Correct Answer - A
Answer- A. Splenic trauma
In splenic rupture the pain may be referred to the tip of the left
shoulder.
This is known as Kehr's sign.
It occurs due to irritation of the undersurface of the diaphragm with
blood and the pain is referred to the shoulder through the affected
fibres of phrenic nerve (C4 and C5).
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Correct Answer - D
Answer- D. Diffuse esophageal spasm
Clinical features-
Hypertrophy of circular muscles
Dysphagia
Chest pain
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Correct Answer - D
Ans. D: Ureterocele
The term ureterocele denotes a cystic ballooning of the distal end of
the ureter. This type of ureterocele is also termed orthotopic, since it
arises from a ureter with a normal insertion into the trigone.
An intravesical ureterocele results from the prolapse of the mucosa
of the terminal segment of the ureter through the ureterovesical
orifice into the bladder.
This prolapsed ureteral mucosa carries with it a portion of the
continuous sheet of the bladder mucosa around the orifice. The
prolapsed segment thus has a wall that consists of a thin layer of
muscle and collagen interposed between the bladder uroepithelium
and the ureter uroepithelium.
Since the terminal ureteral orifice is usually narrowed and partially
obstructed, and since there is no muscle support for the double
mucosal walls of the prolapsed segment, it dilates. This dilated
segment fills with urine and protrudes into the bladder.
On excretory urography, cobra head sign is classically seen with an
intravesical ureterocele.
Correct Answer - B
Ans. is 'b' i.e. Computed tomography
"CT is the most precise test for imaging aortic aneurysm" - Sabiston
'As a preoperative scanning tool, CT scan is the gold standard.
Angiography has largely been replaced by contrast CT scanning" -
Schwartz
Correct Answer - D Postoperative adhesions REF: Bailey & Love 25th edition page 1188, http://emedicine.medscape.com/article/774140overview "The most common cause of small-bowel obstruction (SBO) is postsurgical adhesions" The most common causes of intestinal obstruction in adults are: Intestinal adhesions — bands of fibrous tissue in the abdominal cavity that can form after abdominal or pelvic surgery In children, the most common cause of intestinal obstruction is telescoping of the intestine (intussusception).
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Correct Answer-C
Ans. is 'c' i.e., Charnley
• Father of the modern hip replacement: Professor Sir John
Charnley (1911-82).
• Professor Sir John Charnley was a British orthopaedic surgeon,
inventor and skilled craftsman. He is best known for his development
of the first truly successful operation for total arthroplasty of the hip,
the low-friction arthroplasty. As well as publishing significant works
on closed fracture management and compression arthrodesis, he
can also be accredited with pioneering work in the development of
clean-air operating conditions and body-exhaust suits.
Breast Imaging Reporting and Data System
(BIRADS) score of 3 means that it is a "probably
benign" lesion. The next step should be close
follow-up every 6 months for the next 2 years
During this period, the score can either be
downgraded to BIRADS 2 or upgraded to BIRADS
4 or 5
Magnetic resonance imaging (MRI) is the best
imaging modality for the breasts of women with
implants.
MRI of the breast is also useful for the following
◦ Screening of high-risk individuals (positive
family history)
◦ Assessing loco-regional spread (multifocality
and multicentricity) of carcinoma
◦ Differntiating scar from recurrence in women
who have received breast conservation
therapy for cancer
It is recommended to start an annual breast screening
once the woman reaches 40 years of age.
Until 44 years of age, it is her individual choice to decide
on whether she wants a screening or not. For ages
between 45 and 49 years, it is mandatory to get annual
breast screening. After the age of 50 years, it is adviced
that women get a second yearly screening done
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Correct Answer - C
Answer- C. Subtotal glossectomy + selective neck dissection +
mandibulectomy
The management plan for locally advanced tongue carcinomas
includes subtotal glossectomy + selective neck dissection +
mandibulectomy.
Advanced tumors (T3 and T4) often encroach upon the floor of the
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Correct Answer - A
Both acute and chronic rejection may result in hypertension. The
former causes acute fluid retention and plugging of peritubular
capillaries with inflammatory cells. This may progress to intimal
swelling and medial necrosis and eventuate in ischemia secondary
to endothelial proliferation and obliteration of small vessels. Chronic
rejection, thought to be related to protracted humoral injury, results
in obliteration of capillaries via the development of intimal
hyperplasia. Cyclosporine has a vasoconstrictive effect which,
through activation of the renin-angiotensin system, may lead to
hypertension. RTAS is responsible for hypertension in 4% to 12% of
renal allograft recipients. It responds well to percutaneous
angioplasty. A careful trial of angiotensin-converting enzyme
inhibitors may be diagnostic of RTAS. Recurrent disease such as
membranoproliferative glomerulonephritis and focal glomerular
sclerosis may result in significant hypertension in renal allograft
recipients.
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Answer is d option.
Explanation:
The fourth part of the duodenum (ascending part) is the final part of the duodenum, located on the left side of the aorta and ascending to the level of the L2 vertebra, where it joins the jejunum at the duodenojejunal flexure.
---
🔍 Visceral relations of the 4th part of duodenum:
Structure Relation
Stomach Anterior
Transverse colon Anterior
Head of pancreas Located superiorly and to the right
Jejunum Inferior
Left psoas major muscle Posterior
Abdominal aorta Posterior
Correct Answer- D
Ans. D. Vicryl and catgut
Rectum is dissected to clear of scar tissue & freshening of cut
edges.
Cut edges ofrectum and anus are sutured with vicryl.
Deep muscle of perenial body and levatorani are identified and
sutured with No l-catgut.
Superficial muscle is sutured with vicrylcatgut sutures
The procedure depicted in the image represents
myelography.
MR imaging has replaced X-ray myelography. X-
ray myelography can be used to dynamically
evaluate the spinal canal in patients with
spondylolisthesis.
Myelography is done when there is a
contraindication to MR(non-compatible
pacemaker).
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All growth factors that foster the multiplication
or development of various types of cell act
through activation of Tyrosine Kinases.
Growth factors are polypeptides and proteins
that can be divided into 3 groups:
◦ Agents that foster the multiplication or
development of various types of cell
◦ NGF, IGF-1,PDGF, Epidermal growth factor
(EGF), Activins and Inhibins
◦ Agents important in the regulation of the
immune system
◦ Cytokines
◦ Agents that regulate proliferation and
maturation of RBC & WBC
◦ Colony-stimulating factors
◦ Tyrosine Kinase regulates transcription by
• RAS dependent cascade o
Correct Answer - B
Answer- B (Vitamin B12)
Short-bowel syndrome is a disorder clinically defined by
malabsorption, diarrhea, steatorrhea, fluid and electrolyte
disturbances, and malnutrition.
Changes seen in Terminal lleal Resection
. Malabsorption of bile salts and vitamin B12 (which are normally
absorbed in this region)
• Vitamin B12 Malabsorption - Megaloblastic anemia
• Bile salts Malabsorption Unabsorbed bile salts escape into the
colon and stimulate fluid secretion from the colon - watery diarrhea
• Decreased bile salts in the bile - Cholesterol gall stones
