Q) A 16 year old boy presents with severe groin pain after kicking a football. Imaging confirms a pelvic fracture. A previous pelvic x-ray performed 2 weeks ago shows a lytic lesion with 'onion type' periosteal reaction. What is the lesion?
Q) A 53-year-old woman is found to have an incidental pancreatic lesion on abdominal imaging. CT scan reveals a microcystic mass with a central stellate scar located in the body of the pancreas. Cyst fluid analysis demonstrates low viscosity, and low levels of CEA, CA 19-9, and amylase. Which of the following is the most likely diagnosis?
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) A 25-year-old man presents to the emergency center with complaints of vague chest discomfort. Patient is noted to have a large anterior mediastinal mass. The alpha-fetoprotein levels are markedly elevated. What is the likely diagnosis?
Q) A 50-year-old male with past history of MRSA presents to the emergency department 7 days after sigmoid colectomy with complaints of purulent drainage from his surgical incision
Temp is 102 F
Vitals stable
Purulent drainage is easily expressed from the most inferior aspect of the incision.
Which of the following is the most appropriate management of this patient?
a) Open the incision, obtain a fluid culture, and start on an empiric course of IV Vancomycin and Piperacillin-Tazobactam
b) Open the incision, obtain a fluid culture and start on an empiric course of IV Vancomycin alone
c) Open the incision, obtain a fluid culture, and hold off on starting antimicrobial therapy until culture data returns
d) Discharge home on a 7-day course of oral Cephalexin