Round cell tumors

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Q) 12 yr old girl fever diaphyseal femur mass . Round cell tumor. PAS+VE diastase
sensitive AIIMS onco 2020 ( free Answer) 

A. Ewing's sarcoma 
B. Osteosarcoma
C. Chondroblastoma
D. Chondrosarcoma

Ans a) Ewing

On the basis of round cell pattern tumor classification is 

  1. Diffuse round cell pattern

    1. Ewing's sarcoma

    2. Primitive neuroectodermal tumor (PNET)

    3. Merkel cell carcinoma

    4. Embryonal rhabdomyosarcoma (ERMS)

    5. Small cell carcinoma

    6. Lymphoma

    7. Leukemic infiltrate.

  2. Septate or lobulated round cell pattern

    1. Small round cells are divided by fibrous/fibrovascular septate

    2. Ewing's sarcoma

    3. Alveolar rhabdomyosarcoma (ARMS).

According to size of round cell

  1. Small round cell – Squamous cell carcinoma, PNET, Ewing's sarcoma, melanoma, rhabdomyosarcoma (RMS), Langerhans cell disease, lymphoma, adenocarcinoma, neuroendocrine carcinoma, Merkel cell carcinoma, olfactory neuroblastoma

  2. Large round cell – Squamous cell carcinoma, adenocarcinoma, melanoma, RMS, lymphoid tumors, paraganglioma.

CT colonogrpahy

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Q) Which of the following is not an indication of CT colography

a) Obstructed growth to look for  synchronous lesions
b. Can’t do colonoscopy
c. High risk pt with suspicion of ca colon

d)   50 year old with Average risk

Metastatic NET

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Q) Girl with pain upper abdomen.  CT Abdomen shows  4 X 5 cm mass in segment V  and thickening in ileocecal region.
Liver Biopsy shows NET. Next line of management:?
A. Dotanoc
B. Colonoscopy
C. PET CT 
D. Surgery of liver

Causes of SVC syndrome

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Q) Most common cause of  Superior Vena Cava (SVC)  syndrome

A. Non neoplastic
B. Lung ca
C. Breast ca

D) NHL

 

 

Immunosuppression

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Q) False regarding immunosuppresant medicines ?

a. MMF is a reversible inhibitor of IMD-DH
b. Both Cyclosporine  and tacrolimus inhibit NF-KB and its downstream effects
c. Everolimus acts on FKBP12To inhibit Calcineurin activity
d. ALG are more used in pancreas transplant

Ectopic pancreas

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Q) Not a site of ectopic pancreas
a. Esophagus
b. GB
c. Liver
d. Jejunum

Loss of cell Surface antigen

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Q) Loss of cell surface antigen is a feature of 
A. CIS
B. NO RELATION WITH GRADE
C. LOW GRADE TUMOR
D. HIGH GRADE TUMOR

Ans d High grade

The ABO(H) blood group system consists of terminal oligosaccharide antigens carried by glycoproteins or glycolipids in hematopoietic or epithelial cells 

Their biosynthesis is presumed to be controlled by the ABO(H), Se, H, Le, and X blood group genes .

These antigens are present on normal bladder epithelium of secretor individuals but not on some low-grade and early-stage papillary urothelial carcinomas 

Moreover, initially expressing tumours lose these cell surface antigens upon local recurrence, progression to invasion or metastization 

D 2 gastrectomy

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Q) D2 gastrectomy false (AIIMS 2020 GI) 
a. No benefit in OS

Paraneoplastic syndrome

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Q) Paraneoplastic syndrome with small cell  lung carcinoma

a) SIADH

b) Cushings

c) Hypercalcemia

Risk for gall bladder perforation

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Q) High risk for gall bladder perforation and stone spillage are all except? AIIMS 2020

a. Trainee surgeon
b. Brown stones
c. More than 10 stones
d. Cholecystitis

 

Lesion at floor of mouth

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Q) 56 year old male with 4cm Floor of mouth cancer , invading mandilbe. 2cm lymph node left side of neck, Management will be 
A. Chemotherapy and Radiotherapy (RT) 
B. Surgery followed by RT
C. RT
D. CHEMO ALONE