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A 25-year-old man presents with a chief complaint of persistent, high-pitched ringing
Clinical VignetteA clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.
A 25-year-old man presents with a chief complaint of persistent, high-pitched ringing noises in his ears. Questioning reveals that he has also been losing his balance lately. CT of the head demonstrates bilateral tumors involving the vestibulocochlear nerve. Which of the following chromosomes contains the tumor suppressor gene most likely to be involved in this case?
A. 5q
B. 13q
C. 17q
D. 18q
E. 22q
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
I think the correct answer is Option E (22q)
This must be a case of Acoustic Neuroma, Neurofibromatosis Type 2.
So Chromosome 22 (22q11.1-13.1) contains the tumour supressor gene.
I will go for option E.
Yup, the correct answer is E. The patient has bilateral acoustic neuromas, probably due to neurofibromatosis type II (over 90% of patients with NF-2 develop bilateral acoustic neuromas). This condition is a associated with the NF-2, gene, located on 22q (note all the 2's). Patients often develop meningiomas, gliomas, and schwannomas of cranial and spinal nerves.
5q (choice A) contains the APC tumor suppressor gene, which is associated with familial and sporadic colorectal cancers.
13q (choice B) contains the Rb tumor suppressor gene, which is associated with retinoblastoma and osteosarcoma.
17q (choice C) contains both the NF-1 tumor suppressor gene, which is associated with neurofibromatosis type I, and the p53 tumor suppressor gene, associated with many human cancers.
18q (choice D) contains both the DCC gene, which is associated with colon and gastric carcinomas and the DPC gene, associated with pancreatic cancer.
I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
Re: Clinical MCQs -
10-06-2006, 11:50 PM
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