True/False questions and answers

Published on 11/04/2015 by admin

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Last modified 11/04/2015

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26 True/False questions and answers

Questions

1 Bone metastases:

(a) occur in less than 5% of patients with malignant disease
(b) 10% of patients with bone metastases develop pathological fractures
(c) breast cancer is commonly a cause of bone metastases in women
(d) are detected by X-ray early in the disease process
(e) osteosclerotic lesions are caused by prostate cancer

2 Osteosarcomas:

(a) affect the epiphyses of long bones
(b) are commonly seen around the knee and proximal humerus
(c) can result in pulmonary metastases
(d) are exclusively a disease of younger people
(e) classical radiology demonstrates a sunburst appearance due to soft tissue involvement

3 Rheumatoid arthritis:

(a) is a disease primarily of the synovium
(b) is associated with the HLA antigens
(c) occurs more often in men
(d) the hands, elbows, knees and cervical spine are the commonest joints involved
(e) extra-articular manifestations occur in 20% of patients

4 The oesophagus:

(a) is 25 cm in length
(b) passes behind the left main bronchus in the thorax
(c) is lined by stratified squamous epithelium in the upper two-thirds
(d) is lined by transitional epithelium in the lower third
(e) drains all of its blood into the azygos and hemiazygos veins

5 The axilla contains:

(a) the cords of the brachial plexus
(b) the superior thoracic artery
(c) the latissimus dorsi muscle in its medial wall
(d) the thoracodorsal nerve in its posterior wall
(e) the long thoracic nerve in its medial wall

6 The common bile duct:

(a) lies in the free edge of the greater omentum
(b) lies posterior to the portal vein
(c) lies to the right of the hepatic artery
(d) may open independent of the pancreatic duct into the duodenum
(e) lies posterior to the first part of the duodenum

7 The following structures pass beneath the inguinal ligament:

(a) the tendon of psoas major
(b) the femoral branch of the genitofemoral nerve
(c) the long saphenous vein
(d) the superficial epigastric vein
(e) the superficial femoral artery

8 Concerning carcinoid tumours:

(a) the appendix is the commonest primary site
(b) gastric carcinoid tumours produce little 5-hydroxyindoleacetic acid
(c) liver metastases can result in the carcinoid syndrome
(d) octreotide scintigraphy may identify primary and secondary lesions
(e) plasma chromogranin B may be increased

9 Hashimoto’s thyroiditis:

(a) is an acute suppurative disease of the thyroid
(b) presents as a solitary thyroid nodule
(c) may cause hypothyroidism
(d) anti-thyroglobulin and anti-microsomal antibodies may be increased
(e) increases the risk of thyroid lymphoma

10 Overwhelming post-splenectomy infection (OPSI):

(a) is usually due to unencapsulated bacterial infection
(b) is commonly caused by Streptococcus pneumoniae
(c) may have a mortality of over 50%
(d) the risk of infection can be reduced with pneumococcal and haemophilus vaccination
(e) penicillin antibiotic prophylaxis should be considered for all patients

11 Concerning colonic polyps:

(a) juvenile rectal polyps are adenomatous in nature
(b) metaplastic polyps are malignant
(c) the risk of malignancy is higher in villous rather than tubular adenomas
(d) villous adenomas occasionally cause hypokalaemia
(e) all patients with untreated familial adenomatous polyposis eventually develop colorectal carcinoma

12 Prostate cancer:

(a) affects 50% or more of men over the age of 80
(b) mostly presents with symptoms of bladder outflow obstruction
(c) a PSA concentration of greater than 10 ng/mL is suggestive of the diagnosis
(d) 80% of tumours are androgen independent
(e) historically orchidectomy treated the disease

13 Hodgkin’s lymphoma:

(a) often presents as painless inguinal lymphadenopathy
(b) 50% of patients have splenomegaly
(c) nodular sclerosing type has the best prognosis
(d) stage 3 disease has lymphadenopathy confined to one side of the diaphragm
(e) with modern radiotherapy, stage 1 disease has an excellent 5-year survival

14 A varicocele:

(a) is a dilatation of the testicular artery
(b) is more common on the left
(c) may be associated with a left renal tumour
(d) may be associated with infertility
(e) requires surgery at all times

15 Ultrasound:

(a) can diagnose breast lumps in women aged 35 or older
(b) diagnoses gallstones
(c) diagnoses bone metastases
(d) diagnoses pelvic abscess in a postoperative patient
(e) may detect deep venous thrombosis in any patient with a painful swollen leg

16 Sterilisation of surgical equipment may include the use of:

(a) ethylene oxide
(b) gamma irradiation
(c) autoclave
(d) alcohol
(e) chlorhexidine

17 A postoperative pulmonary embolus:

(a) is always associated with chest pain
(b) is always associated with an abnormal chest X-ray
(c) may be confirmed using a ventilation/perfusion (VQ) scan
(d) may be confirmed on ECG changes
(e) is most commonly seen between 2 and 5 days postoperatively

18 A 5-year-old child is brought to A&E after being hit by a car travelling at 40 mph and sustaining multiple injuries:

(a) the initial priorites for resuscitation are the same as for an adult patient
(b) the correct volume of fluid for initial resuscitation is a bolus of 20 mL/kg
(c) plain X-rays must be avoided because of the risks of ionising radiation
(d) IV access secured via an intraosseous nail cannot be used to transfuse blood
(e) rib fractures indicate a high likelihood of lung contusion and intra-abdominal injury

19 Serum alpha-fetoprotein is increased in:

(a) acute hepatitis
(b) hepatocellular carcinoma
(c) neuroblastoma
(d) teratomas
(e) bladder carcinoma

20 Clostridium tetani:

(a) is a Gram-positive rod
(b) is sensitive to penicillin
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