Skip to content

Home
About Us
Question Bank
Courses
Resources
- Resources – Basic
- Resources – Premium
My Account
Login
News
Contact
Start Learning
Start Learning

Thoracic 3

By David Blitzer / February 4, 2023

Time limit: 0

Quiz Summary

0 of 20 Questions completed

Questions:

Information

You have already completed the quiz before. Hence you can not start it again.

Quiz is loading…

You must sign in or sign up to start the quiz.

You must first complete the following:

Results

Quiz complete. Results are being recorded.

Results

0 of 20 Questions answered correctly

Your time:

Time has elapsed

You have reached 0 of 0 point(s), (0)

Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)

Categories

General Thoracic Surgery 0%

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Current
Review
Answered
Correct
Incorrect

Question 1 of 20

1. Question
The Internal Diameter of a normal adult trachea is approximately:
- 1cm
- 4cm
- 2cm
- 0.5cm
- 3cm
Correct

Incorrect
Question 2 of 20

2. Question
A type III paraesophageal hernia:
- Slides along the axis of the esophagus
- Has the GE junction in its normal position but the fundus of the stomach lies within the chest
- Is associated with other intraabdominal organs (e.g. liver, colon) within the chest
- Has at least 30% of the stomach above the diaphragm
Correct

Incorrect
Question 3 of 20

3. Question
What is the most common type of paraesophageal hernia?
- Type I
- Type II
- Type III
- Type IV
Correct

Incorrect
Question 4 of 20

4. Question
A sliding hiatal hernia is what type of hernia?
- Type I
- Type II
- Type III
- Type IV
Correct

Incorrect
Question 5 of 20

5. Question
A type II paraesophageal hernia is one that:
- Slides along the axis of the esophagus
- Has the GE junction in its normal position but the fundus of the stomach lies within the chest
- Is associated with other intraabdominal organs (e.g. liver, colon) within the chest
- Has at least 30% of the stomach above the diaphragm
Correct

Incorrect
Question 6 of 20

6. Question
Which of the following is true regarding paraesophageal hernia repair?
- Recurrence risk is over 50%
- 2-3 cm of intraabdominal esophagus is needed prior to beginning crural repair
- Permanent mesh repair is associated with superior outcomes compared to absorbable mesh
- Mesh repair is associated with a significant reduction of long-term recurrence
Correct

Incorrect
Question 7 of 20

7. Question
All of the following are true of paraesophageal hernias, EXCEPT:
- Occur more frequently in men
- More than half occur in patients over age 70
- Obesity increases the risk of paraesophageal hernia
- Abdominal ascites is a risk factor
- 40% of patients have associated anemia
Correct

Incorrect
Question 8 of 20

8. Question
All of the following are true of hiatal hernias, EXCEPT:
- All type I hernias should be surgically repaired because of the risk of Barrett's esophagus
- All type II hiatal hernias should be repaired because of the high risk of stomach incarceration and strangulation.
- Chronic iron deficiency anemia is common in type III hiatal hernia.
- Type I is the most common subtype
Correct

Incorrect
Question 9 of 20

9. Question
Which is true regarding emergent paraesophageal hernia for gastric volvulus repair?
- The risk of complications is no different compared to elective repair
- If necrosis is present, and the patient is unstable, the safest approach is emergent laparotomy, subtotal gastrectomy, and roux-en-Y reconstruction
- Flexible endoscopy should never be performed in these patients
- If no necrosis is present, the stomach may be reduced and the hernia repaired in standard fashion
Correct

Incorrect
Question 10 of 20

10. Question
Injury to the vagal nerves during paraesophageal hernia repair will cause:
- Reflex tachycardia
- Diaphragm paralysis
- Diarrhea and dumping syndrome
- Hoarseness
Correct

Incorrect
Question 11 of 20

11. Question
A type IV paraesophageal hernia is one that:
- Slides along the axis of the esophagus
- Has the GE junction in its normal position but the fundus of the stomach lies within the chest
- Is associated with other intraabdominal organs (e.g. liver, colon) within the chest
- Has at least 30% of the stomach above the diaphragm
Correct

