1. what is the colour of the normal thyroid gland ?
answer : brownish-red colour .
2. the thyroid gland is highly vascular. TRUE OR FALSE ?
answer : true .
3. which of the following statements about thyroid is true ?
a- thyroid is located anteriorly in the upper neck
b- thyroid is located posteriorly in the upper neck
c- thyroid is located anteriorly in the lower neck
d- thyroid is located posteriorly in the lower neck
answer : c . the thyroid is located anteriorly in the lower neck .
4. 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 . fifth cervical vertebra to the first thoracic vertebra . C5 to T1.
5. thyroid is ensheathed by a fascia . what is it ?
answer : pretracheal layer of the deep cervical fascia .
6. what are the number of lobes in thyroid ?
answer : 2 lobes . right and left lobes connected by a narrow, median isthmus .
7. what is the weight of the thyroid ?
answer : 25 g ( usually but can vary ) .
8. among men and women, who have heavier thyroids ?
answer : women have slightly heavier thyroids when compared to males.
9. a woman came to the doctor with complaints of increase in the size of thyroid during menstruation . if u were the doctor there, what would u do ?
answer : I would tell her that it is perfectly normal for the size of a woman's thyroid to increase during menstruation .
10. a pregnant woman came to ur clinic with complaints of enlarged thyroid . what would you suggest ?
answer : I would tell her that there is nothing to worry , because it is absolutely normal for a woman's thyroid to enlarge during pregnancy and menstruation .
11. how will you normally estimate the size of the thyroid gland ?
answer : by doing diagnostic ultrasound .
12. As I already told u women have heavier thyroids than men, hence the volume of thyroid in women is slightly more than in men. But there is a phase of life in both males and females where no significant difference between the volumes of the male and female thyroid was observed. When is that phase ?
answer : from 8 months to 15 years . between these ages the volumes of both male and female thyroid show no significant difference .
13. what is the shape of the lobes of the thyroid gland ?
answer : approximately conical .
14. the bases of the thyroid lobes are level with which tracheal cartilage ?
answer : 4th or 5th tracheal cartilages .
15. what is the length of each thyroid lobe ?
answer : 5cms long .
16. the posteromedial aspects of the thyroid lobes are attached to which structure ?
answer : cricoid cartilage .
17. what is the name of the ligament which attaches the lobes of thyroid to the cricoid cartilage posteromedially ?
answer : lateral thyroid ligament .
18. what is the part of the thyroid that connects the lower parts of the two lobes called ?
answer : isthmus .
19. what would you suggest to a healthy patient who has no isthmus ?
answer : I would suggest that it is physiologically normal for a person to be born without an isthmus and this happens occasionally . I would assure him that there is nothing to worry .
20. what is the length of the isthmus ?
answer : 1.25 cms transversely and vertically .
21. the isthmus normally lies anterior to which tracheal cartilages ?
answer : it usually lies anterior to second and third tracheal cartilages. ( it can lie slightly higher or slightly lower sometimes because of the variations in size and site of the thyroid gland )
22. what is the tumor marker of the medullary carcinoma of the thyroid?
answer : calcitonin .
23. what is the most common position of the thyroglossal cyst ?
answer : below the hyoid bone . ( check again ).
24. what is the name of the surgery done to treat the thyroglossal cyst/fistula ?
answer : sistrunk's operation .
25. what is the hormone secreted by the thyroid that controls the calcium metabolism ?
answer : calcitonin .
26. superior thyroid artery is a branch of which artery ?
answer : external carotid artery .
( the branches of the external carotid artery are 1. superior thyroid artery 2.lingual artery 3.posterior auricular artery 4.facial artery 5.occipital artery 6.ascending pharyngeal artery 7.maxillary artery 8.superficial temporal artery ------ SLPFOAMS ------ SISTER LUCY'S POWDERED FACE OFTEN ATTRACTS MEDICAL STUDENTS . )
27. which is the only medial branch of the external carotid artery ?
answer : ascending pharyngeal artery . ( out of context but important .)
