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gilbert
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05/27/07 - 01:09 PM       #1

9. A previously healthy 30-year-old woman has had a painless lump in her neck for 2 days. Her mother was treated for a thyroid tumor at the age of 35 years. Her 28-year-old sister has an increased serum calcitonin level but no thyroid mass. Examination shows a palpable thyroid nodule. Her serum calcitonin level is increased. Which of the following diagnoses should be excluded prior to surgical treatment of the thyroid gland?

A ) Adrenocortical carcinoma
B ) Lung carcinoma
C ) Ovarian carcinoma
D ) Parathyroid carcinoma
E ) Pheochromocytoma

D?

hanialkhadher
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05/27/07 - 04:48 PM       #2

E

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gilbert
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05/27/07 - 05:00 PM       #3

Is it possible that calcitonin increased secondary to increased calcium caused by PTH? And why exclude pheochromocytoma before surgery? Prevent intraoperational HTN?

nadiabarati

05/27/07 - 06:19 PM       #4

E
because it can be part of MEN IIa or MEN IIb. Look at the family history.

new_n_lost
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05/27/07 - 06:49 PM       #5

Medullary Carcinoma is associated with MEN IIa & MEN IIb n Pheochromocytoma will surely give problems during surgery

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prathapdoctor
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05/28/07 - 12:15 AM       #6

yes, its surely E.

Akeen
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05/28/07 - 03:36 AM       #7

Agrees with E. Operative mgt should be preceded by screening for phaeochromocytoma.

A rapid Review of the MEN!

MEN I - Parathyroid tumor
Pancreatic islet tumor
Pituitory tumor

MEN IIa - Medullary thyroid CA
Phaeochromocytoma
Parathyroid tumor

MEN IIb - Medullary thyroid CA
Phaeochromocytoma
Mucosal Neuroma


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gilbert
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05/28/07 - 07:36 AM       #8

Correction: MEN IIa, parathyroid hyperplasia, not tumor.

ram3
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06/04/07 - 08:32 AM       #9

The answer is pheochromocytoma Big Time

Justice
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06/04/07 - 08:38 AM       #10

E ) Pheochromocytoma

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cirus
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06/07/07 - 09:00 AM       #11

Sure about for phaeochromocytoma
Must cotrol with alpha Bs--> Phentolamine & Phenoxibenzamine
BBS---> containdicated as thy will lead to unopposed Alpha recept action

ashfaque
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06/10/07 - 06:29 AM       #12

E for sure









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