Neoplasia USMLE Step 1 Practice Question
A 43-year-old woman presents with progressive early satiety and 8-kg weight loss over three months. Vital signs show BP 118/76, HR 92, RR 16, temp 37.2°C, SpO2 98%. Upper endoscopy reveals diffuse gastric wall thickening without a discrete mass. CT imaging shows wall thickness of 8 mm without distant metastases. Gastric biopsy demonstrates signet ring cells infiltrating the submucosa and muscularis propria. She denies current NSAID use. Which molecular abnormality most likely contributed to this tumor's development?
Answer choices
- ALoss of E cadherin mediated cell adhesionCorrect answer
- BOverexpression of BCL2 preventing apoptosis
- CMicrosatellite instability from mismatch repair deficiency
- DConstitutive activation of BCR ABL tyrosine kinase
- EDeficiency of p53 mediated DNA repair
- FIncreased expression of HER2 receptor tyrosine kinase
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