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ABIM - Practice Test
Practice test #3
| Question | Answer |
|---|---|
| Sexual interest/arousal disorder | lack of sexual interest thoughts or fantasies, dec initiation of sex or dec responsiveness to partner's initiation, dec excitement/pleasure 4 sex, dec response to sex cues, or dec sensations during sex; assoc personal distress is required. Requires 6 mo. |
| low dopamine transporter uptake in the basal ganglia on single-photon emission CT or PET scans | dementia with Lewy bodies |
| cognitive fluctuations (episodic disorganized speech and functional disability, daytime sleepiness), parkinsonism, visual hallucinations, and severe sensitivity to haloperidol | dementia with Lewy bodies |
| elderly woman w hypothyroidism; 2-week h/o unintentional wt loss, night sweats, and neck swelling. She has more recently also had difficulty swallowing solid foods and positional shortness of breath. thyroid is symmetrically enlarged, firm, and fixed. | Primary thyroid lymphoma |
| How to treat Primary thyroid lymphoma | Treatment typically involves chemotherapy and/or radiation therapy. Thyroidectomy is usually not needed. |
| Presentation of papillary thyroid cancer | tumors typically grow very slowly; thyroid is not typically diffusely enlarged, a distinct nodule and potentially concomitant cervical lymphadenopathy would be expected. |
| Acute onset anterior neck pain. It is typically seen following a viral illness in the preceding months. The changes on CT are typically a patchy infiltrate with minimal lymphadenopathy. | Subacute (de Quervain) thyroiditis |
| Symptoms of a VIPoma | watery diarrhea --> dehydration, hypoK, achlorhydria, acidosis, vasodilation (flushing and hypotension), hypercalcemia and hyperglycemia. |
| What is a VIPoma | non-β islet cell of the pancreas, that produce vasoactive intestinal peptide (VIP) causing watery diarrhea --> dehydration, hypoK, achlorhydria, acidosis, vasodilation (flushing and hypotension), hypercalcemia and hyperglycemia. |
| VIPoma is associated with what | MEN I |
| What is Zollinger Ellison syndrome | non–beta islet cell (islet of Langerhans), gastrin-secreting tumor (gastrinoma) in pancreas -> stimulates the parietal cells to release max H+, with consequent gastric/duodenal ulceration and parietal cell hyperplasia |
| sxs of Zollinger Ellison syndrome | abdominal pain and diarrhea, severe ulceration of the stomach and small bowel, especially if they fail to respond to treatment |
| What syndrome is a gastrinoma associated with | MEN I |
| MEN I | PPP Pituitary tumor, pancreatic (gastrinoma, VIPoma) hyperParathyroidism |
| MEN II | PPM Hyperparathyroidism, pheochromocytoma, medullary thyroid cancer |
| MEN III | PMM Pheochromocytoma, Medullary thyroid cancer, Mucosal neuroma |
| Medullary thyroid carcinoma is associated with what gene? | RET Proto oncogene |
| What will you see on imaging and lab tests for medullary carcinoma of the thyroid? | Increased calcitonin and dense calcification in the tumor |
| What is the treatment for medullary carcinoma? | Total thyroidectomy |
| Why does radio iodine ablation not work for medullary carcinoma of the thyroid? | Because radio iodine is not taken up by the cancer cells |
| How to follow recurrence in medullary carcinoma of the thyroid? | Follow calcitonin levels |
| How you treat for recurrence of medullary thyroid carcinoma? | cabozantinib |
| prior to thyroidectomy in a patient with medullary thyroid carcinoma, what should the patient get? | Test plasma fractionated metadata friends to assess for pheochromocytoma. Failure to identify and treat a pheochromocytoma prior to surgery can result in intraoperative hypertensive crisis |
| Which thyroid cancer has pitted calcifications? | Papillary thyroid carcinoma |
| Papillary thyroid carcinoma is associated with which gene? | BRAF |
| What is the treatment for papillary thyroid carcinoma? | Thyroidectomy followed by radio iodine ablation |
| How do you follow papillary thyroid carcinoma to assess for recurrence? | Follow thyroglobulin |
| How to treat a recurrence of papillary thyroid carcinoma? | sorafenib |
| How does follicular thyroid carcinoma present? | A mass with distant metastases |
| What gene is associated with follicular thyroid carcinoma? | RAS |
| How to treat follicular thyroid carcinoma | Thyroidectomy followed by radio iodine ablation |
| How to follow recurrence of follicular thyroid carcinoma? | Follow thyroglobulin level |
| How to treat a recurrence of follicular thyroid carcinoma? | sorafenib |
| Who usually got anapestic carcinoma of the thyroid? | Presents as a mass in the elderly, worst prognosis |
Created by:
christinapham
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