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Pharmacology 1-30 FMGE MCQs


Pharmacology

1.Which drug name is not a generic name?

A.Atropine

B. Valium

C. Ipratropium

D. Hyoscine

2.Which of the following is not a pharmacokinetic property of a drug?

A. Metabolism

B. Protein-binding

C. Absorption

D. Receptor-binding

3. Sodium hydrogen carbonate is sold as a drug under various names such as alkali, baking soda, uracol, and sodium bicarbonate. Which of the following is considered a proprietary name for this substance?

A. Uracol

B. Sodium bicarbonate

C. Sodium hydrogen carbonate

D. Baking soda

4. Drugs are often protein-bound in the bloodstream. What is the principal protein that does this best?

A. Fibrinogen

B. Albumin

C. Haemoglobin

D. Gamma globulin

5. Natural vitamin E is usually given in gelatine capsules dissolved in soybean oil. Which word would best described the property of vitamin E in this process?

A. Lipophobic

B. Hydrophilic

C. Lipophilic

D. Hydroxylation

6. The principal site of drug metabolism is the:

A. kidneys

B. stomach

C. colon

D. liver

7. The most efficient absorption of a drug takes place in the ileum if the drug is:

A. non-ionised at a pH of ~6

B. a weak base

C. ionised at a pH of ~8

D. a weak acid

8. What is the basic mechanism of action of an osmotic diuretic such as urea?

A. Physical

B. Chemical

C. Enzyme inhibition

D. Receptor activation

9. A drug administered to a person produced a blood concentration of 900 ng/L after 3 hours. After a further 5 hours the concentration had fallen to 300 ng/L. What is the approximate half-life of this drug assuming zero kinetics?

A. 5 hours

B. 3 hours

C. 4.5 hours

D. 3.5 hours

10. Morphine and pentazocine both act upon similar receptors in the central nervous system and produce analgesia. If pentazocine is given to a morphine addict it may produce withdrawal symptoms. What kind of action does pentazocine have at opioid receptors?

A. A full antagonist action

B. A partial agonist action

C. A full agonist action

D. An inhibitor action

11. Which of these drugs is a potent enzyme inhibitor in the liver?

A. Famotidine

B. Nizatidine

C. Ranitidine

D. Cimetidine

12. Under what conditions is it most important to store sodium nitroprusside?

A. Protected from heat

B. Protected from moisture

C. Protected from cold

D. Protected from light

13. It is possible to refer to a medication using different names. Which type of name is best to use in clinical practice?

A. The medication’s trade name.

B. The medication’s proprietary name.

C. The medication’s chemical name.

D. The medication’s generic name.

14. A drug’s margin of safety is the dose range which places it:

A. above both the minimum effective concentration (mec) and maximum safe concentration (msc)

B. below the maximum safe concentration (msc) and above the minimum effective concentration (mec)

C. above the maximum safe concentration (msc) and below the minimum effective concentration (mec)

D. below both the maximum safe concentration (msc) and minimum effective concentration (mec)

15. Blood cell lysis is associated with which type of hypersensitivity reaction?

A. IV

B. III

C. II

D. I

16. Placental drug transfer is affected by the drug’s:

A. molecular size only

B. affinity for plasma proteins only

C. concentration gradient across the placenta only

D. all of the above affect placental drug transfer

17. In reference to the use of medicines in pregnancy, a category X drug is described as a medicine:

A. where animal studies may be inadequate, but there is no evidence of foetal damage

B. that has no proven harmful effects on the foetus

C. have a high risk of causing irreversible damage to the foetus

D. where the harmful effects on the foetus may be reversible

18. A slow acetylator administered a drug metabolised in this way may warrant:

A. an increase in drug dosage

B. a decrease in drug dosage

C. no special considerations in their care

D. more frequent dosage

19. Parenteral drug absorption in a person with congestive cardiac failure might be expected to result in:

A. higher blood concentration and a lower concentration at the injection site

B. lower blood concentration and a higher concentration at the injection site

C. higher blood concentration and a higher concentration at the injection site

D. lower blood concentration and a lower concentration at the injection site

20. Which of the following physiological states would be expected to result in higher plasma levels if the drug was hydrophilic?

