A 64-Year-Old Man Comes to the Office Because of Difficulty

question 779

Multiple Choice

A 64-year-old man comes to the office because of difficulty swallowing due to mouth ulcer. He also reports a swelling in his neck which increase in size during over the past 7 months. He has a long history of using chewing tobacco.  On examination, there is an ulcerative lesion in the left floor of mouth.  There is also a firm, palpable, nontender left submandibular mass.  Biopsy of the submandibular mass is shown in the exhibit.  Which of the following is the most likely route of spread from the floor of mouth to the submandibular mass?

• A)Direct invasion through the floor of mouth
• B)Field cancerization of the oral cavity mucosa
• C)Lymphatic drainage to the submandibular lymph nodes
• D)Perineural spread through the lingual nerve
• E)Sublingual vein to the submandibular gland

Understand various agricultural practices and their impacts on soil conservation and erosion.

Recognize the importance of nutrition, including undernourishment, malnourishment, and overnutrition, and their effects on health.

Identify the causes and effects of wind and water erosion on cultivated lands.

Describe practices for sustainable agriculture and how they mitigate environmental impacts.

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Definitions:

Passive Verbs

Verbs that indicate actions done to the subject rather than the subject doing the action, often used to shift focus or be less direct.

Topic Sentences

Sentences that introduce the main idea or theme of a paragraph, providing a summary for the content that follows.

Parallel Headings

Titles or headings in a document that have the same level of importance and are formatted in the same style, ensuring consistency and clarity in the structure.

Fuel-Efficiency Campaign

An initiative or program aimed at promoting practices or technologies that reduce the amount of fuel consumed by vehicles, thereby conserving energy and lowering emissions.