(Fig. 1) Patient K. on the side of the chest there is pigmented lesion up to 1 cm in greatest
dimension, with rough edges and uneven black color. There is small superficial erosion on the
surface of tumor. Estimated tumor thickness is 2.5 mm. At a distance of 2 cm from the tumor
there is black-bluish lesion 0.8 cm in diameter. Examination of cytology smears from erosion –
melanoma. The regional lymph nodes are intact. What is TNM stage?
A.
T2N1M0
B.
T3N2M0
C.
T3N0M0
D.
T4N0M0
E.
T4N1M0
ANSWER: B
(Fig. 2) What type of tumor is in patient?
A.
Melanoma
B.
Cavernous hemangioma
C.
Kaposi's sarcoma
D.
Basal cell carcinoma
E.
Cylindroma
ANSWER: E
(Fig. 3) Patient S., 15 years old, on the skin of the neck are two exophytic pigmented broadbased lesions 0.8 and 0.5 cm in diameter. What type of tumor is in the patient?
A.
Melanoma
B.
Hemangioma
C.
Verrucous papilloma
D.
Basal cell carcinoma
E.
Keratoacanthoma
ANSWER: C
(Fig. 4) What operation is shown on the figure?
A.
Upper tracheostomy
B.
Middle tracheostomy
C.
Lower tracheostomy
D.
Konicotomy
E.
Laryngostomy
ANSWER: A
(Fig. 5) What operation is shown on the figure?
A.
Upper tracheostomy
B.
Middle tracheostomy
C.
Lower tracheostomy
D.
Konicotomy
E.
Laryngostomy
ANSWER: C
(Fig. 6) What operation is shown on the figure?
A.
Upper tracheostomy
B.
Middle tracheostomy
C.
Lower tracheostomy
D.
Konicotomy
E.
Resection of the thyroid’s isthmus
ANSWER: B
(Fig. 7) What operation on the neck is shown in the figure?
A.
Vanakh operation
B.
Crile operation
C.
Superficial neck lymph node dissection
D.
Laryngectomy
E.
Thyroidectomy
ANSWER: B
(Fig. 8) What device is shown in the figure?
A.
Computerized tomography
B.
Magnetic resonance imaging
C.
Mammography
D.
Ultrasonic diagnosis apparatus
E.
PET scan
ANSWER: C
(Fig. 9) What is the procedure depicted on the figure?
A.
Breast ultrasound
B.
CT of the breast
C.
MRI of the breast
D.
PET of the breast
E.
Mammography
ANSWER: E
(Fig. 10) Skin pigmented lesion 2,0 × 1,5 cm, with rough edges and uneven black-brown color.
What type of tumor is it about?
A.
Hemangioma
B.
Kaposi's sarcoma
C.
Melanoma
D.
Nevus
E.
Basal cell carcinoma
ANSWER: C
(Fig. 11) Tumor 4 cm in diameter with smooth surface and crisp edges is located in the
subcutaneous scalp. What type of tumor is it about?
A.
Atheroma
B.
Cylindroma
C.
Basal cell carcinoma
D.
Keratoacanthoma
E.
Angiomyofibroma
ANSWER: A
(Fig. 12) What diagnostic method is shown on the picture?
A.
Cytological examination
B.
Histological examination
C.
Dermatoscopy
D.
Scanning
E.
Colposcopy
ANSWER: C
(Fig. 13) What is rule used in dermatoscopy for differential diagnosis between precancerous and
malignant pigmented lesions?
A.
Capillary test
B.
Express cytology
C.
Shadow test
D.
ABCDE
E.
FOBT
ANSWER: D
(Fig. 14) The diagnosis of cancer was confirmed under microscope study of smears from skin
ulcer. What method was used for?
A.
Cytological examination
B.
Histological examination
C.
Immunohistochemical study
D.
Electron microscopy
E.
Dermatoscopy
ANSWER: A
(Fig. 15) What diagnostic process is shown on the picture in patient with laryngeal carcinoma?
A.
CT scanning
B.
Scintigraphy
C.
Ultrasonography
D.
MRI
E.
Radionuclide scanning
ANSWER: A
(Fig. 16) What treatment is shown on the picture in patient with cancer?
A.
CT scanning
B.
Scintigraphy
C.
Radiation therapy on linear accelerator
D.
Brachytherapy
E.
Radionuclide scanning
ANSWER: A
(Fig. 17) What diagnostic procedure is on the picture?
A.
Breast ultrasound
B.
Breast CT
C.
Breast MRI
D.
Puncture biopsy of breast under ultrasound control
E.
Mammography
ANSWER: D
(Fig. 18) What method of treatment is on the picture?
A.
Trepanation
B.
Electrochemical lysis of tumor
C.
Laser destruction
D.
Radiotherapy
E.
Thermoablation
ANSWER: D
(Fig. 19) What is clinical form of melanoma in the patient?
A.
Superficial
B.
Nodular
C.
Lentigo
D.
Acral
E.
Amelanotic
ANSWER: C
(Fig. 20) What tumor of larynx vocal cord is shown on figure?