28. the thyroid develops from ?
a- ectoderm
b- mesoderm
c- dorsal pharyngeal gut endoderm
d- ventral pharyngeal gut endoderm
answer : d . ventral pharyngeal gut endoderm .
29. the development of thyroid occurs in which week of the intrauterine life ?
answer : 4th week .
30. what are the cells in the thyroid which produce the calcitonin ?
answer : C cells ( also called as the parafollicular cells .)
31. what is the function of calcitonin ?
answer : lowers blood calcium by inhibiting the bone resorption and inhibiting the calcium recovery from renal tubule ultrafiltrate .
32. the embryonic thyroid descends from a foramen located in the posterior part of the tongue . what is it ?
answer : it is called the foramen caecum .
33. the thyroid usually reaches the front of the trachea by the end of how many months of the intrauterine life ?
answer : by the end of 2nd month of intrauterine life .
34. the thyroglossal duct is originally a hollow tube running from foramen caecum to pharynx . TRUE OR FALSE ?
answer : true . ( check again )
35. thyroglossal duct tissue normally becomes solid and remains uncanalised after transit of the thyroid . TRUE OR FALSE ?
answer : FALSE ( check again )
36. the pyramidal lobe of the thyroid represents part of the thyroglossal duct . TRUE OR FALSE?
answer : TRUE ( check again ) .
37. most common histological type of thyroid cancer ?
answer : papillary carcinoma .
38. thyroid carcinoma with best prognosis ?
answer : papillary carcinoma .
39. screening method for medullary carcinoma of thyroid ?
a- serum calcitonin
b- serum calcium
c- serum ALP
d- serum acid phosphatase
answer : a . serum calcitonin .
40. the carcinoma of thyroid associated with hypocalcemia ?
answer : medullary carcinoma of thyroid . ( remember it secretes calcitonin ).
41. 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 . parafollicular cells .
42. papillary carcinoma of thyroid usually presents as ?
answer : single nodule + local lymph node .
43. 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 . Iodine 131 .
44. which of the following factors contribute to the development of duodenal ulcer ?
a- Iodine 131
b- Iodine 125
c- Technitium 99
d- Phosphorus 32
answer : a . iodine 131 .
45. characteristic eye sign in dysthyroid status ?
a- exopthalmos
b- ptosis
c- optic neuropathy
d- myopathy
answer : a . exopthalmos .
45. 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 . all the above .
46. the C cells of the thyroid parenchyma belongs to the APUD system of dispersed neuron-endocrine cells . what is APUD system ?
answer : AMINE PRECURSOR UPTAKE AND DECARBOXYLATION SYSTEM .
47. how did the C cells get their name ?
answer : C stands for Clear cells , because they have pale staining cytoplasm and hence appear clear .
48. what is arteria thyroidea ima ?
answer : an artery supplying thyroid which is seen occasionally and arises from the brachiocephalic trunk or aortic arch .
49. what are the two main arteries that supply the thyroid ?
answer : superior and inferior thyroid arteries . superior thyroid artery is a branch of the external carotid artery and the inferior thyroid artery is branch of the thyrocervical trunk .
50. 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 . C cells populate the middle one-third of the lateral lobe of the thyroid .
( typically found scattered within thyroid follicles , inside the basal lamina but not reaching the follicle lumen .)
51. 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 ).
52. what are the branches of the thyrocervical trunk ?
answer : 1. inferior thyroid artery 2.suprascapular artery 3.transverse cervical artery ( also called transversalis artery colli ) .
53. thyrocervical trunk arises from which artery ?
answer : subclavian artery .
54. what are the active thyroid hormones secreted by the follicular epithelial
cells of the thyroid ?
answer: tri-iodothyronine T3 and tetra-iodothyronin T4 ( thyroxine ) .
55. 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 . total thyroidectomy + radiotherapy .
56. 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 .
57. 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 . both . near total thyroidectomy with radioiodine and radiotherapy.
58. most common cause of thyroiditis is ?
a- hashimoto's thyroiditis
b- reidl's thyroiditis
c- subacute thyroiditis
d- viral thyroiditis
answer : a . hashimoto's thyroiditis .
