Multiple Choice Questions (MCQ)

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Category: Cardiology--->Genetics, Lipids And Tumours
Page: 6

Question 26#Print Question

You have been asked to see a 56-year-old male inpatient who presented 2 months previously with progressive shortness of breath and fever. He was discovered to have a large pericardial effusion which was tapped and was found to contain poorly differentiated cells. Subsequent CT imaging showed him to have widespread pulmonary metastasis with a 3 cm lobulated mass arising from and projecting into the right atrium, compressing the inferior vena cava. Biopsy tissue was obtained and confirms angiosarcoma.

Which one of the following statements is true?

a. 2% of atrial myxoma can metastasize, typically to the lung
b. The peak age of presentation is the sixth decade
c. Angiosarcoma is typically symptomatic early in the disease process
d. Angiosarcoma is most common in the left ventricle, arising from around the insertion of the posterior mitral valve
e. Tumours showing mutations of the TP53 gene have been described

Question 27#Print Question

A 47-year-old female with known metastatic breast carcinoma has been admitted to the oncology ward for investigation of increasing shortness of breath. A pulmonary embolism was suspected on clinical grounds and a CT pulmonary angiogram was performed. It failed to demonstrate any pulmonary emboli but did show a 2.2 cm global pericardial effusion. On the basis of this, a transthoracic echocardiogram was performed which ruled out tamponade.

Which one of the following statements is correct?

a. Breast carcinoma typically metastasizes to the pericardium but significant pericardial effusions are rare
b. Lymphatic spread is more likely to metastasize to the myocardium, whereas haematological spread usually metastasizes to the pericardium
c. Cardiac spread is unusual in malignant melanoma
d. A constrictive picture can persist following pericardiocentesis
e. Valvular metastases are a common finding in disseminated metastatic disease

Question 28#Print Question

Regarding the prevalence of cardiac tumours:

a. The secondary to primary ratio is approximately 10:1
b. Papillary fibroelastoma is the third most common of the primary benign cardiac tumours, behind myxoma and cardiac fibroma
c. Lung carcimona is the most common metastatic cardiac tumour
d. Although typically thought of as benign, 2% of atrial myxomas metastasize
e. A male predominance of 1.4:1 is seen among the benign primary cardiac tumours

Question 29#Print Question

A 57-year-old male patient is discovered to have an echogenic mass arising from the insertion point of the anterior mitral valve leaflet. He undergoes uneventful surgical resection. The mass is described as reddish and nodular. Frequent areas of calcification are identified by naked eye. Histologically, it is composed of oval CD34, CD31, and factor VIII positive cells consistent with epithelioid haemangioendothelioma. 

Which one of the following five statements regarding this tumour is true?

a. It is rare in females, with a male:female ratio of 20:1
b. It is usually presented by the presence of metastases
c. It typically occurs from the intra-atrial septum
d. The differential diagnosis of adenocarcinoma is excluded by the presence of CD31, CD34, and factor VIII positive cells
e. It often presents with complete heart block

Category: Cardiology--->Genetics, Lipids And Tumours
Page: 6 of 6