Q-31. A 60 year old female presents with history of recurrent abdominal pain. Imaging shows multiple small cystic lesions like a bunch of grapes in the head of pancreas with a grossly dilated main pancreatic duct. The most likely diagnosis is
a) Serous cystadenoma (SCN)
b) Mucinous cystadenoma (MCN)
c) Intra-ductal papillary mucinous neoplasm (IPMN)
d) Pancreatic pseudo-cyst
Answer: Intra-ductal papillary mucinous neoplasm (IPMN)
Explanation:
Bunch of grapes appearance may be seen in serous cystadenoma (SCN) and branch type in intra-ductal papillary mucinous neoplasm (IPMN).
Q-32. Which of the following is the most common cause of a pyogenic liver abscess?
a) Trauma
b) Biliary tract infection
c) Clonic diverticulitis
d) Appendicitis
Answer: Biliary tract infection
Explanation:
Biliary tract infection is the most common cause of a pyogenic liver abscess.
Q-33. Extended criteria for liver donation include all of the following except
a) Donor Age >70 years
b) HBsAg positive donors
c) Mild hepatic steatosis
d) Donor after cardiac death
Answer: HBsAg positive donors
Explanation:
Extended criteria for liver donation:
Donors age > 65 years
Donors after cardiac death
Mild or moderate steatosis
HCV positive donors
HBsAg negative donors
Q-34. Most common cause of isolated splenic metastasis is
a) Ca pancreas
b) Ca stomach
c) Ca ovary
d) Ca cervix
Answer: Ca ovary
Explanation:
Isolated splenic metastasis:
Ovary 27 %
Colo-rectal carcinoma 26 %
Uterus 17 %
Important point:
Ca ovary is most common cause of isolated splenic metastasis.
Q-35. A patient with a suspected renal tumor/ mass is diagnosed by exfoliative urinary cytology. Which of the following histological types is most likely to be diagnosed on urinary exfoliative cytology?
a) Transitional cell carcinoma
b) Adenocarcinoma
c) Well differentiated carcinoma (low grade)
d) All three types can be easily detected on exfoliative cytology
Answer: Transitional cell carcinoma
Explanation:
Exfoliative urinary cytology is most to detect high grade transitional cell carcinoma of the Urothelium as these tumors tend to shed many cells into the urine.
Q-36. A newborn with Meningomyelocele has been posted for surgery. The defect should be immediately covered with
a) Normal saline gauze
b) Povidine iodine Gauze
c) Tincture Benzoin gauze
d) Methylene blue gauze
Answer: Normal saline gauze
Explanation:
Immediately following delivery the infant should be placed in a prone position and Meningomyelocele protected from drying, trauma and infection.
This is generally accompanied by a non adherent sterile saline dressing with a plastic shield wrap to maintain the moisture.
Q-37. Which of the following is the most common complication of total parenteral nutrition (TPN)?
a) Catheter related complications
b) Acidosis
c) Acalculus cholecystitis
d) Hypokalemia
Answer: Catheter related complications
Explanation:
Catheter related complications mechanical complication and sepsis are most common complication associated with total parenteral nutrition (TPN).
Hyperglycemia is the most common metabolic complication.
Q-38. Serious complication of sitting position technique
a) Dys-arrhythmia
b) Hypotension,
c) Nerve paralysis,
d) Venous Air embolism
Answer: Venous Air embolism
Explanation:
Venous Air embolism is most serious complication in sitting position technique in neurosurgery.
Intra-operative trans-esophageal echocardiography (TEE) is found to be the monitoring technique with the highest sensitivity. The sitting position is a safe positioning technique if TEE monitoring is used.
Q-39. Not related with CA colon?
a) EGFR
b) C.myc
c) KRAS
d) Micro satellite instability
Answer: EGFR mutation
Explanation:
Molecular genetics of sporadic colon cancer:
APC
K-ras Oncogene
P53
Mismatch repair genes
DCC (deleted in colon cancer) gene
C-myc Oncogene
Microsatellite instability (MSI) is the condition of genetic hyper-mutability that results from impaired DNA Mismatch Repair.
Micro satellite instability (MSI) may result in colon cancer, gastric cancer, endometrium cancer, ovarian cancer, hepato-biliary tract cancer, urinary tract cancer, brain cancer and skin cancers. MSI is most prevalent in the cause of colon cancers.
EGFR over-expression (known as up-regulation) has been associated with a number of cancers, including lung cancer, anal cancers and glioblastoma multiforme.
Q-40. About neurogenic shock, true is:
a) Hypotension with bradycardia
b) Hypertension and bradycardia
c) Hypotension and tachycardia
d) Hypertension and tachycardia
Answer: Hypotension with bradycardia
Explanation:
In brain or spinal injury, the sympathetic trunk stops working and blood vessels dilate and result in blood pooling away from the heart.
Patients are generally hypotensive with warm, dry skin. The loss of sympathetic tone may impair the ability to redirect blood flow from the periphery to the core circulation leading to excessive heat loss and hypothermia.
Bradycardia is a characteristic finding of neurogenic shock; however, it is not universally present.