59. recurrent laryngeal nerve is in close association with ?
a- superior thyroid artery
b- inferior thyroid artery
c- middle thyroid vein
d- superior thyroid vein
answer : b . inferior thyroid artery .
60. thyroglossal cyst may occasionally give rise to which carcinoma ?
a- papillary
b- anaplastic
c- medullary
d- follicular
answer : a . papillary carcinoma of the thyroid .
61. 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 . I.V calcium gluconate .
62. hypoparathyroidism following thyroid surgery occurs with in ?
a- 24 hours
b- 2-5 days
c- 7-14 days
d- 2-3 weeks
Answer : b . 2-5 days .
63. what are the normal levels of calcium in our body ?
answer : calcium,ionized - wholeblood - 1.1 to 1.4 mmol/litre - 4.5 to 5.6 mg/dl(meq/l) .
calcium - serum - 2.2 to 2.6 mmol/litre - 9 to 10.5 mg/dl(meq/l) .
64. 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 . oral calcium and vitamin D .
65. 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 . oral calcium .
66. which of the following is not a complication of total thyroidectomy ?
a- bleeding
b- airway obstruction
c- hoarseness
d- hypercalcemia
answer : d . hypercalcemia .
67. 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 . remove the stitch and take the patient to the O.T .
67. a patient presents with swelling in the neck following a thyroidectomy. What is the most likely resulting complication ?
a- respiratory obstruction
b- recurrent laryngeal nerve palsy
c- hypovolemia
d- hypocalcemia
answer : a . respiratory obstruction .
68. 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 . open immediately .
69. 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 .
70. which of the following will not lead to respiratory distress after thyroid surgery?
a- laryngomalacia
b- bilateral recurrent laryngeal nerve palsy
c- hypocalcemia
d- none
answer : d . none . all the 3 can lead to respiratory distress .
71. how does hypocalcemia result in respiratory distress ?
answer : pending .
72. papillary carcinoma of the thyroid ( PCT ) patients are ?
a- euthyroid
b- hypothyroid
c- hyperthyroid
d- T3 thyrotoxicosis
Answer : a . euthyroid .
73. medullary carcinoma of thyroid is derived from which cells ?
a- follicular
b- para follicular
c- oxyphilic
d- lymphocytes
answer : para follicular cells ( also called C cells ) .
74. HURTHLE cell carcinomas are derived from which cells ?
a- follicular cells
b- para follicular cells
c- oxyphilic cells
d- lymphocytes
answer : c . oxyphilic cells .
75. patients with MEN 2a also may have hirschsprung's and lichen cutaneous amyloidosis ? TRUE OR FALSE ?
answer : true .
76. the malignancy which is common on long standing goiter ?
a- PCT
b- MCT
c- FCT
d- Anaplastic
Answer : c . Follicular carcinoma of the thyroid .
77. cancer common in iodine deficient areas ?
a- papillary
b- medullary
c- anaplastic
d- follicular
answer : c and d . follicular and anaplastic both are common .
78. least malignant thyroid cancer ?
e- papillary
f- medullary
g- anaplastic
h- follicular
answer : e . papillary .
79. commonest tumor of the thyroid ?
answer : papillary carcinoma of the thyroid .
80. which of the following gene defects is associated with development of the medullary carcinoma of the thyroid ?
a- RET proto oncogene
b- FAP gene
c- RB gene
d- BRCA 1 gene
Answer : a . RET proto oncogene .
81. what are the other diseases associated with the RET gene ?
answer : medullary thyroid carcinoma, hirschsprung's disease and pheochromocytoma.
82. RET proto-oncogene encodes for ?
a- tyrosine kinase receptor on the cytoplasmic membrane
b- protein kinase
c- IP3
d- All the above
Answer : a . tyrosine kinase receptor on the cytoplasmic membrane .
83. RET gene is located on which chromosome ?
Answer : 10 th chromosome .
84. rearrangement of RET gene leads to ?
a- PTC
b- MTC
c- FCT
d- Lymphoma
Answer : a. papillary thyroid cancer .
