Breast, Lung, Heart, Vascular

Question 1

Principal sources of blood of the breast

Answer 1

Internal mammary
Posterior intercostal arteries
Axillary artery

Question 2

Level I, II, III nodes are located:

Answer 2

I - Lateral to pectoralis minor
II - Under pectoralis minor
III - Medial to pectoralis minor

Question 3

Gynecomastia not associated with an increased risk of breast CA in males except in:

Answer 3

Kleinfelter syndrome

Question 4

Treatment for extensive DCIS (>4mm or disease in more than one quadrant)

Answer 4

Mastectomy

Question 5

Sentinel LN biopsy is NOT suitable for the following:

Answer 5

Inflammatory breast CA
Palpable axillary lymphadenopathy and biopsy-proven metastasis
DCIS without mastectomy
Prior axillary surgery

Question 6

Most common pattern of calcification in hamartomas

Answer 6

Popcorn calcification

Question 7

NSCLC patient with a potentially resectable tumor:

If the patient can walk on a flat surface indefinitely, without oxygen and without having to stop and rest secondary to dyspnea, he will be very likely to tolerate:

Answer 7

Lobectomy

Question 8

NSCLC patient with a potentially resectable tumor:

If the patient can walk up two flights of stairs (up two standard levels), without having to stop and rest secondary to dyspnea, he will likely tolerate:

Answer 8

Pneumonectomy

Question 9

The most likely bacterial cause of aspiration pneumonia is:

Answer 9

Anaerobic organisms ONLY (50% of cases)

Question 10

Chest wall mass with elevated ESR may indicate which disease?

Answer 10

Ewing sarcoma

Question 11

Most common benign chest wall tumor

Answer 11

Chondroma

Question 12

Primary site for female patients with malignant pleural effusion is most commonly:

Answer 12

Breast CA

Males: Lung CA

Question 13

Eosinophilic granulomas are associated with which disease?

Answer 13

Langerhans Cell Histiocytosis

Question 14

Chylothorax is likely to be present with a triglyceride level of ____ in the pleural fluid:

Answer 14

Greater than 110 mg/100 mL

Question 15

Causative agent and treatment for epidemic puepural mastitis:

Answer 15

MRSA

Tx: STOP breastfeeding, give antibiotics, and I&D

Question 16

Recurrent periductal mastitis is also known as

Answer 16

Zuska’s disease

Question 17

Baseline mammography should be done at

Answer 17

Age 35

Question 18

Annual mammography should start at:

Answer 18

Age 40

Question 19

Most important prognostic correlate of disease-free and overall survival in breast CA:

Answer 19

Axillary LN status

Question 20

DCIS comedo type has a _____ risk for recurrence

Answer 20

High

Question 21

Treatment options for LCIS

Answer 21

Observation
Tamoxifen chemoprevention
Bilateral total mastectomy

Question 22

Treatment options for DCIS and early invasive breast CA (St I, II)

Answer 22

Mastectomy/lumpectomy + RT

SAME mortality rate, but recurrence is more common in lumpectomy

Question 23

Large, pale, vacuolated cells in the rete

pegs of the epithelium is pathognomonic for:

Answer 23

Paget’s disease of the nipple

Question 24

Treatment for Breast CA St. IIIa, IIIb

Answer 24

Neoadjuvant CT + MRM + adjuvant RT

Question 25

Removed in simple mastectomy

Answer 25

Breast tissue Skin, nipple-areola complex Level I LN

Question 26

Removed in MRM

Answer 26

Breast tissue Skin, nipple-areola complex Level I and II LN (Patey removes pectoralis minor)

Question 27

Most frequent MRM complication

Answer 27

Seromas beneath skin flaps or axilla

Question 28

Structures removed in Halsted Radical Mastectomy that are preserved in MRM

Answer 28

Pectoralis major Pectoralis minor LN III

Question 29

Breast discharge characteristics that are associated with benign disease:

Answer 29

Milky or blue-green

Question 30

Breast characteristics that are associated with malignant disease:

Answer 30

Serous, bloody, clear

Question 31

Most common age to close asymptomatic ASDs

Answer 31

4-5 years old

Question 32

Bidirectional glenn procedure is used to correct

Answer 32

Tricuspid atresia (First stage of Fontan repair)

Question 33

Norwood procedure is used for

Answer 33

Hypoplastic left heart syndrome

Question 34

Arterial switch for TGA is best performed within:

Answer 34

2 weeks of birth

Question 35

Most common VSD requiring surgical correction:

Answer 35

Perimembranous

Question 36

Best predictor of spontaneous closure of VSD:

Answer 36

Age at diagnosis

Question 37

Major determinant of operability of VSD is:

Answer 37

Degree of pulmonary vascular resistance

Question 38

Most common cause of thoracic aortic aneurysms

Answer 38

Nonspecific medial degeneration

Question 39

Most common cause of death in type IV Ehlers Danlos

Answer 39

Ruptured visceral artery

Question 40

Most common complication of extensive repair of distal aortic aneurysms

Answer 40

Pulmonary dysfunction

Question 41

Most common presenting symptom in patients with ascending aortic aneurysm

Answer 41

Anterior chest pain

Question 42

Risk for rupture of AAA is exponentially increased above the size of:

Answer 42

5.5 cm

Question 43

Most commonly affected compartment in a lower leg compartment syndrome is:

Answer 43

Anterior compartment

Question 44

Most common cause of ischemic stroke

Answer 44

Emboli

Question 45

Hollenhorst plaque is found within the:

Answer 45

Retinal vessels

Question 46

Best diagnostic image modality for lower extremity occlusive disease

Answer 46

Contrast angiography

Question 47

Most common source of distal emboli

Answer 47

The heart

Question 48

A syndrome were there is increased DVT formation, characterized by narrowing of the left iliac vein where the right iliac artery crosses over it

Answer 48

May-Thurner Syndrome

Question 49

Extensive DVT of the major axial deep venous channels of the lower extremity with relative sparing of collateral veins causes a condition called:

Answer 49

Phlegmasia cerulea dolens

Question 50

According to the American College of Chest Physicians, the recommended duration of long-term antithrombotic therapy after provoked DVT is:

Answer 50

3 months

Question 51

Heparin-induced thrombocytopenia is characterized by: Previous exposure to heparin Platelet count

Answer 51

PC <100,000 | Decline of >50% following exposure

Question 52

Solitary pulmonary nodule should at least be _ cm in size

Answer 52

3 cm

Question 53

Only true surgical emergency among all congenital heart diseases

Answer 53

TAPVC

Question 54

Hallmark finding of TAPVC

Answer 54

Equalization of O2 sat in all chambers

Question 55

Percentage of chest wall masses that are considered malignant:

Answer 55

50-80%

Question 56

Most commonly recommended age of correction of TOF is:

Answer 56

Younger than 3 months

Question 57

Aneurysm is the increase in size of the abdominal aorta to greater than __cm in diameter

Answer 57

3.0cm

Question 58

Percent of chest wall masses that are malignant (range)

Answer 58

50-80%

Question 59

A patient presenting with a history and findings of dyspnea, wheezing, hemoptysis, and a mediastinal mass in the visceral compartment yields a diagnosis of:

Answer 59

Mediastinal granuloma

Question 60

A patient with an anterior mediastinal mass and elevated serum α-fetoprotein (AFP) most likely has

Answer 60

A nonseminomatous germ cell tumor