Lung cancer remains the leading cause of cancer death for both men and
women. Regarding trends in lung cancer in Canadians, which of the
following statements is correct?
A. Lung cancer death rates continue to climb among women while
decreasing among men. [100%]
B. Lung cancer death rates continue to decrease in both men and
women. [0%]
C. Lung cancer death rates continue to increase in both men and
women. [0%]
D. In men, the incidence of lung cancer has been increasing. [0%]
E. In women, the incidence of lung cancer is low. [0%]
Correct
45% answered correctly
Explanation:
In 2017, an estimated:
- 28,600 Canadians were diagnosed with lung cancer. This represents 14%
of all new cancer cases in 2017.
- 21,100 Canadians died from lung cancer. This represents 26% of all cancer
deaths in 2017.
- 14,400 men were diagnosed with lung cancer and 11,100 died from it.
- 14,200 women were diagnosed with lung cancer and 10,000 died from it.
- On average, 78 Canadians were diagnosed with lung cancer every day.
- On average, 58 Canadians died from lung cancer every day.
(Canadian Cancer Statistics)
While still elevated, the incidence rate seems to be levelling off in women. In
men, the incidence has been decreasing. Lung cancer death rates continue
to climb among women while decreasing among men (choice A).
→ Lung cancer death rates continue to decrease in both men and women
(choice B) is an incorrect statement. As explained above, lung cancer death
rates climb among women and decreasing among men.
→ Lung cancer death rates continue to increase in both men and women
(choice C) is an incorrect statement. As explained above, lung cancer death
rates climb among women and decreasing among men.
→ In men, the incidence of lung cancer has been increasing (choice D) is
,incorrect. In fact, it has been decreasing.
→ In women, the incidence of lung cancer is low (choice E) is incorrect. The
incidence is still high.
QID:27337
Time spent: Last updated:
© UWorld
,When advising women about the need for breast cancer screening, which
one of the following statements is accurate regarding risk factors and the
need for screening?
A. Most women with breast cancer have no identifiable risk factors
[100%]
B. Hereditary breast cancer is more common in postmeopausal
women [0%]
C. Having several second degree relatives with breast cancer carries
the same risk as having one first degree relative with breast cancer
[0%]
D. When hereditary breast cancer strikes several generations of a
family, women descended from a male family member are not at
increased risk [0%]
E. Women of Ashkenazi Jewish descent have a lower risk of
developing breast cancer [0%]
Incorrect. Correct answer is A
57% answered correctly
Explanation:
Most women with breast cancer have no identifiable risk factors (choice A).
→ Hereditary breast cancer is more common in premenopausal women
(choice B is incorrect).
→ The risk is increased three- to fourfold in women with a first degree
relative who has had breast cancer. Having several second degree relatives
with breast cancer results in increased risk, but this risk has not been
quantified (choice C is incorrect).
→ Even women with hereditary breast cancer on the paternal side are at
some increased risk (choice D is incorrect).
→ Women of Ashkenazi Jewish descent have a higher risk of developing
breast cancer (choice E is incorrect). This is because about 1 in 40
Ashkenazi Jewish women carry a BRCA gene mutation, while only 1 in 500
women in the general population have it.
QID:27126
Time spent: Last updated:
© UWorld
, A 40-year-old male is brought to the emergency department in a confused state. His
past medical history is unremarkable. He is not taking any medications. He is
complaining of severe, weakness and lightheadedness that began an hour ago.
A STAT glucometer reveals a value of 2.5 mmol/L. The patient improved dramatically
upon Dextrose 50% infusion. After careful history and physical exam, you ordered
some lab tests that return abnormal for an elevated insulin levels and decreased C-
Peptide.
Which of the following is the most likely diagnosis?
A. Chronic pancreatitis [0%]
B. Factitious disorder [100%]
C. Glucagonoma [0%]
D. Insulinoma [0%]
E. Sulphonylurea overdose [0%]
Incorrect. Correct answer is B
70% answered correctly
Explanation:
Our patient has classic symptoms of hypoglycemia (confusion, weakness,
lightheadedness…), documented by lab test, then improved dramatically with glucose
administration (Whipple’s triad).
This patient is likely injecting insulin surreptitiously for a primary gain (factitious
disorder or Munchausen syndrome) (choice B). The exogenous industrial insulin is
purified and does not have the C-peptide as a component; thus in a person who is
injecting insulin, expect low glucose, high insulin and low C-peptide.
→ Chronic pancreatitis (choice A) may present with hyperglycemia and diabetes
because of insulin deficiency.
→ Glucagonoma (choice C) presents with hyperglycemia and a characteristic rash
(Necrolytic migratory erythema).
→ Insulinoma (choice D) would give high levels of both insulin and C-peptide
(endogenous insulin).
→ Sulphonylurea drugs (choice E) make the beta-cells of the pancreas secrete insulin
thus the lab tests will be similar to insulinoma; a urine toxicology screen for
sulphonylurea drugs will clench the diagnosis.
Key point:
Please remember that the C-peptide is an endogenous substance which is not present
in pharmaceutical insulin and you will answer all the tricky questions around this issue
correct.