85. gene implicated in papillary thyroid cancer is ?
a- RET
b- K ras
c- C myc
d- APC
Answer : a . RET gene .
86. point mutation of RET gene leads to ?
answer : familial medullary carcinoma ( MEN 2A AND MEN 2B ).
87. RET ligand is identified as ?
Answer: GDNF ( glial cell line-derived neurotropic factor ).
88. 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 .
89. 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 . hypocalcemia .
90. in pregnancy ?
a- thiouracil is contraindicated
b- surgery is contraindicated
c- radioiodine is contraindicated
d- none
answer: c . only radioiodine is contraindicated .
91. amyloid stroma is seen in which carcinoma of thyroid?
Answer : medullary carcinoma of thyroid .
92. 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 . metastatic foci from primary carcinoma in the thyroid .
93. a patient with long standing multinodular goiter develops hoarseness of voice ; also the swelling undergoes sudden increase in size. Likely diagnosis is ?
answer : follicular carcinoma of thyroid .
94. a patient has pituitary tumor and pheochromocytoma and a thyroid nodule . which carcinoma is most likely to occur ?
answer : medullary carcinoma of the thyroid . the condition is MEN 2a or MEN 2b. MEN 1 comprises of parathyroid , pituitary and pancreatic tumors. MEN 2a comprises of parathyroid, medullary carcinoma of thyroid and pheochromocytoma tumors. MEN 2b comprises of medullary carcinoma of thyroid, pheochromocytoma and neuromas .
95. 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 .
96. cancer that develops after irradiation ?
a- PCT
b- MCT
c- FCT
d- Anaplastic
Answer : papillary carcinoma of the thyroid .
97. what is an oncogene ?
answer : gene that contributes directly to tumor genesis .
98. mutated p53 gene is formed in most of ?
a- anaplastic carcinomas
b- PCT
c- MCT
d- FCT
Answer : a . anaplastic carcinomas .
99. deletion of which chromosome accompanies transformation of follicular adenoma to follicular adeno carcinoma ?
answer : 3p .
100. treatment of choice for medullary carcinoma of thyroid is ?
a- total thyroidectomy
b- partial thyroidectomy
c- iodine 131 ablation
d- hemithyroidectomy
answer : a . total thyroidectomy .
answer : brownish-red colour .
2. the thyroid gland is highly vascular. TRUE OR FALSE ?
answer : true .
3. which of the following statements about thyroid is true ?
a- thyroid is located anteriorly in the upper neck
b- thyroid is located posteriorly in the upper neck
c- thyroid is located anteriorly in the lower neck
d- thyroid is located posteriorly in the lower neck
answer : c . the thyroid is located anteriorly in the lower neck .
4. 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 . fifth cervical vertebra to the first thoracic vertebra . C5 to T1.
5. thyroid is ensheathed by a fascia . what is it ?
answer : pretracheal layer of the deep cervical fascia .
6. what are the number of lobes in thyroid ?
answer : 2 lobes . right and left lobes connected by a narrow, median isthmus .
7. what is the weight of the thyroid ?
answer : 25 g ( usually but can vary ) .
8. among men and women, who have heavier thyroids ?
answer : women have slightly heavier thyroids when compared to males.
9. a woman came to the doctor with complaints of increase in the size of thyroid during menstruation . if u were the doctor there, what would u do ?
answer : I would tell her that it is perfectly normal for the size of a woman's thyroid to increase during menstruation .
10. a pregnant woman came to ur clinic with complaints of enlarged thyroid . what would you suggest ?
answer : I would tell her that there is nothing to worry , because it is absolutely normal for a woman's thyroid to enlarge during pregnancy and menstruation .
11. how will you normally estimate the size of the thyroid gland ?
answer : by doing diagnostic ultrasound .
12. As I already told u women have heavier thyroids than men, hence the volume of thyroid in women is slightly more than in men. But there is a phase of life in both males and females where no significant difference between the volumes of the male and female thyroid was observed. When is that phase ?
answer : from 8 months to 15 years . between these ages the volumes of both male and female thyroid show no significant difference .
