π Theme: Plastic Surgery β Wound Healing (NEET SS / INI-CET High Yield)
Clinical Wound Healing MCQ
A 28-year-old male presents 48 hours after a clean surgical incision. The wound shows mild erythema without pus. Which of the following cells is predominantly responsible for the inflammatory phase at this stage?
A. Monocytes
B. Lymphocytes
C. Fibroblasts
D. Platelets
Answer: A. Monocytes (macrophages)
Explanation
During the inflammatory phase of wound healing (24β72 hours), monocytes migrate into the wound and differentiate into macrophages. These cells are the key regulators of healing, performing phagocytosis and releasing growth factors that initiate the proliferative phase.
Why other options are incorrect
Lymphocytes: Seen in later or chronic inflammatory phases, not dominant early.
Fibroblasts: Key cells of proliferative phase responsible for collagen deposition.
Platelets: Important in immediate hemostasis phase (first few hours only).
Cystic tumors Pancreas MCQ | Central Scar Microcystic Lesion
Serous Cystadenoma Pancreas MCQ β Central Scar Microcystic Lesion
π Theme: Pancreas β 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.
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.
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.
Mock Test 2 β’ 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
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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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
Correct Answer: B. Type II
Explanation:
Type II: Limited only to ascending aorta
Requires emergency surgical repair β risk of tamponade
Type I: Extends from ascending β arch β descending
Type III: Origin distal to left subclavian; involves descending aorta
Quick Memory Tip:
βType II = A = Ascending only β Always surgicalβ