Thursday, February 5, 2009

40 - parathyroid and adrenal surgery mcqs - 1

1q: primary hyperparathyroidism is caused by ?

a. parathyroid hyperplasia
b. adenosis
c. MEN 1
d. thyrotoxicosis
e. CRF

answer: a , b and c .

2q: parathyroid adenoma most commonly involves which of the following sites ?

a. thyroid substance
b. superior parathyroid lobe
c. inferior parathyroid lobe
d. in the mediastinum

answer: c . inferior parathyroid lobe .

3q: features to differentiate parathyroid adenoma from hyperplasia would include which of the following ?

a. presence of excess chief cells
b. high levels of parathormone
c. infiltration of capsule
d. identifying hyperplasia of all 4 glands at surgery in parathyroid hyperplasia

answer: d .

4q: treatment for parathyroid hyperplasia is ?

a. removal of all four glands
b. calcium
c. removal of 3 and half glands
d. enlarged glands to be removed

answer: c . removal of 3 and half glands .

5q: in case of parathyroid adenoma treatment is ?

a. calcitonin and steroid
b. removal of adenoma
c. total parathyroidectomy and implantation in arm
d. total parathyroidectomy

answer: b . removal of adenoma .

6q: during bilateral adrenalectomy , intraoperative dose of hydrocortisone should be given after ?

a. opening the abdomen
b. ligation of left adrenal vein
c. ligation of right adrenal vein
d. excision of both adrenal glands

answer: d . after excision of both adrenal glands .

7q: rani , a 75 year old woman presents with post myocardial infarction after 6 weeks with mild CHF . there was past H/O neck surgery for parathyroid adenoma
5 years ago , EKG shows slow atrial fibrillation . serum calcium is 13 mg/L and urinary calcium is 300 mg/24 hr . on examination there is small mass in the paratracheal position behind the right clavicle . appropriate management at this time will be ?

a. repeat neck surgery
b. treatment with technetium - 99
c. observation and repeat serum calcium in 2 months
d. ultrasound guided alcohol injection into the mass

answer: d . ultrasound guided alcohol injection into the mass .

8q: Mrs.Neena noted an abdominal mass on the left side of her 6 month old child , which showed calcification near the left kidney. what will be the cause ?

a. leukemia
b. neuroblastoma
c. renal cell carcinoma
d. lymphoma

answer: b . neuroblastoma . this is the most common solid tumor of the infants and also the most common tumor of new borns .

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