Q.1 Which of the following is considered the standard surgical treatment for localized breast cancer?
Lumpectomy with sentinel lymph node biopsy
Total mastectomy without lymph node evaluation
Chemotherapy alone
Radiotherapy alone
Explanation - Lumpectomy with sentinel lymph node biopsy allows for tumor removal while preserving breast tissue and assessing regional lymph node involvement.
Correct answer is: Lumpectomy with sentinel lymph node biopsy
Q.2 What is the primary goal of cytoreductive surgery in ovarian cancer?
Complete removal of metastatic disease
Removal of only the primary tumor
Prophylactic removal of ovaries
Palliative surgery to relieve pain
Explanation - Cytoreductive surgery aims to remove as much tumor burden as possible, which improves the effectiveness of adjuvant chemotherapy and overall survival.
Correct answer is: Complete removal of metastatic disease
Q.3 Which lymph node dissection is standard for gastric cancer surgery?
D1 or D2 lymphadenectomy
Axillary lymph node dissection
Sentinel lymph node biopsy only
No lymph node removal
Explanation - D1 involves perigastric nodes, while D2 includes nodes along major vessels; proper lymphadenectomy is critical for staging and survival.
Correct answer is: D1 or D2 lymphadenectomy
Q.4 Which type of surgery is preferred for early-stage non-small cell lung cancer?
Lobectomy
Pneumonectomy
Wedge resection
Bronchoscopy
Explanation - Lobectomy is the standard of care for operable early-stage NSCLC, providing the best balance of oncologic control and functional preservation.
Correct answer is: Lobectomy
Q.5 What is the main indication for prophylactic colectomy in colorectal cancer?
Familial adenomatous polyposis (FAP)
Sporadic adenomatous polyps
Ulcerative colitis without dysplasia
Hernia repair
Explanation - FAP carries a near 100% lifetime risk of colorectal cancer, making prophylactic colectomy life-saving.
Correct answer is: Familial adenomatous polyposis (FAP)
Q.6 Which surgical procedure is typically performed for pancreatic head cancer?
Whipple procedure (pancreaticoduodenectomy)
Distal pancreatectomy
Total pancreatectomy
Endoscopic stent placement
Explanation - The Whipple procedure removes the pancreatic head, duodenum, gallbladder, and sometimes part of the stomach to achieve curative resection.
Correct answer is: Whipple procedure (pancreaticoduodenectomy)
Q.7 Which of the following is a hallmark of radical mastectomy?
Removal of breast tissue, pectoralis major muscle, and axillary nodes
Lumpectomy with sentinel node biopsy
Partial mastectomy only
Skin-sparing mastectomy
Explanation - Radical mastectomy is rarely performed today but historically involved extensive tissue removal to achieve local control.
Correct answer is: Removal of breast tissue, pectoralis major muscle, and axillary nodes
Q.8 Which surgery is indicated for resectable hepatocellular carcinoma without cirrhosis?
Hepatic resection
Liver transplantation
Radiofrequency ablation only
TACE (Transarterial chemoembolization)
Explanation - Resection is preferred in non-cirrhotic livers because liver function is preserved and curative removal is possible.
Correct answer is: Hepatic resection
Q.9 Sentinel lymph node biopsy is primarily used to:
Stage cancer with minimal lymph node removal
Treat distant metastases
Replace chemotherapy
Identify bone metastases
Explanation - This technique identifies the first lymph node draining the tumor, reducing surgical morbidity while providing staging information.
Correct answer is: Stage cancer with minimal lymph node removal
Q.10 Which surgery is considered for early-stage testicular cancer?
Radical inguinal orchiectomy
Transscrotal biopsy
Testicular-sparing surgery
Chemotherapy only
Explanation - Radical inguinal orchiectomy allows tumor removal and staging; transscrotal approaches risk tumor seeding.
Correct answer is: Radical inguinal orchiectomy
Q.11 In thyroid cancer, total thyroidectomy is preferred for:
Papillary thyroid carcinoma >1 cm or high-risk features
Benign thyroid nodules
Microcarcinomas <1 cm without risk factors
Thyroiditis
Explanation - Total thyroidectomy allows complete tumor removal, facilitates radioactive iodine therapy, and enables better follow-up with thyroglobulin monitoring.
Correct answer is: Papillary thyroid carcinoma >1 cm or high-risk features
Q.12 Which procedure is the treatment of choice for early-stage melanoma?