A.
Cancer
B.
Fibroma
C.
Pahydermia
D.
Papilloma
E.
Sarcoma
ANSWER: B
(Fig. 21) What tumor of larynx vocal cord is shown on figure?
A.
Cancer
B.
Fibroma
C.
Pahydermia
D.
Papilloma
E.
Sarcoma
ANSWER: A
(Fig. 22) What skin lesion is in children?
A.
Melanoma
B.
Hemangioma
C.
Pahydermia
D.
Diffuse dyskeratosis
E.
Xeroderma pigmentosum
ANSWER: B
(Fig. 23) What diagnostic procedure of thyroid gland is shown on picture?
A.
Scintigraphy
B.
Scanning J-131
C.
Lymphography
D.
PET scan
E.
Ultrasonography
ANSWER: E
(Fig. 24) From what tumor the metastases are developed?
A.
Pigmented basal cell carcinoma
B.
Melanoma
C.
Sarcoma
D.
Squamous cell carcinoma
E.
Breast Cancer
ANSWER: B
(Figure 25) What T criterion corresponds to skin melanoma on the picture?
A.
T2b
B.
T3a
C.
T3b
D.
T4a
E.
T4b
ANSWER: E
(Figure 26) What T criterion corresponds to the basal cell carcinoma?
A.
T2b
B.
T3a
C.
T3b
D.
T4
E.
Not enough data
ANSWER: D
(Fig. 27) Patient S., 63 years old, completed thyroid scanning by J-131. What pathological
process most probably present in the patient according to the scintigram?
A.
Follicular adenoma of the left lobe
B.
Follicular adenoma of the right lobe
C.
Fibroma of the right lobe
D.
Cancer of the left lobe
E.
Diffuse toxic goiter in the left lobe
ANSWER: D
(Fig. 28) In 43 years old patient the tumor was found in the neck. What diagnostic method is
shown on the picture?
A.
Lymphography
B.
Angiography
C.
PET
D.
CT
E.
MRI
ANSWER: A
(Fig. 29) Patient S., 63 years old, received a full course of radiation therapy for laryngeal cancer.
Three months later a CT scan was done. What pathological changes present on CT scan?
A.
Metastasis in the left cervical lymph nodes
B.
Adenoma of the left lobe of the thyroid gland
C.
Recurrence of cancer of the larynx
D.
Postradiation stricture of the larynx
E.
Atrophy of the neck muscles
ANSWER: A
(Fig. 30) In patient with enlarged neck lymph nodes what method should be used for
morphological verification of the disease?
A.
Ultrasonography
B.
CT scan
C.
Magnetic resonance imaging
D.
Lymphography
E.
Biopsy of the tumor
ANSWER: E
(Fig. 31) What is most likely pathological process shown in figure?
A.
Follicular tonsillitis
B.
Abscess
C.
Cancer of the left tonsil
D.
Chronic left-side tonsillitis
E.
Basal fibroid
ANSWER: C
(Figure 32) Basal cell skin cancer stage T1 is on left nose wing. Where are most likely to expect
metastases in the future?
A.
Submandibular lymph nodes
B.
Deep cervical lymph nodes
C.
Lungs
D.
Brain
E.
The tumor does not metastasize
ANSWER: E
(Figure 33) Figure shown basal cell carcinoma of the lower eyelid skin (6 mm) with invasion
into cartilage. Which T criterion corresponds to the tumor?
A.
Tis
B.
T1
C.
T2
D.
T3
E.
T4
ANSWER: C
(Figure 34) Figure depicted squamous cell carcinoma of the upper eyelid. Where are most likely
to expect metastasis in the future?
A.
Lymph nodes neck
B.
Liver
C.
Lungs
D.
Brain
E.
The tumor does not metastasize
ANSWER: A
(Fig. 35) What pathological process is shown on picture?
A.
Melanoma with satellite metastases
B.
Multiple basal cell carcinoma
C.
Seborrheic dyskeratosis
D.
Kaposi's sarcoma
E.
Cavernous hemangioma
ANSWER: C
(Fig. 36) During laryngoscopy the fine-grained compacted tumour on one vocal cord was
revealed. What pathology most likely present?
A.
Cancer
B.
Fibroma
C.
Hard papilloma
D.
Pahydermia
E.
Leukoplakia
ANSWER: C
(Fig. 37) Patient has dysplastic nevus on the upper lip’s skin. What treatment in this case is?
A.
Surgery
B.
Radiotherapy
C.
Topical application of cytostatic ointments
D.
Photodynamic laser therapy
E.
Immunotherapy (interferons)
ANSWER: A
(Fig. 38) Patient has forehead atheroma. What is the most common location of these tumors?
A.
Abdominal wall
B.
Limbs
C.
Neck and supraclavicular area
D.
Scalp
E.
Back
ANSWER: D
(Fig. 39) Patient has cancer of the tongue. What is the most common location of tongue’s
malignant tumor?
A.
Base of tongue
B.
Tip
C.
Lateral borders
D.
Dorsal surface
E.
