Thyroid Questions

Q) Which of the following thyroid cancers do not take up radio active iodine

a) Medullary carcinoma thyroid

b) Papillary  carcinoma

c) Follicular carcinoma

d) Hurthle cell carcinoma

Free Answer

a - Medullary carcinoma

Medullary carcinoma of the thyroid is a tumor that arises from the C cells ie the parafollicular cells and not from cells of thyroid follicles.

These are not TSH dependent and hence do not take up radioactive iodine

Hurthle cell carcinoma is a variation of follicular carcinoma only.

In these tumors lymph node involvement is about 60%

Bailey page 769

 

Atrial Septal Defect

 In exams like DNB SS questions on ASD and VSD are common. Most cardiac surgery questions are here

Q) Most common ASD is 

a) Ostium Primum

b) Ostium Secundum

C) Sinus Venosus

d) All are equal

Answer 

b

Ostium Secundum

 

ASDs
Common defects
Ostium secundum: fossa ovalis defect (approximately 70 per cent of ASDs)
Ostium primum: atrioventricular septal defect (approx imately 20 per cent of ASDs)
Sinus venosus defect: often associated with anomalous pulmonary venous drainage (approximately 10 per cent of ASDs)
Patent foramen ovale: common in isolation, usually no left-to-right shunt (not strictly an ASD)

Rarer defects
Inferior vena cava defects: a low sinus venosus defect and may allow shunting of blood into the left atrium
Coronary sinus septal defect: also known as unroofed coronary sinus with the left superior vena cava draining to the left atrium as part of a more complex lesion

 

Parenteral nutrition

Q) IV fluid of choice to increases calories to provide parenteral nutrition  by peripheral route is:

a) DNS

b) Lipid Emulsions

c) Arginine in DNS

d) 25% dextrose

Answer (FREE)  b

Lipid Emulsions can be given by peripheral route. They are the highest source of energy and calories.  25% dextrose, although a good source of energy has high concentration of glucose which can cause thrombophelebitis.

DNS will provide just basic calories and will not cause any increase in calorie intake.

Addition of arginine, which is an amino acid will not increase the energy intake.

 

 

Duodenal atresia

Question on Duodenal atresia was asked in AIIMS 2017 in April

Q) An infant presents with duodenal atresia. Which of the following is true about this condition?

a) It is the most common GI atresia

b) It presents soon after birth with non bilious vomiting

c) Pre natal detection of duodenal atresia is common

d) Gastro jejunostomy is the procedure of choice to bypass the obstruction

Answer (free) 

C- Commonly detected in the pre natal ultrasound

Duodenal atresia is seen in 1:5000 live births and most common atresia is jejunoileal (1in 2000). It is associated with lot of other congenital malformations like Down's,  prematurity, biliary atresia etc.

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