ABSITE LATEST 2026 MAIN EXAM QUESTIONS AND
ANSWERS GRADED A+
✔✔The surface M protein is a virulence factor associated with:
a.) Streptococcus pyogenes.
b.) Peptostreptococcus sp.
c.) Enterococcus faecalis.
d.) Clostridium perfringens.
e.) Staphylococcus aureus. - ✔✔(a)
The M protein coat of streptococci appears to provide relative protection against
phagocytosis.
✔✔A 33yr old patient develops bloody nipple discharge. There is no family history of
breast cancer. The patient denies any trauma, recent pregnancy, prior similar episodes,
pain, or fevers. On examination, both breasts are normal in appearance. There are no
palpable masses in either breast. A very small amount of blood can be expressed from
the right nipple. Which of the following is the most likely diagnosis?
a.) Breast abscess
b.) Cystosarcoma phyllodes
c.) Fibroadenoma
d.) Intraductal papilloma
e.) Mammary dysplasia - ✔✔(d)
presents with bleeding/bloody nipple discharge (most common cause), usually benign,
biopsy/resect via major duct excision
✔✔Which of the following is a contraindication to breast conservation therapy in stage I
breast cancer?
a.) Age of the patient
b) Central breast tumor mass
c) Breast Tumor size less than 5 cm
d.) Small lump to breast ratio - ✔✔(b)
The tumor is central, the advantages of preserving the breast are lost as nipple areola
complex is sacrificed. Others include
1) prior irradiation; 2) inflammatory disease; 3) pregnancy (unless 3rd trimester); 4)
collagen vascular disease
✔✔Regarding the axillary lymphatics:
a.) Level III nodes are lateral to the pectoral minor
,b.) Lymphatics from the nipple & areola drain into the subscapular group of the axillary
nodes.
c.) Survival is directly related to the number of positive nodes
d.) The axillary lymph nodes receive only 50% of the lymphatics of the breast.
e.) None of the above - ✔✔(c)
1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major & pec minor
They receive 80% of the drainage of the breast
✔✔Which of the following is a contraindication to sentinel lymph node biopsy in breast
cancer?
a.) clinically negative axillary examination
b.) multicentric disease
c.) lesion under the nipple
d.) history of previous breast biopsy
e.) patient preference for breast conservation - ✔✔(b)
Contraindications include
1. Clinically suspicious axillary LN
2. T3/T4
3. Large biopsy cavity
4. Prior axillary surgery
5. Recent mammoplasty/breast implant
6. Likely intraductal papilloma
7. Inflammatory disease
✔✔Which of the following statements about the sentinel lymph node in breast cancer is
NOT true?
a.) Sentinal lymph node biopsy is most useful for outer quadrant lesions of the breast
b.) Isosulfan blue dye or radioactive material is injected around the tumor to follow the
drainage pathway of the marker
c.) A negative sentinal node is predictive of a negative axillary dissection
d.) Immunohistochemistry enhances the sensitivity of detecting nodal metastases
e.) Successful lymphatic mapping and detection of the sentinel node requires a palpable
breast mass - ✔✔(e)
The main side effect of Isosulfan blue is cardiac arrhythmias
✔✔What is the main side effect of adriamycin (doxorubacin)?
a.) Neuromuscular blockade
,b.) Cardiomyopathy
c.) Peripheral neuropathy
d.) Neutropenic enterocolitis
e.) Pulmonary fibrosis - ✔✔(b)
cardiomyopathy
✔✔The following are true of inflammatory breast carcinoma EXCEPT
a.) It is characterised by tumor emboli within dermal lymphatics
b.) It is bilateral in over 10% of cases
c.) Treatment includes neoadjuvant chemo then MRM
d.) If untreated the median survival time is less than a year - ✔✔(c)
1.) neoadjuvant chemo 2.) modified radical mastectomy 3.) XRT
✔✔The carotid body
a.) Is a pressure receptor
b.) Is an osmoreceptor
c.) Is a subintimal structure
d.) Is located in the media of the vessel
e.) Is located in the adventitia - ✔✔(e)
The carotid body (carotid glomus or glomus caroticum) is a small cluster of
chemoreceptors that detects changes in the composition of arterial blood flowing
through it, mainly the partial pressure of oxygen, but also of carbon dioxide.
Furthermore, it is also sensitive to changes in pH and temperature.
