Chest Wall, Pleura, Mediastinum

Question 1

All of the following increase the risk for tracheal stenosis EXCEPT

A. Age over 70 years
B. Radiation
C. Male gender
D. Excessive corticosteroid therapy

Answer 1

C. Male gender

Question 2

Adenoid cystic carcinomas

A. Spread submucosally
B. Exhibit aggressive growth
C. Are not radiosensitive
D. Have a 5-year survival rate of >50%

Answer 2

A. Spread submucosally

Question 3

Which of the following is NOT a non–small-cell tumor of the lung?

A. Squamous cell carcinoma
B. Adenocarcinoma
C. Carcinoid tumor
D. Large-cell carcinoma

Answer 3

C. Carcinoid tumor

Question 4

The most common pattern of benign calcification in hamartomas is

A. Solid
B. Diffuse
C. Central
D. Popcorn

Answer 4

D. Popcorn

Question 5

For an adenocarcinoma that has pleural invasion, tumor necrosis, and has lymphovascular invasion the correct subtype is

A. Minimally invasive adenocarcinoma (MIA)
B. Lepidic predominant adenocarcinoma (LPA)
C. Invasive adenocarcinoma
D. Adenocarcinoma in situ

Answer 5

B. Lepidic predominant adenocarcinoma (LPA)

Question 6

The grade of neuroendocrine carcinoma (NEC) that is associated with hemoptysis, pneumonia, and tumor cells arranged in cords and clusters is

A. Grade VI NEC
B. Grade IV NEC
C. Grade II NEC
D. Grade I NEC

Answer 6

D. Grade I NEC

Question 7

Which of the following is NOT a known predictive or prognostic tumor marker for adenocarcinoma?

A. EGFR
B. KRAS
C. AFP
D. EML4-ALK

Answer 7

C. AFP

Question 8

Desmoid tumors

A. Arise from the periosteum of the rib
B. Are treated with wide local excision with a 2- to 4-cm margin
C. Require radical excision (sacrificing neurovascular structures) to obtain 4-cm margins
D. Require chemotherapy to treat or prevent metastatic disease

Answer 8

B. Are treated with wide local excision with a 2- to 4-cm margin

Question 9

A 57-year-old non–small-cell lung cancer patient with a potentially resectable tumor found on CT scan who can walk on a flat surface indefinitely without oxygen or stopping to rest, secondary to dyspnea will most likely tolerate

A. Lobectomy
B. Pneumonectomy
C. Single-lung ventilation
D. Wedge resection

Answer 9

A. Lobectomy

Question 10

An “onion-peel” appearance of a rib on CT is suggestive of

A. Chondroma
B. Ewing sarcoma
C. Plasmacytoma
D. Osteosarcoma

Answer 10

B. Ewing sarcoma

Question 11

Pancoast tumors are identified as involving all of the following EXCEPT

A. The chest wall at or below the second rib.
B. Tumors of the parietal pleura or deeper structures overlying the first rib.
C. The superior sulcus.
D. The extreme apex of the chest

Answer 11

A. The chest wall at or below the second rib.

Question 12

The most likely cause of aspiration pneumonia is

A. A mixture of aerobes and anaerobes B. Aerobes only
C. Anaerobes only
D. Gram-negative bacteria

Answer 12

C. Anaerobes only

Question 13

Laboratory evaluation of a chest wall mass showing elevated erythrocyte sedimentation rates indicates

A. Osteosarcoma
B. Plasmacytoma
C. Ewing sarcoma
D. Multiple myeloma

Answer 13

C. Ewing sarcoma

Question 14

The most common benign chest wall tumor is

A. Chondromas
B. Osteochondromas
C. Desmoid tumors
D. Fibrous dysplasia

Answer 14

A. Chondromas

Question 15

Which of the following is an indication for surgical drainage of a lung abscess?

A. Abscess >3 cm in diameter.
B. Hemoptysis.
C. Failure to decrease in size afer 1 week of antibiotic therapy.
D. Persistent fever

Answer 15

B. Hemoptysis

Question 16

What percentages o chest wall masses are malignant?

A. 10–20%
B. 20–30%
C. 50–80%
D. 40–50%

Answer 16

C. 50-80%

Question 17

The population most at risk for developing active tuberculosis is

A. Elderly
B. Minorities
C. Urban residents
D. Human immunode ciency virus (HIV) infected

Answer 17

D. Human immunode ciency virus (HIV) infected

Question 18

The fungi associated with the highest mortality rate due to invasive mycoses in the United States is

A. Aspergillus
B. Cryptococcus
C. Candidia
D. Mucor

Answer 18

A. Aspergillus

Question 19

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

A. Lymphoma
B. Thymoma with myasthenia gravis
C. Mediastinal granuloma
D. Germ cell tumor

Answer 19

C. Mediastinal granuloma

Question 20

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

A. A teratoma
B. A nonseminomatous germ-cell tumor
C. A seminomatous germ-cell tumor
D. Metastatic hepatocellular carcinoma

Answer 20

B. A nonseminomatous germ-cell tumor

Question 21

The primary site for male patients with malignant pleural effusions is

A. Gastrointestinal tract
B. Lung
C. Genitourinary tract
D. Melanoma

Answer 21

B. Lung

Question 22

Eosinophilic granulomas are associated with

A. Langerhans cell histiocytosis (LCH)
B. Parasitic infections
C. Crohn disease
D. Gardners yndrome

Answer 22

A. Langerhans cell histiocytosis (LCH)

Question 23

A chylothorax is likely to be present in a patient whose pleural fluid analysis results show a triglyceride level of

A. 80 mg/100 mL
B. 100 mg/100 mL
C. 45 mg/100 mL
D. 130 mg/100 mL

Answer 23

D. 130 mg/100 mL

Question 24

Osteosarcoma of the rib

A. Is considered nonoperable if pulmonary metastases are present
B. Is treated with radiation therapy before resection
C. Is treated with adjuvant chemotherapy be ore resection
D. Requires excision with a 6-cm margin

Answer 24

C. Is treated with adjuvant chemotherapy be ore resection

Question 25

Excisional biopsy of a chest wall mass is allowed if

A. Needle biopsy was nondiagnostic.
B. Imaging reveals classic appearance of a chondrosarcoma.
C. It is >3 cm.
D. None of the above.

Answer 25

B. Imaging reveals classic appearance of a chondrosarcoma.