Clinical collections 39

5. Concerning mastitis carcinoma, the incorrect statement among the following is that it: A. Is a highly anaplastic carcinoma B. Occurs most often during pregnancy and lactation C. Is often misdiagnosed as acute mastitis D. Is associated with a palpable mass in the breast E. Causes painless enlargement of the axillary glands Answer: D Explanation: Inflammatory breast cancer often presents with peau d'orange, erythema, and no discrete palpable mass. 10. Which is not poor prognostic of breast cancer: A. Positive estrogen receptor Answer: A Explanation: ER+ = better prognosis (responsive to hormone therapy). Poor prognostic factors: ER-, HER2+, high grade, triple negative. 14. Management of Breast Pathology: A 20-year old woman with a smooth 'rubbery' lump that moves easily. 2cm, no pain, lymphadenopathy. A. X-ray mammography B. Triple assessment C. Ultrasound of the breast D. Fine Needle Aspiration (FNA) E. Scintimammography Answer: B Explanation: Triple assessment (clinical exam + imaging + biopsy) = gold standard for any discrete breast lump. 20. A women has 3 cm breast mass, no palpable axillary nodes, no metastasis. FNA shows duct carcinoma. TNM staging? A. T1N1M1 B. T1N0M0 C. T2N2M0 D. T2N1M0 E. T2N0M0 Answer: E Explanation: T2 = tumor >2 cm but ≤5 cm. N0 = no nodal metastasis. M0 = no distant metastasis. 25. Five Benefits of Tamoxifen in breast carcinoma include all the following EXCEPT: A. Tamoxifen can reduce recurrence B. Tamoxifen can halt the progression of metastatic breast cancer C. Tamoxifen can reduce the risk of cancer in the other breast D. Tamoxifen can help prevent osteoporosis E. Tamoxifen can lower cholesterol levels and decrease incidence of myocardial infarction F. Decrease incidence of endometrial carcinoma Answer: F Explanation: Tamoxifen INCREASES risk of endometrial cancer (SERM with uterine agonist activity). 26. Which of the following is a benign disorder associated with aberration of stromal development of breast? A. Fibroadenoma B. Adolescent hypertrophy C. Duct ectasia D. Epithelial hyperplasia Answer: A Explanation: Fibroadenoma = aberration of normal development and involution (ANDI) - stromal and epithelial proliferation. 29. Pathological nipple discharge is characterized by all of the followings EXCEPT: A. Not spontaneous B. Unilateral C. Associated with mass D. Positive hem occult test E. Non-cyclical Answer: A Explanation: Pathological discharge = spontaneous, unilateral, from single duct, bloody or serous. 30. Concerning mastitis carcinoma, the incorrect statement among the following is that it: (Repeat of Q5) Answer: D Explanation: No palpable mass in inflammatory breast cancer. 32. In which of the following type of breast carcinoma, would you consider biopsy of opposite breast? A. Adenocarcinoma poorly differentiated B. Medullary carcinoma C. Lobular carcinoma D. Comedo carcinoma Answer: C Explanation: Lobular carcinoma has highest rate of bilaterality and multifocality. 37. All are True of breast FNAC EXCEPT: A. Safe and reliable B. Least invasive for cell diagnosis C. Very accurate D. Invasive cancer can be diagnosed from in situ disease Answer: D Explanation: FNAC cannot distinguish invasive from in situ carcinoma (no architecture). Core needle biopsy is needed. 47. Pathological nipple discharge is characterized by all of the followings EXCEPT: (Repeat of Q29) Answer: A Explanation: Pathological = spontaneous. 62. Which of the following women has the lowest risk of breast cancer? A. Menarche 12, first child 24, menopause 47 B. Menarche 14, first child 17, menopause 52 C. Menarche 16, first child 17, menopause 42 D. Menarche 16, first child 32, menopause 42 E. They are all equal Answer: C Explanation: Protective factors = early first pregnancy, early menopause, late menarche. C has earliest pregnancy and earliest menopause. 64. Which of the following is a benign disorder associated with aberrations development of the breast? (Repeat of Q26) Answer: A Explanation: Fibroadenoma.

