Endocrine Surgery

55 recalled  unanswered questions from this year AIIMS Endocrine 2019

1st 10 are free to see after that only premium logged in members have access.

 

Q1.Tumor suppressor gene involved in thyroid tumorigenesis
A. Braf
B. NTRK1
C.PTEN
4. RET

2.Indication to offer total thyroidectomy in Bethesda 4 category FNA all except
A. Multiple nodules on opposite side
B. History of radiation
C. Nodule more than 4 cm
D. Male gender

3.Blood supply of superior parathyroid
A. Superior thyroid artery
B. Inferior thyroid artery
C. Common carotid artery
D. Internal carotid artery

4) 21 year old boy with severe symptoms of bone pain and fractures, high PTH and calcium on MIBI and 4D CT found to have lesion in the left posterior mediastinum. Lesion most likely is
A. Intrathymic parathyroid adenoma
B. Inferior parathyroid adenoma
C. Superior parathyroid adenoma
D. 

5.30 year old male underwent total thyroidectomy + mrnd, hpe with papillary carcinoma thyroid, no lvi or extracapsular invasion, lymphnode with metastasis. TNM Stage of cancer
A. Stage 2
B. Stage 1
C. Stage 3
D. Stage 4

6.All are features of PTC on FNA except
A. Psammoma bodies
B. Nuclear grooving
C. Bizzare cells
D. Orphan anni eye nucleus
7.All are features of Wermer synd except
A. Parathyroid  adenoma
B. Mucosal neuromas
C. Pheochromocytoma
D. Pituitary adenoma

8.Intra op success of parathyroidectomy for adenoma is achieved if IOPTH drops to
A. 10 %
B.50%
C. 30%
D.20%

9.Half Life of PTH 
A. 3-5msec
B.3-5 sec
C.20 min
D. 2-3 minutes
10.Absolute Indication to do thyroid scintigraphy
A. Graves disease
B. Toxic MNG
C. Solitary toxic nodule

