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Medical Quiz Competition

Comprehensive Surgery MCQ Assessment

Reviewed by Professor Dr. Ehsanur Reza (Shovan), Professor and Head of Department (Surgery Department), Mymensingh Medical College and Hospital

Name

Phone

To accurately assess early biological response and identify patients who may require treatment escalation (such as those with a Ki-67 level >10%), an interval biopsy should typically be performed at which stage of Neoadjuvant Endocrine Therapy (NET)?

Within the first 24 to 48 hours of starting treatment to capture immediate molecular shifts.

Between 2 and 4 weeks after the initiation of therapy.

Only after a minimum of 4 months, to allow for significant physical tumour shrinkage.

At the 6-month mark, just prior to definitive surgery.

12 weeks after the completion of all neoadjuvant and adjuvant systemic treatments.

None

Which of the following is classified as a very common adverse event specifically associated with Aromatase Inhibitors (AIs)?

Thromboembolic events, such as deep vein thrombosis or pulmonary embolism.

Endometrial hyperplasia, uterine fibroids, and an increased risk of uterine cancer

AI-associated musculoskeletal syndrome (AIMSS), characterized by joint pain, arthralgia, and stiffness.

Injection-site reactions, including localized hypersensitivity or sciatica.

Interstitial pneumonitis and cataracts.

None

The Preoperative Endocrine Prognostic Index (PEPI) score, a validated tool for identifying patients who may safely omit adjuvant chemotherapy, is calculated at the time of surgery using which four factors?

Patient age, tumour grade, PR expression, and HER2 status.

OR expression, Ki-67 index, pathological tumour size, and nodal status.

Oncotype DX score, MRI volume reduction, Allred score, and surgical margin status.

Menopausal status, duration of therapy, Ki-67 suppression, and BRCA status.

Pathological complete response (pCR), vascular invasion, Allred score, and nodal status.

None

While a linear relationship exists between clinical response and oestrogen receptor expression, the ACOSOG Z1031 trial and clinical guidelines suggest that the most ideal candidates for NET typically possess an Allred score of:

1 or 2

3 or 4

At least 5, but no higher than 6

6 or higher, with peak responses often seen at 7 and 8.

Any score above 0, regardless of intensity.

None

the optimal duration for NET, extending treatment beyond 6 months carries a specific biological risk of:

Developing ligand-independent activation of the oestrogen receptor.

Immediate and irreversible liver toxicity.

Increasing the rate of pathological complete response (pCR) to over 50%.

Causing a sudden spike in Ki-67 levels in all responders.

Inducing a switch from HR+ to Triple-Negative Breast Cancer (TNBC).

None

A patient undergoes microwave ablation for a 1.8 cm tumour. Initial imaging shows complete response, but recurrence occurs 2 years later. What is the most likely underlying cause?

Lack of adjuvant chemotherapy

Hormone receptor variability

Incomplete tumour destruction due to inadequate margin control

Radiation-induced resistance

None

Which of the following percutaneous techniques is unique in being completely non-invasive while still achieving tumour ablation?

Radiofrequency ablation

Microwave ablation

Laser ablation

High-intensity focused ultrasound (HIFU)

None

A 62-year-old patient undergoes cryoablation. Shortly after, she develops local swelling and bruising. What is the most appropriate interpretation?

Serious complication requiring surgery

Normal mild adverse effect

Treatment failure

Metastatic spread

None

Which factor is most crucial when selecting patients for percutaneous treatment?

Age

Tumour size

Healthcare cost

Hospital availability

None

Which is the single most important advantage of percutaneous techniques over surgery?

Ability to assess margins

Elimination of recurrence

Avoidance of general anaesthesia

Better lymph node staging

None

Which modality works by resistive heating using alternating electrical currents?

HIFU

Cryoablation

RFA

Laser ablation

None

1 out of 11

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Scorecard

Rank	User	Correct Score %	Time Taken
1	Sania shabir	100	00:00:33
2	Nabian	100	00:00:35
3	Sadia	100	00:00:50
4	Dr. Rafi Siddique	100	00:00:53
5	Azahar	100	00:01:44
6	Dr. Abdul Hai	100	00:04:00
7	dr robin	100	00:04:31
8	Shimul Das Jolak	100	00:05:08
9	Sarit Kumar Singh Roy	100	00:05:09
10	Jummy	100	00:05:28
11	farhan kanon	100	00:06:37
12	Dr. Shithila	100	00:07:06
13	Syed Rayhan	90	00:01:04
14	shoeb Hasan	90	00:02:07
15	Nayeem	90	00:02:42
16	Tamanna Rahman	90	00:02:59
17	Faria Hasan	90	00:03:24
18	Syed Rayhan	90	00:04:00
19	Dr. Sohan	90	00:04:37
20	Eva	90	00:06:44
21	Mohammad Mustafizur Rahman	90	00:08:03
22	Ahsanul Habib	90	00:08:04
23	Halima aktee	81	00:01:29
24	Dr. Wahida	81	00:07:36
25	Samin Khan	72	00:04:11
26	Sadia Ferdous	72	00:04:20
27	Suooda	72	00:04:37
28	Maleesha Fathimath	72	00:09:50
29	Nusrat Jahan	63	00:02:36
30	arafat islam	63	00:05:16
31	Dr Md Mahfuzur Rahman Rumi	63	00:07:30
32	Md Sanowar Hossen	63	00:08:14
33	Sumaiya	54	00:02:23
34	Tanvir Ahmed	54	00:03:40
35	Nusrat Jahan	54	00:03:41
36	Agni	54	00:05:27
37	Toushe Tabassum	54	00:05:32
38	Shakila Swarna	54	00:06:44
39	Mahmudun Nabi Royal	45	00:03:15
40	Nur Afrin Joti	45	00:04:44
41	Halima	45	00:06:07
42	Dr. Rafi Siddique	36	00:01:48
43	Foyzun	36	00:04:48
44	Nandita Chakraborty	27	00:03:46
45	Md. Nabian Badsha	18	00:02:55

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