GENERAL SURGERY --- SHOCK & FLUID RESUSCITATION 1. All of the following may be useful in the treatment of cardiogenic shock except: A. Dobutamine B. Sodium nitroprusside C. Pneumatic antishock garment D. Intra-aortic balloon pump Answer: C Explanation: Pneumatic antishock garment (MAST suit) is for hypovolemic shock to increase peripheral resistance. In cardiogenic shock, it increases afterload and worsens cardiac output. 27. In acute respiratory alkalosis, bicarbonate level: A. Increase B. Decreased C. Remain constant D. Any of the above Answer: C Explanation: In acute respiratory alkalosis, the kidneys have not yet compensated. Bicarbonate remains normal. In chronic cases, it decreases. 28. Commonest cause of metabolic acidosis in surgical patient: A. Enteric fistula B. Acute circulatory failure C. Pancreatic fistula D. Adrenal insufficiency Answer: B Explanation: Shock (hypoperfusion) → lactic acidosis → most common cause in surgical patients. 34. The hyperdynamic phase of septic shock is characterized by the except: A. Hyperventilation B. Hypotension C. Pale cold extremities D. Oliguria Answer: C Explanation: Hyperdynamic (warm) septic shock = warm, pink extremities, high cardiac output. Cold extremities = late/hypodynamic phase. 39. The severity of hypovolemic shock has been found to correlate with: A. Hematocrit B. Pulmonary wedge capillary pressure (PCWP) C. Lactic acid D. PaO2 E. White blood cells count Answer: C Explanation: Lactate level = best correlate with severity of shock and mortality. Reflects tissue hypoperfusion. 52. In which one of the following shocks is the neck vein distended? A. Septic shock early B. Septic shock late C. Traumatic shock D. Hypovolemic shock E. Cardiogenic shock Answer: E Explanation: Cardiogenic shock = pump failure → blood backs up → distended neck veins. Hypovolemic = flat neck veins. 61. A 30-year-old man in a car accident, unable to move extremities, extremities warm and pink, HR 54, BP 70/40. Diagnosis? A. Hemorrhagic shock B. Cardiogenic shock C. Neurogenic shock D. Septic shock E. Irreversible shock Answer: C Explanation: Spinal cord injury → loss of sympathetic tone → bradycardia, hypotension, warm extremities. Diagnosis of exclusion. 86. True statement regarding neurogenic shock is: A. Tachycardia B. Patient has cold and moist extremities C. It is due to parasympathetic cut-off D. It is a diagnosis of exclusion Answer: D Explanation: Neurogenic shock = diagnosis of exclusion. It presents with bradycardia (not tachycardia) and warm, dry extremities. 95. The incriminated organism in septic shock may be: A. Gram+ve bacteria B. Gram-ve bacteria C. Candida albicans D. Any of the above Answer: D Explanation: Septic shock can be caused by Gram-positive, Gram-negative, or fungi. 102. Which of the following is the best method to assess the adequacy of fluid replacement? A. Decrease in thirst B. Increase in urine output C. Blood pressure D. Increased PaO2 Answer: A Explanation: Thirst is a sensitive clinical indicator of hypovolemia. Its resolution suggests adequate resuscitation. 103. Which of the following is the best guide to fluid replacement in a patient with burns? A. Central venous pressure B. Skin turgor C. Haemoglobin and haematocrit D. Urine osmolality E. Urine output Answer: E Explanation: Urine output (0.5 mL/kg/hr in adults) = gold standard for burn resuscitation. 141. Initial fluid resuscitation of a patient with multiple fractures and hypovolemic shock should be: A. Blood transfusion B. Hypertonic saline C. Fresh frozen plasma D. Ringer's lactate E. Albumin Answer: D Explanation: Ringer's lactate = initial fluid of choice in hemorrhagic shock. Blood is given later if no response.

السلام عليكم ورحمه الله. هذه أسئلة الGeneral مجمعه لكل شابتر من بنك سواعد وبناء وكذلك بنك essence الاصدار الجديد ، تقرأ الشابتر وتحل أسئلته مره واحده ومكان واحد وشرح بسيط للإجابة الصحيحة ، أن شاء الله تستفيدوا ....... #مشاركة_الزميلة_جيهان_منشلين

🔹 مواضيع الـ GIT 👆🏻

🔹 مواضيع الـ General 👆🏻