FORM7 question, please help.
Hi, anybody has done form 7 and has a definitive answer for the following question, please help:
a 65-year man has pain with urination and episodes of blood in his urine for the past 3 months. Physical no abnormal.Cytology exam show transitional cell carcinoma. Which of the following findings on an biopsy of the urinary bladder is the strongest indication for cystectomy?
a. multifocal transitional cell carcinoma in situ.
b.noninvasive high grade papillary transitional call carcinoma.
c.noninvasive low grade transitional cell carcinoma with focal transitional cell carcinoma in situ.
d.papillary transitional cell carcinoma with invasition into detrusor muscle
e.papillary transitional cell carcinoma with more than 10 mitotic figures per 10 high power fields
D
but why?...can u explain a little bit more...
JiYa48740992 wrote:
but why?...can u explain a little bit more...
i agree is D and here is my theory....i will start with a little bit of normal stuff and then move forward;
carcinoma means cancer of epithelium.....under this epithelium there is a basement membrane(BM)...under this BM we have many structures and in our case we have a muscle(detrussor)....as a rule for you from now on: any cancer which is located ONLY to the epithelium(aka carcinoma in situ) most likely will not require a major surgery; if the carcinoma spread under the BM, that patient will probably need a major surgery;
our case: scenario says it's a transitional cell carcinoma; the problem now is it in situ or is spread adjacently or far away(metasasis)? this is critical because the management is different: in our case, the patient has carcinoma and is NOT in situ(spread to the detrussor muscle-aka under the BM)....therefore the most likely treatment is to take out entire bladder(answer D); if this patient would have only in situ carcinoma, the treatment could be wide base excision/radiation, etc depending on what type of tissue is involved; rest of the explanations are pretty much all carcinoma in situ or noninvasive carcinoma(aka does not pass BM); answer E even though is an carcinoma, it does not say is it's in situ or not so you can't bet anything on that(10 mitotic figures per 10 high power fields does not say anything about invasion)....i hope this explanation helps...good luck!
Wow, very thorough explanation, thanks a lot.
Another Q from form 7:
a previously healthy 40-year-old woman, 2 day history of fever, lethargy and confusion: temp 38, pulse 80/min, respiration 18/min, bp 140/90.Physical show scattered petechiae and ecchymoses over the lower extremities. Neurology examination show moderate generalized motor weakness. she is oriented to people but not to place or time.
Lab show: Hb-9g/dl,Hct-27%, leukocyte-8000/mm3 with normal differentiation,platelet-15,000/mm3, PT-12s,PTT-30s,Urea Nitrogen-25mg/dl,Haptoglobin-<10mg/dl, LDH 1000U/L. Direct Coomb is negative, Chest X-ray is normal.
The patient is admitted and IV plasma exchange twice daily is started. Three days later, the patient is fully oriented, her Hb is 11g/dl, hct is 33% and platelet count is 85,000/mm3. A peripheral smear at the time of admission would likely show which of the following RBC abnormalities.
a. Cabot ring
b. hypochromatic microcytes
c. Pappenheimer bodies
d. schistocytes
e. Teardrop forms
schistocytes, she has ttp. and jeez, that was such a long vignette
HEY, I JUST DID FORM 7. HOW DID U MANAGE TO COPY AND PASTE THE WHOLE QUESTION ON THIS BLOG? I CAN'T EVEN ACCESS THE FORM ANYMORE. ANY IDEAS? I REALLY WANT TO KNOW WHICH QUESTIONS I GOT WRONG. THERE ARE SOME ANSWER KEYS FLOATING ON THESE BLOGS. PLEASE HELP.
anam.khan wrote:
HEY, I JUST DID FORM 7. HOW DID U MANAGE TO COPY AND PASTE THE WHOLE QUESTION ON THIS BLOG? I CAN'T EVEN ACCESS THE FORM ANYMORE. ANY IDEAS? I REALLY WANT TO KNOW WHICH QUESTIONS I GOT WRONG. THERE ARE SOME ANSWER KEYS FLOATING ON THESE BLOGS. PLEASE HELP.
Well, I paid extra $10, so it allow me to review my wroing questions...
[quote=JiYa48740992]Another Q from form 7:
a previously healthy 40-year-old woman, 2 day history of fever, lethargy and confusion: temp 38, pulse 80/min, respiration 18/min, bp 140/90.Physical show scattered petechiae and ecchymoses over the lower extremities. Neurology examination show moderate generalized motor weakness. she is oriented to people but not to place or time.
Lab show: Hb-9g/dl,Hct-27%, leukocyte-8000/mm3 with normal differentiation,platelet-15,000/mm3, PT-12s,PTT-30s,Urea Nitrogen-25mg/dl,Haptoglobin-<10mg/dl, LDH 1000U/L. Direct Coomb is negative, Chest X-ray is normal.
The patient is admitted and IV plasma exchange twice daily is started. Three days later, the patient is fully oriented, her Hb is 11g/dl, hct is 33% and platelet count is 85,000/mm3. A peripheral smear at the time of admission would likely show which of the following RBC abnormalities.
if any one seriously want to discuss form 7 in one day pls mail at
[email protected], i did form 7 have 50 wrong questions with me pls
edited by krs94446307 on 2/12/2011
ig A production did u get trascytosis as correct , because i read it as endoctosis
krs94446307 wrote:
ig A production did u get trascytosis as correct , because i read it as endoctosis
Yes..definitely transcytosis..
i just took nbme and 7 got a questions
a 47 year old man comes into the er because of 2 hour history vomiting bright red blood. he drinks alchol for 2o years. the most likely cause of bleeding is an indirect shunt of blood to svc via which of the follwing veins?
a. hepatic
b.inferior mesenstric
c. left gastic
d.right gastroepiploic
e.splenic
i think its hepatic cuz the portal traid i dont know if that is right or i was thinking of splenic
f. superior mesenstric
wawa15236613 wrote:
i just took nbme and 7 got a questions
a 47 year old man comes into the er because of 2 hour history vomiting bright red blood. he drinks alchol for 2o years. the most likely cause of bleeding is an indirect shunt of blood to svc via which of the follwing veins?
a. hepatic
b.inferior mesenstric
c. left gastic
d.right gastroepiploic
e.splenic
i think its hepatic cuz the portal traid i dont know if that is right or i was thinking of splenic
f. superior mesenstric
Well, 20 yrs alochol drinking=liver cirrhosis=portal hypertension= upper GI bleeding(bright red blood=bleeding above stomach), so it should be the left gastric bleeding because of portal hypertension---C. Hope this helps...
wawa15236613 wrote:
i just took nbme and 7 got a questions
a 47 year old man comes into the er because of 2 hour history vomiting bright red blood. he drinks alchol for 2o years. the most likely cause of bleeding is an indirect shunt of blood to svc via which of the follwing veins?
a. hepatic
b.inferior mesenstric
c. left gastic
d.right gastroepiploic
e.splenic
i think its hepatic cuz the portal traid i dont know if that is right or i was thinking of splenic
f. superior mesenstric
hi there pal,
answer is C. left gastric (bleeding esophageal varices secondary to cirrhosis of the liver) portosystemic anastomosis between the eosophageal vessels and left gastric vessels. thanks for the question and all the best.
pages:
1