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Cystic tumors Pancreas

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Cystic tumors Pancreas MCQ | Central Scar Microcystic Lesion

Serous Cystadenoma Pancreas MCQ – Central Scar Microcystic Lesion

📘 Theme: Pancreas – Cystic Neoplasms (NEET SS / INI-CET High Yield)

Cystic tumors Pancreas Imaging MCQ

A 52-year-old woman undergoes imaging for vague abdominal discomfort. CT scan shows a well-circumscribed lesion in the head of the pancreas with multiple small cysts and a central stellate scar. Serum CEA and CA 19-9 levels are normal. What is the most likely diagnosis?

A. Mucinous cystic neoplasm
B. Intraductal papillary mucinous neoplasm (IPMN)
C. Serous cystadenoma
D. Solid pseudopapillary tumor

Answer: C. Serous cystadenoma

Explanation

Serous cystadenoma (microcystic adenoma) is a benign pancreatic cystic tumor characterized by a microcystic appearance and a central stellate scar (sunburst pattern). Tumor markers such as CEA and CA 19-9 are typically normal, helping differentiate it from mucinous lesions.

Why other options are incorrect

  • Mucinous cystic neoplasm: Macrocystic, occurs in body/tail, elevated CEA, malignant potential.
  • IPMN: Communicates with pancreatic duct, causes ductal dilation, may raise CA 19-9.
  • Solid pseudopapillary tumor: Seen in young women, mixed solid-cystic, no central scar.

High-yield teaching points

  • Central stellate scar + microcystic lesion = serous cystadenoma.
  • Normal CEA favors serous over mucinous lesions.
  • Surgery indicated only if symptomatic, large, or uncertain diagnosis.

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Brain tumor MCQ

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A 60-year-old male presents with progressive headache, personality changes, and recent-onset seizures. NCCT brain shows a heterogeneously hypodense lesion in the frontal lobe with irregular margins and surrounding edema. On contrast imaging, there is ring enhancement with central necrosis and significant mass effect.

What is the most likely diagnosis?

A. Meningioma
B. Glioblastoma multiforme
C. Brain abscess
D. Oligodendroglioma



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Pelvic floor

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📘 Theme: Mock Test – 1 March 2026

Pelvic Floor Mechanics

During anorectal manometry, a patient demonstrates preservation of resting continence despite severe internal anal sphincter damage. Which structure is most responsible for maintaining continence in this scenario?

A. Pubococcygeus
B. Iliococcygeus
C. Puborectalis
D. External anal sphincter

Answer: C. Puborectalis

Explanation:
The puborectalis muscle forms a U-shaped sling around the anorectal junction and is the most critical muscle for maintaining fecal continence. Its tonic contraction maintains an acute anorectal angle, preventing involuntary stool passage. Even with internal anal sphincter damage, the puborectalis sling can preserve continence.

Teaching Points:

  • Puborectalis forms a sling at the anorectal junction.
  • Maintains anorectal angle (~80–90°) → continence.
  • Relaxes during defecation → angle straightens.
  • Dysfunction → dyssynergic defecation or fecal incontinence.
  • Key compensatory mechanism when sphincters are weak.

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Waldeyer fascia

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Mock Test 2 • 1 March 2026 | Rectal Surgical Anatomy

A 60-year-old man undergoes total mesorectal excision for low rectal cancer. During posterior dissection, a dense fascial condensation at the level of S4 is divided to enter the deep retrorectal space.

All of the following statements regarding Waldeyer fascia are true EXCEPT:

A. It forms the anterior boundary of the mesorectum and separates the rectum from the prostate
B. It connects the presacral fascia to the fascia propria of the rectum
C. It is usually encountered at the level of the fourth sacral vertebra
D. Division allows entry into the deep retrorectal space
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Small bowel distenson

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NOMI MCQ | mcqsurgery.com
Q) A critically ill ICU patient on high-dose vasopressors develops abdominal distension and rising lactate. CT angiography shows patent mesenteric vessels but poor distal bowel wall enhancement. The most appropriate management is:
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Valve Surgery

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Valve Choice in Young Female with Rheumatic Mitral Stenosis MCQ

Clinical Scenario: A 28-year-old woman with rheumatic mitral stenosis requires valve replacement. She wishes to become pregnant.

Best valve choice?

A. Mechanical mitral valve
B. Bioprosthetic mitral valve
C. Ross procedure
D. Mitral valve repair is contraindicated

Nutritional Screening

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NRS-2002 Nutritional Screening MCQ | mcqsurgery.com
Q) According to NRS-2002, which patient needs nutritional intervention?
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Debakey Classification

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Aortic Dissection – DeBakey Classification MCQ

Clinical Scenario: A 52-year-old hypertensive male presents with sudden retrosternal chest pain radiating to the back. CT angiography reveals dissection confined to the ascending aorta without involvement of the arch or descending thoracic aorta.

Which DeBakey classification does this correspond to?

A. Type I
B. Type II
C. Type IIIa
D. Type IIIb

AFP & Embryomal cell carcinoma of Testis

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AFP in Pure Embryonal Cell Carcinoma MCQ | mcqsurgery.com
Q) Which of the following statements about alpha-fetoprotein (AFP) in pure embryonal cell carcinoma is most accurate?
✅ Answer: c) AFP is elevated in 50-80% of cases of pure embryonal cell carcinoma.

🔍 Explanation:
Alpha-fetoprotein (AFP) is a **tumor marker** commonly elevated in **non-seminomatous germ cell tumors** (NSGCTs), which includes **embryonal cell carcinoma**. AFP levels are elevated in approximately **50-80%** of cases of **pure embryonal carcinoma**, and this elevation is associated with the **yolk sac tumor component** that is often seen within these tumors.
  • AFP is a **glycoprotein** produced by the fetal liver and yolk sac, and its levels are typically **low in adults**.
  • It is elevated in conditions like **liver cancer**, **germ cell tumors**, and **yolk sac tumors** (which may be seen with embryonal carcinoma).
  • In **seminomas**, AFP is **usually normal**, and they are typically not associated with AFP elevation.
  • Correct interpretation of AFP levels is important for **diagnosis**, **monitoring treatment response**, and **detecting recurrence** in **germ cell tumors**.
Misinterpreting AFP levels can lead to **incorrect staging** or **diagnosis** of testicular cancers.
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