Tuesday, May 7, 2013

MCQs : Thyroid

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1- what is the vertical extension of the thyroid in relation to the vertebrae ?

a- C4 to T1
b- C5 to T1
c- C6 to T1
d- C3 to T1

answer : B

2- the thyroid develops from ?

a- ectoderm
b- mesoderm
c- dorsal pharyngeal gut endoderm
d- ventral pharyngeal gut endoderm

answer : D

3- screening method for medullary carcinoma of thyroid ?

a- serum calcitonin
b- serum calcium
c- serum ALP
d- serum acid phosphatase

answer : A

4- medullary carcinoma of thyroid arises from ?

a- parafollicular cells
b- cells lining the acini
c- capsule of thyroid
d- stroma of the gland

answer : A

5- which of the following is/are used in the management of thyroid malignancy?

a- Iodine 131
b- Iodine 125
c- Technitium 99
d- Phosphorus 32
e- strontium

answer is A

6- characteristic eye sign in dysthyroid status ?

a- exopthalmos
b- ptosis
c- optic neuropathy
d- myopathy

answer : A

7- hurthle cells are seen in ?

a- hashimoto's thyroiditis
b- follicular cell carcinoma
c- hurthle cell thyroid adenoma
d- all the above

answer is D

8- C cells populate which part of the lateral lobe of the thyroid ?

a- upper one-third of the lateral lobe of thyroid
b- middle one-third of the lateral lobe of thyroid
c- lower one-third of the lateral lobe of the thyroid
d- distributed equally all over the lateral lobe of the thyroid

answer :B

9- pick out the correct statements .

a- the external laryngeal nerve runs close to the superior thyroid artery .
b- the recurrent laryngeal nerve runs close to the inferior thyroid artery .
c- the external laryngeal nerve runs close to the inferior thyroid artery .
d- the recurrent laryngeal nerve runs close to the superior thyroid artery .

answer : both A and B are correct . ( so the surgeon has to be very careful while ligating those arteries, while performing thyroidectomy ).

10- treatment of medullary carcinoma of the thyroid with lymphnode metastasis?

a- subtotal thyroidectomy + radioiodine
b- subtotal thyroidectomy + radiotherapy
c- neartotal thyroidectomy + radioiodine
d- neartotal thyroidectomy + radiotherapy
e- total thyroidectomy + radiotherapy

answer : E

11- what is near total thyroidectomy ?

a- right lobectomy + isthmusectomy
b- left lobectomy + isthmusectomy
c- bilateral lobectomy with isthmusectomy
d- right lobectomy + isthmusectomy + left half lobectomy
e- right and left lobectomy

answer : D

 12- papillary carcinoma of thyroid with bone metastasis is treated by?

a- subtotal thyroidectomy + radioiodine
b- subtotal thyroidectomy + radiotherapy
c- near total thyroidectomy + radioiodine
d- near total thyroidectomy + radiotherapy
e- total thyroidectomy + chemotherapy

answer : C and D

13- most common cause of thyroiditis is ?

a- hashimoto's thyroiditis
b- reidl's thyroiditis
c- subacute thyroiditis
d- viral thyroiditis

answer : A

14-  thyroglossal cyst may occasionally give rise to which carcinoma ?

a- papillary
b- anaplastic
c- medullary
d- follicular

answer : A

15- a post-thyroidectomy patient develops signs and symptoms of tetany. The management is ?

a- I.V calcium gluconate
b- Bicarbonate
c- Calcitonin
d- Vitamin D

Answer : A

16- hypoparathyroidism following thyroid surgery occurs with in ?

a- 24 hours
b- 2-5 days
c- 7-14 days
d- 2-3 weeks

Answer : B

17- a patient undergoes thyroid surgery following which he develops perioral tingling . his blood calcium is 8.9 meq/l. next step in the management is ?

a- vitamin D orally
b- oral calcium and vitamin D
c- intravenous calcium gluconate and serial monitoring
d- wait for calcium to decrease to less than 7 meq/l before taking further action

answer : B

18- a patient after undergoing thyroid surgery presents with perioral paraesthesia . serum calcium level is 7 mg/dl . what will be the best management ?