13. what is the shape of the lobes of the thyroid gland ?
answer : approximately conical .
14. the bases of the thyroid lobes are level with which tracheal cartilage ?
answer : 4th or 5th tracheal cartilages .
15. what is the length of each thyroid lobe ?
answer : 5cms long .
16. the posteromedial aspects of the thyroid lobes are attached to which structure ?
answer : cricoid cartilage .
17. what is the name of the ligament which attaches the lobes of thyroid to the cricoid cartilage posteromedially ?
answer : lateral thyroid ligament .
18. what is the part of the thyroid that connects the lower parts of the two lobes called ?
answer : isthmus .
19. what would you suggest to a healthy patient who has no isthmus ?
answer : I would suggest that it is physiologically normal for a person to be born without an isthmus and this happens occasionally . I would assure him that there is nothing to worry .
20. what is the length of the isthmus ?
answer : 1.25 cms transversely and vertically .
21. the isthmus normally lies anterior to which tracheal cartilages ?
answer : it usually lies anterior to second and third tracheal cartilages. ( it can lie slightly higher or slightly lower sometimes because of the variations in size and site of the thyroid gland )
22. what is the tumor marker of the medullary carcinoma of the thyroid?
answer : calcitonin .
23. what is the most common position of the thyroglossal cyst ?
answer : below the hyoid bone . ( check again ).
24. what is the name of the surgery done to treat the thyroglossal cyst/fistula ?
answer : sistrunk's operation .
25. what is the hormone secreted by the thyroid that controls the calcium metabolism ?
answer : calcitonin .
26. superior thyroid artery is a branch of which artery ?
answer : external carotid artery .
( the branches of the external carotid artery are 1. superior thyroid artery 2.lingual artery 3.posterior auricular artery 4.facial artery 5.occipital artery 6.ascending pharyngeal artery 7.maxillary artery 8.superficial temporal artery ------ SLPFOAMS ------ SISTER LUCY'S POWDERED FACE OFTEN ATTRACTS MEDICAL STUDENTS . )
27. which is the only medial branch of the external carotid artery ?
answer : ascending pharyngeal artery . ( out of context but important .)
28. the thyroid develops from ?
a- ectoderm
b- mesoderm
c- dorsal pharyngeal gut endoderm
d- ventral pharyngeal gut endoderm
answer : d . ventral pharyngeal gut endoderm .
29. the development of thyroid occurs in which week of the intrauterine life ?
answer : 4th week .
30. what are the cells in the thyroid which produce the calcitonin ?
answer : C cells ( also called as the parafollicular cells .)
31. what is the function of calcitonin ?
answer : lowers blood calcium by inhibiting the bone resorption and inhibiting the calcium recovery from renal tubule ultrafiltrate .
32. the embryonic thyroid descends from a foramen located in the posterior part of the tongue . what is it ?
answer : it is called the foramen caecum .
33. the thyroid usually reaches the front of the trachea by the end of how many months of the intrauterine life ?
answer : by the end of 2nd month of intrauterine life .
34. the thyroglossal duct is originally a hollow tube running from foramen caecum to pharynx . TRUE OR FALSE ?
answer : true . ( check again )
35. thyroglossal duct tissue normally becomes solid and remains uncanalised after transit of the thyroid . TRUE OR FALSE ?
answer : FALSE ( check again )
36. the pyramidal lobe of the thyroid represents part of the thyroglossal duct . TRUE OR FALSE?
answer : TRUE ( check again ) .
37. most common histological type of thyroid cancer ?
answer : papillary carcinoma .
38. thyroid carcinoma with best prognosis ?
answer : papillary carcinoma .
39. screening method for medullary carcinoma of thyroid ?
a- serum calcitonin
b- serum calcium
c- serum ALP
d- serum acid phosphatase
answer : a . serum calcitonin .
40. the carcinoma of thyroid associated with hypocalcemia ?
answer : medullary carcinoma of thyroid . ( remember it secretes calcitonin ).
