Ludwig’s Angina

Q Cause of mortality in Ludwig’s angina
A. Asphyxia
B. Pneumothorax
C. Hemorrhage
D. Sepsis

Answer

Ludwig's angina is an inflammatory  condition of the neck which is due to 

  1. Streptococcal infection
  2. Anaerobic infection
  3. Infection of malignancy in the neck

Read on ......

 

Dieulafoy lesion

Diuelafoy lesion which is false? (AIIMS 2018) 
A. Most of the bleed cannot be visualised due to small mucosal defect lies over large arterial
bleed.
B. Large 1-3 mm artery in the submucosa is the source
C. MC in the greater curvature
D. Found within 6 cm from GEJ

Answer 

 

Spinal cord injury

Q) Out of the following which will require Spinal immobilization most?
a. 22 yr Female had a high-speed motor vehicle collision who complains of backpain and no
numbness
b.16 yr male jumped from 6ft landed on both foot denies back pain and weakness
C. Gunshot injury
D. Abdominal injury

Answer is free 

a) 

Spinal cord injuries are a common cause of morbidity and expenditure. Mortality is associated with cervical injuries but not lower spinal cord injuries.

Motor vehicle accidents are the most common cause and gunshot injuries the least common for spinal cord injuries.

Mechanism of injury 

  1. Blunt trauma - Direct impingement, Ischemia, compression or bleeding 
  2. Penetrating - Laceration of spinal cord

Chance fracture - is a type of spinal cord fracture in which there is transverse fracture of all vertebral elements

Management

1 Complete immobilisation

2. Management of associated neurogenic shock ( due to loss of sympathetic tone) with vasopressors  and fluids

Sabiston page 420

 

Lymphatic right adrenal

Q) Lymphatic drainage of Right adrenal gland is to 
a. Para aortic group
b. Inter Aortocaval
c. Pre aortic.
d. Para Caval

Answer free 

a)  Para-aortic lymph node.

Small lymphatic channels from both cortex and medulla drain into  the hilum, from where larger calibre lymphatic emerge to drain directly into the lateral group of  para-aortic lymph nodes

  • arterial supply is via three adrenal arteries 
    • superior adrenal artery (from inferior phrenic artery)
    • middle adrenal artery (from abdominal aorta)
    • inferior adrenal artery (from renal artery)
  • venous drainage 
    • adrenal veins emerge from the hilum and drain to different veins depending on the side:
      • left adrenal vein drains to the left renal vein
      • right adrenal gland drains to the IVC

( Grays anatomy)

Isotonic fluid

Q) Isotonic fluid  solution is
A. Half normal saline
B. 1/5
th normal saline
C. Ringer lactate
D. Dextrose in Normal saline

Answer is free

Ringer lactate and Normal saline are isotonic fluid. they are useful in replacing GI losses. Ringer lactate has a bit of potassium as well.

Body actually requires bicarbonate and not lactate. Lactate is the more stable form in IV solutions and is used, it is converted by liver into bicarbonates.

Half NS is used in replacing losses when sodium concentration is high in the body, mainly as maintenance fluid

1/5th NS is hardly used clinically

Dextrose in Saline or DNS is used for maintenance and is not isotonic