GIST Stomach

Q ) Antral GIST 1cm incidentally found on UGIE. True regarding its management

a) Surgical resection resection of GIST (More questions on GIST here) 

b) Endoscopic resection

c) Resection required if EUS suggests irregular border with cystic spaces

d) Endoscopic surveillance, if size >2cm then resect

Answer ( You need to be a premium member to see this) 

GIST are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%). Clinically they appear  in patients older than 50 years.

They generally have an equal male-to-female ratio or a slight male predominance.

They are rarely associated with familial syndromes such as GISTparaganglioma syndrome (Carney triad), neurofibromatosis 1, and von Hippel-Lindau disease, but most develop de novo. 

Hyperbaric oxygen

 Hyperbaric oxygen therapy in radiation proctitis all are true except
A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis
B. Oxygen increases the growth of residual tumor and hence tumor should be completely
resected
C. Complications include Parkinsonism, barotrauma
D. Usually 30-40 sessions are required for treatment


Answer free for all

a

Hyperbaric oxygen overcomes chronic tissue hypoxia in radiation damaged tissues and with repeated sessions induces growth of regenerative tissue, capillaries, and epithelium. Successful therapy may take multiple sessions.
 18 to 60 treatments

Ref Shackelford page 2211

HBO treatments for hypoxic wounds are usually delivered at 1.9 to 2.5 atm

for sessions of 90 to 120 minutes each. Treatments are given once daily, five to six times per week and should be given as an adjunct to surgical or medical therapies. Clinical evidence of wound improvement should be noted after 15 to 20 treatments. Read More ...

Gastric Lymphoma

Q) Gastric Lymphomas false is 

a) The optimal treatment for lymphomas unresponsive to initial H. pylori antibiotic treatment remains unclear and includes the chemotherapy, radiotherapy, surgical resection, etc

b) Almost all MALT-lymphoma may regress with conventional H. pylori treatment. 

c) Need for surgery in lymphoma is mainly for its complication

d) Risk of perforation is over estimated in the literature

Answer

Familial Adenomatous polyposis

Q. All are false about adenomatous polyposis syndrome except
A. 25% do not have family history
B. Attenuated FAP has less than 100 polyps and delayed onset (50-55 yrs)
C. More than 20 rectal polyps have to be operated as there is high risk of Carcinoma
D. Attenuated FAP don’t have extracolonic manifestations and carry APC mutation

Answer visible here or below if you are a premium member and logged in 

 

GIST stomach

Q) Antral GIST 1cm incidentally found on UGIE. True regarding its management
a) Surgical resection 
b) Endoscopic resection
c) Resection required if EUS suggests irregular border with cystic spaces
d) Endoscopic surveillance, if size >2cm then resect

Answer  (Pemium members who are logged in can see explanation below) 

 

 

Neuroblastoma

Q Not a true statement about Neuroblastoma 
A. Arises from adrenal cortex
B. Can cause paraplegia
C. May cause Hypertension
D. Secretes hormones

Answer see below if you are a premium member and logged in

Pancreatic protocol CT

Q) All are true about pancreatic protocol CT except (AIIMS 2012) 

a) > 90% unresectable lesions picked up by CT

b) Dual phase CT with cuts taken at 40 secs and 70 secs

c) Liver metastasis detected in early arterial phase

d)

Answer is free for all 

c

Pancreatic protocol CT involves  imaging  at  the  pancreatic  phase (i.e.,  approximately  45  seconds  after  contrast  administration)  and  at  the  portal  venous  phase  (i.e.,  approximately 70  seconds  after  contrast  administration). It is useful for detection of adenocarcinoma of pancreas. 

Metastatic lesions are seen in  the  portal  venous  phase,  because  the  lesions  are  not  typically  well  vascularized.

  Arterial  phase images  are  principally  used  to  distinguish  metastatic  disease from  benign  vascular  lesions,  such  as  hemangiomas,  or  to  better define  the  arterial  anatomy  of  the  liver.

Non contrast phase used for  Read More ...