Primary Hyperparathyroidism

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Q) Which is not a feature of primary hyperthyroidism?

a) Increase Parathormone

b) Increase Calcium

c) Decreased phosphate

d) Dystrophic calcification

Ans d 

Clinical features of Hyperparathyroidism are

  1. Subperiosteal bone erosions
  2. Primary Hyperthyroidism  is defined as hypercalcaemia in the presence of an unsuppressed and therefore relatively, or absolutely, elevated PTH level. Elevated calcium and elevated PTH are important  in diagnosis of PTH
  3. The presence of kidney stones remains the most common clinical manifestation of symptomatic PHPT.
  4. It is associated with a low serum phosphate in the setting of normal creatinine and vitamin D levels

Ref Bailey and Love Page 826

 Some useful questions can be bought here  MCQs and EMQs in Surgery: A Bailey & Love Revision Guide, Second Edition 

Some uncommon disorders associated with hyperparathyroidism include

peptic ulcers, pancreatitis, and bone disease

central nervous system symptoms 


Causes of Primary Hyperparathyroidism are

  1. Parathyroid Adenoma -75% (can be localised by Sestamibi scanning)

Management of primary hyperparathyroidism

Patients with symptomatic primary hyperparathyroidism as manifested by kidney stones, renal dysfunction, or osteoporosis should undergo parathyroidectomy.

If the patient is asymptomatic and detected to have high parathyroid levels then surgery is done only if

  1. age is less than 50
  2. very high excretion of calcium in urine
  3. low creatinine clearance
  4. kidney stones
  5. high serum calcium

 

Colorectal Hepatic metastasis

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Q) Colo Rectal Cancer  with hepatic metastasis. All are  bad prognostic  factors  except,..
A) CEA>100
B) > 5cm size

C )bilobar
D) mets occurring <12 months

TIPS

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Q) Absolute contraindication to TIPS are all except

a)PVT

b) Multiple hepatic cysts

c) Chronic heart falure

d) Severe TR

FAP

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Q) False regarding FAP

a) Mean age of development of cancer is 40

b)50% population develop gastric polyp and duodenal adenoma

c) 2nd most common cause of death is desmoid

d) 

AIIMS November MCQs

Parotid tumors (AIIMS ONCO 2019)

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Q7. 70 year old smoker, with right parotid swelling, histopath- lymphocytic  stroma with oncocytes and proteinaceous background

What is the diagnosis

a) Oncocytoma

b) Warthin tumor

c) Pleomorphic adenoma

d) Mucoepidermoid