Step 1 Question of the Week #2

Weekly Free USMLE Style Questions

A 62-year-old male comes to physician’s clinic with complaints of painful non-healing ulcer over the ventral surface of the tongue for the past one year. The ulcer is gradually increasing in size over the last one year. He gave a history of chewing tobacco for the past ten years. His temperature is 37ºC (98.6 F), pulse is 88/min and respirations are 18/min and blood pressure is 110/78 mm of Hg. On physical examination, an ulcer of size 2.5cm X 3cm, oval in shape with irregular margins is present on the ventral surface of the tongue. Rest of the physical examination shows no abnormality. On histological examination, numerous nests and islands of malignant keratinocytes invading the underlying connective tissue stroma are seen.

Which of the following finding is the most likely present in this condition?

A. Anticipation

B. Field cancerization

C. Pseudohypertrophy

D. Central core disease

E. Myofibers containing rimmed vacuoles