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Pathology > MEN Stem #2 > Flashcards

MEN Stem #2 Flashcards

Stem; A young female with thyroid nodule and Elevated calcitonin levels.

1
Q

Stem; A young female with thyroid nodule and Elevated calcitonin levels.

Q1: What is the single best investigation to be done ? (Bed side invx)

A

FNAC

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Q

Q2. What is the type of cancer you suspect and why ?

A

Medullary Thy. Ca, due amyloid and calcitonin (in report)

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Q3:what is the source of this type of cancer?
Med. Thyroid Cancer.

A

Parafollicular c cells

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4
Q

Q4. what is IHC in simple words ?

A

Method to localize certain antigens based on Ag-Ab reaction recognition

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Q5: How does it work ?
IHC

A

Ab is labeled with florescent dye (Enzyme) when attached to ag it will be activated and the Ag will be seen under microscope

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6
Q

Q6.What is the type of Ag- Ab reaction in IHC?

A

Complement fixation

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7
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Q7. TNM classification of Thyroid cancer ? (you’ll be shown a report Tumor size =4cm / No mets / 2 of 6 regoinal LN involved)

A

T3N1M0

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Q8. If the patient developed hypertension , what will you suspect she might have?

A

Pheochromocytoma

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Q9. What are the other adrenal gland swelling you know ?

A

Medulloblastoma / Neuroblastoma / Hematoma / Infection

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Q10. How can you diagnose pheochromocytoma ?

A

Plasma – Free metanephrines and catecholamines and catecholamines stimulation test
Urine – VMA, Fractionated metanephrines , total metanephrines and catecholamines.
Img; US / CT with contrast / MRI / PET / MIBG scintography

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11
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Q11: If the condition is familial what other pathology you will suspect ?

A

Parathyroid Hyperplasia

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12
Q

Q12: what are the types of MEN? ((4 types))

A

MEN-1 – > pit. Adenoma / Pancreatic tumor / PT hyperplesia
MEN-2a (RET oncogene , AD) – > Pheochromocytoma / ParaThy hyperplasia / Medullary thyroid carcinoma
MEN-2b – > as 2a with addition to marfanoid features and mucosal neuromas

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13
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Q13. What is the treatment plan of medullary thyroid cancer?

A

Discuss with MDT after total exam and Invx
Total Thyroidectomy with block neck dissection

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14
Q

Types of Block neck dissection

A

(Radical / Modified Radical / Selective)

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15
Q

Q. Difference btw Lugol’s iodine and Radioactive Iodine?

A

Lugol lodine
Inhibitor thyroid hormone synthesis
Inhibitor conversion of T4 to T3
Radioactive iodine
Diagnostic and therapeutic
Destroy thyroid tissue so no thyroid hormone secretion

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Pathology (37 decks)

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