Part 2. Surgery

1. 24 years old woman presented with diffusely enlarged thyroid gland and weight loss . On examination there was fine tremors and bulged eyes . What is the most likely Diagnosis ?

Hashimoto's thyroiditis

Grave's disease

De Quervain's thyroiditis

Riedel's thyroiditis

Key points :
- Age
- Diffusely enlarged thyroid
- weight loss
- fine tremors + exophthalmos

Explanation

Key points :
- Age
- Diffusely enlarged thyroid
- weight loss
- fine tremors + exophthalmos

2. 26 years old male presented with bloody diarrhea , abdominal pain and weight loss , Barium enema revealed cobblstone appearance with colonic strictures . What is the most likely diagnosis ?

Ulcerative colitis

Diverticulosis

Crohn's disease

Intussusception

Key Points :
- Bloody diarrhea
- Abdominal pain
- Weight loss
- Cobblstone appearance
- colonic strictures

Explanation

Key Points :
- Bloody diarrhea
- Abdominal pain
- Weight loss
- Cobblstone appearance
- colonic strictures

3. 38 years old patient presented with 2.5 cm on the Rt-sided thyroid mass , on examination there is mild enlargment of cervical lymph nodes . Thyroidectomy is performed and histology revealed non-encapsulated infiltrative mass , Psammoma bodies and epithelial cells with large clear areas within nuclei are noted . What is the most likely diagnosis ?

Papillary carcinoma

Anaplastic carcinoma

Medullary carcinoma

Follicular adenoma

Key points :
- Age
- thyroid mass with lymphadenopathy
- Psammoma bodies and epithelial cells in histology

Explanation

Key points :
- Age
- thyroid mass with lymphadenopathy
- Psammoma bodies and epithelial cells in histology

4. 50 years old male with long history of arthritis presented with constant severe generalized abdominal pain , on examination he was distressed with abdominal rigidity , pulse 110 and BP 90/60 . What is the most likely Diagnosis ?

Acute pancreatits

Aortic Dissection

Acute cholecystitis

Perforated peptic ulcer

Key points :
- Age
- Long History of Arthritis >> Long Use Of Aspirin >> Peptic Ulcer
- Generalized Severe Abdominal Pain With Rigidity
- He in shock
- You can find air-under diaphragm on erect abdominal X-ray

Explanation

Key points :
- Age
- Long History of Arthritis >> Long Use Of Aspirin >> Peptic Ulcer
- Generalized Severe Abdominal Pain With Rigidity
- He in shock
- You can find air-under diaphragm on erect abdominal X-ray