DM ONCOPATH – THYROID Welcome to DM ONCOPATH - THYROID The quiz has a total of 20 questions. Each correct answer carries 4 marks and each wrong answer carries -1 mark. Maximum marks- 80 GOOD LUCK! 1. Colloid formation usually starts during? a. Week 14 of the embryonal stage b. Week 12 c. Week 20 d. Week 21 1 out of 20 2. Development of thyroid is controlled by all of the following except? a. TTF-1 b. PAX-8 c. NKX 2.1 d. NKX 2.5 2 out of 20 3. Which of the following is the best marker to demonstrate thyroid origin of an anaplastic carcinoma? a. NKX 2-1 b. PAX -8 c. TTF-1 d. HHEX 3 out of 20 4. Which of the following statements is true regarding Intra-thymic carcinoma (ITC) ? a. CD 5 and CD 117 is highly suggestive b. Nests of thyroid follicular cells with lymphocytes infiltrate is the key microscopic feature c. High mitotic count d. Aggressive tumor 4 out of 20 5. Which of the following malignancies is not associated with Hashimoto thyroiditis? a. Malignant lymphoma B-cell type b. Plasmacytomas c. Mucoepidermoid carcinoma with eosinophilia d. Adenoid cystic carcinoma 5 out of 20 6. Which of the following findings favour Riedel's thyroiditis over Hashimotos thyroiditis? a. Infiltration into adjacent tissues b. Sclerosis is confined to the thyroid tissue c. Lobular architechture of the thyroid tissue is maintained d. All of the following are suggestive of Riedel thyroiditis 6 out of 20 7. Which of the following syndromes is not associated with papillary carcinoma of thyroid? a. Familial adenomatous polyposis coli (FAP) b. Peutz-Jeghers syndrome c. Turcot syndrome d. Cowden syndrome 7 out of 20 8. Which of the following statements is true regarding papillary microcarcinoma? a. Aggressive tumor with lymphatic and vascular invasion b. Defined by a size <= 1 cm c. p63 immunostaining is positive d. Total thyroidectomy has to be done 8 out of 20 9. Which of the following statements is false regarding follicular variant of papillary thyroid carcinoma? a. Majority of them have RAS mutations b. Neoplastic cells are often seen to be scattered within a background of normal follicles c. Psammoma bodies are extremely common in this variant of papillary thyroid carcinoma d. A distinct BRAF mutation (BRAF K601E) is found in encapsulated follicular variant of papillary thyroid carcinoma 9 out of 20 10. A 60 year old male presented with a palpable thyroid swelling. Histopathological examination showed the image below. Which of the following statements is false regarding the lesion? a. Has a very good prognosis b. More than 50% cases are BRAF V600E c. Cells are usually three times as tall as it is wide d. Cytology shows granular eosinophilic cytoplasm with soap bubble appearance 10 out of 20 11. What percentage of tall cells are required for designation of a papillary thyroid carcinoma as tall cell variant according to WHO 2017? >20 % >30% >40% >50% 11 out of 20 12. Which of the following immunostains is positive in normal thyroid follicular cells but is negative in papillary carcinoma of thyroid? a. HBME 1 b. CD 56 c. CITED 1 d. GALECTIN 1 12 out of 20 13. Which of the following variants of papillary thyroid carcinoma is common in children and young adults? a. Tall cell variant b. Diffuse sclerosis variant c. Cribriform morular variant d. Warthin like variant 13 out of 20 14. Identify the false statement regarding the cribriform morular variant of papillary carcinoma thyroid? a. Associated with familial adenomatous polyosis b. All cases show mutations in APC gene c. BRAF mutations are the second most common after APC gene mutation d. These tumors are exclusively seen in women 14 out of 20 15. All of the following are diagnostic features of Non invasive follicular variant of papillary thyroid carcinoma (NIFTP) except? a. Absence of psammoma bodies b. More than 50% trabecular, insular or solid growth pattern c. No invasion of the capsule d. Predominantly follicular growth pattern 15 out of 20 16. Which of the following antibiotics can result in blackish discoloration of the thyroid gland? a. Penicillin b. Imipenem c. Minocycline d. Isotretinoin 16 out of 20 17. All of the following are included in the Turin criteria in poorly differentiated carcinoma except? a. Presence of solid, trabecular and/or insular pattern, b. Presence of nuclear features of papillary carcinoma c. Carcinoma of follicular cell derivation d. Presence of tumor necrosis 17 out of 20 18. Which of the following variants of papillary thyroid carcinoma is not matched correctly with the corresponding mutations? a. Papillary microcarcinoma- BRAF V600E b. Cribriform morular variant- APC c. Diffuse sclerosing variant- RAS d. Solid trabecular variant- RET/PTC 3 18 out of 20 19. Which of the following is correct regarding C-cell hyperplasia? a. They can transform into follicular thyroid carcinoma b. Reactive C cell hyperplasia often has RET gain of function mutation c. Reactive chief cell hyperplasia is not evident on routine H and E staining d. PAS and collagen IV antibodies are often used to distinguish between Neoplastic C - cell hyperplasia and microfollicular carcinoma 19 out of 20 20. A 22-year old woman presented with a left sided neck mass for one year duration. Ultrasound and fine-needle aspiration biopsy were performed, and cytopathology was positive for malignant cells, The patient subsequently underwent a total thyroidectomy. Photomicrograph of a histopathology section is shown below. Which of the following statements is false regarding this type of thyroid carcinoma? a. Sporadic tumors are commoner in women b. It is an aggressive tumor with worse outcome c. It is common in lateral upper two thirds of the thyroid gland d. Small cell variant has a better prognosis 20 out of 20 Please fill in the comment box below. Time is Up! 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