Surgery MCQ questions
Q 41 Drug causing urinary bladder carcinoma
Q 42 Viruses causes carcinoma in
Q 43 Imatinib mesylate is indicated in
Q 44 Pigmented lesion which is suspicious of melanoma of size 1 cm with ulceration and features of ABCD, next step
A. Wide Local Excision with 1 cm margin
B. Excision biopsy with 1-2 mm margin
C. Punch biopsy at the edge of the lesion
D. Incisional biopsy
Q 45 Synovial sarcoma, true is
A. t(X;18)(p11.2;q11.2) translocation
B. t(X;18)(p12.2;q12.2) translocation
C. t(11;22)(p11.2;q11.2) translocation
D. t(11;22)(p12.2;q12.2) translocation
Q 46 Most common malignant chest wall tumor
C. Synovial sarcoma
Q47) Submucosal Cleft soft palate : True is
A. Velopharyngeal insufficiency
B. Normal feeding
C. Normal Uvula
D. Cleft of hard palate remains attached to the vomer and nasal septum
Q 49 Cause of mortality in Ludwig’s angina
50) Length of Esophagus (DNB 2018)
A 41) a Cyclophosphamide
|Sabiston page 695|
|Azathioprine - Non-Hodgkin lymphoma, squamous cell cancer of the skin, hepatocellular carcinoma,|
Cyclophosphamide Cancer of the urinary bladder, leukemia
Tamoxifen Endometrial cancer
Estrogens (OCP, HRT) Cancer of the breast and endometrium
42) d 15%
HPV - Cervical cancer is the commonest
HCC - HBC and HCV
REF Sabiston page 696
Biopsy of a suspicious skin lesion is necessary. The correct way is to do a full thickness biopsy with 1-2 mm of normal margin.
Depth is important to include dermis and part of subcutaneous tissue for assessing the architecture of the lesion and also for measurement of tumor thickness.
Ref Devita 10th page 1354
Ref Devita 1244
Secondary chest wall tumors from other sites are most common.
Chondrosarcoma is the most common malignant chest wall tumor. It accounts for 20% of all chest wall tumors.
Radiology shows a poorly defined tumor mass that is destroying cortical bone.
Primary osteosarcomas in the chest account for 10% to 15% of malignant
tumors. tumor grows rapidly, and radiographic characteristics include a sunburst pattern on CXR.
Ewing sarcoma commonly arises in bones of the pelvis, humerus, or femur of young
men. It is the third most common malignant chest wall tumor
(5% to 10%). Radiographic characteristics include an onion peel appearance with periosteal elevation and bony remodeling.
Ref Sabiston 1602
Indications of post op RT in head and neck tumors
1, Positive margin or less than 5 mm
2. Multiple positive nodes
3. Invasion of soft tissue of neck
4. Endothelial lined space invasion
6. More than 5mm of subglottic invasion
Ref Devita 430
Ludwig's angina is an inflammatory condition of the neck which is due to
- Streptococcal infection
- Anaerobic infection
- Infection of malignancy in the neck
There is brawny swelling of the submandibular region with inflammatory edema of the mouth with halitosis
Edema of the mylohyoid muscle causes the tongue to displaced upwards and backwards causing dysphagia and airway obstruction.
Treatment is broad spectrum antibiotic with anaerobic cover
Surgical incision, if required is curved submental to drain both submandibular triangles and mylohyoid muscle.
Ref Bailey page 703