A. When taking the drug with food

B. Diuresis

C. An increase in gut peristalsis

D. In hepatic disorders

21. Which of the following statements is applicable when administering a drug to a paediatric client?

A. Involve the parents in the procedure

B. In order to gain the child’s co-operation tell the child that injections don’t hurt.

C. Prepare the medications in front of the child.

D. Avoid the oral route when giving a drug to a young child.

22. Generally, the most reliable indicator for paediatric dose calculations is:

A. age

B. bodyweight

C. sex

D. body surface area

23. Why is it important to assess the number of medications an elderly client is taking?

A. Solely to minimise drug interactions

B. Solely to minimise adverse drug reactions

C. Only because the person may be seeing a number of doctors who do not communicate with each other about the drugs they have prescribed

D. All of the above

24. Which of the following factors would not be expected to contribute to compliance with drug treatment in the elderly?

A. Individualised medication education

B. Complicated drug regimens

C. Use of a dosette box

D. Thorough assessment of clients

25. If aspirin is administered together with warfarin, what is the most likely outcome with respect to protein binding?

A. There will be more unbound (free) form of the warfarin available, leading to a decreased bleeding tendency.

B. There will be more bound form of the warfarin available, leading to an increased bleeding tendency.

C. There will be more bound form of the warfarin available, leading to a decreased bleeding tendency.

D. There will be more free (or unbound) form of the warfarin available, leading to increased bleeding tendency.

26. Which of the following is not a type of phase I metabolism?

A. Removal or addition of an active molecule group on a drug.

B. Conjugation of a drug with a polar molecule to render the product soluble for excretion.

C. Oxidation of a drug.

D. Reduction and hydrolysis of a drug.

27. _______ medications have a larger volume of distribution in neonates and young infants compared with adults and therefore require a larger dose to reach therapeutic levels.

A. highly protein bound

B. hydrophilic and lipophilic

C. hydrophilic

D. lipophilic

28. In which state are drugs more likely to be well absorbed?

A. Polar

B. Un-ionised

C. Charged

D. Hydrophilic

29. In a case of poisoning, a drug with which apparent volume of distribution would be most effectively cleared from the body by haemodialysis?

A. 50 L/kg

B. 0.57 L/kg

C. 0.04 L/kg

D. 3 L/kg

30. The parameters that contribute to determining the drug half-life are:

A. clearance and apparent volumegggof distribution

B. apparent volume of distribution and plasma drug concentration

C. loading dose and clearance

D. frequency of administration and plasma drug concentration

SURGERY 21 – 40 FMGE MOST COMMON QUESTONS


Question 21: All the following are correct about radiological evaluation of a patient with Cushing’s syndrome except

1. Adrenal CT scan distinguishes adrenal cortical hyperplasia from an adrenal tumor

2. CT of sella tursica is diagnostic when a pituitary tumor is present

3. MRI of the adrenals may distinguish adrenal adenoma from carcinoma

4. Petrosal sinus sampling is the best way to distinguish tumor from an ectopic ACTH producing tumor

Question 22: Most physiological treatment of duodenal ulcer is

1. Highly selective vagotomy

2. Antrectomy

3. Vagotomy & gastrojejunostomy

4. Gastrojejunostomy

Question 23: A 30 year old male was brought to the casualty following a road traffic accident. His physical examination revealed that his right lower limb was short, internally rotated, and flexed and adducted at the hip. The most likely diagnosis is

1. Posterior dislocation of hip

2. Central Fracture dislocation of hip

3. Trochanteric fracture

4. Fracture neck of femur

Question 24: Incontinence in urinary tract infection is

1. False

2. True

3. Stress

4. Urge

Question 25: Inversion injury of foot is associated with damage to all the following except 1.

1. Lateral malleolus

2. Base of 5th metatarsal bone

3. Sustentaculum tali

4. Extensor digitorum brevis

Question 26: A man aged 60 yrs has h/o IHD and atherosclerosis. He presents with abdominal pain and maroon stools, likely diagnosis is

1. Acute intestinal obstruction

2. Acute mesenteric ischemia

3. Peritonitis

4. Appendicitis

Question 27: An anterolateral corodotomy relieving pain in right leg is effective because it interrupts the:

1. Left dorsal column

2. Left ventral spinothalmic tract

3. Left lateral spinothalmic tract

4. Right lateral spinothalmic tract

Question 28: Thickness of stomach in ultrasound is

1. 2mm

2. 5mm

3. 7mm

4. 10mm

Question 29: A 27 year old man presents with a left testicular tumor with a 10 cm retroperitoneal lymph node mass. The treatment of choice is

1. Radiotherapy

2. Immunotherapy with interferon and interleukins

3. Left high inguinal orchiectomy plus chemotherapy

4. Chemotherapy alone

Question 30: Sympathectomy is indicated in all the following conditions except

1. Ischaemic ulcers

2. Anhidrosis

3. Intermittent claudication

4. Acrocyanosis

Question 31: Most common cause of acute pancreatitis is

1. Gall stone

2. Alcohol

3. Trauma

4. Cyst

Question 32: True intracavernous aneurysms present with

1. Ophthalmological problems

2. Headache

3. Nasal intonation of voice

4. Vomiting

Question 33: Littre’s hernia includes

1. Meckel’s diverticulum

2. Intestinal margins

3. Umblicus

4. Omentum

Question 34: The commonest site for congenital “Arachnoid cyst” is

1. Sylvian fissure

2. Cerebello-pontine angle

3. Cerebello-pontine angle

4. Cerebellar vermis

Question 35: A post thyroidectomy patient presents with tingling and perioral paresthesia. Serum calcium level was 7 mg/dL. Which of the following is the best line of management

1. Oral vitamin D3

2. Oral vitamin D3 with calcium

3. I.V.calcium gluconate

4. Observation

Question 36: In which of the following conditions is paradoxical respiration observed

1. Stove-in chest

2. Flail chest

3. Pneumothorax

4. Haemopneumothorax

Question 37: Which one of the following radio-isotopes is commonly used as a source for external beam radiotherapy in the treatment of cancer patients

1. Strontium-89

2. Radium-226

3. Cobalt-59

4. Cobalt-60

Question 38: Shepherd crook deformity is seen in

1. Osteopetrosis

2. Fibrous dysplasia

3. Rheumatoid arthritis

4. Osteoarthritis

Question 39: Fraying and cupping of metaphyses of long bones in an child does not occur in

1. Rickets

2. Lead poisoning

3. Metaphyseal dysplasia

4. Hypophosphatasia

Question 40: “CSF Rhinorrhoea” may occur because of all except

1. Trauma

2. Chronically Raised Intracranial pressure

3. Acoustic tumor

4. Pituitary surgery

55 Mcq’s with Explanations & Imp. Points


Click to Download: 55 Mcq’s n Imp Points Pdf File

1. All of the following muscles are composite muscles except:
a. Pectineus
b. Rectus femoris
c. Adductor magnus
d. Biceps femoris
The pectineus is supplied by the femoral nerve and the accessory Obturator nerve (L3). also receives a branch from the Obturator nerve. adductor magnus and biceps femoris have a dual nerve supply.

2. All of the following are digastric muscles, except:
a. Muscle fibers in the ligament of Trietz
b. Omohyoid
c. Occipitofrontalis
d. Sternocleidomastoid
The sternocleidomastoid takes origin by two heads and is not a digastric muscle

3. In the lungs bronchial arteries supply the bronchopulmonary tree:
a. Till the tertiary bronchus
b. Till segmental bronchi
c. Till respiratory bronchiole
d. Till alveolar sacs
The arteries supply as far as the respiratory bronchioles. Tissues which do not have close access to atmospheric oxygen are supplied by the bronchial arteries.

4. The skin overlying the region where a venous cutdown is made to access the great saphenous vein is supplied by:
a. Femoral nerve
b. Sural nerve
c. Tibial nerve
d. Superficial peroneal nerve
The skin is supplied by the saphenous nerve which is a branch of the femoral nerve.

5. Which of the following is the correct order of pathway for a sperm:
a. Straight tubules- rete testis- efferent tubules
b. Rete testis- efferent tubules- straight tubules
c. Efferent tubules- rete testis- straight tubules
d. Straight tubules- efferent tubules- rete testis
Straight tubules are seminiferous tubules. The sperm passes through the rete testis to reach the efferent tubules (ductules).

