NEET Questions 71-75

NEET Questions 71-75

NEET SS TEST


Questions 46-50         Questions 51-55        Questions 56-60             Questions 61-66         Questions 67-70     More


 

Q71) False about choledochal cyst is 

a) Type IV is also known as Caroli's disease

b) Type I choledochal cyst is the most common type

c) Type III is also called as choledochocele

d) Type II choledochal cyst is diverticular disease


Q72 ) How should you transport amputated finger?

a) Plastic bag with wet ice inside

b) Plastic bag with wet ice outside

c) Plastic bag with dry ice outside

d) Over sterile gauge 


Q73 ) According to Siewert classification tumors at GE junction are

a) Type I

b) Type II

c) Type III

d) Type IV


Q 74) In LYMPHEDEMA STOCKING class A pressure is ?
a. 20 -30mmHg
b. 30-40 mmHg
c. 40-50 mmHg
d. 50-60


Q75) Starburst appearance is seen in

a) Mucinous cystic neoplasm

b) Serous cystic neoplasm

c) IPMN

d) Pseudocyst of pancreas


Answers 71

a

Original classification of choledochal cysts was given by Alonso Lej and later modified by Todani. 

Type I most common and and is fusiform dilatation

Type II saccular diverticulum

Type III dilatation in the intramural duodenum also called choledochocele

Type IV 

IVa Both intrahepatic and extrahepatic biliary tree

IV b Multiple extrahepatic biliary

Type V - Caroli disease

Intrahepatic ducts only can be single or multiple

Ref Sabiston page 1510


72 ) b

Amputated finger should be clean of debris and it should be carefully wrapped in a sterile towel or gauge which is moistened with ringer lactate to prevent desiccation. It is  placed in a plastic bag and transported in an insulated bag with ice outside at a temp of 4 degree celcius

Direct contact of ice with the finger should not happen.

Ref http://www.digimed.ir/Books/sabiston_2009/HTML/728.htm


73) b

Type I   Lower  (centre located within between 1-5cm above the anatomic OGJ)

Type II Real GE junction  (within 1cm above and 2cm below the OGJ)

Type III  (2-5cm below OGJ)

This classification has only 3 subtypes

According to the Siewert-Stein classification,

Type I tumour 25% approx

Type II - Most common 49%

Type III was present in 25%

This classification helps in deciding the operative management and unified pre op classificationT

Types of Surgery

Type I cancer--depending of the size of the tumour--distal 2/3 oesophagectomy with the resection of the proximal lesser curve of the stomach or total gastrectomy  or THE

In patients with types II and III cancers total gastrectomy


 

Ans 74) a

Compression garments are the mainstay of management for lymphedema. It provides compression with a high resting pressure and can follow the contour of the limb as the swelling reduces.

Pressure should be graduated from bottom above, 100 %  at ankle, 70% knee, 50% thigh and 40% groin

Ankle brachial pressure index  has to be serially followed to prevent too tight bandaging. Initially when the swelling is too much non elastic compression is used and later compression in maintenance phase.

The British  System (classes I: 14–17 mmHg; II: 18–24 mmHg; III: 25–35 mmHg)

 International (USA)  (classes I: 20–30 mmHg; II: 30–40 mmHg; III: 40–50 mmHg; IV 50–60 mmHg) 

Ans Bailey page 936


75) b

Serous cystic neoplasm

CT scan in SCN show starburst appearance in 20% of cases in which there is central calcification with radiating septa.

They are large well circumscribed masses, and on microscopy they appear as multiple lobulated small cysts which are glycogen rich.

Their most common position is head of pancreas and present with pain, abdominal mass and weight loss and obstructive jaundice.

Ref: Sabiston page 1538

 

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