NEET Pattern Questions

Marjolin Ulcer

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Q) 35 year old male has come with Marjolin ulcer if the leg. True about Marjolin's ulcer is ?

a) Lymphatic spread is common

b) They are painful

c) Aggressive and fast growing tumors

d) Squamous cell carcinoma is the most common type

d. squamous cell carcinoma

When a SCC or BCC occurs in a long standing scar, it is called marjolin's ulcer.

Marjolin's type of ulcer is a malignant change that can occur in any long standing ulcer (ie venous ulcer)

Scar tissue is devoid of lymphatics, so no lymphatic spread. Lymphatic spread can still occur when it invades normal tissue. also nerve endings are not in scar tissue, so pain is a late feature

They are slow growing tumors but have propensity for distal metastasis  and squamous cell carcinoma is the most common type. Slow growth is again due to avascular characteristic

Bailey 28th 625

Contrast hazards in radiology

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Q1. Not true about hazards of contrast medium use in radiological interventions?

a) Use of newer agents have improved the risk of sudden death

b) Low osmolar contrast agents are better than previously used high contrast medium

c) After contrast injections, patients should be observed for 30 mins

d) Metformin can be continued in patients with normal renal function
Answer 1

lymphatics of colon

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Q ) Which of the following group of lymph nodes  lymphatics of the colon first drain to?

a) Paracolic

b) Epicolic

c) Nodes along SMA/IMA

d) Para aortic

Ans ) b

Lymphatics first drain to epicolic group along the bowel wall

Then it goes to  paracolic group along the marginal artery

Intermediate group along the named vessels SMA/IMA

Finally to para aortic 

Colon and upper 2/5 of rectum --- Para aortic

Lower 1/5 of rectum and anal canal - Superficial inguinal lymph nodes

Ref Sabiston-1317

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