Breast & Endocrine Surgery

Topics in this chapter

• Benign Breast Disorders
• Breast Cancer Management
• Axillary Surgery and Staging
• Thyroid Nodules and Cancer
• Thyroidectomy Complications
• Parathyroid Disorders and Surgery
• Adrenal Tumors and Pheochromocytoma

Practice questions

1. Question 1Q-0CD467

   A 35-year-old female presents with a painless, smooth, mobile, firm lump in the upper outer quadrant of her right breast. Ultrasound reveals a well-circumscribed, hypoechoic oval lesion with wider-than-tall dimensions. Which of the following is the most appropriate next step in management?

   1. A.Immediate wide local excision
   2. B.Core needle biopsy for confirmation
   3. C.Modified radical mastectomy
   4. D.Routine reassurance and clinical follow-up
   See the answer and solution
2. Question 2Q-0B2D35

   A 45-year-old woman undergoes core needle biopsy for a suspicious microcalcification cluster on mammography, which confirms Ductal Carcinoma In Situ (DCIS). What is the single most important factor determining the risk of local recurrence after breast-conserving surgery for DCIS?

   1. A.Patient age
   2. B.Surgical margin status
   3. C.Presence of comedonecrosis
   4. D.Nuclear grade
   See the answer and solution
3. Question 3Q-510E22

   During a total thyroidectomy for multinodular goiter, the surgeon meticulously identifies the recurrent laryngeal nerve. At the lower pole of the thyroid gland, what is the most crucial anatomical relationship to keep in mind regarding the recurrent laryngeal nerve and the inferior thyroid artery?

   1. A.The nerve always passes strictly anterior to the artery
   2. B.The nerve typically crosses anterior to, posterior to, or between the branches of the artery
   3. C.The nerve is located at least 2 cm away from the artery
   4. D.The nerve runs superficial to the suspensory ligament of Berry
   See the answer and solution
4. Question 4Q-57AFA8

   A 52-year-old female undergoes a right hemithyroidectomy for a follicular thyroid neoplasm. Postoperatively, she complains of circumoral numbness, tingling in her fingers, and a positive Chvostek sign on day one. What is the most likely diagnosis?

   1. A.Hypercalcemia due to vitamin D toxicity
   2. B.Transient hypoparathyroidism
   3. C.Recurrent laryngeal nerve neuropraxia
   4. D.Thyroid storm
   See the answer and solution
5. Question 5Q-BAA982

   A 28-year-old male is evaluated for episodic headaches, diaphoresis, and severe hypertension. Biochemical evaluation reveals markedly elevated 24-hour urinary metanephrines. Imaging localizes a 4 cm left adrenal mass. Which of the following preoperative medical preparations is mandatory prior to surgical resection of this tumor?

   1. A.Beta-blocker monotherapy followed immediately by surgery
   2. B.Alpha-adrenergic blockade followed by sodium and volume repletion
   3. C.High-dose glucocorticoid replacement therapy
   4. D.Immediate fine-needle aspiration cytology
   See the answer and solution