Time spent: QID:27013 Last updated:
women. Regarding trends in lung cancer in Canadians, which of the
following statements is correct?
A. Lung cancer death rates continue to climb among women while
decreasing among men. [100%]
B. Lung cancer death rates continue to decrease in both men and
women. [0%]
C. Lung cancer death rates continue to increase in both men and
women. [0%]
D. In men, the incidence of lung cancer has been increasing. [0%]
E. In women, the incidence of lung cancer is low. [0%]
Correct
45% answered correctly
Explanation:
In 2017, an estimated:
- 28,600 Canadians were diagnosed with lung cancer. This represents 14%
of all new cancer cases in 2017.
- 21,100 Canadians died from lung cancer. This represents 26% of all cancer
deaths in 2017.
- 14,400 men were diagnosed with lung cancer and 11,100 died from it.
- 14,200 women were diagnosed with lung cancer and 10,000 died from it.
- On average, 78 Canadians were diagnosed with lung cancer every day.
- On average, 58 Canadians died from lung cancer every day.
(Canadian Cancer Statistics)
While still elevated, the incidence rate seems to be levelling off in women. In
men, the incidence has been decreasing. Lung cancer death rates continue
to climb among women while decreasing among men (choice A).
→ Lung cancer death rates continue to decrease in both men and women
(choice B) is an incorrect statement. As explained above, lung cancer death
rates climb among women and decreasing among men.
→ Lung cancer death rates continue to increase in both men and women
(choice C) is an incorrect statement. As explained above, lung cancer death
rates climb among women and decreasing among men.
→ In men, the incidence of lung cancer has been increasing (choice D) is
,incorrect. In fact, it has been decreasing.
→ In women, the incidence of lung cancer is low (choice E) is incorrect. The
incidence is still high.
QID:27337
Time spent: Last updated:
© UWorld
,When advising women about the need for breast cancer screening, which
one of the following statements is accurate regarding risk factors and the
need for screening?
A. Most women with breast cancer have no identifiable risk factors
[100%]
B. Hereditary breast cancer is more common in postmeopausal
women [0%]
C. Having several second degree relatives with breast cancer carries
the same risk as having one first degree relative with breast cancer
[0%]
D. When hereditary breast cancer strikes several generations of a
family, women descended from a male family member are not at
increased risk [0%]
E. Women of Ashkenazi Jewish descent have a lower risk of
developing breast cancer [0%]
Incorrect. Correct answer is A
57% answered correctly
Explanation:
Most women with breast cancer have no identifiable risk factors (choice A).
→ Hereditary breast cancer is more common in premenopausal women
(choice B is incorrect).
→ The risk is increased three- to fourfold in women with a first degree
relative who has had breast cancer. Having several second degree relatives
with breast cancer results in increased risk, but this risk has not been
quantified (choice C is incorrect).
→ Even women with hereditary breast cancer on the paternal side are at
some increased risk (choice D is incorrect).
→ Women of Ashkenazi Jewish descent have a higher risk of developing
breast cancer (choice E is incorrect). This is because about 1 in 40
Ashkenazi Jewish women carry a BRCA gene mutation, while only 1 in 500
women in the general population have it.
QID:27126
Time spent: Last updated:
© UWorld
, A 40-year-old male is brought to the emergency department in a confused state. His
past medical history is unremarkable. He is not taking any medications. He is
complaining of severe, weakness and lightheadedness that began an hour ago.
A STAT glucometer reveals a value of 2.5 mmol/L. The patient improved dramatically
upon Dextrose 50% infusion. After careful history and physical exam, you ordered
some lab tests that return abnormal for an elevated insulin levels and decreased C-
Peptide.
Which of the following is the most likely diagnosis?
A. Chronic pancreatitis [0%]
B. Factitious disorder [100%]
C. Glucagonoma [0%]
D. Insulinoma [0%]
E. Sulphonylurea overdose [0%]
Incorrect. Correct answer is B
70% answered correctly
Explanation:
Our patient has classic symptoms of hypoglycemia (confusion, weakness,
lightheadedness…), documented by lab test, then improved dramatically with glucose
administration (Whipple’s triad).
This patient is likely injecting insulin surreptitiously for a primary gain (factitious
disorder or Munchausen syndrome) (choice B). The exogenous industrial insulin is
purified and does not have the C-peptide as a component; thus in a person who is
injecting insulin, expect low glucose, high insulin and low C-peptide.
→ Chronic pancreatitis (choice A) may present with hyperglycemia and diabetes
because of insulin deficiency.
→ Glucagonoma (choice C) presents with hyperglycemia and a characteristic rash
(Necrolytic migratory erythema).
→ Insulinoma (choice D) would give high levels of both insulin and C-peptide
(endogenous insulin).
→ Sulphonylurea drugs (choice E) make the beta-cells of the pancreas secrete insulin
thus the lab tests will be similar to insulinoma; a urine toxicology screen for
sulphonylurea drugs will clench the diagnosis.
Key point:
Please remember that the C-peptide is an endogenous substance which is not present
in pharmaceutical insulin and you will answer all the tricky questions around this issue
correct.
Time spent: QID:27013 Last updated:
