AIIMS Endocrine MCH entrance exam 2016-2017 questions

Exact choices are given only when remembered

AIIMS Breast and Endocrine MCH questions

Q1) Toboggan technique is used in

A) Substernal goitre.

It is a technique employed to prevent injury to recurrent laryngeal nerve during manipulation. Toboggan is a sled like transport used in snow.

Toboggan

Main operative issues

Isthmus of the thyroid is liberated 1st. It is separated from the anterior part of trachea and transected.
Middle thyroid vein and superior pole vessels are then divided
Recurrent laryngeal nerve is identified at its entry into the larynx
Dissection continues between the nerve and posterior part of thyroid from top to bottom

Q2) ACOZOG Z0011 trial

A)It is a prospective, randomized, multicenter trial that compared the survival and locoregional recurrence rates after complete axillary lymph node dissection (ALND) versus sentinel node biopsy (SNB) alone in women with a positive sentinel node in an effort to avoid the complications associated with ALND.

See the results of this trial here

Q3) Milan trial radical mastectomy Vs MRM

Q4) Structure preserved in modified radical mastectomy

A) Nerve of bell

B) Thoracodorsal vein

C) Lateral thoracic vein

Answer All three have to be preserved.

An excellent account of MRM Can be seen here

Questions on Breast Surgery

Q5) One of the following is not seen in Cushing syndrome

a) High Blood sugar

b) Pretibial myxedema

c) Moon facies

d) striae

Answer b Pretibial Myxedema

Symptoms and signs of Cushing's syndrome

Symptom or sign	Reported incidence, percent
Centripetal obesity	79 to 97
Facial plethora	50 to 94
Glucose intolerance	39 to 90
Weakness, proximal myopathy	29 to 90
Hypertension	74 to 87
Psychological changes	31 to 86
Easy bruisability	23 to 84
Hirsutism	64 to 81
Oligomenorrhea or amenorrhea	55 to 80
Impotence	55 to 80
Acne, oily skin	26 to 80
Abdominal striae	51 to 71
Ankle edema	28 to 60
Backache, vertebral collapse, fracture	40 to 50
Polydipsia, polyuria	25 to 44
Renal calculi	15 to 19
Hyperpigmentation	4 to 16
Headache	0 to 47
Exophthalmos	0 to 33
Tinea versicolor infection	0 to 30
Abdominal pain	0 to 21

Q6) Functional incidentaloma

Ans

10-15% of incidentalomas are functional ie secrete a hormone
Excessive gluco corticoid secretion is the most common - Subclinical Cushing
Pheochromocytoma
Hyperaldosteronoma
All should undergo adrenalectomy

Q7) Codon directed surgery in thyroid cancer is done for

a) Well differentiated adenocarcinoma

b) Anaplastic carcinoma

C) Medullary carcinoms

Answer C ) Medullary Carcinoma.

In MEN 2B, codon directed ret mutations are identified and prophylactic thyroidectomy is carried out.

Q8) Sentinel lymph node biopsy in breast

Summary on sentinel lymph node biopsy

Lymphatic mapping is based upon the concept that one or more nodes are the first to be involved with metastatic disease within a given lymph node basin. If these sentinel lymph nodes are not involved, the entire basin should be free of tumor.
Clinically if there are no lymphnodes in axilla, sentinel lymph node biopsy can help prevent unnecessary axillary lymph node dissections
No role in node positive axilla

Questions 9-20 (Premium)