Incorrect
Question 12 of 20

12. Question
A 45-year-old woman with shortness of breath and chest pain has a 12 cm lobulated mass in the anterior mediastinum on CT with invasion of the pericardium, pericardial effusion, invasion of the SVC, and an elevated right hemidiaphragm. The effusion has been percutaneously aspirated and her symptoms improved. There were no atypical cells in the aspirate. What is the best definitive treatment for this patient?
- Core biopsy, induction chemotherapy, reevaluation for resection
- Subxyphoid pericardial window and palliative chemotherapy
- Sternotomy, en bloc mass excision
- FNA biopsy
Correct

Incorrect
Question 13 of 20

13. Question
Which is true about phrenic nerve involvement by thymic carcinoma?
- If one phrenic nerve is involved, it can be resected along with the tumor if necessary to achieve an R0 resection
- Diaphragmatic plication is not a helpful adjunct when phrenic nerve resection is performed
- Phrenic nerve involvement is a contraindication to resection
- Debulking of the tumor should be performed with sparing of the phrenic nerve
Correct

Incorrect
Question 14 of 20

14. Question
A 32-year-old male has a 16 cm lobulated, heterogeneous anterior mediastinal mass associated with significantly elevated beta-HCG and AFP. What is the next best step in management?
- CHOP chemotherapy
- VIP (etoposide, ifosfamide, cisplatin) chemotherapy
- CT-guided core needle biopsy
- BEP (bleomycin, etoposide, and cisplatin) chemotherapy
Correct

Incorrect
Question 15 of 20

15. Question
A 32-year-old male has a 16 cm homogeneous anterior mediastinal mass with associated mediastinal and retroperitoneal lymphadenopathy. Beta-HCG is slightly elevated, LDH and AFP are within reference ranges. What is the most likely diagnosis with its best treatment?
- Seminoma, Cisplatin-based chemotherapy
- Seminoma, neoadjuvant chemoradiation followed by resection of residual mass
- Teratoma, definitive surgical resection
- Non-seminomatous germ cell tumor, Cisplatin-based chemotherapy followed by resection of residual disease
Correct

Incorrect
Question 16 of 20

16. Question
Significantly elevated AFP is most commonly associated with which of the following?
- Seminomatous germ cell tumor
- Non-seminomatous germ cell tumor
- Thymoma
- Mediastinal lymphoma
Correct

Incorrect
Question 17 of 20

17. Question
A 50-year-old otherwise healthy female with generalized fatigue and eyelid “drooping” late in the day undergoes CT-guided biopsy of a 7 cm anterior mediastinal mass and thymoma is confirmed. The mass on CT scan appears homogenous and encapsulated and is sitting anterior to the pericardium without apparent invasion. Which of the following is the best management option?
- Robot-assisted mass excision alone leaving the remaining thymus in situ
- Sternotomy with removal of all thymic tissue including the mass
- Neoadjuvant chemotherapy
- Steroids and ongoing medical management
Correct

Incorrect
Question 18 of 20

18. Question
Which is true regarding thymoma?
- Most patients with myasthenia gravis have a thymoma.
- Patients with a thymoma rarely have myasthenia gravis.
- Patients with myasthenia gravis without evidence of thymoma can sometimes benefit from thymectomy.
- Radiation therapy has no role in treatment for patients who undergo surgical resection
Correct

Incorrect
Question 19 of 20

19. Question
An 8 cm anterior mediastinal mass seen on CT is heterogeneous with evidence of bone, cystic components, and other mixed tissues. Beta-HCG, LDH, and AFP are all within reference ranges. What is the next best step?
- MRI chest with and without contrast
- Core biopsy to rule out malignancy
- Complete surgical excision
- Follow-up CT in 6 months
Correct

Incorrect
Question 20 of 20

20. Question
A 50-year-old, healthy, non-smoking female presents with an asymptomatic 4 cm mass in her anterior mediastinum. The mass on CT scan appears homogenous, encapsulated, sitting anterior to the pericardium, without apparent invasion. Of the following, what is the next best step to diagnose this mass?
- MRI chest with and without contrast
- CTA chest
- CT guided FNA
- Surgical excision
- Check serum tumor markers
Correct

Incorrect

Copyright © 2024 TSRA

Powered by TSRA

error: Content is protected!

Login

Accessing this course requires a login. Please enter your credentials below!

Username or Email Address

Password

Remember Me

Lost Your Password?

Register

Don't have an account? Register one!

Register an Account