Treatment of recurrent ranula is:

 # Treatment of recurrent ranula is:

A. Incision

B. Excision

C. Excision with adjacent glands

D. Marsupialization

The correct answer is: C. Excision with adjacent glands.

Treatment for recurrent ranula is enucleation of mucocele involving mucous gland and surrounding tissue.

Large ranulas can be best treated by marsupialization whereas the recurrent ranulas are best treated by sublingual gland excision. 

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Most common cause of mucocele is:

 # Most common cause of mucocele is:

A. Rupture of a salivary duct

B. Partial or complete compression of the salivary acini

C. Inflammatory changes in the glandular interstitial tissue

D. Partial or complete obstruction of the salivary duct by calculus

The correct answer is: A. Rupture of a salivary duct

Mucoceles often have been classified as:

(1) an extravasation mucocele, - mostly originates due to rupture of salivary duct following trauma that results in pooling of saliva and consequent swelling.

(2) a retention mucocele (or true retention cyst) - true retention cyst, arises due to obstruction of the duct by sialoliths (salivary duct stones)

The extravasation type is far more common than the retention type.

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High content of cholesterol is present in:

 # High content of cholesterol is present in:

A. Coconut oil

B. Egg yolk

C. Hydrogenated fat

D. Ghee (Unsaturated)

The correct answer is B. Egg yolk.

Cholesterol is exclusively found in animals and is the most abundant animal sterol. It is a major component of cell membranes and lipoproteins.

Elevation of serum cholesterol beyond 200 mg/dL increases the risk of atherosclerosis and coronary heart diseases. 

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The first heart sound is loud in all of the following EXCEPT

 # The first heart sound is loud in all of the following EXCEPT:

 A. Mitral stenosis

B. Short PR interval

C. Tachycardia

D. Mitral valve calcification

The correct answer is D. Mitral valve calcification.

The intensity of the first sound is primarily related to the position of the atrioventricular valves at the onset of ventricular systole.

The first sound is usually louder in subjects with a short PQ interval than in those with a long PQ interval.

Loud first heart sound: is seen in mitral stenosis, left atrial myxoma, conditions that increase myocardial contractility, including hyperadrenergic states (e.g. exercise, anxiety, anemia, fever, pregnancy, and thyrotoxicosis) and in patients with thin chest walls. 

A loud first heart sound is a hallmark of hemodynamically significant mitral stenosis. Mobile but stiff mitral leaflets produce a loud S1 unless the leaflets are heavily calcified. The main reason for the increase in the intensity of S1 in these conditions is the increased rate of pressure development in the ventricles. 

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