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MCQ

EXPLAINATORY ANSWER

33.Pateys modification of radical


mastectomy involves removal of
following except:
A. Pectoralis minor muscle and its
covering fascia
B. Axilary vein
C. the skin surrounding the
carcinomatous zone
D. pectoralis major muscle with fascia
Ans:D

Removal of all breast tissue, nippleareolar complex, skin, level I and level
II
, axillary nodes Pateys
modification: Divide and remove the
pectoralis minor. Level
I,II,III nodes
can be removed. In Pateys pectoralis
major will not be removed.
Ref: Bailey & loves short practice of
surgery,
Edited by Norman S. Williams
Christopher J.K. Bulstrode
P. Ronan OConnell. 26th edition,
Pg.813

MCQ
34.Mc Govern nipple is:
A. Secondaries in breast
B. Spread of Ca breast to opposite
side
C. Radical mastectomy but nipple
preserved
D. Used for choanal atresia
Ans: D

EXPLAINATORY ANSWER
A large nipple can be modified by
having its intraoral tip cut off to create
a patent oral passage.This Mc Govern
nipple can then be attached to ties
placed around occiput.This method is
used to establish an oral airway.
Ref: Rhinology and facial plastic
surgery
Edited by Fred J.Sticker,Chris de
Sousa,Guy S.Kenyon,Timothy
S.Lian,Wolfgang Drag,Bernhard
Schick,2nd edition,pg.687

MCQ
35.Most malignant type of carcinoma
breast is:
A. Pagets disease
B. Anaplastic carcinoma
C. Scirrhouss carcinoma
D. Atrophic Scirrhouss carcinoma
E. Mastitis carcinomatosa
Ans: E

EXPLAINATORY ANSWER
Inflammatory carcinoma/Lactating
carcinoma/Mastitis carcinomatosis:
Most malignant type of carcinoma
breast. It is 2% common. It is
common in lactating women or
pregnancy. It mimics acute mastitis
because of its short duration, pain,
warmth and tenderness.
Ref: SRBs manual of surgery,3rd
edition, by Sriram Bhatt
M,Pg.469,491-493.

MCQ
36.Carcinoma of breast 4cm. in size
fixed to the pectoralis muscle would

EXPLAINATORY ANSWER
According to TNM criteria ,
T2: Tumor >2 cm but <5 cm in

qualify as:
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Ans: C

greatest dimension
N2: cancer in fixed nodes
M0:no metastasis
Stage I T1N0M0
Stage IIa T0N1M0, T1N1M0, T2N0M0
Stage IIb T2N0M0, T3N0M0
Stage IIIa T0N2M0, T1N2M0,
T2N2M0, T3N1M0, T3N2M0
Stage IIIb T4N0M0, T4N1M0, T4N2M0
Stage IIIc any T, N3M0
Stage IV any T; any N; M1

Ref: The Washington Manual of


Surgery,
Mary E. Klingensmith MD
Abdulhameed Aziz MD
Ankit Bharat MD
Amy C. Fox MD
Matthew R. Porembka MD
Department of Surgery, Washington
University, School of Medicine, St.
Louis, Missouri.6th edition
Pg.617-618.
MCQ
37.A painless, hard swelling of breast
in old woman is generally due to:
A. Cancer
B. Calcified haematoma
C. Fat necrosis
D. Fibroadenoma
Ans: B

EXPLAINATORY ANSWER
Fibroadenoma presents as a painless
swelling in one of the quadrants,
which is smooth, firm, nontender, well
localized and moves freely within the
breast tissue. It occurs commonly in
young females of 15-25 years age
group.
Traumatic fat necrosis is a painless
swelling in the breast which is smooth,
hard, nontender and adherent to
breast tissue.It is mostly seen in
middle aged women.
Causes of hard swellings in the breast
Carcinoma breast Antibioma
breast Traumatic fat necrosis
Calcified haematoma Fibroadenoma
hard variety
Ref: SRBs manual of surgery,3rd
edition,by Sriram Bhatt
M,Pg.457,460,496.

MCQ
38.Mondors disease is :
A. Superficial thrombophlebitis of
breast veins
B. Carcinoma breast

EXPLAINATORY ANSWER
Mondors disease is thrombophlebitis
of the superficial veins of the breast
and anterior chest wall.
Commonly involved veins -superior

C. Filariasis of breast
D. Premalignant breast lesion
Ans: A

epigastric vein, thoracoepigastric


vein, lateral thoracic vein.
Pathognomonic feature-- thrombosed
subcutaneous cord, usually attached
to the skin.
Differential diagnosis--lymphatic
permeation from an occult carcinoma
of breast.
Ref: Bailey & loves short practice of
surgery, ,
Edited by Norman S. Williams
Christopher J.K. Bulstrode,
P. Ronan OConnell.26th edition,
Pg.8051.

MCQ
39.In a female patient of Breast
Cancer with lung metastases, the
most common presenting symptom is:
A. Chronic cough
B. Hemoptysis
C. No specific complaint
D. Dyspnoea
Ans: C

EXPLAINATORY ANSWER
According to TNM classification,
distant metastasis to lungs indicate
stage IV.Lung metastases are usually
asymptomatic and are associated with
longer survival period.
Ref: Bailey & loves short practice of
surgery,26th edition,
Edited by Norman S. Williams
Christopher J.K. Bulstrode
P. Ronan OConnell. Pg810,811
Essentials of Breast Surgery: A Volume
in the Surgical Foundations Series
By Michael S. Sabel,1st edition,pg.138

MCQ
40.Worst prognosis in breast
carcinoma is seen in:
A. colloid
B. lobular
C. inflammatory
D.papillary
Ans: C

EXPLAINATORY ANSWER
Tubular, colloid, papillary types has
got better prognosis. Medullary
carcinoma has got better prognosis
than scirrhous carcinoma because of
lymphocytic infiltration. Invasive
carcinoma has got worser prognosis.
Inflammatory carcinoma breast has
worst prognosis.
Ref: SRBs manual of surgery,3rd
edition,by Sriram Bhatt M,Pg.492-493.