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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

papain

beta-blockers

endoscopy

Answer

2
What is the MOST common site of oesophageal rupture with Boerhaaves
syndrome?
A

Cervical oesophagus

Midthoracic oesophagus posteriorly

Distal oesophagus posteriorly

Infradiaphragmatic oesophagus

Answer

3
At which vertebral level is a retained foreign body MOST commonly seen in
a child?
A

C-4

C-6

T-1

T-4

Answer

4
All of the following are classic radiographic findings for oesophageal
perforation EXCEPT
A

mediastinal air

pleural capping

left-sided pleural effusion

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

Pulmonary infection is the most commonly associated condition in


secondary spontaneous pneumothorax

Hamman's sign is a pathognomonic finding

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

At the time of 1 diagnosis of Lung Carcinoma less than 50% of patients


have distal metastasis.

Small cell & Squamous cell lung carcinoma are associated with smoking

Adeno & Large cell lung carcinoma tend to occur peripherally and do not
cause local obstruction

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 trauma

Pleural effusion is more commonly right sided

Mortality in blunt trauma is approximately 50%

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 dorange 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.

Increased prolactin levels are found after chest wall trauma and breast
augmentation procedures

Answer

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

Obtain an abdominal radiograph to find the other coin

Obtain a lateral chest radiograph

Admit for observation for 12-24 hours before any removal procedure

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?

C4

T1

T4

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