Items 615–616
A 65-year-old man who smokes two packs per day has left chest wall pain. His medical history is otherwise unremarkable. A chest x-ray reveals a mass adjacent to the chest wall with evidence of rib destruction in the 6th rib. Percutaneous needle biopsy reveals squamous cell carcinoma.
615. Prethoracotomy evaluation should include all of the following EXCEPT
bronchoscopy
dobutamine stress echocardiography
anterior mediastinotomy
thoracoabdominal computed tomography
pulmonary function testing
616. Which of the following would most negatively influence this patient’s survival prognosis?
Mass size greater than 6 cm
Requirement for resection of more than one rib
A single positive mediastinal node
His squamous histology
Failure to give postoperative adjuvant radiotherapy
For the incomplete statement in Item 615, select the one completion that is BEST, and for the question in Item 616, select the BEST answer.
For the critique of items 615 and 616 see page 148.
Footnotes
(Reproduced by permission from SESAP ’96–’98 Syllabus Surgical Education and Self-Assessment Program, Volume 2, 9th edition. For enrolment in the Surgical Education and Self-Assessment Program, please apply to the American College of Surgeons, 55 East Erie St., Chicago, IL 60611, USA.)