Quiz: Surgery — AUA MCQ

The inferior parathyroid gland is derived from the

A 2 nd branchial pouch B - 3 rd branchial pouch C 4 th branchial pouch D th branchial pouch

Parathormone secretion is stimulated by

A Hypermagnesemia B Vit D deficiency C Hypokalemia D Parasympathetic stimulation

The left adrenal vein drains into the

A IVC B Splenic vein C Left gonadal vein D Left renal vein

Which of the following is the substrate for the catecholamines?

A Alanine B Leucine C Tyrosine D Tryptophan

The adrenal cortex arises from

A Ectoderm B Mesoderm C Endoderm D Neural crest

The first drug to be started in a symptomatic pheochromocytoma

A ACE inhibitor B Alpha blockers C Beta blocker D Calcium channel blockers

About MEN1 the following is true except

A Nephrolithiasis is a common clinical presentation B Pancreatic endocrine tumors C Insulinoma is the common pancreatic tumor D All pituitary tumors should be resected

About MEN2 which of the following is true except

A Primary hyperparathyroidism is early manifestation B Diagnostic work up should include scintography C Thyroidectomy is indicated for mutation carrier D Adrenalectomy is appropriate for phychromocytoma

About medical management of hyperparathyroidism, the following are true except

A The use of diuretics B - Intravenous saline for hypercalcemic crisis C Serum calcium 14 is an emergency D Bisphosphinate is used to reduce calcium level

The commonest position of the recurrent laryngeal nerve is

A Anterior to the inferior thyroid artery B Posterior to the inferior thyroid artery C Between branches of the inferior thyroid artery D Nonrecurring recurrent laryngeal nerve

The superior thyroid artery arises from

A The internal carotid artery B Thyrocervical trunk C External carotid artery D Subclavian artery

Propylthiouracil

A Given once daily for hyperthyroidism B Lead to agranulocytosis C Have no effect on conversion of peripheral T4 toT3 D Never cross the placenta

Subacute thyroiditis

A Is associated with hypothyroidism B Common in old age\ C Preceded by upper respiratory tract infection D Treated by thyroidectomy

The treatment option for meddulary carcinoma with no lymph node clinically

A Lobectomy and isthmectomy B Subtotal thyroidectomy C Total thyroidectomy with neck dissection D Total thyroidectomy alone

As regards papillary carcinoma of the thyroid

A It is common in children B May be associated with external irradiation C Exclusive in men D All of the above

Riedel's thyroiditis is best treated by

A Observation B Antibiotic C Corticosteroids D Surgery

The commonest etiology for supportive thyroiditis is

A E coli B Pseudomonas C Streptococcus D Staphylococcus aureus

Treatment of lingual thyroid is

A Observation B Radioactive iodine C Radiotherapy D Surgery

What is the first to be done for solitary thyroid nodule?

A Radioactive iodine B CT scan C Fine needle biopsy D Core biopsy

All the following cancer occur in thyroglossal cyst except

A Medullary carcinoma B Follicular carcinoma C Papillary carcinoma D Anaplastic carcinoma

Which of the following conditions is not presented with hyperthyroidism?

A Graves' disease B Toxic nodule C Thyroid malignancy D De-Quervain's disease

Which of the following is not a manifestation of thyrotoxicosis?

A Irritability B Hair loss C Muscle weakness D Heart block

- Surgery is not indicated in which of the following cases of hyperthyroidism

A Diffuse toxic goiter B Relapse after graves' disease C Toxic nodule D Multinodular goiter

Presentation of myxedema include all of the following except

A Heart block B Ventricular tachycardia C Depression D sepsis

As regards medullary carcinoma which of the following is false?

A May be presented with MEN syndrome B It is not depending on TSH C Have poor prognosis D May be presented with diarrhea

Which of the following is false as regards thyroid cancer?

