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MCQ Thoracic surgery
1 All of the following have been used successfully to treat meat impaction in the oesophagus EXCEPT A
glucagon
B
papain
C
beta-blockers
D
endoscopy
Answer
2 What is the MOST common site of oesophageal rupture with Boerhaave’s syndrome? A
Cervical oesophagus
B
Midthoracic oesophagus posteriorly
C
Distal oesophagus posteriorly
D
Infradiaphragmatic oesophagus
Answer
3 At which vertebral level is a retained foreign body MOST commonly seen in a child? A
C-4
B
C-6
C
T-1
D
T-4
Answer
4 All of the following are classic radiographic findings for oesophageal perforation EXCEPT A
mediastinal air
B
pleural capping
C
left-sided pleural effusion
D
pneumothorax
Answer
5 Which statement regarding spontaneous pneumothorax is TRUE A
The recurrence rate following a single episode is 10 % over the ensuing five years
B
Pulmonary infection is the most commonly associated condition in secondary spontaneous pneumothorax
C
Hamman's sign is a pathognomonic finding
D
In the absence of any further air leak, a 20 % pneumothorax would be expected to reabsorb over approximately 15 - 20 days
Answer
6 Which of the following statements about lung neoplasms is INCORRECT st
A
At the time of 1 diagnosis of Lung Carcinoma less than 50% of patients have distal metastasis.
B
Small cell & Squamous cell lung carcinoma are associated with smoking
C
Adeno & Large cell lung carcinoma tend to occur peripherally and do not cause local obstruction
D
Small cell carcinoma is associated with ‘SVC syndrome’
Answer
7 Regarding oesophageal perforation, which of the following is TRUE? A
Perforation from blunt trauma is more common than penetrating trau ma
B
Pleural effusion is more commonly right sided
C
Mortality in blunt trauma is approximately 50%
D
Diagnosis of perforation due to blunt trauma is delayed in 2/3
Answer
8 Which of the following regarding breast disease is TRUE? A
Peau d’orange is caused by mastitis in the underlying breast
B Pagets disease of the nipple is a benign disease. C
A good marker of a malignant discharge from the nipple is that it arises from multiple ducts.
D
Increased prolactin levels are found after chest wall trauma and breast augmentation procedures
Answer
9
Two hours after swallowing 2 coins, a PA chest radiograph of a previously healthy child reveals a coin in the upper oesophagus. The child is clinically stable and asymptomatic. The MOST appropriate next step is
A
Obtain an abdominal radiograph to find the other coin
B
Obtain a lateral chest radiograph
C
Admit for observation for 12-24 hours before any removal procedure
D
Refer the child to the pediatric radiologist for a Foley catheter removal
Answer
10
Which of the following is NOT a common radiological level for oesophageal FB to become lodged, in children?
A
C4
B
T1
C
T4
D
T6
Answer
Answers
1. 2. 3. 4. 5. 6. 7. 8. 9.
C C B B D A D D B
10. A
nd
A-if 2nd coin in stomach is of no clinical value B need to ensure 2 coin is not in trachea C,D and E need to assess inhaled FB first and can be expectantly managed for first 24 hrs if airway okay EMPRAC review A Cricopharyngeus is at C6!.rest are correct T1 thoracic inlet, T4 aortic arch, T6 tracheal bifurcation, T10 cardiac sphincter. Tintinalli chap 75.n
