High-Yield and Frequently Missed ABSITE
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Breast: What is presentation, treatment, prognosis for intraductal papilloma? - CORRECT
ANSWER - presents with bleeding/bloody nipple discharge (most common cause), usually
benign, biopsy/resect via major duct excision
Breast: What are contraindications to BCT (lumpectomy) in stage I breast cancer (and what
specifically is not)? - CORRECT ANSWER - 1) prior irradiation;
2) pos margins;
3) inflammatory;
4) pregnancy (unless 3rd trimester)
Breast: what are the axillary node levels (1-3, and one more category)? - CORRECT
ANSWER - 1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major and pec minor
Breast: when is SNLB indicated (size, nodes, tumor status, metastatic risk)>? - CORRECT
ANSWER - >1 cm, no positive nodes (obviously), primary tumor present, low risk of
axillary mets,
Breast: what do you do if you can't find radiotracer dye in SNLB? - CORRECT
ANSWER - have to do formal ALND
Breast: what is treatment for DCIS in male/female? - CORRECT ANSWER - female --
BCT + xrt OR mastectomy; male -- mastectomy
,Breast: what is not needed for patient with negative SLNB? - CORRECT ANSWER -
ALND -- just do BCT or mastectomy depending on tumor is fine
Breast: what patient would get only mastectomy/BCT + tamoxifen for 5 years (4
characteristics)? - CORRECT ANSWER - negative SLN, old, ER+, and tumor <2 cm
Breast: what patient would get mastectomy/BCT + tamoxifen for 5 years plus chemo (4
characteristics)? - CORRECT ANSWER - negative SLN, young, ER+, and tumor >1cm
Breast: what are 3 chemo agents used for breast CA typically? - CORRECT ANSWER - 1)
adriamycin; 2) cyclophosphamide; 3) taxol
Breast: what patient would get mastectomy/BCT + chemo (no tamoxifen)? - CORRECT
ANSWER - negative SLN, ER-
Breast: what is main SE of taxol? - CORRECT ANSWER - taxol - neuropathy
Breast: what is main SE of adriamycin (doxorubacin)? - CORRECT ANSWER -
cardiomyopathy
Breast: what is treatment for inflammatory breast cancer (in order)? - CORRECT
ANSWER - neoadjuvant chemo, then mastectomy (mod radical), then XRT
Breast: what options are available for breast mass post neoadjuvant therapy? - CORRECT
ANSWER - same as de novo breast cancer -- BCT or mastectomy -- if tumor shrunk and
now amenable to BCT, that's fine, even if it was big before and needed mastectomy based on size
Breast: LCIS -- who primarily gets this, what is most important characteristic, what % get
cancer, where, and what type? - CORRECT ANSWER - - pre-menopausal
- NOT premalignant itself
- 30% lifetime risk
,70% ductal CA
Breast: LCIS -- what % have synchronous cancer? - CORRECT ANSWER - 5%
Breast: LCIS -- what is treatment (4 possibility, 2 things not needed ever)? - CORRECT
ANSWER - 1) Need to resect the lesion but do not need neg margins
2) nothing and careful F/U
3) Hormonal therapy
-(pre-meno: tamoxifen; Post-meno: raloxifene)
4) bilateral subcutaneous mastectomy (no ALND)
Breast: What are the benign proliferative breast lesions that have increased risk of CA? (3)
Tx? - CORRECT ANSWER - - LCIS
- Atypical ductal hyperplasia
- atypical lobular hyperplasia
Tx: resect the lesion w/ (-) margins
Breast: for atypical ductal hyperplasia; atypical lobular hyperplasia; LCIS, how are these
characterized and what treatment should be considered? - CORRECT ANSWER - benign
proliferative dz. Incr risk of CA.
Need to resect - don't need (-) margins
Can give hormone therapy
- pre-meno: tamoxifen
- post-meno: raloxifene
Bilateral total mastectomy (no ALND)
Liver: amebic abscess - how does organism enter, what organism is it - CORRECT
ANSWER - through portal system
, Liver: amebic abscess - what are 3 presenting symptoms? - CORRECT ANSWER - fever,
RUQ pain, RUQ tenderness
Liver: amebic abscess - what test may help diagnose? - CORRECT ANSWER - indirect
hemagglutination
Liver: amebic abscess - what is first line treatment, when should surgery be done, and what other
option exists? - CORRECT ANSWER - first option metronidazole -- surgery or
percutaneous drainage if failure
Liver: what are 2 primary routes for pyogenic liver abscess, and what are 2 specific causes for
each? - CORRECT ANSWER - biliary infection (cholecystitis/cholangitis) - most common
seeding from portal vein drainage (appendicitis, diverticulitis)
Liver: pyogenic abscess - what are most common organisms (3)? - CORRECT ANSWER -
e. coli, klebsiella, strep
Liver: treatment for pyogenic abscess (variuos options)? - CORRECT ANSWER - abx
and/or percutaneous drainage, always search for primary source
Liver: echinococcal abscess - what is treatment? - CORRECT ANSWER - Antiparasitics
(albendazole/mabendazole)
PA - Perc aspiration
I - inject (w/ hypertonic saline or alcohol)
R - resect
Liver: echinococcal abscess - what is diagnosis (2)? - CORRECT ANSWER - indirect
hemagglutination / ELISA
Liver: how many segments, and what is each? - CORRECT ANSWER - 1) caudate; 2-4)
left lobe (2-3 left lateral); 5-8) right lobe
