5000+ High-Yield MCQs & Explanations – NEET SS MCH
Q) 47 year old premenopausal lady with a 3X 3cm left breast lump with IDC grade III, TNBC.
On examination, there is a single subcentimetric mobile soft mobile ipsilateral axillary LN palpable. Usg nodes no loss of hilum. Management of axilla?
a) SLND
b) ALND
c) Radiotherapy only
d) No treatment
Q) Optimal duration of tamoxifen in premenstrual women
a. 5 yrs
b. 10 yrs
c 3
d 15
Q) According to SENTINA trial how many minimum sentinel lymph nodes to be removed (Onco 2019)
A. 1
B. 2
C. 3
D. 4
Q. True about breast cancer is?
a) Doubling time of breast tumor is 1 month
b) Skip metastasis in level iii lymph nodes is common
c) Lungs are commonly involved by direct invasion
d) Dimpling of skin is due to shortening of cooper's ligaments
Ans
Q ) Hereditary diffuse Gastric carcinoma is associated with which breast cancer
A. Ductal carcinoma NOS subtype
B. Lobular carcinoma
C. DCIS
D. Metaplastic carcinoma
Answer for Q 79
Majority of Gastric Cancers are sporadic,
1–3% of GCs arise as a result of inherited cancer predisposition syndromes.
Li-Fraumeni syndrome, Lynch syndrome, Peutz-Jeghers syndrome, hereditary breast and ovarian cancer,1MUTYH-associated adenomatous polyposis (MAP), familial adenomatous polyposis, juvenile polyposis syndrome and PTENhamartoma tumour syndrome (Cowden syndrome).
Ductal carcinoma in situ is a pre invasive state in which the cancer cells have not breached the epithelial membrane. It can develop into cancer in 20%.
Simple mastectomy is the standard of care but many centers now consider it over treatment.
Van Nuys system uses
On mammography this is seen as clustered clustered calcification
Treatment options are
More recently, Eastern Cooperative Oncology Group investigators reported the frst result of a relatively large prospective single-arm study of surgery with negative margins of at least 3 mm without radiation therapy for patients with favorable subsets of DCIS.
Patients with low-grade or intermediate-grade DCIS measuring 2.5 cm or smaller had a 5-year rate of ipsilateral breast recurrence of only 6.1%. In contrast, patients with high-grade disease had a much higher 5-year ipsilateral breast recurrence rate of 15.3%.
REF : Sabiston 853
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334775/
Q) In terms of cure best results in inflammatory carcinoma breast are seen with-
a) Surgery alone
b) Chemotherapy
c) Radiotherapy
d) All of the above
Ans wer
d)
Inflammatory carcinoma of the breast is a rare aggressive tumor that blocks the sub dermal lymphatics as a result of which cutaneous edema is common . Differentiating it from a breast abscess is important and biopsy is diagnostic. It is also responsible to peau d orange
Treatment is multidisciplinary and involves, chemotherapy followed by surgery followed by radiotherapy.
Q) Simple nipple inversion is seen in?
a) Duct ectasia
b) Puberty
c) Peri ductal fibrosis
d) Carcinoma breast
Answer of this question is free. Click the link for more similar questions for MCH preparation
Ans is b
Inversion of nipple is seen in a lot of conditions, both benign and malignant.
Rapid unilateral development of inversion of nipple is a dangerous sign and warrants further diagnosis. Further circumferential retraction is also sign of carcinoma.
Simple nipple inversion occurring at puberty or retracted nipple is of unknown cause and is bilateral in 25%. Mostly No treatment is required for this and condition resolves spontaneously during pregnancy and lactation.
Suction pumps and cosmetic surgery can also help.
Inversion of nipple associated with malignancy may be with or without the presence of lump. Associated discharge from the nipple can point to the diagnosis.
Ref - Bailey 801
Grading of benign nipple inversions for management
In grade I, the nipple is easily pulled out manually and maintains its projection quite well. It has minimal fibrosis thus, manual traction and a single, buried purse-string suture are enough for the correction.
Grade II (majority) the nipples can be pulled out but cannot maintain projection and tend to go back again. These nipples are thought to have moderate fibrosis beneath the nipple.
In grade III, to which the least number of inverted-nipple cases belong, the nipple can hardly be pulled out manually. Severe fibrosis made it impossible to reach optimal release of the fibrotic band with the preservation of the ducts.
Ref https://www.ncbi.nlm.nih.gov/pubmed/10654681
BEST TEXTBOOKS FOR GENERAL SURGERY
Bailey & Love’s Short Practice of Surgery, 27th Edition
Sabiston’s Textbook of Surgery
Schwartz’s Principles Of Surgery
BEST BOOKS FOR OPERATIVE SURGERY
Operative Techniques in Surgery by Michael W. Mulholland et al
Chassin’s Operative Strategy in General Surgery
Farquharson’s Textbook of Operative General Surgery
Q) Is nipple inversion a sign of breast cancer?
A) Not always but above the danger signs and symptoms are listed
Free answer to Surgery MCQs
a
Calcifications associated with fibroadenomas have been termed popcorn calcifications because of their large size and dense, coarse appearance. Calcifications in fibroadenomas usually begin at the periphery and then involve the central portion of the fibroadenoma.