Pretest endo/breast

Question 1

hot thyroid nodule?

Answer 1

isolated focus of increased uptake on a thyroid scan = Hyperfunctioning adenomas or hot nodules –> hyperthyroidism

Question 2

diffuse radioactive iodine uptake on thyroid scan?

Answer 2

Graves

Question 3

Diminished radioactive iodine uptake on thyroid scan?

Answer 3

cold nodule = carcinoma

Question 4

various activity of multiple nodules in radioactive iodine uptake on thyroid scan?

Answer 4

Multinodular goiter

Question 5

isolated focus of increased uptake on a thyroid scan

Answer 5

Hyperfunctioning adenomas or hot nodules

Question 6

Addison disease constellation?

Answer 6

skin pigmentation, weakness, weight loss, hypotension, nausea, vomiting, abdominal pain, hypoglycemia, hyponatremia, and hyperkalemia.

Question 7

Tx for wound hematoma?

Answer 7

exploration of the wound, drainage of the hematoma, and identification and control of any bleeding vessels

Question 8

Inflammatory breast ca tx?

Answer 8

neoadjuvant chemotherapy, surgery, and radiation

Question 9

erythema and edema of the right breast with palpable axillary lymphadenopathy with neoplastic cells in the dermal lymphatics. Dx?

Answer 9

inflammatory breast CA

Question 10

What breast CA presents like mastitis?

Answer 10

inflammatory

Question 11

peau d’orange

Answer 11

inflammatory breast CA

Question 12

Tx for prolactinoma?

Answer 12

bromocriptine, surgery

Question 13

What is bromocriptine?

Answer 13

Dopamine agonist

Question 14

Hyperparathyroidism diagnosis?

Answer 14

high PTH with high serum Ca++ (>11)

Question 15

tumor in tail of pancreas + rash = ?

Answer 15

glucagonoma.

Question 16

What is a glucagonoma?

Answer 16

tumor of islet alpha cells

Question 17

syndrome of a characteristic rash, diabetes mellitus, anemia, weight loss, and elevated levels of circulating glucagon

Answer 17

glucagonoma

Question 18

Tx for glucagonoma?

Answer 18

TPN + octreotide

Question 19

tx simple breast cyst?

Answer 19

reassurance and reexamination

Question 20

tx complex breast cyst?

Answer 20

aspiration bc risk of malignancy

Question 21

Treatment of high-risk thyroid papillary carcinomas?

Answer 21

thyroidectomy +/- nodes, modified radical neck dissection

Question 22

Medullary thyroid carcinoma is associated with?

Answer 22

MEN syndrome

Question 23

Lobular carcinoma in situ (LCIS) is a risk factor for?

Answer 23

invasive breast carcinoma

Question 24

most common breast tumors between puberty and the early thirties?

Answer 24

fibroadenoma

Question 25

breast lesion: characteristic fish flesh texture?

Answer 25

Lymphomas

Question 26

breast lesion: bulging, very firm, lobulated surface with a whorl-like pattern?

Answer 26

fibroadenoma

Question 27

dx? groans, stones, and bones

Answer 27

hyperparathyroidism

Question 28

Tx for hyperparathyroidism?

Answer 28

fluids, loop diuretics (furosemide), surgery if stones

Question 29

45-year-old woman presents with hypertension, development of facial hair, and a 7-cm suprarenal mass. Dx?

Answer 29

Adrenocortical carcinoma

Question 30

How do you determine malignancy in adrenocortical carcinoma?

Answer 30

size of tumor

Question 31

Tx for adrenocortical carcinoma?

Answer 31

en bloc resection of the tumor and involved adjacent organs, such as the kidney or the tail of the pancreas

Question 32

Dx? hypertension and symptoms of excessive catecholamine production

Answer 32

pheochromocytomas

Question 33

pre-op tx for pheochromocytoma?

Answer 33

α-blockade using phenoxybenzamine for 1-3 weeks, +/- beta-blockade; fluids

Question 34

tx? invasive ductal carcinoma in pregnancy

Answer 34

modified radical mastectomy

Question 35

dx? 40-year-old woman presents with a rash involving the nipple-areola complex for the last month with associated itching, crusting, and ulceration of the nipple with surrounding erythema involving the areola and surrounding skin

Answer 35

Paget disease of the breas

Question 36

Tx Paget disease of the breast?

Answer 36

modified radical mastectomy

Question 37

40-year-old woman presents with a rash involving the nipple-areola complex for the last month with associated itching, crusting, and ulceration of the nipple with surrounding erythema involving the areola and surrounding skin. Next step?

Answer 37

mammo and biopsy

Question 38

Zollinger-Ellison syndrome diagnosis?

Answer 38

very high basal levels of gastric acid (> 35 mEq/h) and serum gastrin (usually > 1000 pg/mL); rise in serum gastrin after giving secretin (>200pg/mL gastrin level increase)

Question 39

presence of hypercalcemia in a patient with ZES should prompt a workup for?

Answer 39

MEN1 (multiple endocrine neoplasia type 1)

Question 40

How to reduce the risk of developing thyroid storm in the operating room?

Answer 40

Drops of Lugol iodine solution daily beginning 10 days preoperatively

Question 41

hypertension, weakness, bone pain, and a serum calcium level of 15.2 mg/dL. Hand films below show osteitis fibrosa cystica. Dx?

Answer 41

Primary hyperparathyroidism

Question 42

tx thyroid storm?

Answer 42

rapid fluid replacement, antithyroid medication such as propylthiouracil (PTU), β-blockers, iodine solutions, and steroids

Question 43

Dx? HTN with hypokalemia

Answer 43

hyperaldosteronism

Question 44

Hyperaldosteronism test?

Answer 44

Plasma renin activity and plasma aldosterone concentration (PAC: PAR ratio of 25 to 30:1 is strongly suggestive of the diagnosis)

Question 45

cystosarcoma phyllodes tx?

Answer 45

wide local excision

Question 46

cystosarcoma phyllodes- benign or mal?

Answer 46

usu benign

Question 47

follicular thyroid ca tx?

Answer 47

lobectomy if small; total thyroidectomy if greater than 4cm

Question 48

Insulinoma findings? - glucose level - insulin level - C-peptide level

Answer 48

- glucose level <50 - insulin level elevated - C-peptide level elevated

Question 49

C-peptide on insulin: endogenous or exogenous?

Answer 49

endogenous