NIFA SURGICAL SPECIALITIES ACTUAL EXAM
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ Thoracic Surgery:
What is a pharmacologic test that can be done in a patient with suspected
myasthenia gravis? Answer: Suspect MG in anyone with anterior
mediastinal mass and fatigue, weakness, difficulty chewing.
Test to be done:
Tensilon (edrophonium)
◉ Thoracic Surgery:
What is main cause of SVC obstruction? Answer: 1) Usually related to
malignancy (80%) - Lung main ethology
2) Used to be due to Syphillis
◉ Thoracic Surgery:
,What are alternative blood return pathways in the setting of SVC
obstruction? (3). Answer: 1) Azygous system
2) Internal mammary system
3) Long thoracic venous system
◉ Thoracic Surgery:
When can a chest tube be safety removed? (4). Answer: 1) Less than
150-200cc drainage per 24 hours
2) Pneumothorax resolved
3) No air leak
4) Empyema resolved
◉ Thoracic Surgery:
What are contraindications to chest tube? (5). Answer: 1) Skin infection
over chest tube insertion site
2) Coagulopathy
3) Pulmonary, pleural or thoracic adhesions
4) Loculated pleural effusion or empyema
5) Only absolute contraindication is need for emergent thoracotomy
◉ Thoracic Surgery:
,What are indications for urgent thoracotomy? Answer: 1) Penetrating
injury with either previously witnessed cardiac activity or unresponsive
hypotension
2) Blunt injury with either rapid exsanguination from chest tube
(>1500ml immediately returned, or unresponsive hypotension)
◉ Thoracic Surgery:
What is best management of chronic empyema? Answer: Decortication
◉ Thoracic Surgery:
What are common causes of empyema? (4). Answer: 1) Pneumonia -
50% of cases
2) Post surgical - 25% of cases
3) Subphrenic abscess extension - 10% of cases
4) Post traumatic - 3-5%
◉ Thoracic Surgery:
, What is most common cause of spontaneous pneumothorax? Answer:
Apical bleb
◉ Thoracic Surgery:
An abnormality in the cricopharyngeous muscle can lead to which
abnormality? Answer: Zenkels Diverticulum
◉ Thoracic Surgery:
What is diagnostic test for suspected esophageal rupture? Answer:
Contrast esophagram
◉ Thoracic Surgery:
What is risk of transforming Barrett's esophagus to adenocarcinoma by
year? Answer: 1%
◉ Thoracic Surgery:
What are indications for chest tube? (6). Answer: 1) Tension
pneumothorax
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ Thoracic Surgery:
What is a pharmacologic test that can be done in a patient with suspected
myasthenia gravis? Answer: Suspect MG in anyone with anterior
mediastinal mass and fatigue, weakness, difficulty chewing.
Test to be done:
Tensilon (edrophonium)
◉ Thoracic Surgery:
What is main cause of SVC obstruction? Answer: 1) Usually related to
malignancy (80%) - Lung main ethology
2) Used to be due to Syphillis
◉ Thoracic Surgery:
,What are alternative blood return pathways in the setting of SVC
obstruction? (3). Answer: 1) Azygous system
2) Internal mammary system
3) Long thoracic venous system
◉ Thoracic Surgery:
When can a chest tube be safety removed? (4). Answer: 1) Less than
150-200cc drainage per 24 hours
2) Pneumothorax resolved
3) No air leak
4) Empyema resolved
◉ Thoracic Surgery:
What are contraindications to chest tube? (5). Answer: 1) Skin infection
over chest tube insertion site
2) Coagulopathy
3) Pulmonary, pleural or thoracic adhesions
4) Loculated pleural effusion or empyema
5) Only absolute contraindication is need for emergent thoracotomy
◉ Thoracic Surgery:
,What are indications for urgent thoracotomy? Answer: 1) Penetrating
injury with either previously witnessed cardiac activity or unresponsive
hypotension
2) Blunt injury with either rapid exsanguination from chest tube
(>1500ml immediately returned, or unresponsive hypotension)
◉ Thoracic Surgery:
What is best management of chronic empyema? Answer: Decortication
◉ Thoracic Surgery:
What are common causes of empyema? (4). Answer: 1) Pneumonia -
50% of cases
2) Post surgical - 25% of cases
3) Subphrenic abscess extension - 10% of cases
4) Post traumatic - 3-5%
◉ Thoracic Surgery:
, What is most common cause of spontaneous pneumothorax? Answer:
Apical bleb
◉ Thoracic Surgery:
An abnormality in the cricopharyngeous muscle can lead to which
abnormality? Answer: Zenkels Diverticulum
◉ Thoracic Surgery:
What is diagnostic test for suspected esophageal rupture? Answer:
Contrast esophagram
◉ Thoracic Surgery:
What is risk of transforming Barrett's esophagus to adenocarcinoma by
year? Answer: 1%
◉ Thoracic Surgery:
What are indications for chest tube? (6). Answer: 1) Tension
pneumothorax