6. Which of the following veins is found in relation to the paraduodenal fossa:
a. Inferior mesenteric vein
b. Middle colic vein
c. Left colic vein
d. Splenic vein

7. The artery to the ductus deferns is a branch of:
• Inferior epigastric artery
• Superior epigastric artery
• Superior vesical artery
• Cremasteric artery
An artery supplying a visceral structure is always a branch of another visceral artery to some related viscera. Here only the superior vesical artery is a visceral artery and the rest all the parietal (supply the structures in the abdominal wall).

8. Tributary of the cavernous sinus includes all of the following except:
• Superior petrosal sinus
• Inferior petrosal sinus
• Superficial middle cerebral vein
• Deep middle cerebral vein
Deep middle cerebral vein forms the basal vein. The basal veins join the great cerebral vein and finally drain into the straight sinus.

9. All of the following statements about diploic veins are true, except:
• Develop around 8 weeks of gestation
• These have no valves
• Present in cranial bones
• Have a thin wall lined by a single layer of endothelium
The diploic veins are absent at birth and appear at 2 years of age.
10. Which of the following bones do not contribute to the formation of the nasal septum:
• Sphenoid
• Lacrimal
• Palatine
• Ethmoid
Mainly formed by the vomer and the ethmoid with small contributions from the palatine and sphenoid bones.

11. All of the following cranial nerves contain somatic efferents except:
• Facial nerve
• Oculomotor nerve
• Trochlear nerve
• Abducent nerve
Facial nerve contains no somatic efferent fibers as it supplies only the muscles derived from the branchial arches. It does not supply any muscle derived from the somites.

12. Facial colliculus is seen in the:
• Midbrain
• Pons
• Medulla
• Interpeduncular fossa
Facial colliculus is seen on the posterior aspect of the pons in the floor of the fourth ventricle.

13. Which is the nucleus of masseteric reflex:
• Superior sensory nucleus of the trigeminal nerve
• Spinal nucleus of trigeminal nerve
• Mesencephalic nucleus of trigeminal nerve
• Dorsal nucleus of vagus nerve
Proprioceptive impulses from the masticatory muscles are conveyed through the mesencephalic nucleus of the trigeminal nerve. The neurons are unique in being the only primary sensory neurons with cell bodies in the CNS. The masseteric reflex or the jaw jerk is the only supraspinal monosynaptic reflex and the mesencephalic nucleus is a relay station for the same.

14. Primordial germ cells are derived from:
• Ectoderm
• Mesoderm
• Endoderm
• Mesodermal sinus
Technically, the primordial germ cells are derived from the epiblast long before the establishment of the three germ layers. There is a difference between where they are first seen and from where they are derived. Well they are definitely first seen in the endoderm.
15. Movements of pronation and supination occurs in all the following joints except:
• Superior radio ulnar joint
• Middle radio ulnar joint
• Inferior radio ulnar joint
• Radio carpal joint
these movements take place only between the radius and the ulna. Rotatory movements are not possible at the wrist joint.

16. About posterior cruciate ligament- true statement is:
• Attached to the lateral femoral condyle
• Intrasynovial
• Prevents posterior dislocation of tibia
• Relaxed in full flexion
The posterior cruciate ligament is attached anteriorly to the medial femoral condyle and posteriorly to the upper surface of tibia. It prevents the posterior dislocation of tibia on the femur. everything is taut during extension.

17. Structures that pass from thorax to abdomen behind the diaphragm are all except:
• Azygous vein
• Aorta
• Thoracic duct
• Greater splanchnic nerve
Technically all the structures passing through the aortic hiatus are posterior to the diaphragm. The greater splanchnic nerves pierce the diaphragm to reach the abdominal cavity.

18. Most common site of Morgagni hernia is:
• Left anterior
• Right posterior
• Right anterior
• Left posterior
These are Subcostosternal hernias through a defect in the anterior diaphragm. Most commonly occurs on the right side.

19. Structure that does not cross the midline is:
• Left gonadal vein
• Left renal vein
• Left brachiocephalic vein
• Hemiazygous vein
All the veins of the left side cross the midline to join the veins on the right side, directly or indirectly, because the left drainage channel to the heart (the left horn of sinus venosus) disappears during development. The left gonadal vein drains into the left renal vein and thus does not physically cross the midline.

