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High-Yield NEET SS Surgery Breast and Endocrine Questions

Feb 14, 2024


1. A 49-year-old woman presents to the clinic with concerns about a palpable mass in her left breast. The mass has been gradually increasing in size over the past few months and is accompanied by breast skin changes, such as dimpling and redness. The physician orders a biopsy to determine the nature of the mass. Which biopsy technique is most commonly used for the initial pathological diagnosis of a breast mass with these clinical features?

  1. Core Needle Biopsy
  2. Fine Needle Aspiratio
  3. Excisional Biopsy
  4. Incisional Biopsy

2. A 56-year-old woman, with no significant family history of breast cancer, presents to a breast oncology clinic after being diagnosed with invasive ductal carcinoma in her right breast through a biopsy. She is otherwise healthy, and her mammogram revealed no concerning findings in the contralateral breast. Considering the patient's presentation and clinical context, which of the following treatment strategies would be the most appropriate initial approach for this patient?

  1. Oncoplastic breast-conserving Surgery followed by radiotherapy
  2. Neoadjuvant systemic therapy to assess tumour response
  3. Total mastectomy of the right breast with immediate reconstruction
  4. Palliative care and close monitoring

3. A 35-year-old woman with a history of blunt trauma to her left breast complained of mild discomfort and a palpable cord-like sensation in the affected area. Examination reveals a tender left breast, mild oedema and scant inflammation. The skin over the breast stretched by raising the arm showed a narrow, shallow subcutaneous groove in the inferior outer quadrant. The systemic examination is otherwise normal. What is the most likely diagnosis?

  1. Bacterial Mastitis
  2. Breast Abscess
  3. Mondor's Disease
  4. Inflammatory Carcinoma

4. A 50-year-old woman undergoes screening mammography that demonstrates a left breast lesion. Her lesion is classified as highly suggestive of malignancy after-diagnostic mammography, and she is scheduled to undergo a tissue biopsy. What are the mammographic findings most likely associated with her lesion?

  1. Popcorn-like coarse calcifications
  2. Asymmetric mass with segmental calcifications
  3. Vascular calcifications
  4. Nonpalpable, well-circumscribed mass

5. A 45-year-old male patient presents to your clinic with a 6-month history of bilateral breast enlargement and tenderness. The patient has no history of hormone therapy, drug abuse, or liver disease. His BMI is 32, and he reports feeling embarrassed about the appearance of his chest. Laboratory findings reveal normal testosterone and estradiol levels. As a physician, which of the following management options would be most appropriate for this patient’s gynecomastia?

1. Initiate hormonal therapy with selective estrogen receptor modulators (SERMs)

2. Recommend weight loss and lifestyle modifications, followed by reassessment in 6 months

3. Refer the patient for surgical mastectomy to remove glandular breast tissue

4. Proceed with liposuction for removal of excess fatty tissue

6. A 52-year-old man presents to the endocrinology clinic complaining of bilateral breast enlargement for six months. He denies any associated pain, nipple discharge, or recent weight changes. He has a medical history of hypertension and type 2 diabetes, controlled with medications. His family history is unremarkable. His physical examination confirms bilateral gynecomastia. What is the risk of malignancy in this patient’s gynecomastia?

1. Low

2. Moderate

3. High

4. Negligible

7. A 60-year-old woman with a history of invasive ductal carcinoma of the left breast underwent left breast mastectomy. Following the surgery, the patient was informed by her oncologist that she would require post-mastectomy radiation therapy to reduce the risk of recurrence. The patient expresses concern about the impact of radiation therapy on her breast reconstruction. Which of the following is a potential complication of post-mastectomy radiation therapy on breast reconstruction?

1. Low risk of infection

2. Early healing

3. Tissue shrinkage

4. Improved cosmetic outcome

8. After undergoing a modified radical mastectomy for right breast invasive ductal carcinoma, a 33-year-old woman had a silicone breast implant. She slipped and fell on an ice rink two years later. There were no noticeable bruises or skin lacerations upon physical examination. She had an MRI afterwards, which showed that the tissues and skin of her breasts above had contracted. What is the upcoming management strategy?