41. 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 . parafollicular cells .
42. papillary carcinoma of thyroid usually presents as ?
answer : single nodule + local lymph node .
43. 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 . Iodine 131 .
44. which of the following factors contribute to the development of duodenal ulcer ?
a- Iodine 131
b- Iodine 125
c- Technitium 99
d- Phosphorus 32
answer : a . iodine 131 .
45. characteristic eye sign in dysthyroid status ?
a- exopthalmos
b- ptosis
c- optic neuropathy
d- myopathy
answer : a . exopthalmos .
45. 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 . all the above .
46. the C cells of the thyroid parenchyma belongs to the APUD system of dispersed neuron-endocrine cells . what is APUD system ?
answer : AMINE PRECURSOR UPTAKE AND DECARBOXYLATION SYSTEM .
47. how did the C cells get their name ?
answer : C stands for Clear cells , because they have pale staining cytoplasm and hence appear clear .
48. what is arteria thyroidea ima ?
answer : an artery supplying thyroid which is seen occasionally and arises from the brachiocephalic trunk or aortic arch .
49. what are the two main arteries that supply the thyroid ?
answer : superior and inferior thyroid arteries . superior thyroid artery is a branch of the external carotid artery and the inferior thyroid artery is branch of the thyrocervical trunk .
50. 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 . C cells populate the middle one-third of the lateral lobe of the thyroid .
( typically found scattered within thyroid follicles , inside the basal lamina but not reaching the follicle lumen .)
51. 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 ).
52. what are the branches of the thyrocervical trunk ?
answer : 1. inferior thyroid artery 2.suprascapular artery 3.transverse cervical artery ( also called transversalis artery colli ) .
53. thyrocervical trunk arises from which artery ?
answer : subclavian artery .
54. what are the active thyroid hormones secreted by the follicular epithelial
cells of the thyroid ?
answer: tri-iodothyronine T3 and tetra-iodothyronin T4 ( thyroxine ) .
55. 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 . total thyroidectomy + radiotherapy .
56. 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 .
57. 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 . both . near total thyroidectomy with radioiodine and radiotherapy.
58. most common cause of thyroiditis is ?
a- hashimoto's thyroiditis
b- reidl's thyroiditis
c- subacute thyroiditis
d- viral thyroiditis
answer : a . hashimoto's thyroiditis .
59. recurrent laryngeal nerve is in close association with ?
a- superior thyroid artery
b- inferior thyroid artery
c- middle thyroid vein
d- superior thyroid vein
answer : b . inferior thyroid artery .
60. thyroglossal cyst may occasionally give rise to which carcinoma ?
a- papillary
b- anaplastic
c- medullary
d- follicular
answer : a . papillary carcinoma of the thyroid .
61. 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 . I.V calcium gluconate .
62. hypoparathyroidism following thyroid surgery occurs with in ?
a- 24 hours
b- 2-5 days
c- 7-14 days
d- 2-3 weeks
Answer : b . 2-5 days .
63. what are the normal levels of calcium in our body ?
answer : calcium,ionized - wholeblood - 1.1 to 1.4 mmol/litre - 4.5 to 5.6 mg/dl(meq/l) .
calcium - serum - 2.2 to 2.6 mmol/litre - 9 to 10.5 mg/dl(meq/l) .
64. 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 . oral calcium and vitamin D .
65. 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 . oral calcium .
66. which of the following is not a complication of total thyroidectomy ?
a- bleeding
b- airway obstruction
c- hoarseness
d- hypercalcemia
answer : d . hypercalcemia .
67. 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 . remove the stitch and take the patient to the O.T .
67. a patient presents with swelling in the neck following a thyroidectomy. What is the most likely resulting complication ?
a- respiratory obstruction
b- recurrent laryngeal nerve palsy
c- hypovolemia
d- hypocalcemia
answer : a . respiratory obstruction .
68. 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 . open immediately .
69. 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 .
70. which of the following will not lead to respiratory distress after thyroid surgery?
a- laryngomalacia
b- bilateral recurrent laryngeal nerve palsy
c- hypocalcemia
d- none
answer : d . none . all the 3 can lead to respiratory distress .
