CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam - CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2

Question 1

A 34-year-old female presents with a 1.5 cm asymptomatic, firm nodule in the left lobe of the thyroid, discovered incidentally on carotid duplex ultrasound. Fine-needle aspiration biopsy (FNAB) yields Bethesda Category VI (papillary thyroid carcinoma). Ultrasound of the neck shows no evidence of cervical lymphadenopathy or extrathyroidal extension, and thyroid function tests are normal. What is the most appropriate initial surgical management?

Left thyroid lobectomy Total thyroidectomy with bilateral routine prophylactic central neck dissection (Level VI) Total thyroidectomy without central neck dissection Active surveillance with serial neck ultrasounds every 6 months

Correct Answer:

Left thyroid lobectomy

Question 2

A 62-year-old postmenopausal female presents with recurrent nephrolithiasis, fatigue, and diffuse bone pain. Her serum calcium is 2.92 mmol/L (normal: 2.15-2.55 mmol/L), serum phosphate is 0.72 mmol/L (normal: 0.8-1.5 mmol/L), and intact parathyroid hormone (PTH) is elevated at 145 pg/mL (normal: 10-65 pg/mL). A dual-energy X-ray absorptiometry (DEXA) scan shows a T-score of -2.8 at the femoral neck. What is the most sensitive and widely used localizing study to plan a minimally invasive parathyroidectomy?

Technetium-99m sestamibi scintigraphy combined with SPECT/CT High-resolution 4D-CT scan of the neck High-resolution ultrasound of the neck Selective venous sampling for PTH

Correct Answer:

Technetium-99m sestamibi scintigraphy combined with SPECT/CT

Question 3

A 48-year-old female undergoes a left lumpectomy and sentinel lymph node biopsy for an invasive ductal carcinoma. Pathology reveals a 2.2 cm tumor with clear surgical margins. Immunohistochemistry shows Estrogen Receptor (ER) negative, Progesterone Receptor (PR) negative, and Human Epidermal Growth Factor Receptor 2 (HER2) strongly positive (3+ by immunohistochemistry). The sentinel node biopsy is negative for metastatic disease (0/2 nodes). What adjuvant systemic therapy regimen is most appropriate for this patient?

Adjuvant chemotherapy combined with Trastuzumab followed by Trastuzumab monotherapy for a total of 1 year Adjuvant endocrine therapy with Tamoxifen for 5 years Adjuvant Trastuzumab emtansine (T-DM1) monotherapy for 14 cycles No adjuvant systemic therapy is required given the lymph node-negative status

Correct Answer:

Adjuvant chemotherapy combined with Trastuzumab followed by Trastuzumab monotherapy for a total of 1 year

Question 4

A 58-year-old male presents with progressive dysphagia, early satiety, and a weight loss of 8 kg over the past 3 months. Upper gastrointestinal endoscopy reveals a large, ulcerated mass in the gastric body. Biopsies confirm gastric adenocarcinoma. What is the most appropriate next step to assess for distant metastases and determine the initial management strategy?

Contrast-enhanced CT scan of the chest, abdomen, and pelvis Positron emission tomography (PET/CT) scan Diagnostic laparoscopy with peritoneal washing Endoscopic ultrasound (EUS) of the upper GI tract

Correct Answer:

Contrast-enhanced CT scan of the chest, abdomen, and pelvis

Question 5

A 45-year-old diabetic female presents with a 24-hour history of severe, constant right upper quadrant pain, radiating to the right scapula, accompanied by nausea and low-grade fever (37.9°C). On examination, she has marked tenderness in the right upper quadrant with a positive Murphy's sign. Lab results show a white blood cell count of 14.8 x 10^9/L and mildly elevated C-reactive protein. Transabdominal ultrasound reveals a distended gallbladder with a thickened wall (5 mm), pericholecystic fluid, and multiple gallstones, with one impacted in the gallbladder neck. What is the most appropriate management?

Early laparoscopic cholecystectomy within 72 hours of symptom onset Intravenous antibiotics and bowel rest, followed by elective interval cholecystectomy in 6 to 8 weeks Emergent percutaneous transhepatic cholecystostomy tube placement Endoscopic retrograde cholangiopancreatography (ERCP) with biliary stenting

Correct Answer:

Early laparoscopic cholecystectomy within 72 hours of symptom onset

Question 1

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Prepare with the CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam practice quiz. This question bank includes 100 questions covering year-old, male, examination, pain, and presents. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, male, examination, pain, and presents. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

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CSHK Part 2 EMQ Practice Questions - MHKICBSC Part 2 - Clinical Problem Solving EMQ Exam

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