Afmg Dec Surgery Breast & Thyroid Test

The first investigation to be done in this case is FNAC (Fine Needle Aspiration Cytology). FNAC is a minimally invasive procedure in which a thin needle is used to extract cells from the lump in the breast. These cells are then examined under a microscope to determine if they are cancerous or benign. FNAC is often the initial diagnostic test for breast lumps as it is quick, relatively painless, and provides valuable information about the nature of the lump. It helps in determining whether further tests like mammography or core biopsy are required.

The correct answer is "Surgical treatment needed in all cases." This means that surgical intervention is not always necessary for gynaecomastia. Gynaecomastia can be caused by various factors, such as hormonal imbalances, medication side effects, or obesity. In some cases, the underlying cause can be addressed without the need for surgery. Non-surgical treatments, such as hormone therapy or lifestyle changes, may be effective in reducing the breast tissue in gynaecomastia. Therefore, surgical treatment is not always needed in all cases of gynaecomastia.

Hyperthyroidism is a condition where the thyroid gland produces excessive amounts of thyroid hormones. This leads to an overactive metabolism and a range of symptoms. Common symptoms of hyperthyroidism include increased heart rate (tachycardia), bulging eyes (exopthalmos), and thickening of the skin on the lower legs (pretibial myxedema). However, decreased sweating is not a typical symptom of hyperthyroidism. Sweating is often increased in individuals with hyperthyroidism due to the increased metabolic activity. Therefore, the correct answer is "Decreased sweating."

Surgery in thyroiditis is necessary to overcome pressure on the trachea. Thyroiditis is inflammation of the thyroid gland, which can cause the gland to enlarge and put pressure on the trachea, leading to difficulty breathing and other respiratory problems. Surgery is performed to remove the enlarged thyroid gland and alleviate the pressure on the trachea, allowing for normal breathing and preventing further complications.

The most appropriate management for a 45-year-old female with intraductal carcinoma, as indicated by the diffuse micro calcifications and biopsy, would be a simple mastectomy. This surgical procedure involves the complete removal of the breast tissue, including the nipple and areola, in order to eliminate the cancerous cells. This approach is often recommended for cases where the cancer is confined to the ducts and has not spread to the surrounding tissue. It offers a high likelihood of complete removal of the cancer and reduces the risk of recurrence.

Multiparity refers to the condition of a woman having given birth to multiple children. In the context of breast cancer, multiparity is considered a protective factor rather than a risk factor. Multiple pregnancies and childbirths have been associated with a reduced risk of breast cancer due to the hormonal changes that occur during pregnancy and breastfeeding. Therefore, the correct answer is multiparity, as it is not a risk factor for breast cancer.

Thyroxine is the correct answer because it is the main hormone produced by the thyroid gland and is responsible for regulating the body's metabolism. In the case of chronic lymphocytic thyroiditis, the thyroid gland is enlarged and not producing enough thyroxine, leading to an increase in TSH and a decrease in T4 and T3 levels. Therefore, supplementing with thyroxine (thyroid hormone replacement therapy) would help normalize the hormone levels and alleviate symptoms. Total thyroidectomy, radio iodine, and antithyroid drugs are not appropriate treatments for this condition.

The superior thyroid artery is a branch of the external carotid artery. The external carotid artery is one of the major arteries that supplies blood to the head and neck region. It arises from the common carotid artery and gives off various branches, including the superior thyroid artery. This artery provides blood supply to the thyroid gland, as well as other structures in the neck such as the larynx and the muscles of the pharynx.

The hyoid bone is removed to prevent the recurrence of a throglossal cyst. Throglossal cysts are congenital cysts that develop from remnants of the thyroglossal duct, which is a structure that forms during embryonic development. The hyoid bone is located in the neck and is closely associated with the thyroglossal duct. By removing the hyoid bone, surgeons ensure that all remnants of the thyroglossal duct are excised, reducing the risk of recurrence of the cyst.

Acute mastitis is a condition characterized by inflammation of the breast tissue, often caused by an infection. It is common during lactation, as breastfeeding can lead to cracked or sore nipples, which can provide an entry point for bacteria. It is a very painful condition, as the breast becomes swollen, red, and tender. Staphylococcus aureus is indeed the most common causative organism. However, fluctuation, which refers to the presence of a fluid-filled pocket within the breast, is not always present in acute mastitis.

