9q: which of the following is a good prognostic factor for neuroblastomas ?
a. N-myc amplification
b. RAS oncogene
answer: c . hyperdiploidy . if the age of the baby is less than or equal to one year at the time of presentation then it is a good prognostic factor , but if the age is greater than 1 year then it is a bad prognostic sign for neuroblastomas. stage 1,2A,2B,4S are all favourable prognosis. stage 3 , 4 are bad prognostic factors. evidence of schwannian stroma and gangliocytic differentiation is a good prognostic sign and absence of it is a bad prognostic sign. presence of intratumoral calcification is a good prognostic sign.
10q: a 35 year old woman has had recurrent episodes of headache and sweating . her mother had renal calculi and died of thyroid cancer. physical observation revealed a thyroid nodule and ipsilateral enlarged cervical lymphnodes. before performing thyroid surgery the woman's physician should order ?
a. thyroid scan
b. estimation of hydroxy indole acetic acid in urine
c. estimation of urinary metanephrines, VMA and catecholamines .
d. estimation of TSH and TRH levels in serum
answer: c . estimation of urinary metanephrines, VMA and catecholamines .
11q: a 20 year old male presents with chronic constipation ,headache and palpitations. on examination he had marfanoid habitus , neuromas of tongue, medullated corneal nerve fibers and nodule of 2 x 2 cm size in the left lobe of thyroid . this patient is a case of ?
a. sporadic medullary carcinoma of thyroid
b. familial medullary carcinoma of thyroid
c. MEN II A
d. MEN II B
answer: MEN II B also called as sipple syndrome . hirschsprung's disease and amyloidosis are features of MEN II A also called wermer syndrome .
12q: MEN II A includes all except ?
b. cutaneous lichen amyloids
c. mutation in RET in chromosome 10
d. parathyroid adenoma
e. adrenal adenoma
answer: a . ganglioneuromas are a feature of MEN II B .
13q: true about MEN 1 ?
a. increased VMA in urine
b. increased calcitonin
e. increased calcium
answer: c , d , e . hyperprolactinemia results due to parathyroid adenoma. hypergastrinemia results due to pancreatic carcinoma or islet cell hyperplasia . increased calcium results because of hyperparathyroidism which causes increase in parathormone levels that increase the serum calcium .
14q: young female presents with hypertension with VMA greater than 14 mg/day associated with ?
a. medullary carcinoma of thyroid
b. von hippel lindau disease
c. sturge weber syndrome
d. grave's disease
answer: a, b , c, e . pheochromocytoma can be an associated feature of medullary carcinoma of thyroid or von hippel lindau disease or sturge weber syndrome or neurofibromatosis .
15q: most common cause of hyperparathyroidism ?
a. single adenoma
b. multiple adenomas
c. single gland hyperplasia
d. multiple gland hyperplasia
answer: a . single adenoma .
16q: most common cause of hypercalcemic crisis ?
a. parathyroid adenoma
b. parathyroid hyperplasia
c. carcinoma breast
d. paget's disease
answer: c . carcinoma breast . malignant tumors are the most common cause of hypercalcemic crisis of which breast carcinoma is the common cause .
pituitary adenoma is the most common cause of hypercalcemia .