Explanation

Malignant tumors of the larynx can spread through multiple pathways, including:

1. Lymphatic channel: The most common route of metastasis for laryngeal cancer is the lymphatic system.
2. Nerve: Perineural invasion can occur, although it is less common than lymphatic spread.
3. Blood: Hematogenous spread (through the bloodstream) can occur, leading to distant metastases.
4. Direct spread to distant structures: Laryngeal cancer can directly invade adjacent structures such as the thyroid, esophagus, and neck muscles
   

Explanation

For high‐risk GTN, EMA/CO is the most commonly used first‐line therapy, with platinum‐etoposide combinations

EMA/CO therapy consists of the combination of etoposide, methotrexate, and actinomycin D, along with cyclophosphamide and vincristine.

Explanation

The statement that is not correct regarding snake bites is The type of first aid given to the victim will decide the severity of the outcome.

The first aid given may help in stabilizing the victim temporarily but does not ultimately determine the severity of the outcome.

While prompt and appropriate first aid can help mitigate the effects of a snake bite,

the severity of the outcome is influenced by various factors including:

• the type of snake
• the amount of venom injected
• the location of the bite
• the size and health of the victim
• the availability and timeliness of medical treatment.
  

Explanation

"hypertension" is often referred to as the iceberg disease.

This is because hypertension often has no obvious symptoms in its early stages, earning it the nickname "the silent killer.

"Iceberg disease" is a term used to describe conditions where only a small portion of the problem is visible or apparent

Explanation

Etomidate is the imidazole derivative among the options provided.

Imidazole is a five-membered aromatic ring containing:

• two non-adjacent nitrogen atoms
• etomidate

This imidazole ring structure is in its chemical composition.

Additional information:

Thiopentone sodium and methohexitone are barbiturate derivatives, and propofol is a phenol derivative.