Surgery

Question 1

Venous plexus that extends from the base of the skull to the sacrum and provides route for metastasis of breast cancer to the axial bones

Answer 1

BATSON VERTEBRAL PLEXUS

Question 2

Most common location of malignant mass since it has a greater volume of tissue

Answer 2

Upper Outer quadrant

Question 3

Breast tissue measuring at least __cms in order to be considered gynecomastia

Answer 3

2 cms.

Question 4

a 28 year old G1P1.CC of breast myalgia and nipple fissuring. what is the best managament

Answer 4

Breast emptying using suction; Antibiotics as needed

Dx: Non Epidemic(Sporadic) Mastitis
**important to diff from Epidemic Mastitis (MRSA) since I and D is contraindicated(may cause milk fistula)

Question 5

Most common cause of bloody nipple discharge

Answer 5

Intraductal papilloma

Question 6

High-risk groups in breast CA

Answer 6

GAIL Score >1.7
BRCA mutations
LCIS

Question 7

Breast Histopath findings:
Large,Vacuolated cells in Rete pegs of epithelium
(+) CEA

PE: Chronic,eczematous with nipple eruption

Answer 7

Paget Disease

Question 8

Breast Histopath findings:
Central stellate configuration with streaks

PE: Solitary,firm mass with poorly defined margins in 55 year old woman

Answer 8

Invasive ductal CA

-seen in peri/ menopausal women in 5th-6th decade of life

Question 9

Breast Histopath findings:

• Dense lymphoreticular infiltrate of lymphocytes and plasma cells.
• Poorly differentiated sheet-like growth pattern.
• Soft,hemmorhagic and bulky.

BRCA (+)

Answer 9

Meduary CA

Question 10

85 y/F

Breast Histopath findings:
-EXTRACELLULAR pools of mucin surrounding low-grade cancer cells.

Answer 10

Mucinous (colloid) carcinoma

Question 11

70y/F

Breast Histopath findings:
-papillae formation with fibrovascular stalk

Answer 11

Papillary carcinoma

Question 12

50y/ Menopause

Breast Histopath findings:

• haphazard array of small tubular elements
• (-) ALN

Answer 12

Tubular Carcinoma

Question 13

PE: bilateral,multifocal,multicentric

Breast Histopath findings:

• Small cells arranged in a single file configuration ( Indian File Configuration)
• intracytoplasmic mucin displacing nucleus (signet cell ring carcinoma)

Answer 13

Invasive lobular carcinoma

Question 14

nerves removed in Halstead mastectomy

Answer 14

1. Long thoracic
2. Thoracodorsal
3. Lateral and
4. Medial pectoral

Question 15

Preserves pec major but removes pec minor

Answer 15

Patey

Question 16

Preserves Pec minor with level 1 and 2 axillary node dissection

Answer 16

Madden and Auchinloss

Question 17

Transects the pec minor followed by repair

Answer 17

Scanlon

Question 18

Give the stage:

Brawny, induratee, erythema with raided edges and edema
Peau d’ orange

(+) ALN

Answer 18

3B

dx: INFLAMMATORY BREAST CA

Question 19

PE: sharply demarcated tumor

Breast Histopath findings:

• stroma has greater cellular activity than fibroadenoma
• (-) LN

Answer 19

Phylloides tumor

Question 20

Most Common branchial cleft anomaly

Answer 20

2nd brachial cleft anomaly

• external openning: lateral neck at SCM
• internal openning: tonsillar fossa

Question 21

Highly expansile and destructive fibrovascular neoplasm typically in adolescent males who present with epistaxis

Answer 21

Juvenile Nasopharyngeal Angiofibroma

Question 22

Tumor that is associated with impacted tooth. It is painless but locally aggresive

(+)soap-bubble appearance/multilocular radioluscent appearance

Answer 22

Ameloblastome (Adamantinoma)

Question 23

cause by injury to auricotemporal nerve due to parotidectomy

- sweating of saliva in affected part

Answer 23

FREY SYNDROME

- Post gustatory sweating