 1. Capsulectomy and reaugmentation with a new implant

 2. Conservative management with pain control

 3. Systemic oral antibiotics

 4. Topical steroids

9. A 35-year-old female underwent breast augmentation surgery a few years ago. Examination reveals a late peri-implant effusion, and cytologic analysis of the periprosthetic fluid reveals large pleomorphic epithelioid lymphocytes. Which of the following is the most likely diagnosis?

1. Breast Implant-Associated Anaplastic Large Cell Lymphoma

2. Capsular contracture

3. Rupture of breast implant

4. Normal response to breast implant

10. Patients undergoing multiple procedures should undergo perioperative chemoprophylaxis because they are at risk of which of the following complications?

    1. Venous thrombosis

   2. Anemia

  3. Breast infection

  4. Extreme breast pain

11. After performing a reduction mammoplasty on a 50-year-old female, the doctor applies epinephrine on the incision lines and uses drains. Do these procedures reduce the rates of hematoma post-operatively?

1. There is no significant decrease in the rates of hematoma

2. There is a significant decrease in the rates of hematoma

3. Epinephrine increases the venous thrombosis and hematoma rates

4. Epinephrine has no effect but drains decrease hematoma rates

12. A 27-year-old primigravida presents to the outpatient department at 10 weeks of gestation due to palpitations for 1 week. Physical examination reveals proptosis, lid lag, and pretibial myxoedema. She is diagnosed with Graves’ disease. Which of the following is the treatment of choice for this patient

1. Propylthiouracil

2. Methimazole

3. Radioactive iodine ablation

4. Thyroidectomy

13. A 35-year-old female patient arrives at the clinic complaining of palpitations, excessive perspiration, and weight loss for three weeks. Examination revealed a diffusely enlarged and non-tender thyroid gland. Graves' disease was diagnosed, and she was counseled about various treatment options. She inquired about the benefits of radioactive iodine. In which of the following populations is radioactive iodine (I-131) suitable for treatment?

1. Elderly patients with ischemic heart disease

2. Children

3. Young adults with recent onset Graves' disease

4. Pregnant women

14. A 61-year-old woman with a history of coronary artery presented with a mass in the front of her neck. On physical examination, an ill-defined 4 cm right thyroid nodule was noted associated with tracheal deviation. Hemithyroidectomy was done, and the H&E stain was positive for the nest of tumor cells containing calcitonin and is associated with RET proto-oncogene. Which one of the following is the correct diagnosis?

1. Medullary thyroid cancer

2. Follicular thyroid cancer

3. Papillary thyroid cancer

4. Anaplastic thyroid cancer

15. An 82-year-old man presented to the clinic with a rapidly growing neck mass. He states that he has lost weight over a couple of months. He also complained of backache and dysphagia. A physical examination reveals a large, hard mass in his neck obstructing his airway and associated with p53. His blood test shows hypercalcemia. What is the most likely diagnosis?

1. Follicular thyroid carcinoma

2. Anaplastic thyroid carcinoma

3. Medullary thyroid carcinoma

4. Papillary thyroid carcinoma

16. A 45-year-old male presents to the clinic complaining of slowly enlarging neck swelling for the past few months. Other than weight loss, she does not have any symptoms. On examination, a central neck swelling is present. The ultrasound findings are suspicious of malignancy. Biopsy shows complex papilla with pseudo inclusions and nuclear grooving. Which of the following is associated with this neoplasia?

1. Primarily spreads through blood.

2. Psammoma bodies are absent

3. Distant metastasis typically occurs in the liver

4. It affects central and lateral cervical lymph nodes.

17. A 55-year-old female presents with a 3 cm nodule in her left thyroid lobe, which was incidentally discovered during a routine ultrasound. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. The size of the tumour is 5 cm. She has no symptoms related to the nodule, no family history of thyroid cancer, and no history of radiation exposure. Which of the following is the appropriate treatment plan for this patient?

