A 33-Year-Old Man Comes to the Office Due to Trouble

question 289

Multiple Choice

A 33-year-old man comes to the office due to trouble swallowing and a chronic sore throat.  He has no chronic medical conditions and does not use tobacco or alcohol.  Physical examination shows an enlarged, ulcerated right tonsil.  Biopsy of the ulcerated lesion reveals infiltrating nests of moderately differentiated squamous cells.  Immunohistochemistry is positive for p16, suggesting that the tumor is likely due to human papilloma virus.  Further imaging studies for cancer staging are planned.  This patient's tumor is most likely to spread first to which of the following locations?

• A)Adenoid tissue
• B)Adrenal glands
• C)Gray-white matter junction
• D)Jugular lymph nodes
• E)Lung parenchyma
• F)Vertebral bodies

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Definitions:

Radio Station

A service that broadcasts audio content to the public or specific audiences via radio waves or digital transmissions.

Charter

A document that establishes the principles, functions, and organization of a corporation, city, or other entity.

Provincial Election

An electoral process to choose representatives for the legislative assembly or parliament of a province within a federal system.

Canadian Citizen

An individual who legally belongs to Canada and has rights and privileges under Canadian law including the right to vote and receive protection.