Misc Flashcards

Question

Five R of radiotherapy does not include ? A. Repair B. Reoxygenation C. Repopulation D. Regression

Answer 1

Ans D Repair - given sufficient time between fractions the cells will repair the radiation induced damage. Repair half times are 3-6 hours. Fractionation offers a means to exploit the differences in repair capacity b/w tumor cells and normal cells. Reoxygenation - hypoxic cells are relatively radioresistant. Tumors are often hyoxic, thus it is a therapeutic disadvantage. Problem can be mitigated if a sequence of daily treatment is used. As more cells die, the hypoxia of remaining tumor cells decreases, making them more susceptible. Repopulation - As radiotherapy kills cancer cells within a tumor, it may provide a stimulus for rapid proliferation of tumor cells. Thus if the duration of treatment is prolonged the production of cells by the tumor may be equal or even more than radiation induced cell loss. Thus duration of the treatment should be kept as small as possible. Redistribution - Susceptibility of a cell to radiation depends on the phase of cell cycle it is in. This may lead to a degree of synchronisation in the tumor. Ideally the fractions of radiotherapy would be timed to co-incide with vulnerable phases of cell cycle (Late G2 and M) Radiosensitivity - Cells derived from tumor differ in their intrinsic sensitivity of radiation. They may be so intrinsically resistant that no viable schedule of radiotherapy would be able to eliminate them. Conversely some cells may be so sensitive that virtually any schedule would be successful.

Answer 2

Ans - B Congenital heart disease ``` Congenital Diaphragmatic hernia 1:3000 TEF 1:3500 Congenital heart disease 1:150 Gastroschisis 1:7500 Hirschsprung disease 1:5000 Anorectal malformation 1:4000-5000 Biliary atresia 1:17000 Choledochal cyst 1:50000 Hypospadias 1:300 PUJ dysfunction 1:1000 ```

Answer 3

Ans E - ``` Related to disease activity - Erythema nodosum Pyoderma gangrenosum Arthropathy Eye complications Apthous ulcers Amyloidosis ``` ``` Unrelated to disease activity PSC Gallstones and Renal stones Chronic active hepatitis Sacroilitis ```

Answer 4

Ans A - Dorsal artery is responsible for engorgement of the glans during erection. Campbell.

Answer 5

Ans C - | In the kidney most of these tumors commonly arise from the renal capsule.

Answer 6

Ans D - recurrent uncontrolled passage of fecal matter in an individual with developmental age more than 4 years, for more than 1 month.

Answer 7

ans C <2 mmol/L - early total care 2-3 mmol/L - look at the trend - increasing or decreasing. >3 mmol/L - may be under-resuscitated. Should either have further resuscitation or damage control surgery if surgery is urgent. >5 mmol/L - Damage control surgery. Bailey 27e

Answer 8

Ans A - Obvious features - Chance fracture of the lumbar spine, Dislocated Knee, Head injury. Covert injuries - Duodenal rupture, popliteal artery disruption, cervical spine fracture.

Answer 9

Ans A - Posterior dislocation of shoulder may be seen as a covert injury in electric shock. Left sided impact from road traffic accident can have splenic injury and EDH as covert injuries whereas lateral pelvic compression and left sided pneumothorax are obvious injuries. Posterior dislocation of the hip can be covert injury in the dash board impact. Bailey 27e

Answer 10

Ans C - Inferior portion of the cartilaginous canal is termed as Conley's pointer or Tragal pointer. Indicates position of the facial nerve which lies 1cm deep and inferior to its tip. Upper border of the posterior belly of digastric. Identification of this muscle not only helps to mobilize the parotid gland, but also exposes an area immediately superior in which the facial nerve is located. sqaumotympanic fissure, styloid process (nerve is superficial to it) and mastoid process (can be drilled to identify the nerve) are other landmarks. Bailey 27e

Answer 11

Ans 3. 20 days

Answer 12

Ans -2 | Nearly 50% of the spigelian hernia are acquired.

Answer 13

Answer - c - pain is the most common initial complaint - fascial defect is covered by external oblique aponeurosis - repair is done using transverse incision - incarceration rate is 20-30% and therefore elective repair is recommended upon diagnosis

Answer 14

Ans B fusiform is the most common (77%)

Answer 15

Ans 6. Vimentin Cd117 - expresses by >95%, c-kit CD34 - human progenitor cell antigen - 70-90% Actin - 20-30% S100 and desmin - 2-4%

Answer 16

Ans D Most common location is stomach (60%), followed by jejunum and ileum (30%) Benign stromal tumors are 3-4 times more common than malignant Distribution is equal among men and women Most commonly seen in fifth decade

Answer 17

Even mitotic counts higher than 2 per 50 hpf imply and increased risk of local recurrence Although low mitotic index is defined as <5 per 50 hpf, where as high mitotic index is >5 per 50 hpf

Answer 18

Ans 4. Bleeding is the most common indication of surgery in benign stromal tumors

Answer 19

Ans C Aplasia is most common in ivc May Thurner syndrome is membranous occlusion of left common iliac vein. Often develops where the vein travels behind the right common iliac artery (iliac vein compression syndrome) Duplications are quite common

Answer 20

Ans A - Endometrial cancer is the most common gynaecological malignancy. Also the 4th most common cancer among women. Devita 1048.

Answer 21

Ans Collagenous colitis is a condition that generally occurs in women older than 50 years of age. Typical presentation is profuse watery diarrhea. There is marked thickening of the colonic sub-epithelial basement membrane. The mucosa appears normal in most patients, and the diagnosis is made by endoscopic biopsy. Treatment of collagenous colitis is medical. Sabiston 20e 1342.

Answer 22

Ans C If lymphangiomas are less than 5cm in size they are named lymphangioma circumscriptum, and if they are more widespread they are termed as lymphangioma diffusum. If they have a reticulate pattern of ridges then they are termed as Lymphedema ab igne Bailey 999.

Misc Flashcards

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