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Surgery MCQ 25
2008-02-02 07:10:00
The relationship between small-cell and non-small cell lung cancers can be described by the following: They differ by histology, clinical behavior and cell of origin Of all lung cancers, approximately 80% are non-small cell and 20% are small cell Both cell types are predictably responsive to chemotherapy The International Staging System can be applied to both tumor types The majority of non-small cell cancer patients vs. the minority of small cell cancer patients are candidates for pulmonary resection Previous MCQ AnswerNext MCQ
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Surgery MCQ 24
2008-02-02 07:09:00
A 62-year-old male smoker presents with right anterior chest pain. There is a 3 cm mass attached to the chest wall with radiographic evidence of rib erosion and positive cytology for non-small cell carcinoma. Which of the follow is/are true: The patient is inoperable due to tumor size and chest wall involvement Radiation therapy is the preferred initial treatment Operative resection should be performed with en bloc removal of the tumor and adjacent chest wall as well as a mediastinal lymph node resection Positive mediastinal nodes will have little effect on survival The patient would be classified Stage IIIa Previous MCQ AnswerNext MCQ
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Surgery MCQ 23
2008-02-02 07:09:00
For the patient in the pervious question to become an operative candidate which of the following must be met? Extrathoracic metastases must be able to be controlled by another modality, e.g. radiotherapy Tumor doubling time must exceed 40 days If there is recurrence at the primary site, it must be treated before the metastatic disease Even if effective systemic therapy is available, resection of metastases is preferred If pulmonary reserve is marginal, resection of the maximal number of metastatic foci should be performed Previous MCQ AnswerNext MCQ
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Surgery MCQ 22
2008-02-02 07:08:00
Biopsy of the lesion in the previous question is reported as “bronchial carcinoid with no signs of atypia.” Which of the follow is/are true? Sleeve resection of the bronchus would be appropriate Lymph node biopsy at time of resection is unnecessary Associated carcinoid syndrome is very unlikely If carcinoid syndrome were found in a tumor this size, hepatic metastases would be likely When bronchial carcinoid syndrome occurs, right-sided cardiac valves are affected Previous MCQ AnswerNext MCQ
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Surgery MCQ 21
2008-02-02 07:07:00
In the evaluation and preparation of a 55-year-old smoker for resection of a 3 cm pulmonary adenocarcinoma, the following is/are true: Preoperative cessation of smoking does not reduce postoperative pulmonary complications Resting PaCO2 is of more value than PaO2 FEV1 is of more value than measured vital capacity Diffusion capacity should be measured routinely V/Q lung scan is useful when pulmonary reserve is marginal Previous MCQ AnswerNext MCQ
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Surgery MCQ 20
2008-02-01 05:52:00
Following resection of a T1N1 squamous cell cancer in a 47-year-old male, the following is/are true: There is a higher risk of local recurrence than with any other histologic type of non-small cell cancer The greatest risk to the patient is a distant metastasis Of all metastatic sites, liver is most likely If the patient survives five years, there is a greater risk of a new lung cancer than recurrence To improve survival, the patient should be considered for adjuvant chemotherapy Previous MCQ AnswerNext MCQ
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Surgery MCQ 19
2008-02-01 05:51:00
A 42-year-old woman with hemoptysis is seen to have a 2 cm mulberry appearing polypoid lesion in the left mainstem bronchus suspicious for bronchial adenoma. The differential diagnosis includes which of the following: Mucoepidermoid carcinoma Plasma cell granuloma Carcinoid tumor Adenoid cystic carcinoma Mucous gland adenoma Previous MCQ AnswerNext MCQ
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Surgery MCQ 18
2008-02-01 05:50:00
A 42-year-old man has a solitary “coin lesion” 2 cm in diameter in the area of the right upper lobe on a routine chest radiograph. Which of the following is/are true? A previous radiograph from five years prior showing the lesion to be 1.2 cm in diameter indicates malignancy If a CT scan shows mediastinal adenopathy, mediastinoscopy is preferable to thoracotomy In the absence of previous radiographs, the lesion should be followed by serial films at 6 month intervals Calcification in a concentric or “popcorn” configuration denotes a benign lesion Needle aspiration showing “chronic inflammatory cells” denotes a benign lesion Previous MCQ AnswerNext MCQ
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Surgery MCQ 17
2008-02-01 05:49:00
A 2 cm peripheral squamous cell carcinoma in the lung of a 60-year-old male with a pleural effusion positive for malignant cells would be classified as: T1N0M1 T3N0M0 T3N0M1 T4N0M0 T4N0M1 Previous MCQ AnswerNext MCQ
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Surgery MCQ 16
2008-02-01 05:47:00
A 53-year-old woman who had a malignant tumor removed 2 years ago presents with a solitary lung nodule 1.5 cm in diameter. The following is/are true: If the primary tumor originated in the breast, the lesion is most likely to represent a new primary lung cancer. If the primary tumor was melanoma, the lesion is most likely to be metastatic If the remainder of the lung fields are clear, a CT scan is unnecessary If the primary tumor was in the GI tract, there is very little chance that the lesion is a new primary lung cancer Fine needle aspiration should always be performed prior to resection of the lung lesion Previous MCQ AnswerNext MCQ
