Q-61. In blast injury, which of the following organ is least vulnerable to blast wave?
a) GIT
b) Lungs
c) Ear drum
d) Liver
Answer: Liver
Explanation:
Primary injuries are caused by blast overpressure waves, or shock waves.
The ears are most often affected by the overpressure, followed by the lungs and the hollow organs of the gastrointestinal tract.
Gastrointestinal injuries may present after a delay of hours or even days.
Pulmonary baro-trauma is the most common fatal primary blast injuries.
Q-62. On mammogram all of the following are the features of a malignant tumor except:
a) Spiculation
b) Micro-calcification
c) Macro-calcification
d) Irregular mass
Answer: Macro-calcification
Explanation:
Tiny, irregular deposits called micro-calcifications may be associated with cancer.
Larger, coarser areas of calcification may be caused by aging or by a benign condition such as fibro-adenoma, a common noncancerous tumor of the breast.
Dense areas indicate tissue that is more glandular than fatty, which can make calcifications and masses more difficult to identify or differentiate from normal glandular tissue. Dense areas can also represent cancer. Distorted areas suggest tumors that may have invaded neighboring tissues.
Q-63. Which of the following is the most common endocrine tumor of pancreas?
a) Insulinoma
b) Gastrinoma
c) VIPoma
d) Glucagonoma
Answer: Insulinoma
Explanation:
Insulinoma is the most common form of pancreatic endocrine tumor. They can often be small and hard to find and most are benign.
Insulinomas are found evenly distributed within the pancreas.
Ninety percent of patients will be able to have surgical resection of the tumor.
In about 10% of all cases of insulinoma, it will be found to have spread (metastasized) to nearby lymph nodes or to the liver, and this is known as malignant insulinoma.
In these cases, surgical resection of both the tumor and the metastases is considered and chemotherapy is sometimes offered.
Q-64. A 40 year old patient is suffering from carotid body tumor. Which of the following is the best choice of treatment for him?
a) Excision of tumor
b) Radiotherapy
c) Chemotherapy
d) Carotid artery ligation both proximal and distal to the tumor
Answer: Excision of tumor
Explanation: Carotid body tumor
A carotid body tumor is a highly vascular glomus tumor that arises from the para-ganglion cells of the carotid body.
Clinical presentation is usually with a slow growing rounded neck mass. It is usually located anterior to the Sternocleidomastoid near the angle of the mandible at the level of the hyoid bone.
Characteristically, the tumor can be moved side to side but not up or down, due to its location within the carotid sheath.
Cranial nerves that travel in the carotid sheath (vagus, glosso-pharyngeal, accessory and hypoglossal nerves) may be involved. Associated symptoms relate to their dysfunction.
Surgical excision is the treatment of choice. The larger the tumor the higher is the risk of operative complication.
In patients for whom the risk of complications precludes surgery, radiotherapy may be considered.
Malignant transformation is encountered in 2-36% of cases with metastases most commonly to bone, lung and liver and regional lymph nodes.
Q-65. A Warthin’s tumor is:
a) An adeno-lymphoma of parotid gland
b) A pleomorphic adenoma of the parotid
c) A carcinoma of the parotid
d) A carcinoma of submandibular salivary gland
Answer: An adeno-lymphoma of parotid gland
Explanation:
Warthin’s tumor also known as papillary cystadenoma lymphomatosum, monomorphic adenoma or adeno-lymphoma, is a type of benign tumor of the salivary glands.
The gland most likely affected is the parotid gland. They are the 2nd most common benign parotid tumor (after pleomorphic adenoma) and are the commonest bilateral or multifocal benign parotid tumor.
Q-66. The diagnosis of congenital mega-colon is confirmed by-
a) Clinical features
b) Barium enema
c) Rectal biopsy
d) Recto-sigmoidoscopy
Answer: Rectal biopsy
Explanation:
Congenital Mega-Colon (Congenital aganglionic mega-colon)
During normal fetal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called Auerbach’s plexus and Meissner’s plexus. In Hirschsprug’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon.
Diagnostic techniques involve ano-rectal manometry, barium enema, and rectal biopsy.
The suction rectal biopsy is considered the current international gold standard in the diagnosis of Hirschsprug’s disease.
A histologic examination of the tissue would show a lack of ganglionic nerve cells.
Q-67. The defective migration of neural crest cells results in
a) Congenital mega-colon
b) Albinism
c) Adrenogenital hypoplasia
d) Dentinogenesis imperfecta
Answer: Congenital mega-colon and Albinism
Explanation:
The defective migration of neural crest cells results in
Congenital mega-colon
Albinism
Neurocristopathies
Melanoma
Oropharyngeal Teratoma
Elephant man
Q-68. Barrett’s esophagus is
a) Intestinal metaplasia
b) Squamous metaplasia
c) Columnar metaplasia
d) Intestinal dysplasia
Answer: Intestinal metaplasia
Explanation:
Barrett’s esophagus is a serious complication of GERD (Gastro-esophageal reflux disease). In Barrett’s esophagus, normal tissue lining the esophagus changes to tissue that resembles the lining of the intestine.
Barrett esophagus is marked by the presence of columnar epithelia in the lower esophagus, replacing the normal squamous cell epithelium—an example of metaplasia. This metaplasia confers an increased risk of adeno-carcinoma.
The presence of goblet cells, called intestinal metaplasia, is necessary to make a diagnosis of Barrett esophagus.
Q-69. Which of the following renal calculi are most difficult to treat with lithotripsy?
a) Uric acid stones
b) Cystine stones
c) Calcium oxalate stones
d) Triple phosphate stones
Answer: Cystine stones
Explanation:
Stones that are between 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameter are most likely to be treated with ESWL.
ESWL may work best for kidney stones in the kidney or in the part of the ureter close to the kidney.
ESWL does not successfully treat Cystine kidney stones.
ESWL is usually not used in
Pregnancy
Bleeding disorder
Kidney infection and urinary tract infection
Kidney cancer
Kidneys with abnormal structure or function
Q-70. Most common site of spinal cord tumour is:
a) Intra-dural extra-medullary
b) Extra-dural
c) Intra-medullary
d) Equally distributed
Answer: Extra-dural
Explanation:
Spinal tumors are neoplasms located in the spinal cord. Extra-dural tumors are more common than intra-dural neoplasms.
Extra-dural tumors are mostly metastases from primary cancers elsewhere (commonly breast, prostate and lung cancer).