Wide local excision
Mohs micrographic surgery
Lymph node dissection without tumor excision
Cryotherapy
Explanation - Wide local excision ensures removal of the primary melanoma with adequate margins while preserving surrounding tissue.
Correct answer is: Wide local excision
Q.13 Which surgery is standard for resectable esophageal cancer?
Esophagectomy
Endoscopic dilation
Partial gastrectomy
Tracheostomy
Explanation - Esophagectomy removes the tumor-bearing esophagus with lymph nodes and provides the best chance for cure in resectable disease.
Correct answer is: Esophagectomy
Q.14 Which is a common goal of palliative oncologic surgery?
Relieve symptoms and improve quality of life
Achieve complete cure
Prevent cancer recurrence
Eliminate need for chemotherapy
Explanation - Palliative surgery focuses on managing pain, obstruction, or bleeding rather than curing the disease.
Correct answer is: Relieve symptoms and improve quality of life
Q.15 In rectal cancer, total mesorectal excision (TME) is performed to:
Remove the rectum and surrounding lymphatic tissue for oncologic control
Perform local polyp removal only
Bypass obstruction with stoma
Administer intraluminal chemotherapy
Explanation - TME reduces local recurrence and improves survival by removing the rectum along with its mesorectal envelope containing lymph nodes.
Correct answer is: Remove the rectum and surrounding lymphatic tissue for oncologic control
Q.16 Which procedure is typically used for early-stage laryngeal cancer?
Partial laryngectomy
Total laryngectomy
Tracheostomy alone
Radiotherapy only
Explanation - Partial laryngectomy removes the tumor while preserving voice and swallowing function, indicated for select early-stage tumors.
Correct answer is: Partial laryngectomy
Q.17 Which surgery is indicated for Wilms tumor in children?
Radical nephrectomy
Partial nephrectomy in all cases
Biopsy only
Chemotherapy without surgery
Explanation - Complete removal of the affected kidney along with the tumor ensures proper staging and improves outcomes.
Correct answer is: Radical nephrectomy
Q.18 In sarcoma management, limb-sparing surgery is preferred when:
Wide resection can achieve negative margins while preserving function
Amputation is easier
Tumor invades major neurovascular bundles
Metastases are present
Explanation - Limb-sparing surgery reduces morbidity and maintains quality of life without compromising oncologic safety when feasible.
Correct answer is: Wide resection can achieve negative margins while preserving function
Q.19 Which surgery is indicated for resectable cholangiocarcinoma at the hepatic hilum?
Hepatic resection with bile duct excision
Whipple procedure
Liver transplantation in all cases
Endoscopic stenting alone
Explanation - Complete surgical removal with negative margins offers the only chance for cure in hilar cholangiocarcinoma.
Correct answer is: Hepatic resection with bile duct excision
Q.20 Which procedure is standard for localized renal cell carcinoma?
Partial or radical nephrectomy
Biopsy only
Chemotherapy
Embolization only
Explanation - Surgical removal is curative for localized RCC; partial nephrectomy is preferred when feasible to preserve renal function.
Correct answer is: Partial or radical nephrectomy
Q.21 In gastric cancer, a Roux-en-Y reconstruction is used after:
Subtotal or total gastrectomy
Appendectomy
Liver biopsy
Esophagectomy
Explanation - Roux-en-Y reconstruction restores gastrointestinal continuity and prevents bile reflux after stomach removal.
Correct answer is: Subtotal or total gastrectomy
Q.22 Which surgery is indicated for medullary thyroid carcinoma with MEN2 syndrome?
Total thyroidectomy with central neck dissection
Partial thyroidectomy only
Observation
Radioactive iodine ablation
Explanation - Complete thyroidectomy with lymph node removal is recommended due to high risk of bilateral disease and lymphatic spread.
Correct answer is: Total thyroidectomy with central neck dissection
Q.23 Which approach is preferred for localized soft tissue sarcomas?
Wide local excision with negative margins
Marginal excision only
Amputation in all cases
Chemotherapy without surgery
Explanation - Achieving negative margins is essential for local control, while amputation is reserved for cases where function cannot be preserved.
Correct answer is: Wide local excision with negative margins
Q.24 Which surgical strategy is used for primary colorectal cancer with liver metastases?
Resection of both primary and liver metastases if feasible
Primary resection only
Liver resection only
Chemotherapy without surgery
Explanation - Simultaneous or staged resection can offer long-term survival in select patients with limited liver metastases.
Correct answer is: Resection of both primary and liver metastases if feasible