NBME 23 Serum calcitonin concentration (NBME Answers)

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Retired NBME 23 Answers

nbme23/Block 2/Question#8 (reveal difficulty score)
An 8-year-old boy is brought to the physician ...
Serum calcitonin concentration 🔍 / 📺 / 🌳 / 📖
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submitted by ∗mousie(272)

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Marfanoid habitus + Mucosal neuromas + Neck mass = MEN 2B (PMM) Pheo, Medullary thyroid CA (Calcitonin secreting), mucosal neuromas

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thotcandy I knew it was MEN2B but forgot medullary ca of Thyroid is parafollicular/c cells which means Calcitonin, not T3/T4 Other answers: AntiThyroglobulin: Hashimoto's (or other thyroiditis) Dexamethasone suppression test: positive/suppressed in pituitary adenoma (acth secreting), negative/unresponsive in Adrenal hyperplasia/adenoma (suppressed by high dose) or ectopic acth (unresponsive to high dose) Serum TSH test: for papillary or follicular ca, thyroid adenomas are usually cold but could also cause HyperT TSHR antibodies: graves disease, hyperT +6

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submitted by ∗madamestep(17)

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Remember that medullary carcinoma of the thyroid is medullary. So it's between the follicles. What's between the follicles in the thyroid? C cells that secrete calcitonin.

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submitted by ∗mannan(18)

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Why is medullary thyroid cancer on the lateral side of the neck???

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username I think it is referring to like not in the midline but lateral to it. Not completely lateral but like center lateral +

yesa It's cancer so the thyroid won't be uniformly enlarged; part of it will stick out and be palpable. https://www.google.com/search?q=medullary+carcinoma&tbm=isch&ved=2ahUKEwja9fz88ZPrAhWOIN8KHeGjAD0Q2-cCegQIABAA&oq=medullary+carcinoma&gs_lcp=CgNpbWcQAzICCAAyAggAMgIIADICCAAyAggAMgIIADICCAAyAggAMgIIADICCAA6BAgjECc6BAgAEEM6BQgAELEDOggIABCxAxCDAVCmkT5Yi6E-YJKiPmgAcAB4AYABlwGIAbYJkgEEMTguMZgBAKABAaoBC2d3cy13aXotaW1nwAEB&sclient=img&ei=KfIyX5q9NI7B_Abhx4LoAw&bih=1045&biw=886&hl=en#imgrc=c3__EaYUNxocYM +

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