USMLE Step 1 Year: 2024 Number: 0958

A 34-year-old woman comes to the physician because of a 2-day history of mild nausea, increased urinary urgency and frequency, and constipation. She also has had a 4.5-kg (10-lb) weight loss during the past 2 weeks and a 3-week history of vaginal bleeding. Pelvic examination shows a nodular cervix with an irregular, friable posterior lip, and a rock-hard, irregular, immobile pelvic mass that extends across the pelvis. Examination of biopsy specimens from the cervix and anterior wall of the vagina show well-differentiated keratinizing squamous cell carcinoma. Which of the following best describes the pathogenesis of this patient's disease?

Inactivation of cellular p53
Insertion of viral promotors adjacent to cellular growth factor genes
Specialized transduction
Transactivation of cellular growth factor genes by TAX
Translocation of CMYC to an Ig gene promoter