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Breast: What is presentation, treatment, prognosis for intraductal papilloma? - CORRECT
ANSWER - presents with bleeding/bloody nipple discharge (most common cause), usually
benign, biopsy/resect via major duct excision
Breast: What are contraindications to BCT (lumpectomy) in stage I breast cancer (and what
specifically is not)? - CORRECT ANSWER - 1) prior irradiation;
2) pos margins;
3) inflammatory;
4) pregnancy (unless 3rd trimester)
Breast: what are the axillary node levels (1-3, and one more category)? - CORRECT
ANSWER - 1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major and pec minor
Breast: when is SNLB indicated (size, nodes, tumor status, metastatic risk)>? - CORRECT
ANSWER - >1 cm, no positive nodes (obviously), primary tumor present, low risk of
axillary mets,
Breast: what do you do if you can't find radiotracer dye in SNLB? - CORRECT
ANSWER - have to do formal ALND
Breast: what is treatment for DCIS in male/female? - CORRECT ANSWER - female --
BCT + xrt OR mastectomy; male -- mastectomy
,Breast: what is not needed for patient with negative SLNB? - CORRECT ANSWER -
ALND -- just do BCT or mastectomy depending on tumor is fine
Breast: what patient would get only mastectomy/BCT + tamoxifen for 5 years (4
characteristics)? - CORRECT ANSWER - negative SLN, old, ER+, and tumor <2 cm
Breast: what patient would get mastectomy/BCT + tamoxifen for 5 years plus chemo (4
characteristics)? - CORRECT ANSWER - negative SLN, young, ER+, and tumor >1cm
Breast: what are 3 chemo agents used for breast CA typically? - CORRECT ANSWER - 1)
adriamycin; 2) cyclophosphamide; 3) taxol
Breast: what patient would get mastectomy/BCT + chemo (no tamoxifen)? - CORRECT
ANSWER - negative SLN, ER-
Breast: what is main SE of taxol? - CORRECT ANSWER - taxol - neuropathy
Breast: what is main SE of adriamycin (doxorubacin)? - CORRECT ANSWER -
cardiomyopathy
Breast: what is treatment for inflammatory breast cancer (in order)? - CORRECT
ANSWER - neoadjuvant chemo, then mastectomy (mod radical), then XRT
Breast: what options are available for breast mass post neoadjuvant therapy? - CORRECT
ANSWER - same as de novo breast cancer -- BCT or mastectomy -- if tumor shrunk and
now amenable to BCT, that's fine, even if it was big before and needed mastectomy based on size
Breast: LCIS -- who primarily gets this, what is most important characteristic, what % get
cancer, where, and what type? - CORRECT ANSWER - - pre-menopausal
- NOT premalignant itself
- 30% lifetime risk
,70% ductal CA
Breast: LCIS -- what % have synchronous cancer? - CORRECT ANSWER - 5%
Breast: LCIS -- what is treatment (4 possibility, 2 things not needed ever)? - CORRECT
ANSWER - 1) Need to resect the lesion but do not need neg margins
2) nothing and careful F/U
3) Hormonal therapy
-(pre-meno: tamoxifen; Post-meno: raloxifene)
4) bilateral subcutaneous mastectomy (no ALND)
Breast: What are the benign proliferative breast lesions that have increased risk of CA? (3)
Tx? - CORRECT ANSWER - - LCIS
- Atypical ductal hyperplasia
- atypical lobular hyperplasia
Tx: resect the lesion w/ (-) margins
Breast: for atypical ductal hyperplasia; atypical lobular hyperplasia; LCIS, how are these
characterized and what treatment should be considered? - CORRECT ANSWER - benign
proliferative dz. Incr risk of CA.
Need to resect - don't need (-) margins
Can give hormone therapy
- pre-meno: tamoxifen
- post-meno: raloxifene
Bilateral total mastectomy (no ALND)
Liver: amebic abscess - how does organism enter, what organism is it - CORRECT
ANSWER - through portal system
, Liver: amebic abscess - what are 3 presenting symptoms? - CORRECT ANSWER - fever,
RUQ pain, RUQ tenderness
Liver: amebic abscess - what test may help diagnose? - CORRECT ANSWER - indirect
hemagglutination
Liver: amebic abscess - what is first line treatment, when should surgery be done, and what other
option exists? - CORRECT ANSWER - first option metronidazole -- surgery or
percutaneous drainage if failure
Liver: what are 2 primary routes for pyogenic liver abscess, and what are 2 specific causes for
each? - CORRECT ANSWER - biliary infection (cholecystitis/cholangitis) - most common
seeding from portal vein drainage (appendicitis, diverticulitis)
Liver: pyogenic abscess - what are most common organisms (3)? - CORRECT ANSWER -
e. coli, klebsiella, strep
Liver: treatment for pyogenic abscess (variuos options)? - CORRECT ANSWER - abx
and/or percutaneous drainage, always search for primary source
Liver: echinococcal abscess - what is treatment? - CORRECT ANSWER - Antiparasitics
(albendazole/mabendazole)
PA - Perc aspiration
I - inject (w/ hypertonic saline or alcohol)
R - resect
Liver: echinococcal abscess - what is diagnosis (2)? - CORRECT ANSWER - indirect
hemagglutination / ELISA
Liver: how many segments, and what is each? - CORRECT ANSWER - 1) caudate; 2-4)
left lobe (2-3 left lateral); 5-8) right lobe