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Surgery MCQ 15
2008-02-01 05:46:00
A 61-year-old male presents with a painful mass 3.5 cm in diameter below the clavicle and attached to the chest wall. The following is/are true: A CT scan is the best study to determine rib destruction The lesion should be removed enbloc without biopsy to minimize the chances for local recurrence The chances are approximately 40% that the lesion is metastatic If it is metastatic, the most likely primary tumor is in the lung or pancreas Fortunately, less than 50% of chest wall tumors are malignant Previous MCQ AnswerNext MCQ
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Surgery MCQ 14
2008-02-01 05:45:00
Concerning the sternum, the following is/are true: The xiphoid process is the anterior border of the thoracic outlet Gladiolus is the body of the sternum The angle of Louis is at the level of the 2nd costal cartilage The 11th rib is attached via costal cartilage to the xiphoid The sterno-manubrial junction is at the level of T4 posteriorly Previous MCQ AnswerNext MCQ
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Surgery MCQ 13
2008-02-01 05:43:00
A 22-year-old woman recovering from a traumatic head injury is noted to have bright red bleeding when her tracheostomy is suctioned. The following is/are true statement(s): Antibiotics should be administered to treat the bronchitis Deflation of the tracheal tube cuff is a useful diagnostic maneuver If massive bleeding occurs, a finger should be used to compress the innominate artery against the sternum Operative treatment of a tracheoinnominate fistula includes resection and prosthetic replacement of the innominate artery Tracheal resection is usually required for a tracheoinnominate fistula to prevent recurrence Previous MCQ AnswerNext MCQ
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Surgery MCQ 12
2008-01-31 06:41:00
A 52-year-old alcoholic with fever and a cough productive of purulent sputum is found to have the opacity on chest film as shown (Fig. 62-15). The following is/are true statement(s): The findings suggest a parapneumonic empyema If pus is found on aspiration of the pleural space, a chest tube should be placed If pus is found on aspiration, bronchoscopy is a necessary part of the patient’s evaluation In this situation, rib resection for drainage is preferred to a large-bore chest tube Decortication of the lung should be considered if the lung fails to expand within 4 weeks Previous MCQ AnswerNext MCQ
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Surgery MCQ 11
2008-01-31 06:39:00
The lesion shown (Fig. 62-6) was found on a 32-year-old male on a routine chest film required for his employment. Which of the following is/are true? The stippled calcification and intact cortex of the rib are characteristic of osteochondroma The stippled calcification is characteristic of osteogenic sarcoma If the lesion is osteogenic sarcoma, the optimal treatment is resection and radiation therapy If the lesion is an osteochondroma, it need not be resected in this age group The radiographic picture is typical for Ewing sarcoma Previous MCQ AnswerNext MCQ
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Surgery MCQ 10
2008-01-31 06:38:00
To resect a chondrosarcoma of the chest wall in a 42-year-old man, ribs 2–4 were removed, leaving a defect 8 x 8 cm. For reconstruction, the following is/are true: If this were to be posterior, beneath the scapula, reconstruction would not be required If this defect is anterior, the primary benefit of reconstruction is an improved cosmetic result Whenever chest wall reconstruction is considered, it should be delayed 6–12 months to allow detection of recurrent tumor If Marlex is used for reconstruction, no wound drainage tube is necessary If PTFE is used for reconstruction, both pleural and wound tubes should be used Previous MCQ AnswerNext MCQ
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Surgery MCQ 09
2008-01-31 06:37:00
An upright chest film of a cachectic, homeless 47-year-old woman shows blunting of the right costophrenic angle. The following is/are true: A lateral decubitus film should be obtained to confirm the presence of fluid rather than a CT scan Tuberculous effusion can readily be identified by stain and culture of aspirated fluid A pleural fluid glucose level lower than in the serum is diagnostic of empyema Bloody pleural effusion in this patient is diagnostic of an underlying malignancy Pleural fluid cytology report of lumphoma should be viewed with skepticism Previous MCQ AnswerNext MCQ
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Surgery MCQ 08
2008-01-31 06:35:00
Following shotgun wound of the chest wall, a 39-year-old woman desires reconstruction without a foreign-body prosthesis. Old incisions prohibit use of her rectus abdominus muscles. Considering chest wall muscles for reconstruction, the following is/are true statement(s): The pectoralis major muscle is available and innervated by the medial and lateral pectoral nerves so named because it describes their relationship to the pectoralis minor The serratus anterior muscle is available since its absence has no functional significance There is no serratus posterior muscle The latissimus dorsi muscle is available and supplied by the thoracodorsal artery The latissimus dorsi is innervated by the thoracodorsal nerve with fibers from C6, C7 and C8 Previous MCQ AnswerNext MCQ
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Surgery MCQ 07
2008-01-31 06:34:00
