1q: primary hyperparathyroidism is caused by ?
a. parathyroid hyperplasia
c. MEN 1
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
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 ?
c. renal cell carcinoma
answer: b . neuroblastoma . this is the most common solid tumor of the infants and also the most common tumor of new borns .