20. Portosystemic shunt is not seen in
• Liver
• Spleen
• Anorectum
• Gastroesophageal
Portosystemic shunt is primarily seen in the structures derived from or related to the gastrointestinal tract. Spleen develops outside the gastrointestinal system

21. Injury to the male urethra below the perineal membrane causes urine to accumulate in:
• Superficial perineal pouch
• Deep perineal pouch
• Space of retzius
• Pouch of douglas
Superficial perineal pouch is superficial to the perineal membrane.

22. All are true about the trigone of the urinary bladder except:
• Mucosa is loosely attached to the underlying musculature
• Mucosa is smooth
• It is lined by transitional epithelium
• It is derived from the absorbed part of the mesonephric duct
Mucosa is never loosely attached to the underlying mucosa anywhere in the body. the efficient expansion of the bladder is due to the transitional epithelium and not due to a loosely attached mucosa.

23. Supports of the uterus are all except:
• Uterosacral ligament
• Broad ligament
• Mackenrodt’s ligament
• Levator ani
Broad ligament is just a fold of peritoneum.

24. Posterior communicating artery is a branch of:
• Internal carotid
• External carotid
• Middle cerebral
• Posterior superior cerebellar
Posterior communicating artery is a branch of the cerebral part of internal carotid artery.

25. Which of the following is not a branch of cavernous segment of the internal carotid artery
• Cavernous branch
• Inferior hypophyseal artery
• Meningeal branch
• Ophthalmic branch
The Ophthalmic artery is a branch from the cavernous part.

26. Difference between typical cervical and thoracic vertebra:
• Has a triangular body
• Has foramen transversarium
• Superior articular facet directed backwards and upwards
• Has a large vertebral body
Foramen transversarium is a feature unique to the cervical vertebrae.

27. Which part of the vertebral canal will show secondary curves with concavity backwards:
• Cervical
• Thoracic
• Sacral
• Coccyx
The two secondary curves are the lumbar and the cervical curves. Both are convex anteriorly.

28. Which of the following has an intra articular tendon:
• Sartorius
• Semitendinosus
• Anconeus
• Popliteus
The tendon of popliteus is enclosed by the knee joint capsule.

29. Which of the following is not a sign of stellate ganglion block:
• Miosis
• Exophthalmos
• Nasal congestion
• Conjunctival redness
Obviously, exophthalmos. The enophthalmos that is seen is because of the ptosis. There is no true retraction of the eyeball into the orbital cavity.

30. A 43 year old woman came with a large abscess in the middle of the right posterior triangle of the neck. The physician incised and drained the abscess. Five days later the patient noticed that she could not extend her right hand above her head to brush her hair. Which of the following are the signs and symptoms of additional harm:
• Damage to scalenus medius
• Injury to suprascapular nerve
• Cut to spinal part of accessory nerve
• Spread of infection to the shoulder joint
The trapezius and the Serratus anterior are responsible for overhead abduction. Trapezius is supplied by the spinal part of accessory nerve which lies in the posterior triangle of the neck.

31. Middle meningeal artery is a direct branch of:
• External carotid artery
• Internal maxillary artery
• Superficial temporal artery
• Middle cerebral artery
It is a direct branch of the first part of the maxillary artery.

32. In adults, the spinal cord normally ends at:
• Lower border of L1
• Lower border of L3
• Lower border of S1
• Lower border of L5
In adults it is the lower border of L1.

33. Lymphatic drainage of the cervix occurs by all of the following lymph nodes except:
• Parametrial lymph nodes
• Deep inguinal lymph nodes
• Obturator lymph nodes
• External iliac lymph nodes
The superficial inguinal nodes receive lymphatics from the uterus but not the deep inguinal nodes.

34. All of the following are the components of the white pulp of spleen except:
• Periarteriolar lymphoid sheath
• B cells
• Antigen presenting cells
• Vascular sinus
The vascular sinuses represent the red pulp.

35. Polar bodies are formed during:
• Spermatogenesis
• Organogenesis
• Oogenesis
• Morphogenesis

36. The carpal tunnel contains all of the following important structures except:
• Median nerve
• Flexor pollicis longus
• Flexor carpi radialis
• Flexor digitorum superficialis
The flexor carpi radialis is superficial to the flexor retinaculum.