71. how does hypocalcemia result in respiratory distress ?
answer : pending .
72. papillary carcinoma of the thyroid ( PCT ) patients are ?
a- euthyroid
b- hypothyroid
c- hyperthyroid
d- T3 thyrotoxicosis
Answer : a . euthyroid .
73. medullary carcinoma of thyroid is derived from which cells ?
a- follicular
b- para follicular
c- oxyphilic
d- lymphocytes
answer : para follicular cells ( also called C cells ) .
74. HURTHLE cell carcinomas are derived from which cells ?
a- follicular cells
b- para follicular cells
c- oxyphilic cells
d- lymphocytes
answer : c . oxyphilic cells .
75. patients with MEN 2a also may have hirschsprung's and lichen cutaneous amyloidosis ? TRUE OR FALSE ?
answer : true .
76. the malignancy which is common on long standing goiter ?
a- PCT
b- MCT
c- FCT
d- Anaplastic
Answer : c . Follicular carcinoma of the thyroid .
77. cancer common in iodine deficient areas ?
a- papillary
b- medullary
c- anaplastic
d- follicular
answer : c and d . follicular and anaplastic both are common .
78. least malignant thyroid cancer ?
e- papillary
f- medullary
g- anaplastic
h- follicular
answer : e . papillary .
79. commonest tumor of the thyroid ?
answer : papillary carcinoma of the thyroid .
80. which of the following gene defects is associated with development of the medullary carcinoma of the thyroid ?
a- RET proto oncogene
b- FAP gene
c- RB gene
d- BRCA 1 gene
Answer : a . RET proto oncogene .
81. what are the other diseases associated with the RET gene ?
answer : medullary thyroid carcinoma, hirschsprung's disease and pheochromocytoma.
82. RET proto-oncogene encodes for ?
a- tyrosine kinase receptor on the cytoplasmic membrane
b- protein kinase
c- IP3
d- All the above
Answer : a . tyrosine kinase receptor on the cytoplasmic membrane .
83. RET gene is located on which chromosome ?
Answer : 10 th chromosome .
84. rearrangement of RET gene leads to ?
a- PTC
b- MTC
c- FCT
d- Lymphoma
Answer : a. papillary thyroid cancer .
85. gene implicated in papillary thyroid cancer is ?
a- RET
b- K ras
c- C myc
d- APC
Answer : a . RET gene .
86. point mutation of RET gene leads to ?
answer : familial medullary carcinoma ( MEN 2A AND MEN 2B ).
87. RET ligand is identified as ?
Answer: GDNF ( glial cell line-derived neurotropic factor ).
88. 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 .
89. 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 . hypocalcemia .
90. in pregnancy ?
a- thiouracil is contraindicated
b- surgery is contraindicated
c- radioiodine is contraindicated
d- none
answer: c . only radioiodine is contraindicated .
91. amyloid stroma is seen in which carcinoma of thyroid?
Answer : medullary carcinoma of thyroid .
92. 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 . metastatic foci from primary carcinoma in the thyroid .
93. a patient with long standing multinodular goiter develops hoarseness of voice ; also the swelling undergoes sudden increase in size. Likely diagnosis is ?
answer : follicular carcinoma of thyroid .
94. a patient has pituitary tumor and pheochromocytoma and a thyroid nodule . which carcinoma is most likely to occur ?
answer : medullary carcinoma of the thyroid . the condition is MEN 2a or MEN 2b. MEN 1 comprises of parathyroid , pituitary and pancreatic tumors. MEN 2a comprises of parathyroid, medullary carcinoma of thyroid and pheochromocytoma tumors. MEN 2b comprises of medullary carcinoma of thyroid, pheochromocytoma and neuromas .
95. 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 .
96. cancer that develops after irradiation ?
a- PCT
b- MCT
c- FCT
d- Anaplastic
Answer : papillary carcinoma of the thyroid .
97. what is an oncogene ?
answer : gene that contributes directly to tumor genesis .
