Test questions - study and discussion thread

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seper

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Greetings,

With writtens and radbio/physics boards coming up, why don't we create a thread to discuss difficult questions that we use for studying.

Here is one:

Which results in the highest dose to contralateral breast?
a) Lateral wedge
b) cereobend half-beam block,
c) jaw half-beam block
d) coplanar deep tangents

I'm not sure the question is worded properly, but I vote for a)
 
I thought cerobend contributed the highest amount to the contralateral breast, but I'm not certain.
 
I'd have thought deep tangents that cover the IMNs, and cross over midline. I've seen that question before, but one of the answers was medial wedge, which probably would be high, too.

-S
 
how about this one?

Location of the obturator nodes.
a. Origin of the obturator vessels
b. paracervical triangle,

c. top of oburator foramen.
 
I'd like to say none of the above.
Paracervical triangle is point A, and obturators are at point B. RTOG recommends stopping contouring obturators at the top of symphysis, so c is incorrect. Old surgical text that I googled says obturators are located at the PERIPHERAL branches of obturator a.

how about this one?

Location of the obturator nodes.
a. Origin of the obturator vessels
b. paracervical triangle,
c. top of oburator foramen.
 
Definitely not B or C
Process of elimination, would go with A, but no idea really.
Should have asked in a more radiologic/anatomical way
S
 
I agree. Not a good test question.
A better one:

What factor is most prognostic for Wilm’s outcome:
a) histology

b) age,

c) sex
d) duration of symptoms


I'm pretty sure that a) - anaplasia - trumps everything. Is there a specific study to support it?
 
Also, what if e) stage was included? Does stage III favorable histology do worse than stage 1 unfavorable?

I agree. Not a good test question.
A better one:

What factor is most prognostic for Wilm’s outcome:
a) histology
b) age,
c) sex
d) duration of symptoms


I'm pretty sure that a) - anaplasia - trumps everything. Is there a specific study to support it?
 
Which of these CN's is most commonly injured from high dose radiation to the head and neck?

5, 7, 10, 11, 12?

In general, CN II is probably the most sensitive, followed by VIII.
Of the listed above, it's between V and VII, and most data are probably in acoustic neuroma studies. I'd vote for V. Any takers?
 
Is it just me or exam drumbeat is getting louder?

Question:
Which uterine sarcoma subtype is most commonly incidentally discovered in hysterectomy specimen?

a. MMMT
b. leiomysarcoma
c. ESS

I see no studies in Pubmed addressing this.
It's going to be either a or b.
 
Anybody seen this one?

. .Following organ transplant, EBV is most likely to result in which form of NHL: lymphoblastic lymphoma, follicular, DLBCL, Mantle

the only one I can exclude with certainty is lymphoblastic lymphoma - it is not EBV-associated
 
Post-transplant lymphoproliferative disorder is almost always DLBCL...
 
thanks
poor prognosis - makes sense
 
Which brainstem tumor can you observe because of “favorable” natural history:

diffuse pontine,
exophytic pontine,
pretectal tumor,
midbrain
cervicomedullary tumor


I've seen this one a few times and not sure what they are eluding too.
I would say a LGG in midbrain can be observed?
 
Based on clinical experience at our children's hospital, I'd say pretectal. I've seen those observed, none of the others. I have no reference to back that up right now though...
 
Based on clinical experience at our children's hospital, I'd say pretectal. I've seen those observed, none of the others. I have no reference to back that up right now though...

I'm inclined to agree with stlo. If a tumor were to enlarge and demonstrate mass effect in the midbrain, pons, or cervical-medullary junction the neurological sequelae could be life-threatening.
 
thank you both for the input.

as the exams get closer, feel free to expand this thread, including Physics/RadBio.
 
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