37. The femoral ring is bounded by the following structures except:
• Femoral vein
• Inguinal ligament
• Femoral artery
• Lacunar ligament
The femoral ring is the entrance to the femoral canal. The femoral vein lies medial to the femoral canal and the femoral artery lies lateral to the vein.

38. While doing thoracocentesis, it is advisable to introduce needle along:
• Upper border of the rib
• Lower border of the rib
• In the center of the intercostal space
• In the anterior part of the intercostal space
The lower border of the ribs contains the neurovascular bundle.

39. Benign prostatic hypertrophy results in obstruction of the urinary tract. The specific condition is associated with enlargement of the:
• Entire prostate gland
• Lateral lobes
• Median lobe
• Posterior lobe
The median lobe of the prostate is classically described as enlarged during BPH.

40. Prostatic urethra is characterized by all of the following features, except that it:
• Is the widest and most dilatable part
• Presents a concavity posteriorly
• Lies closer to anterior surface of prostate
• Receives prostatic ductules along its posterior wall
The posterior wall of the prostatic urethra is convex anteriorly. the convexity is known as the urethral crest.

41. All of the following statements regarding vas deferns are true except:
• The terminal part is dilated to form ampulla
• It crosses ureter in the region of ischial spine
• It passes lateral to the inferior epigastric artery at the deep inguinal ring
• It is separated from the base of the bladder by the peritoneum
There is no peritoneum between the base of the bladder and the vas deferns.

42. The following groups of lymph nodes receive lymphatics from the uterus except:
• External iliac
• Internalilliac
• Superficial inguinal
• Deep inguinal
The deep inguinal nodes do not receive lymphatics from the uterus.

43. In an adult male, on per rectal examination, the following structures can be felt anteriorly except:
• Internal illiac lymph nodes
• Bulb of the penis
• Prostate
• Seminal vesicle when enlarged
The internal iliac nodes are at the level of the sigmoid colon. they can be felt posteriorly, if enlarged.

44. All of the following are branches of the external carotid artery except:
• Superior thyroid artery
• Anterior ethmoidal artery
• Occipital artery
• Posterior auricular artery
Anterior ethmoidal artery is not a branch from the external carotid artery.

45. Paralysis of 3rd, 4th, 6th nerves with involvement of the ophthalmic division of the 5th nerve, localizes the lesion to:
• Cavernous sinus
• Apex of the orbit
• Brainstem
• Base of the skull
All these nerves are in relation to the cavernous sinus.

46. The superior oblique muscle is supplied by:
• 3rd cranial nerve
• 4th cranial nerve
• 5th cranial nerve
• 6th cranial nerve
SO4, LR6

47. The following statements concerning chorda tympani nerve are true except that it:
• Carries secretomotor fibers to submandibular gland
• Joins lingual nerve in the infratemporal fossa
• Is a branch of the facial nerve
• Contains postganglionic parasympathetic fibers
The nerve contains preganglionic parasympathetic and taste fibers.

48. The type of joint between sacrum and the coccyx is a:
• Symphysis
• Synostosis
• Synchondrosis
• Syndesmosis
It is secondary cartilaginous joint also known as a symphysis

49. All of the following physiological processes occur during the growth at the Epiphyseal plate except:
• Proliferation and hypertrophy
• Calcification and ossification
• Vasculogenesis and erosion
• Replacement of red bone marrow with yellow marrow
Bone marrow is not present in the Epiphyseal plate.

50. Barr body is found in the following phase of the cell cycle:
• Interphase
• Metaphase
• GI phase
• Telophase
A Barr body is only seen during periods of inactivity.

Anesthesia

51. A patient with bilirubin value of 8 mg/dl and serum creatinine of 1.9 mg/dl is planned for surgery. What is the muscle relaxant of choice in this patient?
A. Vecuronium
B. Pancuronium
C. Atracurium
D. Rocuronium
Ans: C.

