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  #1  
Old 06-26-2012
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Default A 55-year-old man with a 60 pack-year history...

A 55-year-old man with a 60 pack-year history of smoking has been diagnosed with a squamous call carcinoma of the larynx. He receives 4000 cGy in divided doses to treat the carcinoma. One year later, endoscopy shows no gross evidence of residual carcinoma. Which of the following is most likely to be present in this patient as a result of treatment?

a) hypocellular bone marrow
b) absent spermatogenesis
c) colonic ulceration
d) vascular fibrosis
e) cerebral atrophy

Please try to briefly explain your answer
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Old 06-26-2012
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d) vascular fibrosis


seems more likely to me (considering region of exposure)
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Old 06-26-2012
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I have really found this question to be difficult,
First because we are dealing with late effects and not acute.

I know the one of the most important late side effect is fibrosis like pulmonary fibrosis, but in this question we are not asked about that.
Most of the tissues can regenerate them self after radiation, bone marrow, muscosal cells.
brain is practically not affected by radiation

I would go with B. one of the side effects of radiation is sterility acutely, and usually it can be irreversible so it may persist as late side effect.
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Old 06-26-2012
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c) is my second option
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Old 06-26-2012
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my second option is D. vascular fibrosis (which i think now i right) it is also a common late side effect, and as the person before me said they dont have to irradiate the whole body.
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Old 06-26-2012
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i think VASCULAR FIBROSIS is the answer....and the rest options are seen in whole body radiation.....
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Old 06-28-2012
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Default correct answer

Correct answer is d) vascular fibrosis

therapeutic doses of radiation -> vascular injury (endothelial damage and inflammatory reaction) ---> with time ->>> vascular fibrosis (luminal narrowing) which is typical for local radiation (and I think that's what they wanted us to read between the lines).

Bone marrow supression, colonic ulceration would be more probable in whole-body radiation which is not the case in treatment of a squamous call carcinoma of the larynx.
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curiousmind (06-29-2012)



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