Aiims onco surgery 2019 Questions 1-20

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Q21-40 AIIMS onco


Q1)  RHOMboid flap is a type of

A) rotation flap
B) free flap
C) transposition

Ans - c


Q2 ) Blue round cell is seen in all except
A) wilms
B) osteosarcoma
C) Ewing
D) neuroblastoma

Ans b

Small cell osteosarcoma is a dd of small round blue cell, rest all are round cell tumours.


Q3) Shamblin classification is for

Ans Carotid body tumor


Q4. Anti-inflammatory interleukin

Il 10



Q5) Recurrent lymph node in neck after surgery for  differentiated thyroid cancer. How to proceed
a) Surgery again
B) Radio iodine
C) EBRt



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Q6. Nerve injury leading to winging of scapula

A ) The nerve that innervates this muscle is the long thoracic nerve. Sometimes, this nerve can be damaged or impinged, leading to malfunction of the serratus anterior muscle.


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


Q8) Which is not a feature of primary hyperthyroidism?

a) Increase PTH

b) Increase Calcium

c) Decreased phosphate

d) Dystrophic calcification

Ans d 

In Hyperparathyroidism 

  1. Subperiosteal bone erosions
  2. PHPT is defined as hypercalcaemia in the presence of an unsuppressed and therefore relatively, or absolutely, elevated PTH level.
  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 page 826


Q9) 70 year old post whipple's received gemcitabine. Now he has weight loss, decreased appetite and diarrhea with bulky stools

What has to be done next?

a) Rule out metastasis

b) Pancreatic Enzyme supplementation

c) X ray abdomen for ruling out intestinal obstruction

d) Hold Chemotherapy


Q10) Imatinab does not target

a) PDGFRA

b) EGFR

c) cKIT

d) BCR abl


Q11) Prophylactic thyroidectomy is done for 

a) Medullary Carcinoma thyroid

b) Anaplastic

c) Lymphoma

d) Papillary Ca thyroid

ans a) Medullary carcinoma thyroid

Hereditary MTC is identified through  germline RET mutation  

 When to do Prophylactic thyroidectomy

 

Children identified to harbor the ATA highest-risk RET mutations (i.e., Met918Thr) are recommended to undergo total thyroidectomy in the first year of life.

In children with ATA high-risk mutations (i.e., codon Cys634 and Ala883Phe mutations), prophylactic thyroidectomy is typically recommended before 5 years of age, with the exact timing based on annual clinical examination, neck ultrasound, and serum calcitonin levels starting from the age of 3 years

Children with ATA moderate-risk RETmutations, the timing of prophylactic thyroidectomy should be based on the findings of clinical examination, neck ultrasound, and serum calcitonin concentrations commencing at age 5 years. 

Once calcitonin levels are greater than 30 pg/mL, the likelihood of nodal metastases increases, and this will often necessitate central node dissection, which is associated with increased operative morbidity and a reduction in duration of long-term remission. 


Q12. Contrast used in MRI 

A) Gadolinium

Others are gadopentetate dimeglumine (gadolinium diethylene triamine pentaacetic acid (Gd-DTPA), gadodiamide (gadolinium diethylene triamine penta-acetic acid bis-methylamide (GD-DTPA-BMA), Gadoteridol (Gadolinium-1,4,7- tris (carboxymethyl)-10-(2' hydroxypropyl)-1, 4, 7 -10-tetraazacyclododecane (Gd-HPD03A]), gadoterate meglumine (gadolinium-tetraazacyclododecane tetra acetic acid (Gd-DOTA), Dotarem®, gadobenate dimeglumine; gadobutrol.


Q13 ) Thoracodorsal artery  branch of 

Ans Subscapular Thoracodorsal artery bramch of subscapular artery


Q14) Radical Mastectomy given by

Halstead


Q15) Not a component of VON Nuys Prognostic index

a) Age

b) Surgical margin

c) Size of tumor

d)Nodal status


Q16) Most common thyroid cancer

ans ) Papillary 


Q17) Prophylactic thyroidectomy done for 

Ans ) MEN 2B


Q18) Infraclavicular lymph nodes in axilla

a) level I 

b) level II

c) Level III


Q19 Not a boundary of safety triangle
A) Pectoralis major
B) Pectoralis minor
C) L. Dorsi



Q20 ) Not a malignant polyp

a) Juvenile polyp

b) Juvenile polyposis syndrome (JPS) 

c) Peutz jeghers

d) FAP

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