Strongest Layer of Intestine MCQ - Surgery Exam Preparation
Q) Which is the strongest layer of the intestine?
a) Mucosa
b) Submucosa
c) Muscularis propria
d) Muscularis mucosa
Answer:
b) Submucosa is the strongest and most important layer for intestinal anastomosis. It has fibroblasts that will ultimately release collagen and hold the anastomosis together. This layer should be fully incorporated in the anastomosis.
Inverted vs everted anastomosis of intestine debate has been long going on, but now many prefer inverted because mucosa is exposed to mucosa and eventually degrades, joining the two submucosa layers together to cause healing by primary intention.
Q) Endovenous Laser Ablation (EVLA) of varicose veins is best suited for patients:
A. With needle phobia B. With thrombophlebitis C. With excessive tortuosity of the vein D. With primary varicose veins
Ans d
EVLA is thermal ablation of varicose veins in which laser fiber is inserted in the lumen and ablation is done from inside. It is a good modality for primary and recurrent varicose veins and work in both long and short segments.
This treatment is not effective in cases where there is needle phobia or the veins are having excessive tortuousity or thrombophlebitis. This procedure is done under ultrasound guidance and wire is passed from the superficial to the deep veins.
Tumescent means swollen or distended, typically due to the infiltration of fluid.
It refers to the injection of a large volume of dilute local anesthetic solution (usually lidocaine with epinephrine and saline) into subcutaneous tissue.
This causes the tissue to swell or become turgid (tumescent).
In procedures like endovenous thermal ablation:
Tumescent solution:
Compresses the vein to improve contact with the ablation device.
Separates the vein from surrounding structures (like nerves or skin).
Acts as a thermal insulator (heat sink) to prevent collateral damage.
Tumescent local anesthesia also helps
A. Needle phobia – EVLA requires multiple needle sticks (tumescent anesthesia), making this option inappropriate.
B. Thrombophlebitis – Active inflammation or thrombosis is a relative contraindication to EVLA.
C. Excess tortuosity – Makes catheter navigation difficult; EVLA is less suitable.
D. Primary varicose veins – Ideal candidates, especially with straight vein anatomy and valvular incompetence.
Most Common Type of ASD MCQ for NEET SS | mcqsurgery.com
Most common type of atrial septal defect (ASD) is:
Correct Answer
B) Ostium secundum
Explanation
Atrial septal defects are classified according to their anatomical location within the atrial septum.
Ostium secundum ASD:
Located at the region of the fossa ovalis.
It accounts for approximately 70–75% of all atrial septal defects, making it the most common type.
Ostium primum ASD:
Less common.
Typically associated with atrioventricular septal defects and endocardial cushion defects.
Rapid unilateral development of inversion of nipple is a dangerous sign and warrants further diagnosis. Further circumferential retraction is also sign of carcinoma.
Simple nipple inversion occurring at puberty or retracted nipple is of unknown cause and is bilateral in 25%. Mostly No treatment is required for this and condition resolves spontaneously during pregnancy and lactation.
Suction pumps and cosmetic surgery can also help.
Inversion of nipple associated with malignancy may be with or without the presence of lump. Associated discharge from the nipple can point to the diagnosis.
Duct ectasia - slit like retraction of nipple . ALso seen in duct ectasia is green, black or blood stained discharge from nipple
Ref - Bailey 801
Grading of benign nipple inversions for management
In grade I, the nipple is easily pulled out manually and maintains its projection quite well. It has minimal fibrosis thus, manual traction and a single, buried purse-string suture are enough for the correction.
Grade II (majority) the nipples can be pulled out but cannot maintain projection and tend to go back again. These nipples are thought to have moderate fibrosis beneath the nipple.
In grade III, to which the least number of inverted-nipple cases belong, the nipple can hardly be pulled out manually. Severe fibrosis made it impossible to reach optimal release of the fibrotic band with the preservation of the ducts.
Q) Popcorn calcification in breast is seen in which condition
a) Fibroadenoma
b) Periductal fibrosis
c) Carcinoma breast
d) Duct ectasia
Free answer to Surgery MCQs
a
Calcifications associated with fibroadenomas have been termed popcorn calcifications because of their large size and dense, coarse appearance. Calcifications in fibroadenomas usually begin at the periphery and then involve the central portion of the fibroadenoma.