The procedure of choice for a patient with thyrotoxicosis and diagnosed with Graves' disease, but without eye signs, is subtotal thyroidectomy. This surgical procedure involves the removal of a large portion of the thyroid gland, leaving behind a small remnant. Subtotal thyroidectomy is preferred in cases where the patient is young and has a small goiter. It helps to alleviate the symptoms of thyrotoxicosis and reduces the risk of recurrence while preserving some thyroid function.

Fibroadenomas are benign breast tumors that are typically surrounded by a well-demarcated capsule. This means that there is a clear boundary between the tumor and the surrounding breast tissue. This characteristic can often be seen on imaging studies such as mammograms or ultrasounds. The presence of a capsule helps to distinguish fibroadenomas from other breast conditions. FNAC (fine needle aspiration cytology) is not typically used to diagnose fibroadenomas, as it may not provide enough information to differentiate them from other breast lesions. Fibroadenomas are more commonly found in younger women, usually in their 20s or 30s, and are less common in postmenopausal women.

Microdochectomy is the treatment of choice for duct papilloma. Duct papilloma is a benign tumor that arises from the lining of the milk ducts in the breast. It can cause nipple discharge and is usually diagnosed through imaging and biopsy. Microdochectomy involves the surgical removal of the affected milk duct, which effectively treats the condition while preserving the rest of the breast tissue. Simple mastectomy and radial mastectomy are more extensive procedures that involve the removal of the entire breast. Haxfisla's operation is not a recognized treatment for duct papilloma.

Male breast cancer is a rare condition, and it does not typically follow gynaecomastia, which is the enlargement of male breast tissue. The lobular variety of breast cancer is more common in men compared to the ductal variety. Male breast cancer is often estrogen receptor negative, meaning it does not respond to estrogen. The most common and effective treatment for male breast cancer is surgery, making it the treatment of choice.

Ductutasia is the most likely explanation for greenish nipple discharge. Ductutasia refers to the dilation of the mammary ducts, which can cause the discharge. It is a benign condition and is commonly seen in women. Fibrocystic disease is another condition that can cause nipple discharge, but it is not specifically associated with a greenish color. Duct papuloma is a benign growth in the mammary ducts, but it typically presents with bloody discharge rather than greenish discharge. Ductal carcinoma, which is a type of breast cancer, can also cause nipple discharge, but it is less likely to be greenish.

de Quervain's thyroiditis is a condition characterized by painful enlargement of the thyroid gland, which is usually preceded by a viral infection. It is an inflammatory disorder of the thyroid gland, but it is not classified as an autoimmune thyroiditis. Steroids are commonly used as the main treatment for de Quervain's thyroiditis to reduce inflammation and alleviate symptoms. Therefore, the correct answer is "Auto immune thyroiditis."

Fine needle aspiration cytology (FNAC) is the investigation of choice in patients with thyroid nodules. FNAC involves inserting a thin needle into the nodule and aspirating cells for examination under a microscope. This procedure is minimally invasive, cost-effective, and has a high diagnostic accuracy for distinguishing between benign and malignant nodules. It helps in determining the nature of the nodule, guiding further management decisions, and avoiding unnecessary surgeries. Ultrasound (USG) and CT scans may also provide additional information, but FNAC is the preferred initial investigation for thyroid nodules. Iodine uptake is not used for the investigation of thyroid nodules.

Psammoma bodies are a characteristic finding in papillary carcinoma of the thyroid gland, not follicular carcinoma. Follicular carcinoma of the thyroid gland is typically associated with a pulsating bony secondaries of veins, is seen in long-standing multinodular goiter, and cannot be distinguished from follicular adenoma on fine-needle aspiration cytology (FNAC).

The correct answer is "Infiltration of carotid sheath leading to unpalpable carotid pulsation." Berry's sign refers to the infiltration of the carotid sheath by a thyroid carcinoma, which can lead to compression and obstruction of the carotid artery. This compression can result in a decrease or absence of palpable carotid pulsations.

