mcq - nimishkum

[ArchivalUser]

23-year-old man visits his college health center with complaints of nausea, intermittent abdominal pain, and loose stools that began 24 hours ago. The pain is cramp-like and episodes occur intermittently every 20 minutes. He experienced one episode of vomiting 2 hours ago. He denies fever, chills or bloody stools. Vital signs are normal and physical examination is notable for mild abdominal distension and tenderness and the suggestion of a vertically oriented right upper quadrant mass. Stool sample is hemoccult positive. The patient is transported to the university medical center emergency department (ED) where a plain abdominal x-ray shows no signs of perforation but does show right side findings suggestive for intussusception. Contrast enema is immediately performed and confirms the diagnosis, but does not provide therapeutic effect. Also the study indicates a possible mass acting as the apex of the intussusception. Screening laboratory tests including white blood count (WBC), hematocrit (Hct), and coagulation laboratory tests are normal. Thirty minutes later the patient undergoes exploratory laparotomy. The suspected mass is confirmed within the midileal segment and a segmental resection is performed. 24 hours later the patient™s assigned second year resident receives the surgical pathology report that identifies the small bowel tumor as a hamartoma. Based on the histopathology findings the resident examines the patient™s mouth and confirms that the patient has buccal mucosal pigmentation. Assuming the most probable diagnosis, what should be strongly considered as an element of a malignancy screening protocol for this patient?


A. Baseline electrocardiogram (ECG) and yearly ECG beginning at age 30 years
B. Biannual pulmonary function testing (PFT)
C. Biannual renal ultrasound (RUS)
D. Yearly pancreatic ultrasound (US)
E. Yearly thyroid ultrasound (US) and thyroid stimulating hormone (TSH) levels

[ArchivalUser]

tough one...sounds likePeutz-Jhegers...
No idea for the answer...guess is a

[ArchivalUser]

D..

[ArchivalUser]

ans?????

[ArchivalUser]

d??

[ArchivalUser]

ans plz........

[ArchivalUser]

both pancreatic and thyroid malignancies are common in this peutz-jhegars.
soit could be either DDD or EEE????

[ArchivalUser]

Due to the increased risk of pancreatic adenocarcinoma in Peutz-Jeghers syndrome (PJS), screening with endoscopic ultrasound has emerged as a relatively new tool for early diagnosis.