1. Breast/ovary

2.  A 32-year-old Caucasian female presents to your office with a breast mass found to be malignant on biopsy. Ten years ago, she was diagnosed with osteosarcoma and underwent right lower limb amputation. Her mother died of a brain tumor at the age of 35 and her aunt suffered from rhabdomyosarcoma. Which of the following gene mutations might be responsible for this patient’s condition?

3.  A. Rb  B. BRCA-1  C. p53  D. NF2  E. APC

4.  A. Rb  B. BRCA-1  C. p53  D. NF2  E. APC  Li fraumeni syndrome

5.  A 28-year-old Caucasian female diagnosed with breast cancer states that her mother died of ovarian cancer at 34 years of age and her aunt died of breast cancer at 32 years of age. You suspect that this patient’s condition can be explained by mutation of a gene that is normally responsible for

6.  A. Protein degradation  B. Signal transduction  C. DNA repair  D. Intercellular adhesion  E. Angiogenesis

7.  A. Protein degradation  B. Signal transduction  C. DNA repair  D. Intercellular adhesion  E. Angiogenesis http://jcs.biologists.org/content/114/20/3591.fu ll

8.  A. Recurrent grossly bloody stool and low- grade fever  B. Abdominal cramps, distention and nausea C. Constipation alternating with diarrhea  D. Tenesmus and thin stool  E. Weight loss and progressive fatigue

9.  An ovarian mass removed from a 49-year-old female has yellow coloration of its cut surface. The pathologist describes it as a granulosa theca cell tumor. Based on this pathology report, the tumor is most likely to secrete:

10. A. Human chorionic gonadotropin B. Alpha-fetoprotein C. CA-125 D. Estrogen E. Androgen F. Cortisol

11. A. Human chorionic gonadotropin B. Alpha-fetoprotein C. CA-125 D. Estrogen E. Androgen F. Cortisol Functional ovarian tumors: Granulosa theca(the granulosa portion is responsible for estrogen production and the small risk of cancer)

12.  A young couple is being evaluated for infertility. The woman is 28 years old and has never been pregnant before. She reports moderate to severe lower abdominal pain during her menstrual periods as well as pain during intercourse. Pelvic examination shows a normal sized uterus. Her condition most likely involves which of the following?

13.  Endometrial glands in the myometrium  Endometrial glands outside the uterus  Malposition of the uterus  Endometrial hyperplasia  Multiple ovarian cysts with cortical fibrosis

14.  A 47-year-old Caucasian female undergoes surgery for a recently discovered mass in her right breast. After removal the mass is determined to be invasive ductal carcinoma. Excessive production of which of the following indicates a poorer prognosis?

15. A. Nmyc B. Her 2/neu C. ras D. Estrogen receptors

16. A. Nmyc B. Her 2/neu C. ras D. Estrogen receptors

17.  A 25-year-old sexually active woman complains of abnormal vaginal bleeding, nausea and vague abdominal discomfort. Dilation and curettage is performed and material resembling a bunch of grapes is evacuated from the uterus. The level of which of the following hormones should be closely monitored in this patient over the next year?

18.  -B-hcg  alpha-1 anti-trypsin  T NF  Beta interferon

19.  -B-hcg  alpha-1 anti-trypsin  T NF  Beta interferon

20.  A 48-year-old Caucasian female presents to your office with abdominal distention and decreased appetite. Her last menstrual period was 6 years ago. She has no significant family history. Imaging studies show a right-sided ovarian mass and an accumulation of free peritoneal fluid. Her blood work shows a marked elevation of CA-125. Which of the following would have been most likely to prevent this patient’s condition?

21.  A. Fertility-enhancing drugs  B. Long-term antioxidant supplementation  C. Oral contraceptives  D. High body mass index (BMI)  E. Nulliparity  F. Daily aspirin

22.  A. Fertility-enhancing drugs  B. Long-term antioxidant supplementation  C. Oral contraceptives  D. High body mass index (BMI)  E. Nulliparity  F. Daily aspirin