1) Commonest presentation of cancer breast is:

A) Bleeding per nipple

B) Painless lump
C) Pathological fracture of humorous neck
D) Mastalgia

2) Assessment of breast lump includes all of the following except:

A) Mammogram & U/S breast
B) FNAC
C) History taking
D) CT scan of breast

3) Manifestation of locally advanced cancer breast include:

A) 2cm painless lump
B) Skin nodules
C) Large hard mobile axillary lump
D) Hepatic fibrosis

4)Breast cancer commonly metastasis to:

A) Brain and liver

B) Lung and bone
C) Liver and ovaries
D) Lung and brain

5)Cancer breast mostly present at:

A) Upper inner quadrant

B) Lower inner quadrant
C) Upper outer quadrant
D) Lower outer quadrant

6)Treatment of stage 2 cancer breast may include following except:

A) Modified radical mastectomy

B) Breast conserving surgery
C) Adjuvant chemotherapy
D) Extended radical mastectomy

7)The worst prognosis sign in cancer breast among following:

A) Eczema of the nipple

B) Enlarged fixed axillary lymphadenopathy
C) Bloody nipple discharge
 D) Diagnosis after of 60 years

8)Breast conserving surgery means radiotherapy following:

A) Lumpectomy & axillary LN biopsy

B) Wide local excision only
C) Wide local excision & complete axillary dissection
D) Pattey’s operation

A 37 Y old women undergoes a left breast wide local excision and axillary dissection for a 3cm infiltrating
ductal carcinoma. All margin around the axillary were clear and that 4 of 17 axillaryLN have mestastatic
tumor.tumor is reported to be Estrogen and progesterone receptor negative. Which of the following
should further therapy most likely included?

A) Anti estrogen medication (tamoxifen)

B) Conversion to modified radical mastectomy
C) Radiation to the remaining left breast only
D) Radiation to the remaining left breast and systemic chemotherapy
E) Radiation to both breast and tamoxifen

10)A 52 y old undergoes a left modified radical mastectomy for a 2cm breast cancer. She should be
informed that the factor which has greatest importance in her prognosis is :

A) The size of primary tumor

B) The histological type of the carcinoma
C) The number of axillary nodes positive for metastasis
D) Hormonal receptor status of the primary tumor

11)A women develops winging of the scapula following a patey mastectomy. What is most likely causes?

A) Division of pectoralis minor to access level 3 axillary nodes

B) Damage to brachial plexus during axillary dissection
C) Damage to the long thoracic nerve during axillary dissection
D) Division of the thoracodorsal trunk during axillary dissection

12)A 43 y old premenopausal patient has a biopsy showing focal (LCIS), what should you tell the patient?

A) She needs simple mastectomy

B) She must be placed on tamoxifen and chemotherapy
C) This is premalignant lesion, and she requires additional lumpectomy and radiotherapy
D) She is at increase risk of breast cancer and she should just be observed closely
E) LCIS often present with a mass

13)T2N1M0 carcinoma of the breast includes all following except:

A) Tumor > 2cm & <5cm

 B) Fixed ipsilateral lymphadenopathy
C) No evidence of distant metastasis
D) Pattey’s operation is standard surgical treatment

14)In modified radical mastectomy:

A) Dissection of upper flap up to 2nd rib

B) Dissection of lower flap down to rectus sheath
C) Dissection medially to para sternal line
D) Dissection laterally to anterior axillary line

15)Removal of all breast glandular tissue only is called:

A) Modified radical mastectomy

B) Radical mastectomy
C) Palliative mastectomy
D) Areolar nipple skin sparing mastectomy

16) Neo-adjuvant chemotherapy for cancer breast is indicated in:

A) Early breast carcinoma

B) Locally advanced breast cancer
C) In presence of distant metastasis
D) In patient with age more than 50 y

17)A sliding hernia characterize by:

A) Has an abnormally high recurrence rate after repair

B) Involves a retroperitoneal structure
C) Is more common in the right groin
D) Occurs almost exclusively in women

18)Scrotal neck test differentiate between:

A) Inguinal hernia & femoral hernia

B) Inguinal swelling & scrotal selling
C) Scrotal swelling & abdominal swelling
D) Direct & indirect inguinal hernia

The following structure are derived from the external oblique and its aponeurosis, except:

A) The inguinal ligament

B) The lacunar ligament
C) The superficial inguinal ring
D) The deep inguinal ring
20)A 21 y old man has an inguinal hernia and is undergoing a surgical repair. As the surgeon approach
the deep inguinal ring. Which of the following forms the medial edge of this structure?

A) Inferior epigastric artery

B) Conjoint tendon
C) Rectus abdominis muscle
D) External oblique aponeurosis
E) Transversalis fascia

21)The most common complication of hernias is:

A) Irreducibility
B) Intestinal obstruction
C) Strangulation
D) Inflammation
E) Hydrocele of hernia sac

22)Lateral boundary of the femoral ring is:

A) Femoral vein
B) Lacunar ligament
C) Inguinal ligament
D) Pectineal ligament

23)Regarding the type, the commonest hernia to be irreducible is:

A) Para umbilical hernia

B) Femoral hernia
C) Inguinal hernia
D) Epigastric hernia

24)Strangulated hernia is:

A) Reducibility
B) Impulse on cough
C) Soft
D) Tenderness

25)Character of subcutaneous lipoma includes:

A) Firm in consistency
B) Free mobile except to skin overlying
C) Pseudofluctuant
D) Transilluminant

26)Commonest soft tissue neoplasm is:

 A) Lipoma
B) Liposarcoma
C) Fibrosarcoma
D) Lymphoma

27)Carcinoma is characterized more than sarcoma by:

A) Younger age
B) Rapid rate of growth
C) More blood born metastasis
D) Better prognosis

The next imaging study shows a lesion having the following features except:

A) Speculated margins
B) At the upper quadrant
C) At craniocaudal view
D) Higher density

30)The main usage of the following instrument is:

A) Grasp delicate tissues

B) Hold suturing needle
C) Clamp bleeding blood vessel
D) Hold intestine

31) failure to perform radiation after wide excision of an invasive cancer risks which of the following
outcomes?

A) recurrence of cancer in the ipsilateral breast

B) short survival time

C) regional nodal recurrence

D) greater chance of breast cancer