98. mutated p53 gene is formed in most of ?
a- anaplastic carcinomas
b- PCT
c- MCT
d- FCT
Answer : a . anaplastic carcinomas .
99. deletion of which chromosome accompanies transformation of follicular adenoma to follicular adeno carcinoma ?
answer : 3p .
100. treatment of choice for medullary carcinoma of thyroid is ?
a- total thyroidectomy
b- partial thyroidectomy
c- iodine 131 ablation
d- hemithyroidectomy
answer : a . total thyroidectomy .
Studies show that desiccated porcine supplements has a variety of beneficial healing and preventive effects rather than side effects caused by its active ingredients. The different ingredient found in it is more effective when taken together rather than taken separately.
ReplyDeleteTell your doctor right away if you notice new or worsening medical problems such as changes in thinking www.dospalosradio.org
ReplyDeleteThank you for the update, very nice site.. health
ReplyDeleteTo reduce thyroid gland naturally herbal supplements for thyroid is very useful and effective.
ReplyDeleteThere are some natural remedies that can be used in the prevention and eliminate diabetes totally. However, the single most important aspect of a diabetes control plan is adopting a wholesome life style Inner Peace, Nutritious and Healthy Diet, and Regular Physical Exercise. A state of inner peace and self-contentment is essential to enjoying a good physical health and over all well-being. The inner peace and self contentment is a just a state of mind.People with diabetes diseases often use complementary and alternative medicine. I diagnosed diabetes in 2000. Was at work feeling unusually tired and sleepy. I borrowed a glucometer from a co-worker and tested at 760. Went immediately to my doctor and he gave me prescibtion like: Insulin ,Sulfonylureas,Thiazolidinediones but Icould not get the cure rather to reduce the pain abd brink back the pain again. I found a woman testimony name Comfort online how Dr Akhigbe cure her HIV and I aslo contacted the doctor and after I took his medication as instructed, I am now completely free from diabtes by doctor Akhigbe herbal medicine.So diabetes patients reading this testimony to contact his email drrealakhigbe@gmail.com or his Number +2348142454860 He also use his herbal herbs to diseases like:SPIDER BITE, SCHIZOPHRENIA, LUPUS,EXTERNAL INFECTION, COMMON COLD, JOINT PAIN, BODY PAIN, EPILEPSY,STROKE,TUBERCULOSIS ,STOMACH DISEASE. ECZEMA, PROGERIA, EATING DISORDER, LOWER RESPIRATORY INFECTION, DIABETICS,HERPES,HIV/AIDS, ;ALS, CANCER , MENINGITIS,HEPATITIS A AND B, THYROID, ASTHMA, HEART DISEASE, CHRONIC DISEASE. NAUSEA VOMITING OR DIARRHEA,KIDNEY DISEASE, WEAK ERECTION. EYE TWITCHING PAINFUL OR IRREGULAR MENSTRUATION.Dr Akhigbe is a good man and he heal any body that come to him. here is email drrealakhigbe@gmail.com and his Number +2349010754824
ReplyDeleteGreat post.
ReplyDeletehttps://500px.com/7dmc
My husband was diagnosed with early onset Parkinson's disease at 57.his symptoms were shuffling of feet,slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle, things were tough for me, but now he finally free from the disease with the help of total cure ultimate health home, he now walks properly and all symptoms has reversed, he had trouble with balance especially at night, getting into the shower and exiting it is difficult,getting into bed is also another thing he finds impossible.we had to find a better solution for his condition which has really helped him a lot,the biggest helped we had was ultimatehealthhome they walked us through the proper steps,am highly recommended this ultimatehealthhome@gmail.com to anyone who needs help.
ReplyDeleteGaining a degree in health services can be done by enrolling in an accredited educational training program. There are a number of schools and colleges that provide students with the opportunity to earn the degree they desire in the field of health care. right to itemized medical bill
ReplyDeleteHowever, do you know where to look for the best opportunities for you? A healthcare staffing agency will be able to locate and find the best assignment for you. marco's pizza diabetic pizza
ReplyDelete