General Surgery

NEET, DNB questions from general surgery

Lymphatic right adrenal

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Lymphatic Drainage of Right Adrenal Gland | Adrenal Surgery MCQ

Q) Lymphatic drainage of Right adrenal gland is to

a) Para aortic group
b) Inter Aortocaval
c) Pre aortic
d) Para Caval

Correct Answer: d) Para-caval for right and Para aortic for left

Small lymphatic channels from both cortex and medulla drain into the hilum, from where larger calibre lymphatic emerge to drain directly into the lateral group of para-aortic lymph nodes.

  • Right side adrenal → Para-caval
  • Left side adrenal → Para-aortic

Arterial supply:

  • Superior adrenal artery (from inferior phrenic artery)
  • Middle adrenal artery (from abdominal aorta)
  • Inferior adrenal artery (from renal artery)

Venous drainage:

  • Left adrenal vein → Left renal vein
  • Right adrenal vein → IVC

Understanding lymphatic, arterial and venous drainage of the adrenal gland is critical in adrenalectomy and adrenal trauma surgery.

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Isotonic fluid

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NEET SS Surgery MCQ – Isotonic Fluid (Free)
Q) Isotonic fluid solution is
  • A. Half normal saline
  • B. 1/5th normal saline
  • C. Ringer lactate
  • D. Dextrose in Normal saline

Answer: C – Ringer lactate

Ringer lactate and Normal saline are isotonic fluids. They are useful in replacing GI losses. Ringer lactate has a bit of potassium as well.

Ringer Lactate (Correct Answer):
Ringer lactate is an isotonic solution, meaning its osmolarity (around 273 mOsm/L) is close to that of human blood (around 275–295 mOsm/L). This solution contains electrolytes like sodium, potassium, calcium, and chloride, helping maintain fluid and electrolyte balance. It's commonly used for fluid replacement in surgical and trauma patients.

A. Half Normal Saline (0.45% NaCl):
Half normal saline is a hypotonic solution (~154 mOsm/L), which draws water into cells and may cause swelling—unsuitable for isotonic fluid replacement.

B. 1/5th Normal Saline (0.18% NaCl):
This is also hypotonic (~77 mOsm/L), risking excessive fluid entering cells and causing edema—unsuitable as an isotonic option.

D. Dextrose in Normal Saline (D5NS):
D5NS is hypertonic due to added dextrose, increasing osmolarity above blood levels, which can lead to water exiting cells and potential dehydration.

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