Q- A lady who is 9 weeks pregnant comes with a 2.5 cm mass in the upper outer quadrant of left breast. Ultrasound failed to show any abnormality. The ideal management will be to:
A. Aspirate the cyst and reassure
B. Finger guided core biopsy
C. Call patient one month after delivery
D. Do mammography.
Answer is B. Finger guided core biopsy
▪️Most breast lesions in pregnancy - Benign.
▪️MC non-gynecologic malignancy associated with pregnancy.
▪️Ductal carcinoma - MC type - 75-90%° breast cancer in pregnancy.
Diagnosis:
▪️Biopsy - To rule out malignancy.
▪️Core-needle biopsy with or without ultrasound guidance - Safe & reliable method.
▪️Mammography - Rarely indicated.
🔹Due to decreased sensitivity during pregnancy & lactation.
🔹Fetus needs shield during mammography.
Q- A 6 months old child woke up in night, crying with abdominal pain, which got relieved on passing red stool. What is the most likely diagnosis?
A. Meckel's diverticulum
B. Intussusception
C. Malrotation
D. Intestinal obstruction
Answer is B. Intussusception
▪️'Intussusception refers to the telescoping of a proxintal segment of intestine into a clistal segment(intussuscipiens)
▪️This is a common cause of intestinal obstruction in children between 3 monlhs and 6 years.
▪️Most cases occur in infants during the weaning period following introduction of a new food, vaccination or upper respiraton' tract infection.
▪️The classic triad of abdominal pain, red carrent jelly stools (blood and mucus) and palpable mass is seen only in a small percentage of children.
Ultrasound is the investigation of choice
Q- The most common type of Tracheo-Oesophageal Fistula is -
A. Esophageal atresia without tracheoesophageal fistula
B. Esophageal atresia with proximal tracheoesophageal fistula
C. Esophageal atresia with distal tracheoesophageal fistula
D. Esophageal atresia with proximal and distal fistula
Answer is C. Esophageal atresia with distal tracheoesophageal fistula
TEF is classified into five types based on presence of esophageal atresia and location of fistula:
Type A : There is esophageal atresia without TEF. There is no gas in abdomen. It is 2'd most common type.
Type B : There is proximal TEF. There is no gas in abdomen.
Type C : There is proximal esophageal atresia with distal TEF. Gas in abdomen is present. It is most common.
Type D : Both proximal and distal fistula are present. Gas in abdomen is present. It is least common.
Type E : Isolated TEF (H or N type) is there.
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