Neoplasia USMLE Step 1 Practice Question
A 56-year-old woman presents with progressive proximal muscle weakness and difficulty climbing stairs. On examination, she has a heliotrope rash and Gottron papules. Vital signs show BP 128/82, HR 92, RR 16, temp 37.2°C, SpO2 98%. Laboratory studies reveal elevated creatine kinase at 1,240 U/L and positive anti-Jo-1 antibodies. Chest radiograph shows no pulmonary involvement. She denies recent medication use. Imaging subsequently identifies an ovarian neoplasm. Which mechanism best explains the relationship between her myositis and the malignancy?
Answer choices
- AAdverse effect of platinum chemotherapy
- BOpportunistic infection due to tumor associated neutropenia
- CDirect metastatic invasion of skeletal muscle
- DParaneoplastic syndrome associated with adenocarcinomaCorrect answer
- EEctopic ACTH production by a neuroendocrine tumor
- FAutoimmune cross-reactivity between tumor-associated antigens and myositis-specific autoantigens
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