Monday, July 13, 2009

ANSWER for DMS : 155 - 159

155. C. Amitriptyline
Indication:
A (benzodiazepine) = anxiety, mixed-anxiety depressive disorder panic disorder, social phobia, OCD,PTSD, depression, bipolar I disorder, akathisia, Parkinson’s disease
B (SSRI) = separation anxiety disorder
C (tricyclics/tetracyclics) = major depression disorder, MOOD DISORDER DUE TO GENERAL MEDICAL CONDITION WITH DEPRESSIVE FEATURES, panic disorder with agoraphobia, generalized anxiety disorder, OCD, eating disorder, PAIN DISORDER
D = depression, bipolar disorder, ADHD, cocaine detoxification, smoking cessation
E = depressive, insomnia
Reference: Kaplan saddock

156. C. T2
-Hoarseness may be a sign of laryngeal cancer. Thus, refer TNM classification for head and neck cancer for oropharynx:
T grade oropharynx
T1 0-2 cm
T2 2.1-4 cm
T3 > 4 cm
T4a Larynx, muscle of tongue, medial pterygoid, hard palate, mandible invasion
T4b Lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, or skull base or encases carotid artery invasion
Reference: Harrison’s pg549

157. A. I
Refer TNM classification for head and neck trauma for regional lymph node:
NX Regional lymph node cannot be assessed
N0 No regional lymph node metastasis
N1 Unilateral metastasis in lymph node(s), ≤6cm in greatest dimension, above the supraclavicular fossa
N2 Bilateral metastasis in lymph node(s), ≤6cm in greatest dimension, above the supraclavicular fossa
N3 Metastasis in a lymph node(s) >6cm and/or to supraclavicular fossa
N3a > 6cm
N3b Extension to supraclavicular
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis
Reference: Harrison’s pg 549

158. E.Thyroid mass
It moves upward on swallowingthyroid

159. B. Jugulodigastric
-Nasopharynx is located posterior to the nose and superior to soft palate
-The abundant lymphoid tissue in pharynx forms an incomplete tonsillar ring around the superior part of the pharynx. The lymphoid tissue is aggregated in certain regions to form masses called tonsils
-Jugulodigastric node or also known as tonsillar node because of its frequent enlargement when the tonsil is inflamed
Reference: Moore anatomy pg 1102,1109
P/s:cant find the exact answer,but my guess wud be jugulodigastric.sorry.
159

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