rman
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43. An 18-year-old woman, gravida 1, para 1, comes to the physician for a routine postpartum examination. She says that she often has milk leakage even when she is not ready to breast-feed her 6-week-old son. She reports that this symptom is particularly severe whenever he begins to cry. The physician reassures her that this is an entirely normal response. This reaction is most likely caused by psychogenic stimuli that promote secretion of which of the following mediators?
A ) Dopamine
B ) Luteinizing hormone
C ) Oxytocin
D ) Progesterone
E ) Prolactin
45. A male newborn delivered to a mother with type 1 diabetes mellitus at 30 weeks' gestation has profound hypoglycemia and is difficult to arouse. He requires a glucose infusion. An umbilical venous catheter is utilized as a central line for glucose administration with the tip directed for placement in the right atrium. In order to reach its destination, the catheter must pass through which of the following vessels?
A ) Azygos vein
B ) Ductus venosus
C ) Left hepatic artery
D ) Right portal vein
E ) Superior epigastric vein
47. A 50-year-old man comes to the physician's office for a routine health maintenance examination. He had radiation therapy for treatment of a benign thymic enlargement when he was 8 days old. Which of the following aspects of the physical examination is most likely to identify a long-term complication of this therapy?
A ) Auscultation over the cardiac apex
B ) Auscultation over the cardiac base
C ) Auscultation over the trachea and upper airways
D ) Indirect laryngoscopy
E ) Inspection of the hypopharynx
F ) Nasopharyngoscopy
G ) Palpation of the thyroid gland
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| rman
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E, B, G?
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| robin082006
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C
B
E
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| rman
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Explain, please...? I thought I would worry about secondary malignancy of thyroid gland with irradiation. What would be the problem with the hypopharynx?
Edited by rman on 06/22/06 - 12:02 PM
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| nadiabarati
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C oxytocin is responsible for milk ejection
B
G
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| robin082006
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For question 47 i go with E, to inspect the invasion of thymus.
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| nadiabarati
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He is 50 years old Robin. Increased thyroid malignancy in people with a history of irradiation to head and neck.
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| robin082006
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so what do you expect when examining thyroid?
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| robin082006
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Cancer of thyroid?
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| nadiabarati
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yes why not?
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| docarchana
Forum Guru
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radiation induced papillary ca of thyroid
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| fox
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Its C, B & G only. Everybody agrees upon C & B. Robin , the last one is G & not E hypopharynx bcos, radiation is a known risk of developing pappilary ca of thyroid. Especially radiation to tymus & head & neck region. People in the past who had undergone radiation for acne etc had developed this complication. Hence radiation for acne was stopped. Cases of papillary ca spurted after chernobyl incident & the atomic bombing of hiroshima & nagasaki. Secondly, only smoking 7 alcohol have been proved as positive risk factor for hypopharyngeal ca. Lastly ur thoughts of thymic enlargement infiltrating the hypopharynx is not possible as thymus is an upper mediastinal mass & hypopharynx is high up in the neck. Thyroid neoplasms however can involve the hypopharynx. Probably U were confused with the thyroid.
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