A Papillary carcinoma is the commonest B Men are commonly affected than women C Thyroid cancer is common after the age of 70 D C cells is the origin of medullary carcinoma

Signs and symptoms of unsuspected Addison’s disease include

A Hypothermia B Hypokalemia C Hyperglycemia D Hyponatremia

Which of the following statements regarding adrenal cortical insufficiency is true?

A Treatment with exogenous steroids is usually ineffective B It is commonly seen as a consequence of metastasis of distant cancers, such as lung or breast, to the adrenal glands C Chronic adrenal insufficiency (Addison’s disease) in the preoperative patient should be recognizable by a constellation of findings, including hyperglycemia, hypernatremia, and hypokalemia D Death from untreated chronic adrenal insufficiency may occur within hours of surgery

Somatostatin contributes to which of the following processes?

A Inhibition of adrenocortical cells B inhibition of pancreatic α cells C Stimulation of antral gastrin cells D Stimulation of antral gastrin cells

The diagnosis of primary hyperparathyroidism is most strongly suggested by

A Serum acid phosphatase above 120 IU/L B Serum alkaline phosphatase above 120 IU/L C Serum calcium above 11 mg/Dl D Urinary calcium below 100 mg/day

Statements concerning Cushing syndrome secondary to adrenal adenoma is true

A Adrenal adenomas cause 40–60% of all cases of Cushing syndrome B Biochemical and x-ray procedures are generally unsuccessful in lateralizing the tumors preoperatively C Exploration of both adrenal glands is indicated D Postoperative corticoid therapy is required to prevent hypoadrenalism

The most likely diagnosis in a patient with hypertension, hypokalemia, and a 7-cm suprarenal mass is

A Hypernephroma B Cushing’s disease C - Adrenocortical carcinoma D Carcinoid

Of the common complications of thyroidectomy, the one that may be avoided through prophylaxis is

A Injury to the recurrent laryngeal nerve B Injury to the superior laryngeal nerve C Symptomatic hypocalcemia D Thyroid storm

This 30-year-old woman presented with weakness, bone pain, an elevated parathormone level, and a serum calcium level of 15.2 mg/dL. Skeletal survey films were taken, including the hand films and chest x-ray shown. The most likely cause of these findings is

A Sarcoidosis B Vitamin D intoxication C Paget’s disease D Primary hyperparathyroidism

Which of the following is found in patient with adrenal insufficiency?

A Hyperglycemia B Hyperkalemia C Hypercalcemia D Hypernatremia

Indication of surgery in patient with hyperparathyroidism

A Calcium level 12 B PTH more than 250 C Progressive renal failure D None of the above

The most common adrenal mass incidentally discovered in CT is

A Adenoma B Adrenal cyst C Adrenal hemorrhage D Lipoma

Which of the following is not a possible complication of thyroidectomy?

A Laryngeal edema B Hypercalcemia C Hypothyroidism D Hematoma

Which of the following is not a feature of multiple endocrine neoplasia type 2?

A Medullary thyroid cancer B Pheochromocytoma C Pituitary adenoma D Parathyroid tumor

The best treatment option for early anaplastic carcinoma

A Radiotherapy B Chemotherapy C Resection and radiotherapy D Total thyroidectomy

The commonest cause of vocal cord paralysis is

A Idiopathic B Malignancy C Trauma D Iatrogenic

Breast feeding woman with hyperthyroidism. What is the best treatment option?

A Radioactive iodine B Radioactive iodine C Propylthiourcil D Atenolol therapy

Parathormone hormone secretion is decreased by

A Increased serum phosphate B Decreased free Ca++ C decreased serum magnesium D Increased serum K+

All the following are associated with Cushing syndrome except

A Hypernatremia B Hypokalemia C Hyperglycemia D Low plasma adrenocorticotrophic hormone (ACTH)

Which of the following structure is a skeletal derivative of the 3rd branchial arch?

A Stapes B Styloid process C Incus and malleus D Greater cornu of hyoid bone

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