natural history breast cancer

Q. True about breast cancer is?

a) Doubling time of breast tumor is 1 month

b) Skip metastasis in level iii lymph nodes is common

c) Lungs are commonly involved by direct invasion

d) Dimpling of skin is due to shortening of cooper's ligaments

Ans

Hyperbaric oxygen

Q)  Hyperbaric oxygen therapy in radiation proctitis all are true except
A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis
B. Oxygen increases the growth of residual tumor and hence tumor should be completely
resected
C. Complications include Parkinsonism, barotrauma
D. Usually 30-40 sessions are required for treatment


 a

Hyperbaric oxygen overcomes chronic tissue hypoxia in radiation damaged tissues and with repeated sessions induces growth of regenerative tissue, capillaries, and epithelium. Successful therapy may take multiple sessions.
 18 to 60 treatments

Ref Shackelford page 2211

HBO treatments for hypoxic wounds are usually delivered at 1.9 to 2.5 atm

for sessions of 90 to 120 minutes each. Treatments are given once daily, five to six times per week and should be given as an adjunct to surgical or medical therapies. Clinical evidence of wound improvement should be noted after 15 to 20 treatments.

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Gastric Lymphoma

Q) Gastric Lymphomas false is 

a) The optimal treatment for lymphomas unresponsive to initial H. pylori antibiotic treatment remains unclear and includes the chemotherapy, radiotherapy, surgical resection, etc

b) Almost all MALT-lymphoma may regress with conventional H. pylori treatment. 

c) Need for surgery in lymphoma is mainly for its complication

d) Risk of perforation is over estimated in the literature

Answer

GIST stomach

Q) Antral GIST 1cm incidentally found on UGIE. True regarding its management
a) Surgical resection 
b) Endoscopic resection
c) Resection required if  EUS suggests irregular border with cystic spaces
d) Endoscopic surveillance, if size >2cm then resect

 

Ans 

c

GIST more than 2 cm should undergo resection. Management of GIST less than 2 cm  is dependent on weather high risk features are present on EUS. 

The high risk features are 

1. Irrgeular margins

2. Heterogenous architecture

3. Ulcers

Management of low risk GIST less than 2 cm is  surveillance every 6 months

 

 

 

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