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:

Equitable Jurisdiction

The authority of a court to decide on cases based on fairness and ethical judgment rather than strictly on laws.

Undue Influence

Excessive pressure or influence exerted on someone, forcing them to act against their will or better judgment in legal and financial transactions.

Non Est Factum

A legal defense claiming that a signed contract is invalid because the signing party was mistaken about its nature.

Independent Legal Advice

Guidance from a lawyer who has no conflicts of interest with the client.