D. Hashimoto thyroiditis


11.Absolute contraindication to BCS

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15.40 year old with CKD stage 3, 6months later develops stress fractures, pTH 300, Deca bone scan with z and t values of -2.5. patient is suffering from
A. Tertiary hyperparathyroidism
B. Secondary hyperparathyroidism
C.Primary hyperparathyroidism
16.All are treatment for hypercalcaemic crisis except
A. Cinacalcet
B.Bisphosphanate
C. Loop diuretic
D. Glucocorticoid
17.All are screening test for adrenal incidentals except
A. Overnight dexa suppression
B. High dose dexa suppression
C. Renin Aldosterone ratio
D. 24hours urine metanephrines
18.30 year old patient suspected to have Addison's disease. 8am Cortisol is borderline low. Next step in evaluation
A. Measure sex hormones and aldosterone
B. Measure 8am ACTH
C. Do dexa suppression test
D. Do ACTH stimulation test 
19.Multiparous women completed family with recurrent periductal mastitis and on multiple course of antibiotics comes with recurrent mastitis to you. Tuberculosis was rules out. What will you do
A. Microdocotomy
B. Radical duct excision
C. Antibiotics
D. Abscess drainage
20.Lymphatic drainage of larynx
A. Level 1,2,3,4,5,6
B. Level 2,3,4,6
C. Level 2,3,4
D. Level 
21.Cernea classification is for
A. Internal branch of superior laryngeal nerve
B. External branch of superior laryngeal nerve
C. Recurrent laryngeal nerve
D. 
22.Other than breast cancer where is SLNB used
A. Colon cancer
B. Penile cancer
C. Rectal cancer
23.SLNB use is most established in 
A. Breast cancer
B. Penile cancer
C. Melanoma
D.inflammatory breast cancer 
24.Worldwide most commonly used reconstruction method after mastectomy is
A. TRAM flap
B. LD flap
C. Breast implants
D. Free flaps
25.Rotters node is present in between
A. Pec major and minor
B. Pec major and serratus anterior
C. Deep to pec minor
D. 
26.What can be sacrificed during axillary dissection
A. Nerve of Bell
B. Thoracodorsal vein
C. Lateral thoracic vein
D. Thoracodorsal nerve
27.collagen seen most commonly in first 48hours of wound healing
A. Type I
B.type III
C Type IV
D. Type II
28.Breast tissue is present between
A. Dermis and pec fascia
B  subcutaneous fat and pec muscle
C. Pec major and chest wall
D.
29.USg finding most sensitive to diagnose thyroid malignancy(already on your site)
30.Pancreas develop during 
A. Week 1
B. Week 5
C. Week 3
D.week 6
31.All are false regarding BRCA 1 breasts cancer except
A. Hormone receptor positive
B. Can develop DCIS
C. Young age of onset
D. Aggressive tumor histology
32.Invasive breast cancer among following is 
A. Comedo
B. Colloid
C.Papillary
D. Tubular
33.ECG changes in hypokalemia are all except
A.Flat T wave
B.Prominent U wave
C.Prolonged PR interval
D.Prolonged QT interval
34.False about PNET (not very sure about the options. There was one more question on MEN 1)
A. They arise in different locations and are different in mode of onset and function
B. In Men 1 most common site of insulinoma is pancreas transplant slept cells and gastrinoma is duodenum
C. PNET is the most common lesion in MEN 1
D. 
35. Half Life of I131
A. 12 hours
B. 5 days
C. 7 days
D. 72 hours
36. 80 percent of superior and inferior parathyroid receive blood supply from
Similar options like above
37. Patient with hyperthyroidism (thyrotoxicosis). Biochemical picture would be
A. Elevated TSH , elevated T4 
B. Elevated TSH, depressed T4
C. Depressed TSH , depressed T4
D. Depressed TSH, elevated T4
38. Treatment of Plummers disease before preparing for surgery all except
A. Carbimazole
B. Lugol's iodine
C. Steroid
D. I131 ablation 
39. False is
A. On usg parathyroid adenoma appears hyperechoic 
B. 4d CT 4th dimension is time
C. 4d CT is less sensitive and specific than usg in parathyroid 
D. 4d CT gives anatomical and functional information 
40. Which is evidence based inthe treatment of benign breasts disease
A. NSAIDS
B. Vit E
C. Primrose oil
D. Centchroman
41.35year old lady with no high risk features asymptomatic on mammogram have birads 2 lesion.  What is the next line of management.
A. Mammography after 2 years
B. Follow up after 6 months
C. 
42. After intraductal papilloma what is the most common cause of blood discharge form the nipple
A. Paget's disease
B. Periductal mastitis
C.IDC
43. Lethal triad includes all except
A. Hypothermia
B. Hypoxia
C. Coagulopathy
D. Acidosis
44. Young lady diagnosed with intestinal tuberculosis. Lab values total calcium 6.8mg/dl, albumin 1.5 gm/dl, creat 1.5. what's her corrected calcium
A. 8.4mg/
B. 9.2
C. 10.10
D. 9.8
45.50 y male admitted in icu for 2 weeks . Weight currently is 48 kgs. His wife claims his pre admission weight to be 60 kgs. What is percentage loss of weight 
A. 25
B. 20
C. 15
D. 30
46. All are true regarding right renal vein except(weird question!)
A. Drain into right IVC
B. Can drain into right gonadal vein
C. Drain into right adrenal vein
D. Drain into right phrenic vein
47. Best statistical method to prognosticate 5 year survival in cancer
A. ANOVA
B. Kaplan Meir
C. Log regression 
D. Cox analysis
48. In ARDS what should be the airway pressure on the ventilator ( not sure about the question)
A. 6 cm of water
B.8 cm of water
C. 10 cm of water 
49. Which is false regarding sensitivity screening in breast 
A. Clinical examination 18 %(CI range was given)
B. Usg 60%(CI...)
C. MRI 
D. Mammogram 
50.False regarding Birads
A. 0 is normal
B.2 is benign
C. 3..
D. 
51. In the era of minimal invasive thyroidectomy , which is not standard of care for proven malignancy
A. Subtotal thyroidectomy
B. Nodulectomy
C. Lobectomy plus isthusmectomy
D. Total thyroidectomy
52.not a contraindication for transaxillary minimally invasive thyroidectomy 
A. Lymphnodal Mets
B. Age more than 40
C. Previous neck irradiation
D. Previous neck surgery 
52. Regarding PNET false is 
A. Frozen section done intraop to look for malignancy 
B. Fnac some pre op to establish diagnosis
C.Malignancy is seen in 10 percent insulinoma and 90 percent glucagonoma and somatostatinoma
53.Charles operation is associated with
A. Venous ulcer
B . Lymphatic disease
C. Arterial disease
54. Earliest improvement seen within weeks of parathyroid adenoma excision in
A. Renal function 
B. Bone density
C. Weight 
55. Middle aged lady with right breast lump of size ... And mobile axillary nodes. Core biopsy of lump shows IDC ER PR 7/8 and 8/8
 Allred score. Her 2 NEU Equivocal. What's the next plan..
A. Upfront surgery
B. Start chemotherapy
C Fluorescence Insitu hybridisation for Her2
D. Start on Herceptin
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