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SURGERY 4THLE SAMPLEX (2010-2011)CHOOSE THE BEST ANSWER:

1. A 30 years old male was found to have a posteriormediastinal mass. He must probably has:a. thymomab. teratodermoidc. neurogenic tumord. lymphoma Ans C

M! 1.0

". #he most common anterior mediastinal tumor is:a. thymomab. teratodermoidc. neurogenic tumord. lymphoma Ans A M! 0.$

3. A %$ year old male was diagnosed to have a thymoma.&or' up should include tests for:a. myasthenia gravisb. brain metastasisc. red cell aphasiad. immune de(ciency Ans A M! 0.$

%. )uring sternotomy for thymoma* the tunor was notedto have in(ltrated the ad+acent pleura* pericardium*

and the phrenic nerve. #he best option is:a. wide e,cision to include the nerveb. radiationc. platinum based chemotherapyd. supportive treatment Ans A M! 0.3

$. #he so called - dumbel tumor is seen ina. neurogenic tumorb. thymomac. !ymphomad. thoracic aneurysm Ans A M! 0.$

/. ndoscopic esophageal punch biopsy should beavoided in esophageala. leiomyomab. suamos cell CA

c. adenocarcinomad. diverticulum Ans. 2 M! 0.$

. Cardiovascular collapse in tension pneumothora, is dueto:a. shunt mechanisb. mediastinal shiftc. decreased fraction of inspired o,ygend. hypoventilation Ans 2 M! 0.$

4. ulmonary collapsed and dyspenea is tensionpneumothora, is due toa. shunt mechanismb. mediastinal shiftc. decreased fraction of ispired o,ygen

d. hypoventilation Ans A M! 0.$5. #he initial procedure of choice in pleural e6usion is:

a. thoracentesisb. pleural biopsyc. thoracoscopyd. thoracostomy Ans A M! 0.$

10. #o diagnose chylothora,* the pleural 7uid is e,aminedfora. amplaseb. triglyceridesc. sugard. creatinine Ans 2 M! 1.0

11. #he treatment of #2 e6usion is:a. anti #2 drugsb. tube thoracostomyc. thoracentesisd. decortication Ans A M! 0.$

1". 8n phythora,* the tube thoracostomy should be placedata. "nd interspace* midclavicular line

b. 3rd interspace* anterior a,illary linec. /th interspace* posterior a,illary lined. 4th interspace* mid a,illary line Ans C M! 0.$

13. 8n chronic #2 e6usion attention should be given to:a. nutritionb. electrolyte imbalancec. adeuate antibioticsd. thoracostomy tube position Ans M! 0.3

1%. #he defect in pectus e,cavatum is in thea. sternumb. bony ribc. spined. chondral cartilage M! 1.0

1$. #he most common primary malignancy of the pleura is:a. mesotheliomab. adenocarcinomac. lymphomad. liposarcoma Ans A M! 0.$

1/. A 5 month old female was brought to the emergencyroom because of a non reducible inguinal mass of "hours duration. #he parents noted this mass previouslysince she was % months old but this wouldspontaneously reduce. 9pon your e,amination themass is already reduced. our recommendation shouldbe:a. Admit the patient and observeb. Admit the patient and have emergency

herniorrhaphyc. Admit and have elective herniorrhaphy; .33d.

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a. Dentilatory

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%". High chance for cure A ."%3. May regress spontaneously 2 ."%%. Chemotherapy maybe started without de(nite diagnosis ) ."

%$. A 1 year old has a abdominal tumor located at the?9J* has no +aundice nor splenomegaly. Alpha etorotein is elevated. #he most li'ely problem is a :a. Hemangioendotheliomab. Mesenchymal Hamrtomac. Hepatoblastoma ; .$

d. Hepatocellular Carcinoma

%/. A boy has a testicular mass on the ?. #he si=e is "times the left testicle. 8t is hard and does nottransilluminate. #he most li'ely tumor is:a. mbryonalb.

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e. adenosuamous carcinoma

/1. A /0year old +eepney driver* chronic smo'er*consulted at the >) for an incidental (nding of a "cmnodule in the right upper lobe. C# scan guided needlebiopsy showed suamous cell carcinoma with right hilarand paratracheal nodal enlargement. #he # status ofthe diseasea. #1ab. #1b ; 1.0c. #"a

d. #"be. #3

/". #he following invasive diagnostic procedures willobtain tissue samples from the nodes visuali=ed in theC# scan in the clinical situation previously mentionede,cept:a. right mediastinotomyb. mediastinoscopyc. videoassisted thoracoscopyd. (beroptic bronchoscopy ; 0."0e. open thoracotomy

/3. ositive nodal samples from the ipsilateral hilar

and mediastinal nodes from suamous cell carcinomain the procedureLs performed will mean what stage ofthe disease:a. 82b. 88Ac. 882d. 888A ; 1.0e. 8882

/%. A %$year old male carpenter was referred to the

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/. A 3/year old female post 'idney transplant /months ago was brough to the ? for remittent feverand cough productive of blood strea'ed sputum. Chest,ray showed mar'ed pneumonic in(ltration of the leftlower lobe with cavitation and probable abscessformation. ollowup chest c,ray 3 days later showedprogression inspite of antibiotic coverage. C# guidedaspiration suspicious for fungal organisms. Mostprobable diagnosis:a. #uberculosis in the immunocompromised hostb. Mucormycosis ; 0.33c. Atypical pneumoniad. Aspergillomae. Histoplasmosis

. #reatment of choice in the clinical situationa. 9rgent surgery #horacotomy and lower lobecotmy ;

1.0b. Amphotericin 2c. 8tracona=oled. Juadruple anti KochBs therapye. Antibiotics for anaerobic bacteria

4. #he congenital heart defect that results todecreased pulmonary blood 7ow is:a. )A

b. #>c. D

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5$. #he most common cause of thoracic aorticaneurysm:a. infectionb. traumac. non speci(c medial degenerationd. genetic disorders C. mpl .$

5/. #he critical diameter for rupture of descendingthoracic aortic aneurysm is:a. $ cmb. / cm

c. cmd. 4 cm C mpl .$

5. #he most common site of rupture of descendingaortic dissection is:a. pro,imal 3rd of descending aortab. middle 3rdc. distal halfd. distal 3rd A. mpl .$

54. mbryology of the F8#

a. the 3rd part of the duodenum is to the left of the