The correct answer is wide local excision. Cystosarcoma phylloides is a rare type of breast tumor that is typically treated with surgery. Wide local excision involves removing the tumor along with a margin of healthy tissue around it, while preserving the breast. This approach is often chosen when the tumor is small and the surrounding breast tissue is not extensively involved. Simple mastectomy involves removing the entire breast, while MRM (modified radical mastectomy) and radical mastectomy involve removing the breast along with the underlying muscles and lymph nodes. These more extensive surgeries are typically reserved for larger tumors or cases where the tumor has spread to nearby tissues.

The management of choice for a patient presenting with a swelling in the thyroid gland and a lymph node in the neck, with aspiration of the node showing amyloid material, is total thyroidectomy with neck dissection. This is because the presence of amyloid material suggests the possibility of medullary thyroid carcinoma, which requires complete removal of the thyroid gland (total thyroidectomy) along with removal of the affected lymph nodes (neck dissection) to achieve optimal treatment outcomes. Hemithyroidectomy alone may not be sufficient in this case. Neck irradiation is not the preferred management option in this scenario.

Thyroxine is the correct answer for the treatment of Hashimoto's disease. Hashimoto's disease is an autoimmune disorder where the immune system attacks the thyroid gland, leading to an underactive thyroid. Thyroxine, a synthetic form of the thyroid hormone, is prescribed to replace the hormone that the thyroid gland is unable to produce. This medication helps to regulate the body's metabolism and energy levels. By taking thyroxine, patients with Hashimoto's disease can manage their symptoms and maintain a healthy thyroid function.

Silicon prosthesis is the procedure of choice for breast reconstruction. This involves the use of silicone implants to create a natural-looking breast shape and size. It is a popular option as it provides immediate results, requires less surgery time compared to other procedures, and allows for customization based on the patient's preferences. Silicone prosthesis also has a lower risk of complications and provides a long-lasting solution for breast reconstruction.

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After thyroid surgery, it is possible that the patient is experiencing severe dyspnea due to the sutures being too tight or causing compression on the airway. Therefore, the first treatment would be to open the sutures to relieve the pressure and allow for proper airflow. Tracheostomy may be considered if the dyspnea persists or worsens after opening the sutures, but it is not the initial treatment. "Wart & watch" and "Trid thyroidectomy" are not relevant options in this scenario.

Hurthle cell carcinoma is a variant of follicular carcinoma. Hurthle cells are a type of thyroid cells that are larger and have more mitochondria compared to normal thyroid cells. In Hurthle cell carcinoma, these cells become cancerous and form a tumor in the thyroid gland. Follicular carcinoma is another type of thyroid cancer that arises from the follicular cells of the thyroid gland. Both Hurthle cell carcinoma and follicular carcinoma have similar characteristics and treatment approaches, which is why Hurthle cell carcinoma is considered a variant of follicular carcinoma.

The most common side effect of tamoxifen, a medication commonly used to treat breast cancer, is hot flushes. Hot flushes, also known as hot flashes, are a sudden feeling of warmth or heat that is often accompanied by sweating and a reddening of the skin. This side effect is caused by tamoxifen's effect on estrogen levels in the body. While weight gain, endometrial cancer, and thromboembolism are potential side effects of tamoxifen, hot flushes are the most commonly reported.

In Patey's mastectomy, which is a surgical procedure for breast cancer, the entire breast is removed along with the pectoralis major muscle, axillary lymph nodes, and the lining over the chest muscles. However, the pectoralis minor muscle is not removed during this procedure. Therefore, all structures mentioned in the options are preserved except for the pectoralis minor muscle.

Damage to the superior laryngeal nerve can lead to a loss of timbre and resonance in the voice. The superior laryngeal nerve controls the cricothyroid muscle, which is responsible for adjusting the tension of the vocal cords. When this nerve is damaged, it can result in a change in the quality of the voice, causing it to lose its characteristic tone and resonance. This can make the voice sound dull or flat, affecting the overall sound and quality of speech.