Ventral surface
ANSWER: C
(Fig. 40) In patients after laryngectomy due to cancer was formed artificial esophageal-tracheal
fistula. For what purpose it was done?
A.
To voice rehabilitation
B.
To prevent food aspiration into the airways
C.
To prevent drying of the tracheal mucosa
D.
To warm the inhaled air
E.
To drainage sputum into the esophagus
ANSWER: A
(Fig. 41) Patient has cancer of the tongue. Where are more likely to expect the development of
metastases?
A.
Neck lymph nodes
B.
Liver
C.
Lung
D.
Brain
E.
Bone
ANSWER: A
(Fig. 42) Patient has anaplastic thyroid cancer T4N0M0. What is stage of disease?
A.
I
B.
II
C.
III
D.
IV
E.
Not enough data
ANSWER: D
(Fig. 43) Patient has basal cell carcinoma on the right cheek. Where is the "most favorite"
location of skin basalioma?
A.
Face
B.
Body
C.
Legs
D.
Perineum
E.
Arms
ANSWER: A
(Fig. 44) Patient K., 60 years old, received a full course of radiation therapy on laryngeal
carcinoma with good effect – a primary tumor completely disappeared. After 4 months
developed metastasis in the left neck lymph nodes. Which treatment should be preferred in this
case?
A.
Surgery
B.
Radiotherapy
C.
Chemotherapy
D.
Immunotherapy
E.
Photodynamic laser therapy
ANSWER: A
(Fig. 45) Patient has cancer of lower lip. Which T criterion corresponds to this tumor?
A.
T1
B.
T2
C.
T3a
D.
T3b
E.
T4
ANSWER: E
(Fig. 46) Patient has papilloma of the tongue. Which treatment should be preferred to complete
recovery of the patient?
A. Surgery
B. Radiotherapy
C. Chemotherapy
D. Immunotherapy
E. Cryodestruction
ANSWER: A
(Fig. 47) In the heavy smoking patient on the red part of lower lip locates tumor in the form of
warty growths. Regional lymph nodes are not enlarged. Cytological exam found the
keratinocytes, squamous epithelium and blood elements. Select the most likely diagnosis.
A. Leukoplakia
B. Erythroplakia
C. Keratoakantoma
D. Hyperkeratosis
E. Fibroma
ANSWER: D
(Fig. 48) Patient has a papilloma of lower lip. Select the best method of treatment.
A.
Triangle lip resection
B.
Rectangular resection with lip reconstruction
C.
Radiotherapy
D.
Laser therapy
E.
Cytostatic ointments
ANSWER: A
(Fig. 49) Patient has malignant melanoma of the 1st finger on left foot. What clinical form meets
this location?
A.
Superficial spreading melanoma
B.
Nodular melanoma
C.
Lentigo melanoma
D.
Acral melanoma
E.
Amelanotic
ANSWER: D
(Fig. 50) Patient has polymorphic adenoma of the parotid salivary gland. What complications
most frequently occur in the surgical treatment of tumors?
A.
Salivary fistula
B.
Damage of superficial temporal artery
C.
Damage of vena jugularis externa
D.
Damage of facial nerve branches
E.
Damage of vena jugularis interna
ANSWER: D
(Fig. 51) Patient has exophytic form of lip cancer. What is the preferred way to metastasize of
this type of cancer?
A.
Lymphogenous
B.
Hematogenous
C.
Implantation
D.
Metastasize in different ways with the same frequency
E.
Exophytic tumors do not metastasize
ANSWER: A
(Fig. 52) Patient has endophytic form of lip cancer. What is the preferred way to metastasize of
this type of cancer?
A.
Lymphogenous
B.
Hematogenous
C.
Implantation
D.
Metastasize in different ways with the same frequency
E.
Endophytic tumors do not metastasize
ANSWER: A
(Fig. 52) Patient has advanced squamous cell carcinoma of the lower lip. Select the best option
of treatment of the primary tumor.
A.
Extirpation of the lower lip
B.
Radiation therapy
C.
Combined treatment: preoperative radiation therapy + surgery
D.
Surgical treatment + active immunotherapy
E.
Chemotherapy
ANSWER: C
(Fig. 53) Patient has metastatic melanoma into inguinal lymph nodes. What is name the inguinalfemoral lymphadenectomy by author?
A.
Crile operation
B.
Dyuken operation
C.
Diffenbah operation
D.
Szymanowski operation
E.
Schepotin operation
ANSWER: B
(Fig. 54) Patient has basal cell skin carcinoma stage I, T1N0M0. Select the best option of
treatment of the primary tumor.
A.
Surgery (wide local excision)
B.
X-ray therapy
C.
Gamma-ray radiotherapy
D.
Topical chemotherapy
E.
Topical immunotherapy
ANSWER: B
(Fig. 55) At the morphological study of the tumor revealed its spindle cell variant. What kind of
tumor is it about?
A.
Squamous cell carcinoma
B.
Basal cell carcinoma
C.
Kaposi's sarcoma
D.
Bowen’s disease
E.
Melanoma
ANSWER: E