a- oral vitamin D3
b- oral vitamin D3 and calcium
c- I.V calcium gluconate
d- Oral calcium

Answer : D

19- which of the following is not a complication of total thyroidectomy ?

a- bleeding
b- airway obstruction
c- hoarseness
d- hypercalcemia

answer : D

20- in post operative room after thyroid surgery , patient developed sudden respiratory distress , dressing was removed and it was found to be slightly blood stained and wound was bulging . what will be the first thing to be done ?

a- tracheostomy
b- cricothyroidectomy
c- laryngoscopy and intubation
d- remove the stitch and take the patient to O.T

answer : D

21- a patient presents with neck swelling and respiratory distress few hours after a thyroidectomy surgery. Next management would be ?

a- open immediately
b- tracheostomy
c- wait and watch
d- oxygen by mask

answer : A

22- after thyroidectomy patient developed stridor within 2 hours. All are likely causes of stridor except ?

a- hypocalcemia
b- recurrent laryngeal nerve palsy
c- laryngomalacia
d- wound hematoma

answer : A . hypocalcemia due to hypoparathyroidism after thyroid surgey normall results with in 2-5 days .


23- papillary carcinoma of the thyroid ( PCT ) patients are ?

a- euthyroid
b- hypothyroid
c- hyperthyroid
d- T3 thyrotoxicosis

Answer : A

24- HURTHLE cell carcinomas are derived from which cells ?

a- follicular cells
b- para follicular cells
c- oxyphilic cells
d- lymphocytes

answer : C

25- the malignancy which is common on long standing goiter ?

a- PCT
b- MCT
c- FCT
d- Anaplastic

Answer : C . Follicular carcinoma of the thyroid .


26- least malignant thyroid cancer ?

a- papillary
b- medullary
c- anaplastic
d- follicular

answer : a ( mean the more differentiation ) and the commonest tumor is it .

27- which of the following gene defects is associated with development of the medullary carcinoma of the thyroid ?

a- RET proto oncogene ( on chromosm 10 )
b- FAP gene
c- RB gene
d- BRCA 1 gene

Answer :A
RET proto gene : associated with medullary thyroid carcinoma, hirschsprung's disease and pheochromocytoma and rearrangement of RET gene leads to papillary thyroid carcinoma

28-  psammoma bodies are seen in all of the following conditions except ?

a- serous cystadenoma of ovary
b- papillary carcinoma of thyroid
c- meningioma
d- mucinous cystadenoma of ovary

answer : D

29- all of the following are early life threatening complications of thyroid operation except ?

a- tracheomalacia and collapse of larynx
b- wound hematoma with compression of the trachea
c- hypocalcemia
d- thyroid storm

answer : C

30- in pregnancy ?

a- thiouracil is contraindicated
b- surgery is contraindicated
c- radioiodine is contraindicated
d- none

answer: C


31- lateral aberrant thyroid refers to ?

a- congenital thyroid abnormality
b- metastatic foci from primary in the thyroid
c- struma ovarii
d- lingual thyroid

answer : B

32- a patient presented with headache and flushing . he has a family history of his relative having died of a thyroid tumor. The investigation that would be required for this patient will be ?

a- chest x-ray
b- measurement of 5-HIAA
c- measurement of catecholamine
d- intravenous pyelography

answer : C . measurement of catecholamines . headache and flushing suggest symptoms of adrenal tumor and a history of thyroid tumor in the relative suggest the MEN syndrome type 2a or 2b . so the adrenal tumor is probably pheochromocytoma and so catecholamines have to be measured .


33- cancer that develops after irradiation ?

a- PCT
b- MCT
c- FCT
d- Anaplastic

Answer : A

34- mutated p53 gene is formed in most of ?

a- anaplastic carcinomas
b- PCT
c- MCT
d- FCT

Answer : A

35- treatment of choice for medullary carcinoma of thyroid is ?

a- total thyroidectomy
b- partial thyroidectomy
c- iodine 131 ablation
d- hemithyroidectomy

answer : A

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