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
Correct Answer:b) Small cell lung cancer
Patient: 73-year-old male, heavy smoker Symptoms: Hemoptysis, cachexia, clubbing Imaging: Main bronchial tumor with massive mediastinal lymphadenopathy and widespread visceral metastases
Likely Variant: Small Cell Lung Cancer (SCLC) is the most likely diagnosis.
Association: Strongly linked to smoking
Behavior: Highly aggressive with early widespread metastasis
Presentation: Hemoptysis, cachexia, clubbing — classic for SCLC
Differential:
Adenocarcinoma: Common in non-smokers, usually peripheral
Squamous Cell Carcinoma: Centrally located, slower growing, less often metastatic early
Large Cell Lung Cancer: Less commonly associated with extensive lymphadenopathy
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
Correct Answer:c) Radio active Iodine
Explanation:
In the management of a thyroid storm, radioactive iodine (RAI) is not used. In fact, RAI can precipitate a thyroid storm and is contraindicated during acute crises.
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?
Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase
Q) 50-year-old male with 1 x1 cm mass in the Peripheral part of the right lung was resected with clear margins. histopathology was suggestive of Adenocarcinoma and there was no lymph nodes positive what will be the further management A. Observe B. Adjuvant RT C. Adjuvant CT D. EGFR testing