Q) A 73 year male, old heavy smoker presents with haemoptysis. On examination he is cachectic and shows evidence of clubbing. Imaging shows a main bronchial tumour with massive mediastinal lymphadenopathy together with widespread visceral metastases. Which of the following variant is likely in him? ( Theme from mock test 12- 24)
a) Adenocarcinoma B. Small cell lung cancer C. Large cell lung cancer D. Squamous cell carcinoma
Ans b
Small cell lung cancer Small cell carcinoma is associated with disseminated disease at presentation in the majority of cases. Most cases occur in the main airways and paraneoplastic features are common
Adenocarcinomas are the most common tumour type present in never smokers. They are usually located at the periphery.
Squamous cell carcinomas are reported to be more slow growing and are typically centrally located
Q) 40 year old lady was on anti thyroid medications which she stopped for 2 weeks. She presented in emergency with high grade fever and hypotension. ( Thyroid Storm) .What is not a part of further management?
This is Thyroid storm. radio active iodine is a predisposing factor and not part of management
Predisposing factors for thyroid storm are
Cessation of anti thyroid medications
Infection
Thyroid or non thyroid surgery in untreated thyrotoxicosis
Trauma in patients with untreated thyrotoxicosis.
Amiodarone
Iodinated contrast agents
RAI therapy
Management is
Beta blockers
Oxygen and hemodynamic support
IV Lugol iodine
PTU
Corticosteroids
The symptoms of thyroid storm are more intense and severe than typical hyperthyroidism symptoms. They can include severe fever, rapid and irregular heartbeat (tachycardia), elevated blood pressure, restlessness, confusion, agitation, tremors, excessive sweating, nausea, vomiting, diarrhea, dehydration, and in severe cases, even delirium, seizures, and coma.
Q) Patient with 2cm lung nodule , biopsy proven adenocarcinoma. CT shows hilar lymph node 1.5cm and left pleural effusion. Pleural fluid cytology is positive for malignant cells. What is the stage?
Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase
Q) 50-year-old male with 1 x1 cm mass in the Peripheral part of the right lung was resected with clear margins. histopathology was suggestive of Adenocarcinoma and there was no lymph nodes positive what will be the further management A. Observe B. Adjuvant RT C. Adjuvant CT D. EGFR testing