Lymph node spread in larynx cancer

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Q) Maximum chances of lymph node spread is in among laryngeal sub site is 

A Fossa of Rosenmuller

B Supraglotic

C Subglottic

D Glottis

GNRH Agonists

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Q) GNRH agonist is
A. Buserelin
B. Anastrazole,
C. Exemestane,
D. letrozole

NO neck

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Q) Treatment of No neck in head and neck cancers is

a) Elective lymph node dissection

b) Modified radical lymph node dissection

c) Radiotherapy

d) Chemotherapy

Free Read 

In patients with a clinically negative neck, the incidence of occult metastases varies with the site, size and thickness of the primary tumour.  The high rate of occult cervical metastases (> 20%) in tumours of the lower part of the oral cavity is the main argument in favour of elective treatment of the neck even if it is N0. Several clinical and pathological studies have demonstrated that the pattern of metastatic lymph node metastases occurs in a predictable fashion in patients with oral and oropharyngeal carcinoma.

The risk of metastases increases as one progresses from the anterior to posterior part of the upper aero-digestive tract; from lip (10%) progressing along the tongue (25%), gum (30%), floor of mouth (40%), oropharynx (55%) to hypopharynx (65%). Endophytic tumors, poorly differentiated tumors, and tumors with a greater thickness (tongue and floor of mouth) are more likely to have metastases

IHC of Anal Adenocarcinoma

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Q) IHC staining in Adeno- Carcinoma Anal canal is 

a)  CK 20 +ve, CK 7-ve

b) CK 20 - , CK 7+ve

c) both positive

d) Both negative


 

Anti rejection drugs

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Q) Anti Rejection medicine which also prevents tumor recurrence? MCH Questions ...

a) M tor inhibitors

b) IL2 blockers

c) Steroids

d) Azathioprine

Ans a) mtor inhibitors 

One Question is always asked about anti rejection medicines, Salient points i am enumerating

  1. Three drug regimen is classic includes IL2 blocker, Mycophenolate and steroids which are tapered . IL 2 blocker  Tacrolimus is used more than Cyclosporine ( cyclosporine less used now). IL2 blocker side effects are hirsutism, hyperkalemia, gum hypertrophy etc) 
  2. Mycophenolate is preferred over azathioprine . Both cause fall in cell lines
  3. Steroids have many side effects like weight gain, cataract, infections and are used in tapering dose

M-tor inhibitors are sirolimus and Everolimus which are used when transplant is done for HCC, IT has anti tumor action.

CA Gall Bladder – Post cholecystectomy

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Q) Post Lap Cholecystectomy Gall bladder shows Carcinoma with muscle layer involvement. No lymphatic or blood vessel involvement. Management is?

a) Close observation

b) Radical cholecystectomy

c) Port site excision

d) Adjuvant chemotherapy

Ans ) b

Two field esophagectomy

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Q) WHIch group of lymph nodes not removed in two field Lymph node dissection in lower esophageal Carcinoma

a) Brachiocephalic

b) coeliac

c) left gastric

d) Lower mediastinal

Other Questions on Esophagus

Quesions 26-30

31-40

Q 41-50

Small for Size Syndrome

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Q) Which of the following is  not done in small for size syndrome in liver transplant
a) Splenectomy
b) Hemi porto caval shunt

Pre op Management of carcinoma head of pancreas

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Q ) 45 year old patient with jaundice and itching diagnosed with adenocarcinoma of carcinoma head of pancreas with ECOG 1 , total  bilirubin  10mg% , s calcium  6.3 , sgot sgpt deranged. What is management
a) Whipple
b) Stenting whiple
c) Triple bypass
d) Biopsy stenting Chemo

HVPG

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Q) Normal value of HPVG
a) 2-3mmHg
b) 6-8
c) 10-15
d) 16-20