1. Thyroid lobectomy

2. Medical treatment

3. Total thyroidectomy

4. Observation

18. A 45-year-old female presents with a painless neck mass that has progressively increased in size over the past 6 months. She also reports feeling more tired than usual and has experienced some unexplained weight loss. Physical examination reveals a hard, irregular mass in the thyroid gland that is fixed to surrounding tissues. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. What is the most common presenting feature of differentiated thyroid carcinoma?

1. Asymptomatic

2. Pain in neck

3. Big neck swelling

4. Dysphagia

19. A 40-year-old male presents to the surgical outpatient department complaining of abdominal pain, back pain, bone tenderness and prolonged depression. He has a serum calcium level of 12 mg/dL, increased alkaline phosphatase, and a T-score of 2.3 lower than the standard bone mineral density. His renal ultrasound shows multiple renal calculi in the right kidney. His neck ultrasound shows an enlarged nodular parathyroid gland. He is referred to the surgical department for further management. Which of the following is the most probable diagnosis?

1. Parathyroid adenoma

2. Parathyroid hyperplasia

3. Secondary hyperparathyroidism

4. Tertiary hyperparathyroidism

20. A 55-year-old female presents to the surgical outpatient department in a depressed mood with mild abdominal discomfort and excessive urination, and itching on her body for 15 days. Her laboratory tests reveal a serum calcium level of 3.0 mmol/L, urinary calcium excretion of 350 mg/24 hours, and bone density T-score of +1. Other biochemical reports show no significant findings. The patient is referred for surgery. What is the most relevant indication of parathyroidectomy in this patient?

1. Decreased bone density

2. Age

3. Excessive urinary calcium excretion

4. Symptomatic hypercalcemia

21. A 60-year-old female presented to the surgical outpatient department complaining of indigestion, bone pain, easy fatigability, and muscular weakness for 2 weeks. Her parathyroid hormone (PTH) level is 58 pg/mL. She shows no evidence of any renal disorder on renal ultrasound and no primary source of PTH on radiography of the neck. The patient is to undergo exploratory surgery to locate the tissue responsible for the ectopic production of parathyroid hormone. Which incision is most likely to be made in this patient?

1. Minimally invasive incision

2. Transverse collar incision

3. Modified Schobinger incision

4. Modified Macfee incision

22. A 45-year-old female diagnosed with chronic renal failure undergoing regular dialysis presents to the surgical outpatient department due to indigestion, muscle weakness, bone pain and recurrent UTIs for 3 months. Her serum calcium is 3.6 mmol/L, and her parathyroid hormone (PTH) is 62 pg/mL. Her bone mineral density is reduced, and alkaline phosphatase is elevated. Neck imaging shows parathyroid hyperplasia of all the parathyroid glands. What is the most probable diagnosis in this patient?

1. Tertiary hyperparathyroidism

2. Secondary hyperparathyroidism

3. Primary hyperparathyroidism

4. Persistent hyperparathyroidism

23. A 58-year-old female comes to the office because she has been feeling a dry mouth, frequent urination and constipation. Family history is significant for isolated familial hyperparathyroidism in her mother. The calcium level is 10.7 mg/dL, and an ultrasound of the kidneys shows kidney stones. Sestamibi scan is positive for parathyroid adenomas. Which of the following is an indication of parathyroidectomy for the pituitary adenoma in this patient?

1. Calcium level of 10.7 mg/dL

2. Kidney stones

3. Presence of parathyroid adenomas

4. Family history

24. A 50-year-old male, diagnosed with parathyroid cancer with recurrent laryngeal nerve involvement but no lymph node metastasis, is planned to undergo an en-bloc resection of the tumor with laryngeal nerve resection. Which of the following is done during the surgery, along with en bloc resection of the tumor and resection of the involved nerve?

1. Reconstruction of laryngeal nerve 3 months after the surgery

2. Immediate reconstruction of the recurrent laryngeal nerve

3. Cervical lymph node dissection

4. Tracheostomy

If you are preparing for NEET-SS 2024 and ahead, check out SS ELITE Plan (Version 3.0) and what makes it the perfect study resource for your super speciality preparation. 

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