Hepatic artery Anomalies

Q)  Most common anomaly of hepatic artery noted during liver resection is
a. Accessory right hepatic artery originating from superior mesenteric artery
b. Replaced right hepatic artery originating from superior mesenteric artery
c. Accessory left hepatic artery originating left gastric artery

d. Replaced left hepatic artery originating from left gastric artery

Skin Grafting

Q) Skin Grafting is healing by 

a) Primary Intention

b) Secondary intention

c) Tertiary Intention

d) None of the above

Questions on Wound Healing

Ans c

Delayed primary closure, or tertiary intention, is utilised when there is a high probability of the wound being infected.

The wound is left open for a few days and, provided any infective process has resolved, the
wound is closed to heal by primary intention.

Skin grafting is another form of tertiary intention healing

Necrotising Infections

MCQ on Necrotizing Infections
Q) Least common Signs or symptoms of necrotising infections is
Answer: D. Fever

🔍 Explanation:
**Fever is usually absent** in necrotizing infections.

Indicators of Necrotizing Infections include:
- **Severe and Unusual Pain**: Patients often report intense pain disproportionate to the visible injury.
- **Swelling Beyond the Redness**: Edema extends past the erythema, signaling deeper tissue involvement.
- **Presence of Crepitus**: A crackling sound or sensation beneath the skin caused by gas-producing bacteria.
- **Formation of Blisters**: Skin blisters indicate significant tissue damage.
- **Dishwater-like Drainage**: The infected site may discharge greyish, watery fluid, resembling dishwater.
- **Discoloration of Skin**: Pink or orange staining in the skin indicates infection severity.
- **Localized Skin Necrosis**: Late-stage gangrene may develop in the skin.

**Systemic Complications** may include shock, coagulopathy, and multi-organ failure as the infection advances.

🧠 Key Point: While fever is a hallmark of most infections, it is often notably absent in necrotizing infections, which can be a distinguishing factor.

📘 Reference: MCQs on Infections (Bailey and Sabiston)