Monday, February 22, 2010

347 - JIPMER 2010 Mcqs with answers - part 1

1q: FISHNET appearance in immunoflouresence is seen in
a. Pemphigus vulgaris
b. Bullous pemphigoid
c. dermatitis herpetiformis
d. ??????



2q: Which of these will kill spores?
a. alcohol
b. phenol
c. chlorine
d. aldehyde

*Aldehydes, such as glutaraldehyde, have a wide microbiocidal activity and are sporocidal and fungicidal. They are partly inactivated by organic matter and have slight residual activity.
*Alcohol is, at best, only partly effective against most non-enveloped viruses (such as hepatitis A), and is not effective against fungal and bacterial spores.

3q: Superficial inguinal ring is a defect in
a. External oblique aponeurosis
b. Transversalis fascia
c. ?????????????
d. ?????????????


*The deep inguinal ring is a defect in Trasversalis fascia. 

Some lecture notes on inguinal region :

*Descent of Gonads (Ovary and Testis); develop and migrate retroperitoneally:


*Gubernaculum: a ligamentous structure that runs between the lower pole of each gonad to each labial/scrotal fold. In the female it becomes the round ligament


*Ovary: reaches and remains at the pelvis by the 3rd month.
*Definitive ovary: reaches deep pelvis trailing its vessels and nerves.


*Testis:
-Processus vaginalis (peritoneal pouch; evaginates into developing scrotum, lies ahead of testis during descent))
-Reaches deep inguinal ring by 7th month;
-Passes through inguinal canal between 7-8 months;
-Reaches scrotum before birth.
-Around birth time: processus vaginalis closes off from peritoneum and forms tunica vaginalis of testis.,
-Patent processus vaginalis predisposes to congenital inguinal hernia.


*Coverings of the Spermatic Cord:
-external spermatic fascia: derived from Ext. Oblique fascia
-cremaster muscle and fascia: derived from Int. oblique muscle and fascia.
-Internal spermatic fascia: derived from transversalis fascia.


*Components of the spermatic cord:
-ductus deferens
-testicular artery
-artery of the ductus deferens
-pampiniform plexus of veins
-nerves (autonomic) and lymphatics
-genital branch of genitofemoral nerve


*Inguinal Canal: a diagonal passage formed by the aponeuroses of the three flat abdominal muscles.


*Contents of Inguinal Canal
-Spermatic Cord (male) or Round Ligament (female)
-Ilioinguinal Nerve


*Boundaries of the Inguinal canal :
-Superficial inguinal ring: triangular defect in the ext. oblique aponeurosis
-Deep inguinal ring: in the transversalis fascia.
-Anterior wall: int.oblique muscle (laterally) and external oblique aponeurosis (medially).
-Roof: falx inguinalis (arching inferior fibers of internal oblique muscle)
-Floor: inguinal ligament and lacunar ligament (medially)
-Posterior wall: transversalis fascia (weak fascia) laterally and conjoint tendon (medially)


*Boundaries of Inguinal Triangle (of Hesselbach):
-Medially: lateral edge of rectus abdominis (linea semilunaris)
-Laterally: inferior epigastric artery
-Inferiorly: inguinal ligament


*Abdominal Wall Hernias:
-Inguinal: hernia passes through the inguinal canal for a variable distance and exits through the ext.inguinal ring.


-Indirect:
-Congenital; through patent processus vaginalis
-Acquired: passes through deep inguinal ring initially, i.e lateral to the inferior epigastric artery and exits through the superficial ring.


-Direct: passes medial to the inferior epigastric artery (in the inguinal triangle) and may pass through the superficial inguinal ring.
-Femoral: below inguinal ligament.
-Obturator


-Other: umbilical; lumbar; incisional; hiatal; etc.

4q: Joint between epiphysis and diaphysis is
a. Syndesmosis
b. Synchondrosis
c. Fibrous joint
d. Plain synovial joint


5q: Amyloid deposits are seen in which thyroid malignancy?
a. Papillary carcinoma of thyroid
b. Medullary carcinoma of thyroid
c. Anaplastic carcinoma
d. Follicular carcinoma


6q: A 60 yrs old diabetic presents with swelling in the ankle joint. X-ray shows soft tissue swelling,loose bodies and bony sclerosis.diagnosis is ?
a. Osteoarthritis
b. Neuropathic joint
c. Gouty arthritis
d. ??????




7q: Secondary brain injury is seen in
a. Concussion
b. Diffuse axonal surgery
c. Depressed skull fracture
d. Intracrebral hematoma



Primary Brain InjurySecondary Brain Injury
  • Intracerebral hemorrhage
  • Subdural hemorrhage
  • Subarachnoid hemorrhage
  • Epidural hemorrhage
  • Cerebral contusion
  • Cerebral laceration
  • Axonal stretch injury
  • Edema
  • Impaired metabolism
  • Altered cerebral blood flow
  • Free radical formation
  • Excitotoxicity

8q: Methotrexate is a
a. Antimetabolite
b. Alkylating agent
c. Antitumor antibiotic
d. ????????




9q: Immune complex disease is seen in which type of hypersensitivity?
a. Type I
b. Type II
c. Type III
d. Type IV




10q: A 1 cm coin lesion is seen on the chest x ray of right upper lobe of the lung.FNAC shows adenocarcinoma.. management-
a) excision and observation
b) excision and chemotherapy
c) neoadjuvant chemotherapy followed by excision
d) ???

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