Intra Op Ultrasound vs Lap Ultrasound

Q) Which is true regarding comparison of Lap intra op Ultrasound with traditional Intra op Ultrasound in liver surgery?

a) It is more sensitive

b) It is more specific

c) More time consuming

d) Anatomy better delineated with IOUS

Ans c

The procedure can be time consuming in patients with dense adhesions.

Sensitivity and Specificity are same

Anatomy seen equally with both

IUS has been shown to successfully locate insulinomas in 85% of cases. When combined with intraoperative palpation, the detection rate can be in the 95 to 100% range. IUS was shown to detect 83% of gastrinomas in one series, including 100% of intrapancreatic lesions.

 

MEN 2A

Q)  MEN 2A also known as
A. Sipple syndrome
B. Wermer syndrome

C) Werner syndrome

Ans a

Sipple and Steiner described the association of thyroid cancer with pheochromocytoma and hyperparathyroidism, respectively

Bailey says MTC combined with phaeochromocytoma alone is called Sipple’s syndrome (page 856)

MEN2A is characterized by MTC,  pheochromocytoma (50%) and hyperparathyroidism (25%).

Associated with mutations in codon 634 in the RET proto-oncogene.

Wermer-  MEN 1 is characterised by the triad of tumours in the anterior pituitary gland, mostly presenting as prolactinomas
or non-functioning tumours, hyperplasia of the parathyroids causing primary hyperparathyroidism (pHPT) and pancreaticoduodenal endocrine tumours (PETs)

Patients with MEN 2B do not develop pHPT

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