NEET Pattern Questions

Lung cancer

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Q) A 73 year male, old heavy smoker presents with haemoptysis.

On examination he is cachectic and shows evidence of clubbing. Imaging shows a main bronchial tumour with massive mediastinal lymphadenopathy together with widespread visceral metastases.

Which of the following variant is likely in him?

(Theme from mock test 12-24)
a) Adenocarcinoma
b) Small cell lung cancer
c) Large cell lung cancer
d) Squamous cell carcinoma

Thyroid storm

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Q) 40 year old lady was on anti thyroid medications which she stopped for 2 weeks.

She presented in emergency with high grade fever and hypotension (Thyroid Storm).

What is not a part of further management?
a) Oxygen
b) Beta blockers
c) Radio active Iodine
d) Lugol's iodine

Staging in Adenocarcinoma lung

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Q) Patient with 2cm lung nodule , biopsy proven adenocarcinoma. CT shows hilar lymph node 1.5cm and left pleural effusion. Pleural fluid cytology is positive for malignant cells. What is the stage?

a. T1N1M0
b. T1N2M1
c. T4N1M0
d. T1N1M1

 

Empyema chest

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Q) Empyema stage II management is ? Theme  from upcoming mock test 25 on 29.9.24

a) VATs

b) Decortication Open

c) IV antibiotics

d) Antibiotics and drainage

Ans d

Antibiotics and drainage

60 years ago, The American Thoracic Society first described the evolution of empyema as a continuous process that subdivides into three stages.

Exudative stage -

initial bacterial infection causes an acute inflammatory response between the pulmonary parenchyma and visceral pleural.

This exudative fluid is usually free-flowing, resolves with appropriate antibiotic treatment, and does not warrant any invasive drainage.

Fibrinopurulent and Loculated stage II)  In the absence of appropriate treatment, the effusion can become complicated via deposition of fibrin clots and membranes resulting in isolated collections of fluid in the pleural space

.At this stage, bacteriology usually becomes positive, and the effusion warrants antimicrobials and drainage.

Chronic Organizational stage - if not drained, fibroblasts coalesce to form a thick pleural peel between the visceral and parietal pleura. This peel can ultimately encase the underlying lung parenchyma and can complicate the clinical course via inhibition of adequate gas exchange, trapped lung or chronic forms of empyema.

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