NEET MCQ SS 51-55

NEET MCQ SS Questions


This page has questions 51-55 from NEET SS Surgery.

 

Q 51) Tracer used in Sentinel lymph node mapping

a) Technetium pertechnate

b) Technetium labelled colloid sulfur

c) Technetium 99

d) Gentian Violet


Q52) What is N2 lymph node involvement in carcinoma esophagus

a) Involvement of upto  2 lymph nodes

b) 3-6 lymph nodes

c) more than 6

d) Supraclavicualr


Q53) Correct about N staging in oral carcinoma

a) N1 ipsilateral more than 6 cm

b) N2a ipsilateral single node between 3-6 cm

c) N2b is Multiple ipsilateral more than 6 cm

d) N2c is Bilateral more than 6 cm


  Q54) In Moya Moya disease which of the following is true

a) It is a disease of geriatric age group

b) Occurs due to the occlusion of vertebral artery

c) There is presence of smoke puff sign on angiography

d)


Q55)  Which of the following is true about reno vascular hypertension

a) Seen in young age group

b) Both kidneys are of same size

c) It is familial

d) 

                                                                              Answers

51. b , Technetium labelled colloid sulfur

Sentinel lymph node is the first lymph node draining the tumor area of the region. If the 1st lymph node in axilla is negative on HPE report, it spares excessive lymph node dissection in the entire axilla.

Dye is injected in the subdermal plexus of breast. Dye is radioisotope labelled albumin and patent blue dye. The lymph node takes up the dye and can be seen by a haand held gamma camera.

Uses, dosages and timings of Technetium labelled colloid sulfur

Lymphoscintigraphy
Gastric emptying scan

Liver /Spleen scan

GI bleed

Ref: Bailey page 814

http://theoncologist.alphamedpress.org/content/3/3/165.full


52. b 

5-7 lymph nodes


53. b

N2a ipsilateral between 3-6 cm

Cervical lymph nodes are divided into (i) Submandibular (II) Upper jugular, (iii) Middle  jugular (iv) Lower jugular and (v) Posterior triangle

Cancer of oral cavity and lips mainly go to lymph nodes I, II, and III

Tongue skip metastasis to level III and IV is common 

Oropharynx - II, III, IV and contralateral

TNM Staging


NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 : Metastasis in a single ipsilateral lymph node <3 cm in greatest dimension
N2a:  Metastasis in a single ipsilateral lymph node >3 cm but not more than 6 cm
N2b:  Metastasis in multiple ipsilateral lymph nodes, none >6 cm in greatest dimension
N2c : Metastasis in bilateral or contralateral lymph nodes, none >6 cm in greatest dimension
N3 Metastasis in any lymph node >6 cm

Ref: Bailey 709


54) c

Moya Moya disease is a progressive obstructive disease of the vascular system of the brain affecting the internal carotid arteries.

It is Autoimmune and seen  in young age 

"Puff of smoke" is produced due to development of collateral circulation of external carotid system

Moya Moya disease angiographic picture
Angiography MOYA MOYA Disease

Treatment options include bypassing the blocked artery

BAiley page 620


55. a

Renal artery occlusion creates ischemia of the kidney which releases renin. Hypereninemia leads to secondary hypertension. This further leads to conversion of angiotensin I to angiotensin II and vasocontriction and eventually release of aldosterone.

It is a disease of young adults and children

Size of the kidneys vary and diuretics do not control hypertension because the mechanism is high renin secretion which is unresponsive to diuretics.

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