✔✔A 48yr old female originally presented for evaluation of a suspicious nonpalpable
lesion in her right breast that was seen on her annual mammogram. A stereotactic core
biopsy shows the presence of DCIS. Which of the following is NOT true?
a.) Typically occurs in premenopausal women
b.) May appear as a palpable mass or a mammographic abnormality
c.) Associated with an increased risk of invasive breast cancer in the affected breast
d.) May be treated with lumpectomy and adjuvant radiotherapy
e.) May be treated with total mastectomy - ✔✔(a)
Ductal carcinoma in situ typically occurs in the postmenopausal (and not the
premenopausal) woman. It often is initially appreciated as microcalcifications on
mammogram, and can be treated with either total mastcectomy or lumpectomy with
radiotherapy. Usually the axillary lymph nodes are not removed because of the low risk
of nodal involvement.
, ✔✔Which of the following regarding LCIS is NOT true?
a.) Tamoxifen increases the risk of invasive cancer
b.) Resection with negative margins is required
c.) It is more common in premenopausal women
d.) Calcifications are usually absent
e.) There is an increased risk for bilateral cancer - ✔✔(b)
✔✔Which of the following is appropriate treatment option for LCIS?
a.) Bilateral simple mastectomies
b.) Random biopsy of the contralateral side and resection of all areas of LCIS
c.) Modified radical mastectomy
d.) Lumpectomy with axillary node dissection
e.) Lumpectomy with axillary node dissection followed by radiation therapy - ✔✔(a)
Options include
1) observation 2) tamoxifen 3) bilateral subcutaneous mastectomy; never need ALND
✔✔Initial management of T4 invasive lobular breast carcinoma is
a.) Tamoxifen
b.) Modified radical mastectomy
c.) Radiation therapy to the breast and ipsilateral axilla
d.) Neoadjuvant chemotherapy - ✔✔(d)
✔✔All of the following are associated with an increased risk in the development of
cancer EXCEPT
a.) Atypical ductal hyperplasia
b.) BRCA 1 mutation
c.) Dense breast tissue
d.) Increased bone density
e.) Conjugated estrogen therapy after hysterectomy - ✔✔(e)
Study of Women's Health Initiative did NOT show increase risk of breast cancer with
estrogen therapy after hysterectomy
✔✔A 48yr old woman presents with thick greenish nipple discharge from both breasts.
There is no palpable breast lump, although both nipples are slightly retracted. The
patient does not take any medication. Mammogram & ultrasound do not show any
evidence of cancer. The most likely diagnosis is:
a.) galactorrhoea
b.) duct papilloma
ANSWERS GRADED A+
✔✔The surface M protein is a virulence factor associated with:
a.) Streptococcus pyogenes.
b.) Peptostreptococcus sp.
c.) Enterococcus faecalis.
d.) Clostridium perfringens.
e.) Staphylococcus aureus. - ✔✔(a)
The M protein coat of streptococci appears to provide relative protection against
phagocytosis.
✔✔A 33yr old patient develops bloody nipple discharge. There is no family history of
breast cancer. The patient denies any trauma, recent pregnancy, prior similar episodes,
pain, or fevers. On examination, both breasts are normal in appearance. There are no
palpable masses in either breast. A very small amount of blood can be expressed from
the right nipple. Which of the following is the most likely diagnosis?
a.) Breast abscess
b.) Cystosarcoma phyllodes
c.) Fibroadenoma
d.) Intraductal papilloma
e.) Mammary dysplasia - ✔✔(d)
presents with bleeding/bloody nipple discharge (most common cause), usually benign,
biopsy/resect via major duct excision
✔✔Which of the following is a contraindication to breast conservation therapy in stage I
breast cancer?
a.) Age of the patient
b) Central breast tumor mass
c) Breast Tumor size less than 5 cm
d.) Small lump to breast ratio - ✔✔(b)
The tumor is central, the advantages of preserving the breast are lost as nipple areola
complex is sacrificed. Others include
1) prior irradiation; 2) inflammatory disease; 3) pregnancy (unless 3rd trimester); 4)
collagen vascular disease
✔✔Regarding the axillary lymphatics:
a.) Level III nodes are lateral to the pectoral minor
,b.) Lymphatics from the nipple & areola drain into the subscapular group of the axillary
nodes.
c.) Survival is directly related to the number of positive nodes
d.) The axillary lymph nodes receive only 50% of the lymphatics of the breast.
e.) None of the above - ✔✔(c)
1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major & pec minor
They receive 80% of the drainage of the breast
✔✔Which of the following is a contraindication to sentinel lymph node biopsy in breast
cancer?
