Natural Killer cells

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Q) What are natural killer cells? a) Multinuclear monocytes b) Special macrophages c) Antibody presenting cells d) Large granular lymphocytes Answer is free d Large granular lymphocytes Natural killer cells are a part of lymphocytes called “null cells”  These are large granular lymphocytes and the 1st line of defence against viruses and bacteria They belong to null cells as they do not rely on specific match or memory. They control both tumor and microbial spread in the body.  Unlike T cells ( which mature in thymus), natural killer cells develop in bone marrow. They identify the viruses and other harmful cells by lack of major histocompatibility complexes (MHC) Antigen presenting cells are B cells T cells are direct cyto toxic cells   Ref: https://study.com/academy/lesson/natural-killer-cells-definition-functions-quiz.html         Sabiston 20th page 601

Paradoxical breathing

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Q) Paradoxical breathing is seen in a) Poland syndrome b) Flail chest c) Pectus excavatum d) Pectus carinatum Answer for premium members

Bilobed grafts

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Q Bi lobed graft is  used in which reconstruction a. Nose. b. Eyelid. c. Cheek. d) Lips Answer

Clinical Paediatric surgery Question

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Q14.  A 6 months old baby is brought to the emergency with continuous crying and drawing his legs up for 1 day. He has vomiting and passage of bloody stools. On examination a lump is found in right hypochondrium. What is the best clinical diagnoses? a) Intussusception b) Gastrochisis c) Hirshprung disease d) Intestinal atresia Answer 

Z plasty

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Q) True about Z plasty. a. 3 limbs equal with 45 degree. b. 3limbs equal 60 degree. c. All limbs equal with 45 degree d. All limbs equal with 60 degree Answer 

Tetrology of Fallot

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Q Autopsy finding  in a patient who dies of Tetrology of Fallot is a)  Brachiocephalic vein draining into the left renal vein b)  Inferior vena cava (IVC) draining to the superior mesenteric vein c)  Atrial Septal Defect (ASD) d) Decreased vascularity of the lung field Answer

Fontan Procedure

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Q 24 Contraindication of Fontan procedure? a) 20 year old male b) Severe MR c) Right pulmonary artery stenosis d) Left ventricular end diastolic pressure of 20 mm Hg 24) d Fontan procedure is for tricuspid atresia and is done when there is low pulmonary vascular resistance. For the same reason it is not done in neonates.  In Tricuspid atresia, venous blood does not go to right ventricle and there is mixing of venous and arterial blood in aorta which leads to decreased oxygenation. Most infants with tricuspid atresia have restrictive pulmonary blood flow.  To improve systemic oxygentaion they undergo modified Blalock-Taussig shunt, which is a small polytetrafluoroethylene (PTFE) graft to connect the subclavian artery and a pulmonary artery. Criteria for Fontan procedure are  Age older than 4 years Sinus rhythm Normal systemic venous return Normal right atrial volume Mean pulmonary artery pressure less than 15 mm  Pulmonary arteriolar resistance less than 4 Wood units/m 2 Pulmonary artery–aorta ratio more than 0.75 Left ventricular ejection fraction more than 0.60 Current absolute contraindications are a pulmonary vascular resistance above 4 Wood units/m2, severe hypoplasia of the pulmonary arteries, and severe diastolic dysfunction of the left ventricle.