The correct answer is steroids. De Quervain's thyroiditis is an inflammatory condition that affects the thyroid gland, causing pain and swelling. Steroids, such as prednisone, are commonly prescribed to reduce inflammation and relieve symptoms. Steroids work by suppressing the immune system and reducing the production of inflammatory substances. This helps to alleviate pain, swelling, and other symptoms associated with de Quervain's thyroiditis. Aspirin, TSH, and ACTH are not typically used in the treatment of this condition.

In this case, the lactating mother has a painful swelling in her breast with cellulitis, which indicates an infection. The presence of localized fluctuation suggests the formation of an abscess. Incision and drainage is the treatment of choice for abscesses, as it allows for the removal of pus and promotes healing. Analgesics and antibiotics alone may not be sufficient to treat the abscess. Hot compression with antibiotics may help with pain relief and control the infection to some extent, but it may not completely resolve the abscess. Reassurance with breast emptying alone would not be enough to treat the abscess.

The question asks for the gene that is not implicated in breast cancer. BRACA1 and BRCA2 are well-known genes associated with an increased risk of breast cancer. P53 is a tumor suppressor gene that plays a crucial role in preventing cancer development. X-ras, on the other hand, is not typically associated with breast cancer. Therefore, X-ras is the correct answer as it is the only gene listed that is not implicated in breast cancer.

The correct answer is PCT. PCT stands for Papillary Thyroid Carcinoma, which is the most common type of thyroid cancer in children. It is a slow-growing cancer that usually has a good prognosis. MCT (Medullary Thyroid Carcinoma) and FCT (Follicular Thyroid Carcinoma) are other types of thyroid cancer, but they are less common in children. Anaplastic thyroid cancer is a rare and aggressive form of thyroid cancer that is typically found in older adults.

Medullary ca is a type of thyroid cancer that originates from the parafollicular cells of the thyroid gland. These cells produce calcitonin, a hormone that helps regulate calcium levels in the body. Therefore, high levels of calcitonin are seen in medullary ca. This hormone can be used as a tumor marker to aid in the diagnosis and monitoring of this specific type of thyroid cancer. Follicular ca, papillary ca, and anaplastic ca are other types of thyroid cancer that do not typically exhibit elevated levels of calcitonin.

Respiratory distress on the fifty day is likely due to hypoparathyroidism. Hypoparathyroidism is a condition characterized by low levels of parathyroid hormone, which can lead to low levels of calcium in the blood. This can cause muscle spasms and contractions, including those in the respiratory muscles, leading to difficulty breathing. Hypoparathyroidism can also cause other symptoms such as numbness and tingling, muscle cramps, and seizures.

Fibroadenoma is a benign breast tumor that is characterized by a well-demarcated capsule. This means that the tumor is encapsulated and can be easily distinguished from the surrounding breast tissue. Fibroadenomas are not typically associated with a phylloides tumor, which is a different type of breast tumor. Additionally, fibroadenomas can occur in women of any age, including those who are postmenopausal. Fine-needle aspiration cytology (FNAC) may be performed to confirm the diagnosis of fibroadenoma, but it is not always conclusive.

The structures preserved in Halsted's mastectomy are the axillary lymph nodes, axillary vein, pectoralis major, and pectoralis minor. The axillary lymph nodes are important for evaluating the spread of cancer and determining the appropriate treatment. The axillary vein is preserved to maintain proper blood flow and prevent complications. The pectoralis major and pectoralis minor muscles are preserved to maintain function and aesthetics of the chest wall.

Median ectopic thyroid refers to the presence of normal thyroid tissue in the midline of the neck, instead of its usual location. This can occur due to abnormal migration of thyroid tissue during embryonic development. Therefore, the correct answer is "Normal thyroid tissue."

Lateral aberrant thyroid refers to the presence of metastasis from a primary tumor located in the thyroid gland. This means that cancer cells from the thyroid have spread to other parts of the body, such as nearby lymph nodes or distant organs. It is important to identify and treat these metastases, as they can have significant implications for the management and prognosis of the patient.

In patients with hypothyroidism, the thyroid gland does not produce enough thyroid hormone, which slows down the body's metabolism. This can lead to symptoms such as weight gain, constipation, and bradycardia (slow heart rate). However, increased appetite leading to weight gain is not a typical symptom of hypothyroidism. In fact, patients with hypothyroidism often experience a decreased appetite.