a.) clinically negative axillary examination
b.) multicentric disease
c.) lesion under the nipple
d.) history of previous breast biopsy
e.) patient preference for breast conservation - ✔✔(b)
Contraindications include
1. Clinically suspicious axillary LN
2. T3/T4
3. Large biopsy cavity
4. Prior axillary surgery
5. Recent mammoplasty/breast implant
6. Likely intraductal papilloma
7. Inflammatory disease
✔✔Which of the following statements about the sentinel lymph node in breast cancer is
NOT true?
a.) Sentinal lymph node biopsy is most useful for outer quadrant lesions of the breast
b.) Isosulfan blue dye or radioactive material is injected around the tumor to follow the
drainage pathway of the marker
c.) A negative sentinal node is predictive of a negative axillary dissection
d.) Immunohistochemistry enhances the sensitivity of detecting nodal metastases
e.) Successful lymphatic mapping and detection of the sentinel node requires a palpable
breast mass - ✔✔(e)
The main side effect of Isosulfan blue is cardiac arrhythmias
✔✔What is the main side effect of adriamycin (doxorubacin)?
a.) Neuromuscular blockade
,b.) Cardiomyopathy
c.) Peripheral neuropathy
d.) Neutropenic enterocolitis
e.) Pulmonary fibrosis - ✔✔(b)
cardiomyopathy
✔✔The following are true of inflammatory breast carcinoma EXCEPT
a.) It is characterised by tumor emboli within dermal lymphatics
b.) It is bilateral in over 10% of cases
c.) Treatment includes neoadjuvant chemo then MRM
d.) If untreated the median survival time is less than a year - ✔✔(c)
1.) neoadjuvant chemo 2.) modified radical mastectomy 3.) XRT
✔✔The carotid body
a.) Is a pressure receptor
b.) Is an osmoreceptor
c.) Is a subintimal structure
d.) Is located in the media of the vessel
e.) Is located in the adventitia - ✔✔(e)
The carotid body (carotid glomus or glomus caroticum) is a small cluster of
chemoreceptors that detects changes in the composition of arterial blood flowing
through it, mainly the partial pressure of oxygen, but also of carbon dioxide.
Furthermore, it is also sensitive to changes in pH and temperature.
✔✔A 48yr old female originally presented for evaluation of a suspicious nonpalpable
lesion in her right breast that was seen on her annual mammogram. A stereotactic core
biopsy shows the presence of DCIS. Which of the following is NOT true?
a.) Typically occurs in premenopausal women
b.) May appear as a palpable mass or a mammographic abnormality
c.) Associated with an increased risk of invasive breast cancer in the affected breast
d.) May be treated with lumpectomy and adjuvant radiotherapy
e.) May be treated with total mastectomy - ✔✔(a)
Ductal carcinoma in situ typically occurs in the postmenopausal (and not the
premenopausal) woman. It often is initially appreciated as microcalcifications on
mammogram, and can be treated with either total mastcectomy or lumpectomy with
radiotherapy. Usually the axillary lymph nodes are not removed because of the low risk
of nodal involvement.
, ✔✔Which of the following regarding LCIS is NOT true?
a.) Tamoxifen increases the risk of invasive cancer
b.) Resection with negative margins is required
c.) It is more common in premenopausal women
d.) Calcifications are usually absent
e.) There is an increased risk for bilateral cancer - ✔✔(b)
✔✔Which of the following is appropriate treatment option for LCIS?
a.) Bilateral simple mastectomies
b.) Random biopsy of the contralateral side and resection of all areas of LCIS
c.) Modified radical mastectomy
d.) Lumpectomy with axillary node dissection
e.) Lumpectomy with axillary node dissection followed by radiation therapy - ✔✔(a)
Options include
1) observation 2) tamoxifen 3) bilateral subcutaneous mastectomy; never need ALND
✔✔Initial management of T4 invasive lobular breast carcinoma is
a.) Tamoxifen
b.) Modified radical mastectomy
c.) Radiation therapy to the breast and ipsilateral axilla
d.) Neoadjuvant chemotherapy - ✔✔(d)
✔✔All of the following are associated with an increased risk in the development of
cancer EXCEPT
a.) Atypical ductal hyperplasia
b.) BRCA 1 mutation
c.) Dense breast tissue
d.) Increased bone density
e.) Conjugated estrogen therapy after hysterectomy - ✔✔(e)
Study of Women's Health Initiative did NOT show increase risk of breast cancer with
estrogen therapy after hysterectomy
✔✔A 48yr old woman presents with thick greenish nipple discharge from both breasts.
There is no palpable breast lump, although both nipples are slightly retracted. The
patient does not take any medication. Mammogram & ultrasound do not show any
evidence of cancer. The most likely diagnosis is:
a.) galactorrhoea
b.) duct papilloma
