Q.1 Which is the most common indication for lung resection surgery?
Pulmonary embolism
Lung cancer
Asthma
Tuberculosis
Explanation - Lung cancer is the most common indication for thoracic surgical procedures such as lobectomy or pneumonectomy.
Correct answer is: Lung cancer
Q.2 Which thoracic surgical procedure involves removal of an entire lung?
Lobectomy
Segmentectomy
Pneumonectomy
Thoracotomy
Explanation - Pneumonectomy refers to surgical removal of the entire lung, usually performed for central tumors not amenable to smaller resections.
Correct answer is: Pneumonectomy
Q.3 What is the most common incision used for thoracotomy?
Midline sternotomy
Posterolateral thoracotomy
Transverse cervical incision
Subcostal incision
Explanation - Posterolateral thoracotomy provides excellent exposure of the lung and mediastinum and is the most common incision in thoracic surgery.
Correct answer is: Posterolateral thoracotomy
Q.4 Which nerve is most at risk during mediastinal lymph node dissection?
Phrenic nerve
Vagus nerve
Recurrent laryngeal nerve
Spinal accessory nerve
Explanation - The recurrent laryngeal nerve is at risk during mediastinal lymph node dissection, leading to hoarseness of voice if injured.
Correct answer is: Recurrent laryngeal nerve
Q.5 Which imaging modality is most useful for preoperative staging of lung cancer?
X-ray
CT scan
MRI
Ultrasound
Explanation - CT scan of the chest and upper abdomen is crucial for evaluating tumor extent and staging lung cancer before surgery.
Correct answer is: CT scan
Q.6 Which thoracic condition is most commonly treated by decortication?
Lung cancer
Empyema
Pulmonary embolism
Asthma
Explanation - Decortication is the removal of fibrous peel overlying the lung, performed to allow re-expansion in cases of chronic empyema.
Correct answer is: Empyema
Q.7 Which surgical procedure is commonly performed for spontaneous pneumothorax?
Pneumonectomy
Bullectomy with pleurodesis
Mediastinoscopy
Thoracic outlet decompression
Explanation - For recurrent spontaneous pneumothorax, bullectomy with pleurodesis is performed to prevent recurrence.
Correct answer is: Bullectomy with pleurodesis
Q.8 Which structure is divided during a standard posterolateral thoracotomy?
Trapezius muscle
Latissimus dorsi muscle
Pectoralis major muscle
Rectus abdominis muscle
Explanation - Posterolateral thoracotomy typically involves division of the latissimus dorsi and sometimes serratus anterior for adequate exposure.
Correct answer is: Latissimus dorsi muscle
Q.9 Which condition is a contraindication for pneumonectomy?
Central lung tumor
Severe contralateral lung disease
Bronchiectasis
Large pleural effusion
Explanation - Pneumonectomy requires sufficient contralateral lung reserve, hence severe disease in the other lung contraindicates it.
Correct answer is: Severe contralateral lung disease
Q.10 Which is the most common complication after thoracotomy?
Infection
Atelectasis
Pulmonary embolism
Air embolism
Explanation - Atelectasis due to poor postoperative coughing and secretion clearance is the most common complication following thoracotomy.
Correct answer is: Atelectasis
Q.11 Which artery is most important to preserve during esophagectomy?
Inferior thyroid artery
Right gastric artery
Right gastroepiploic artery
Splenic artery
Explanation - During esophagectomy, the right gastroepiploic artery is preserved to supply the gastric conduit used for esophageal replacement.
Correct answer is: Right gastroepiploic artery
Q.12 What is the most common indication for VATS (Video-Assisted Thoracic Surgery)?
Lung cancer
Pleural effusion drainage
Empyema
Mediastinal mass biopsy
Explanation - VATS is commonly used for diagnostic and therapeutic drainage of pleural effusion, among other indications.
Correct answer is: Pleural effusion drainage
Q.13 Which complication is most associated with prolonged air leak after lobectomy?
Diaphragmatic hernia
Bronchopleural fistula
Empyema
Chylothorax
Explanation - Prolonged air leak following lung resection often indicates bronchopleural fistula formation.
Correct answer is: Bronchopleural fistula
Q.14 What is the primary surgical treatment for esophageal cancer?
Esophagectomy
Fundoplication
Gastrectomy
Mediastinoscopy
Explanation - Esophagectomy, often combined with gastric pull-up, is the standard surgical treatment for resectable esophageal carcinoma.
Correct answer is: Esophagectomy
Q.15 Which thoracic structure is most vulnerable during subclavian vein cannulation?
Trachea
Pleura
Thoracic duct
Phrenic nerve
Explanation - Subclavian vein cannulation risks injury to the pleura, leading to pneumothorax.
Correct answer is: Pleura
Q.16 Which thoracic surgical approach is most commonly used for heart surgery?
Anterolateral thoracotomy
Median sternotomy
Clamshell incision
Subxiphoid approach
Explanation - Median sternotomy provides direct access to the heart and great vessels and is the standard incision for cardiac surgery.
Correct answer is: Median sternotomy
Q.17 Which thoracic surgery complication can lead to chylothorax?
Thoracic duct injury
Phrenic nerve palsy
Vagus nerve injury
Esophageal perforation
Explanation - Chylothorax results from injury to the thoracic duct during mediastinal or esophageal surgery.
Correct answer is: Thoracic duct injury
Q.18 What is the most common cause of postoperative death following pneumonectomy?
Pulmonary embolism
Bronchopleural fistula
Respiratory failure
Cardiac arrhythmia
Explanation - Respiratory failure due to reduced lung capacity is the leading cause of mortality after pneumonectomy.
Correct answer is: Respiratory failure
Q.19 Which thoracic surgical procedure is performed for myasthenia gravis?
Lobectomy
Pneumonectomy
Thymectomy
Esophagectomy
Explanation - Thymectomy is indicated for myasthenia gravis, especially when a thymoma is present.
Correct answer is: Thymectomy
Q.20 Which imaging study is best to localize a mediastinal mass?
Chest X-ray
CT scan
MRI
PET scan
Explanation - CT scan provides detailed localization and characterization of mediastinal masses.
Correct answer is: CT scan
Q.21 Which condition is most commonly associated with superior vena cava (SVC) syndrome?
Lung cancer
Tuberculosis
Pneumonia
Asthma
Explanation - Lung cancer, especially small cell carcinoma, is the most frequent cause of SVC syndrome due to mediastinal invasion.
Correct answer is: Lung cancer
Q.22 Which is the most common benign tumor of the anterior mediastinum?
Neurofibroma
Thymoma
Lipoma
Teratoma
Explanation - Thymoma is the most common anterior mediastinal benign tumor, often associated with myasthenia gravis.
Correct answer is: Thymoma
Q.23 What is the primary surgical treatment for hydatid cyst of the lung?
Lobectomy
Cystectomy with capitonnage
Segmentectomy
Pneumonectomy
Explanation - Hydatid cysts are managed by cystectomy with capitonnage to preserve lung tissue.
Correct answer is: Cystectomy with capitonnage
Q.24 Which complication is most specific to esophagectomy?
Bronchopleural fistula
Anastomotic leak
Empyema
Chylothorax
Explanation - Anastomotic leak at the esophagogastric junction is a feared and specific complication of esophagectomy.
Correct answer is: Anastomotic leak
Q.25 Which thoracic structure passes through the diaphragm at the T10 level?
Aorta
Inferior vena cava
Esophagus
Thoracic duct
Explanation - The esophagus passes through the diaphragm at the T10 level, remembered by the mnemonic IVC-8, Esophagus-10, Aorta-12.
Correct answer is: Esophagus