

:J:

[Khajool]

wi


my brother i think its a good idea

I thinck the answer is ov. cancer
& I think ( No children) risk factor for Ov. cancer

[PeDiaTroN]

AS ALWAYS

COMIN' LATE

:O:


& of course

after a long boring pathology course

I SHOULD choose

:o:


Ovarian CA.


( No need to comment cuz it's OBVIOUS )



PLEASE :

KEEP ON Puttin' thses great questions


GOD BLESS YOU ALL

[Cardiac Arrest]

The correct answer to the question above is: D.

A.Cervical cancer is associated with infection with particular subtypes of human papilloma virus (HPV), which is more common in individuals with a greater number of sexual partners.
B.Anemia in a middle-aged woman should prompt an investigation to rule out adenocarcinoma of the colon. However, the patient's clinical and histologic findings are different.
C.Hepatocellular carcinoma is associated with abdominal pain if the capsule is involved, and is often associated with elevated ل-fetoprotein.
D.CORRECT: The clinical presentation of ovarian cancer can be quite nonspecific. Patients often present, as in this case, with abdominal distension and pain. Other symptoms can include vaginal bleeding and a change in bowel habits. Females in the sixth to seventh decade of life are most commonly affected. Other risk factors include nulliparity and early menarche (endometrial cancers have similar risk factors). Although initially restricted to the ovary, ovarian cancer spreads to the peritoneum with multiple soft tissue deposits and ascites, termed pseudomyxoma peritonei. It is the spread to the abdominal cavity that can lead to symptoms and therefore, presentation. The asymptomatic nature of the cancer in its early stages results in late presentation and a poor prognosis. CA-125 is elevated in ovarian cancers, and should be used to monitor treatment. It is not an approved means to screen for ovarian cancer, however. Ovarian cancer has 3 major types: serous, mucinous, and endometrioid. This patient has the malignant serous form (serous cystadenocarcinoma). Characteristic histologic findings include columnar epithelial cells and concentric calcified structures (psammoma bodies).
E.Pancreatic cancer presents with jaundice secondary to obstruction of the bile duct.

[GoldenButterfly]

Thanks for your reply Babina


I would like to add something i found about tumor markers

CEA carcinoembryonic antigen is elevated in colorectal ca and stomach ca.
ca 19.9 elevated in 75-90% of pt with pancreatic ca

Thanks Alot Cardiac Arrest



:hp:

[BaBiNa]

Cardiac Arrest

correct answe will be posted after 7 days

:o:







why u r running fast to put the answer..??

:o:

[Cardiac Arrest]

Originally posted by Dr.BaBiNa
Cardiac Arrest



:o:
why u r running fast to put the answer..??

:o:


Sorry, but i thin it is too long

from now, it will be from 3-5 days so we can post more Qs

[sendrayla]

asalamualikum
:12:
thanx alot babena & iam 2
u were realy a gerat leader thanx 4 every thing

:12: this 4 u
BEST OF LUCK 4 ALL
thanx cariac arrest 4 this nice topic
GOD BLESS U

[uday]

I feel its ovarian cancer

[f_ameer376]

thanx for the topic