USMLE-Rx Step 1 Qmax Challenge #1379

Check out today’s Step 1 Qmax Question Challenge.

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A 31-year-old man comes to a gastroenterologist for a complete work-up after experiencing bouts of unexplained rectal bleeding, pain in his abdomen, and diarrhea. A flexible sigmoidoscopy is performed, and the result is shown in the image below on the left. The patient is counseled that his son and daughter must also be evaluated in the future.

The patient was lost to follow-up but returns to clinic 5 years later with similar, yet more severe symptoms. The patient undergoes another sigmoidoscopy and a biopsy specimen is obtained, which is found to be malignant.

Which of the gene pairs in the table above are most likely representative of the mutations present in this patient’s tumor?

A. A
B. B
C. C
D. D
E. E

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