52. A 25 year old overweight female was given fentanyl-pancuronium anesthesia for surgery. After surgery and extubation she was observed to have limited movement of the upper body and chest wall in the recovery room. She was conscious and alert but voluntary respiratory effort was limited. Her blood pressure and heart rate were normal. The likely diagnosis is:
A. Incomplete reversal of pancuronium
B. Pulmonary embolism
C. Fentanyl induced chest wall rigidity
D. Respiratory depression
Ans A.

53. All of the following statements about neuromuscular blockage produced by succinylcholine are true, except:
A. No fade on train of four stimulation
B. Fade on tetanic stimulation
C. No post tetanic facilitation
D. Train of four ratio > 0.4
Ans: B.

54. A 27 year old female was brought to emergency department for acute abdominal pain following which she was shifted to the operation theatre for laparotomy. A speedy intubation was performed but after the intubation, breath sounds were observed to be decreased on the left side and a high end trial CO2 was recorded. The likely diagnosis is:
A. Endotracheal tube blockage
B. Bronchospasm
C. Esophageal intubation
D. Endobronchial intubation
Ans: D.

Important Points:

Aneurysms Important Points

1. The Most common type of true aneurysm is fusiform type.
2. Most common Site: Arterial Aneurysm is Infra renal part of abdominal aorta
3. Popliteal Aneurysms are most common peripheral aneurysms
4. The Most common site for dissecting aneurysms is Ascending aorta
MC AAA (Abdominal aortic aneurysm is Atherosclerosis
True aneurysm tht involve all 3 layes. Present wd Large,Pulsatil mass above the umbilicus.
Once Rupture it present a Classic “Pain-Hypotension-Mass triad” Radiating pain acute sever Constant abdomen to back…..
Medical treatment strict control Bp….
Surgical is definitive treatment… >5.5
Radiology: CT scan…
Cirsoid aneurysmd are common in superficial temporal artery
Berry Aneurysm occur Circle of willis
Anterior Cerebral artery Most common
Rupture in Subarachnoid Hemorrhage (severe pain headache wrost in my life) Most common SAH Trauma Radiology: NCCT scan…. III Cranial Nerve (Optic N) Involve….
Polycystic Kidney disease also present Berry Aneurysm
Micro Aneurysm seen in DM & HTN
Mycotic Aneurysms are seen in Bacterial Infections
Aortic Dissecting Aneurysms due to degeneration of tunica media. Occur in Marfans syndrome (Chromosome 15) also present AR (aortic regurgitation, Ectopic lense Upper temporal lense detachment Retinal detachment) and HTN
Syphilitic Aneurysms or luetic aneurysms involve ascending aorta
Pseudo-aneurysm femoral artery( External iliac artery continuation) follow trauma usually……..

Arterial Diseases

Burgers Disease (Thromoangitis Obliterans)
1. Affects Small and Medium Sized Arteries….
2. Affect young <40years if > 40years then Atherosclerosis…..
3. Ankle index pressure is low here..
4. Smokers
5. Coldness and Numbness of toes is the 1st sign
6. Xanithol nicotinate is used for treatment
7. Lumbar sympathetectomy is done…
8. Martorells sign is (+)ve…..
For Raynauds Disease: affects arterioles. Features are: Blanching, Dusky cyanosis, Red engorgement. (White, Blue & RED)
Butchers thigh is due to injury to femoral artery in femoral triangle….
Lerieches syndrome is due to aortoiliac occlusion..

DVT (Deep vein Thrombosis) – 2011 Sep FMGE, Many Questions on this topic.

• Earliest sign is rise in Temperature.
• Occurs less frequently in upper extremity than lower Extremity
• Heparin is used for DVT prophylaxis
• Most Important Consequences of this disorder are Pulmonary embolism and chronic venous insufficiency
• DVT of the Iliac, femoral or popliteal viens is suggested by unilateral leg swelling warmth, erythema, Pain….
• The Non Invasive test used most often to diagnosis DVT is Duplex Venous USG….
Sign DVT….
1. Holmans sign – Forced Dorsiflexion of ankle causes Pain in Calf
2. Mosses sign – Pain in Calf on squeezing calf muscle
3. Pratts sign – lateral squeezing calf muscle cause pain
4. Phlergma alba dolens – swollen leg (whitish) with edema and blanching
5. Phlegm cerulae dolens – Painful (blue) leg

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