A 38-year-old man presents with facial and upper extremity edema, venous distention in the neck and arms and a cyanotic appearance. The following is/are true statement(s): The most likely cause of the problem is mediastinal granulomatous disease A venogram should be obtained to confirm the diagnosis Mediastinoscopy for diagnosis is contraindicated If a malignancy is identified, resection is indicated for palliation If the etiology is benign disease, gradual improvement without operation is to be expected Previous MCQ AnswerNext MCQ
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Surgery MCQ 06
2008-01-31 06:30:00
A 39-year-old woman with hypertension and radicular chest wall pain was found to have the lesion seen on chest radiograph (Fig. 63-23). The following is/are true statement(s): The location of the lesion suggests a teratoma High urinary vanillylmandelic acid levels would indicate that the lesion is a paraganglioma If the lesion was seen on a film 5 years earlier, resection would not be indicated A neurosurgical consultation should be obtained Vasoactive intestinal polypeptide level elevation suggests a ganglioneuroma Previous MCQ AnswerNext MCQ
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Surgery MCQ 05
2008-01-25 06:46:00
Carbon monoxide diffusion capacity (DLCO) has been shown to correlate with:A. The thickness of the alveolar lining membrane.B. The permeability of the erythrocyte to carbon dioxide.C. Pulmonary emboli.D. Total alveolar-capillary capacity. Previous MCQ AnswerNext MCQ
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Surgery MCQ 04
2008-01-25 06:45:00
Which of the following screening tests are important for preoperative evaluation of pulmonary function?A. History and physical examination.B. Room air arterial blood gases.C. Chest film.D. Vital capacity and forced expiratory volume in 1 second (FEV 1).E. Cardiopulmonary exercise testing. Previous MCQ AnswerNext MCQ
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Surgery MCQ 03
2008-01-25 06:43:00
The pulmonary circulation:A. Is the only vascular system in which the veins do not have the same course as the arteries.B. Has a direct connection of vein to adjacent lung tissue by connective tissue fibers, making the diameter of the tissue fibers dependent upon lung volume.C. Supplies the metabolic needs of the alveoli.D. All of the above. Previous MCQ AnswerNext MCQ
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Surgery MCQ 02
2008-01-25 06:41:00
Clearance of mucus produced in the tracheobronchial tree in chronic bronchitis secondary to smoking may:A. Be hampered by the fact that the amount of mucus is increased by the number of mucus-producing cells at the expense of ciliated cells.B. Be slowed if patients have decreased lung volume and are therefore unable to generate a vigorous cough that would cause an inflammatory process.C. Cause a decrease in diffusion capacity and associated hypoxemia.D. All of the above. Previous MCQ AnswerNext MCQ
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Surgery MCQ 01
2008-01-25 06:40:00
The bronchial circulation:A. Is the blood supply to the conducting airways.B. Drains into a peribronchial venous network that may expand considerably with conditions such as bronchiectasis and chronic obstructive pulmonary disease.C. Is an especially important consideration in pulmonary transplantation.D. All of the above.AnswerNext MCQ
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Break From Blog!
2007-11-03 06:13:00
Friends I will be taking a break from posting MCQS and notes for a while as I will be going on a vacation for 1-2 months. Will start posting agin somewhere in January. Thanks for subscribing to my blog all this while. If you would like any particular topics to be posted do let me know via my mail... drvishaalbhat@gmail(.)com. I will try and get them when I return.
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Pharmacology MCQ 68
2007-10-08 15:59:00
A patient with tuberculosis develops bright orange-red urine and calls his physician in a panic because he is afraid he is bleeding into the urine. The patient has no other urinary tract symptoms. Which of the following medications is most likely to produce this side effect?A. EthambutolB. IsoniazidC. PyridoxineD. RifampinE. StreptomycinAnswer
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MCQ Physiology 32
2007-09-19 05:45:00
Which of the following Starling force changes is the primary cause ofthe edema seen in patients with nephrotic syndrome?A. Decreased capillary hydrostatic pressure (Pc)B. Decreased capillary oncotic pressure (pc)C. Decreased interstitial hydrostatic pressure (Pi)D. Decreased interstitial oncotic pressure (pi)E. Increased capillary hydrostatic pressure (Pc)F. Increased capillary oncotic pressure (pc)G. Increased interstitial hydrostatic pressure (Pi)H. Increased interstitial oncotic pressure (pi)Answer
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MCQ Psychiatry 43
2007-09-19 05:40:00
A 37-year-old woman who was diagnosed with AIDS 3 years earlier is unable to work, is physically debilitated, and requests her physician to provide her with medications with which to take her own life. The most common emotional disorder that results in such requests by patients isA. bipolar I disorder, manic typeB. borderline personality disorderC. factitious disorderD. major depressive disorderE. schizophrenic disorderAnswer
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MCQ Pharmacology 67
2007-09-18 05:30:00
IV administration of drug X to an anesthetized animal produces an increase in blood pressure. After administration of drug Y, readministration of drug X produces a decrease in blood pressure.Which of the following pairs of drugs could produce this sequence of events? .......Drug X............ Drug YA. Acetylcholine .....NeostigmineB. Epinephrine........ PhentolamineC. Isoproterenol .....AtropineD. Norepinephrine.....PropranololE. Phenylephrine .....HexamethoniumAnswer
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