Hashimoto's is the most common cause of hypothyroidism. It is an autoimmune disorder in which the immune system mistakenly attacks the thyroid gland, leading to inflammation and damage. This results in a decreased production of thyroid hormones, leading to hypothyroidism. Thyroidectomy, 131 I therapy, and anti-thyroid drugs are not the most common causes of hypothyroidism, although they can contribute to it in certain cases.

Modified radical mastectomy is the treatment of choice for early breast cancer when conservative breast surgery is not possible. This procedure involves the removal of the entire breast tissue, including the breast lump or tumor, as well as the axillary lymph nodes. Unlike radical mastectomy, which also removes the chest muscles, modified radical mastectomy preserves the chest muscles, resulting in better cosmetic outcomes and improved quality of life for the patient. Extended radical mastectomy is a more extensive procedure that involves the removal of additional tissue, and RT refers to radiation therapy, which is often used as an adjuvant treatment after surgery.

Follicular carcinoma is the correct answer because it is a type of thyroid carcinoma that can spread to other parts of the body, including the lymph nodes. It is characterized by the presence of pulsating secondaries, which refers to the pulsation or throbbing sensation felt in the secondary tumors. This pulsation may be due to increased blood flow or vascularity in the tumors. Other types of thyroid carcinoma, such as papillary carcinoma, medullary carcinoma, and anaplastic carcinoma, do not typically present with pulsating secondaries.

Gynaecomastia is the enlargement of breast tissue in males. It is commonly seen during puberty due to hormonal changes. However, it is not seen in Klienfilters syndrome, Testicular tumours, or Turner's syndrome. Turner's syndrome is a genetic disorder that affects females and is characterized by the absence or abnormalities of the X chromosome. Therefore, the correct answer is Turner's syndrome.

The most important prognostic factor in breast cancer is the axillary lymph node status. The presence of cancer cells in the lymph nodes indicates that the cancer has spread beyond the breast, increasing the risk of recurrence and metastasis. Therefore, the axillary lymph node status is crucial in determining the stage of the cancer and guiding treatment decisions. Tumor size, ER/PR status, and histological type of the tumor are also important factors, but the involvement of the lymph nodes has a stronger impact on prognosis.

A spiculated mass is a common finding of breast cancer in mammography. It refers to a mass with irregular, spiky projections that extend outward from the main mass. This appearance is often indicative of an aggressive and invasive tumor, as the spiculations represent the tumor infiltrating and distorting the surrounding tissue. The presence of a spiculated mass in mammography is concerning and may require further diagnostic tests, such as a biopsy, to determine if it is cancerous.

Hemithyroidectomy is the treatment of choice in a cold nodule. A cold nodule refers to a thyroid nodule that does not take up radioactive iodine (I-131) during a scan. This indicates a lower likelihood of being cancerous. Hemithyroidectomy involves the surgical removal of half of the thyroid gland, which is the affected side where the cold nodule is located. This procedure allows for both diagnosis and treatment of the cold nodule, while preserving the function of the remaining healthy thyroid tissue.

In Patey's mastectomy, the correct answer is "Pectoralis minor removed major preserved". This means that during the surgery, the pectoralis minor muscle is removed while the pectoralis major muscle is preserved.

Papillary carcinoma is a type of thyroid cancer that typically spreads to nearby lymph nodes but rarely spreads to distant sites such as bone. Therefore, the statement "Spreads to bone" is not true for papillary carcinoma.

Thyroiditis is inflammation of the thyroid gland. Hashimoto's thyroiditis is an autoimmune disorder where the body's immune system mistakenly attacks the thyroid gland, leading to chronic inflammation. It is the most common form of thyroiditis and is characterized by an enlarged thyroid gland, fatigue, weight gain, and other symptoms. De-Quervain's thyroiditis is a viral infection that causes sudden pain and swelling of the thyroid gland. Ridel's thyroiditis is a rare form of thyroiditis where the thyroid gland becomes replaced by fibrous tissue. Acute suppurative thyroiditis is a bacterial infection of the thyroid gland. Therefore, the correct answer is Hashimoto's thyroiditis, as it is not associated with areas of iodine deficiency.