Friday, April 3, 2009

197 - UPSC 2007 medical entrance mcqs with answers part 7

31. Consider the following statements:

Venacaval opening of the diaphragm situated at the level of T 8 transmits :

1. Inferior vena cava
2. Vagus nerve
3. Branches of the right phrenic nerve
4. Thoracic duct

Which of the statements given above are correct ?

(a) 1 and 2(b) 2 and 3

(c) 1 and 3 (d) 1 and 4

The vena caval aperture, the highest of the three large openings, lies at about the level of the disc between the eighth and ninth thoracic vertebrae. It is quadrilateral, and located at the junction of the right leaf with the central area of the tendon, so its margins are aponeurotic. It is traversed by the inferior vena cava, which adheres to the margin of the opening, and by some branches of the right phrenic nerve.

32. Vascular complications of acute pancreatitis include the following except

(a) Splenic vein thrombosis
(b) Splenic artery aneurysm
(c) Gastroduodenal artery aneurysm
(d) Middle colic artery thrombosis

The following lines have been taken from this article . the whole credit goes to the author .

The splenic artery, because of its contiguity with the pancreas, is the vessel most commonly involved in pancreatitis. However, virtually all of the pancreatic and peripancreatic vessels can be affected. The gastroduodenal and pancreatico-duodenal arteries are frequently involved, while the left gastric, hepatic and small intra-pancreatic branches are less often implicated.
Unlike arterial thrombosis, thrombosis of the splenic vein is much more common, being reported in .5-45% of patients with pancreatitis. Thrombosis involving the portal and superior mesenteric veins is rare and if present, should raise the suspicion of either a septic stage of severe necrotising pancreatitis or a pancreatic head malignancy.
The article states that embolisation of the middle colic artery infact is used in the management of the pancreatitis induced complications such as hemorrhage from pancreatic and peripancreatic vessels .

P.S : This question was asked in the UPSC CMS 2007 medical entrance paper . click here to view all the mcqs from that paper with answers .

33. With reference to Hirschsprung's disease, which one of the following statements is correct?

(a) It is initially treated by colostomy
(b) In the neonatal period, it is best confirmed by barium enema
(c) It is associated with high incidence of genito-urinary tract anomalies
(d) It is characterised by the absence of ganglion cells in the transverse colon

Explanation : b is wrong because though barium enems helps in the diagnosis only rectal biopsy is confirmatory . d is wrong because distal colon is involved in hirschsprung’s disease . a is correct because of the following

exact lines from Schwartz surgery 8th edition :

The diagnosis of Hirschsprung's disease requires surgery in all cases. The classic surgical approach consisted of a multiple stage procedure. This included a colostomy in the newborn period, followed by a definitive pull-through operation after the child weighed over 10 kg.

34. Which one of the following nerves is injured in anterior dislocation of shoulder?

(a) Radial nerve
(b) Axillary nerve
(c) Median nerve
(d) Ulnar nerve

35. What is the most common complication of fracture of the ischio-pubic ramus of pelvic bone?

(a) Rupture of urinary bladder
(b) Rupture of prostatic urethra
(c) Rupture of membranous urethra
(d) Injury to penile urethra

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