NEET Pattern Questions

Choledochal cyst

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Q) Which of the following statement is false about classification of choledochal cyst ?

a) Type IV is also known as Caroli's disease

b) Type I choledochal cyst is the most common type

c) Type III is also called as choledochocele

d) Type II choledochal cyst is diverticular disease

NEET  MCH 2018 Questions Q no. 71-75

Ans ) a

Original classification of choledochal cysts was given by Alonso Lej and later modified by Todani. 

Type I most common and and is fusiform dilatation

Type II saccular diverticulum

Type III dilatation in the intramural duodenum also called choledochocele

Type IV 

IVa Both intrahepatic and extrahepatic biliary tree

IV b Multiple extrahepatic biliary

Type V - Caroli disease

Intrahepatic ducts only can be single or multiple

Ref Sabiston page 1510

Carbon Monoxide poisoning

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Q. Carbon monoxide poisoning true is 

a)  It is having 10 times more affinity than oxygen
b) 60 percent is not deadly.
c) . Concentration above 10% are dangerous and need observation
d)  Concentration above 10% are dangerous and need treatment with pure oxygen for more than 24 hours

d

Option A: Affinity of CO for Hb is 200-250 times that of oxygen. It causes a conformational change in Hb molecule and reduces affinity of Hb for O2, shifting the oxyhemoglobin dissociation curve to the left.

Option B: Concentrations less than 10% are usually asymptomatic. Concentrations >60% are fatal. Arterial carboxyhemoglobin level must be obtained because pulse oximetry can be falsely elevated.

Option C: Concentrations above 10 per cent are dangerous and need treatment with pure oxygen for more than 24 hours. Administration of 100% O2 reduces the half-life of CO from 250 minutes in room air to 40 to 60 minutes on 100% oxygen.

Examination of cranial nerves in head injury

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Q) Gaze paresis is seen after head injury? What is responsible for this

a) Facial nerve injury

b) Vestibulo cochlear nerve injury

c) Brain stem dysfunction

d) Optic nerve injury

 

Gaze paresis is inability to produce horizontal eye movements in one or both directions. Examination of cranial nerves in head injury is very important to fully assess the extent of injury.

Strongest layer of the intestine

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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 log going on but now many prefer inverted because mucosa is exposed to mucosa and eventually degrades joining the two submuoca together to cause healing by primary intention.

REF Schakelford: page 923

Borrmann’s classification for ca stomach

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Q) According to Borrmann's Classification of Ca stomach Type II is?

a) Fungating

b) Polypoid

c) Ulcerative

d) Infiltrative

Borrmann’s pathologic classification of gastric cancer is  based on gross appearance.

Developed in 1926

Gastric carcinoma is divided into 5 types according to this classification

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Ans  c

Ulcerative with elevated borders

Borrmann’s classification is for advanced gastric tumors. 

It is useful to distinguish between advanced and early gastric tumors because in advanced tumors neo adjuvant therapy improves over all survival.

The gross appearance of advanced gastric carcinomas can be divided into

Type I for polypoid growth or fungating 

Type II for Ulcerated with elevated borders

Type III for ulcerating with invasion of wall

Type IV for diffusely infiltrating growth which is also referred to as linitis plastica 

Type V can not be classified

 

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