Carcinoma Breast and Pregnancy

Q) 30 year old female in 2nd trimester of pregnancy has a 2 cm Ca breast with no axillary lymph node What should be the management?

a) Terminate Pregnancy and MRM

b) Wait till completion of pregnancy and MRM

c) Lumpectomy plus chemo

d) Lumpectomy + axillary dissection + chemo

Breast

Neet SS 22 paper

Ans d

Lumpectomy plus axillary dissection + chemo

Axillary dissection is ideally after SLNB

Radiotherapy can be given after termination of pregnancy

Hormonal therapy is also given after pregnancy if required

No need to terminate pregnancy

Bailey 28th page 942

Anal malformation

Q) Newborn with abdominal distension on day 2, not passed meconium. There is absent anal orifice. WHat is the next step? # NEET SS 22 

a) Cross table X ray

b) Invertogram

c) Anoplasty

d) Sigmoid colostomy

Ans a) Cross table X ray

1st step in such cases Rule out congenital abnormalities of spine, sacrum , kidney heart etc

2nd step Cross table x ray  If it shows Perineal fistula do ANoplasty, If x ray shows rectal gas below coccyx do PSA RP with or without colostomy, If it shows gas above coccyx with associated defects do colostomy

Table 67.14 Sabiston 

 

Hepatic adenoma

Q Which of the following statement about hepatic adenoma is CORRECT?

a) It is more common in males

b) Ct shows a central stellate scar

c) Associated with cirrhotic liver

d) Risk of rupture and fatal hemorrhage is present 

Giving a clinical scenario of Hepatic Adenoma 

A 37 year old lady presents with right upper quadrant pain and nausea. She is otherwise well and her only medical therapy is the oral contraceptive pill which she has taken for many years with no ill effects. Her liver function tests and serum alpha feto protein are normal. An ultrasound examination demonstrates a 4cm non encapsulated lesion in the right lobe of the liver which has a mixed echogenicity and heterogeneous texture.

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