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Renal cell carcinoma

Renal cell carcinoma

Q) False about Renal cell carcinoma is

a) More common in males

b) Associated with von hippel lindau syndrome

c) Always require radical nephrectomy

d) Has paraneoplastic manifestaions

Answer

c


Renal cell carcinoma is more common in males

Genetic

loss of heterozygosity in chromosome 3p

B/l RCC is associated with VHL syndrome

Paraneoplastic of RCC

Anemia, hypettension, erythrocytosis.

Radical nephrectomy is the gold standard but not always necessary and partial nephrectomies in selected cases give good clearance

Annular pancreas

Annular pancreas

Q) All are true about annular pancreas except ( AIIMS GI Surgery Question bank)

a) They are mostly asymptomatic

b) It has equal incidence in children and adults

c) Treatment of choice is duodenojejunostomy


 

Answer c

Annular pancreas is a congenital malformation but manifestations can appear in the adult life.

Annulus means a ring of pancreatic tissue around the duodenum. For annular pancreas to be diagnosed, this ring can be complete or incomplete.

Embryological basis

Normally the ventral buds of pancreas and  dorsal bud fuses together. Non rotation and fusion of these two leads to the formation of annular pancreas. It envelops the duodenum.

Age of presentation

Incidence is equal in both adults and children

Presentation in children is congenital anomalies and dudenal obstruction

Presents in adults as pancreatitis usually in 3rd or 4th decade

Association with other pancreatic conditions

1. Pancreas  divisum 35- 40%

2. Chronic pancreatitis 45- 50%

Treatment

It is duodenal bypass and not resection of duodenum as duodenum excision can lead to pancreatitis

in children its duodeno - duodenostomy

in adults duodenoduodenostomy which has now replaced duodenojejunostomy

Sabiston

 

 

 

Budd chiari

Budd chiari

Q31) In Budd Chiari Syndrome best management for patients when all three hepatic veins are blocked with deranged LFT

a) Liver transplant

b) Side to side porto caval shunt

c) MEso atrial Shunt

d) TIPS

Answer

Roux en Y Gastric bypass

Roux en Y Gastric bypass

  •  

Q 35) To prevent bile reflux gastritis in RYGB, false is

a) Jejunum divided at 45cm from the DJ

b) Roux loop length is 40 cm and above

c) Enteroenterostomy done at 45cm from the GJ

Answer q 35

Achalasia cardia with perforation

Achalasia cardia with perforation

Q) What is the management of achalasia cardia with perforation ?

a) Suture ligation of the perforation

b) Suture ligation with myotomy on opposite side with fundoplication

c) Suturing with fundoplication

d) esophagectomy

Answer 

Splenectomy

Splenectomy

Q1. Which of the following is not an indication for splenectomy in Non Hodgkin Lymphoma?
 
a)  Massive splenomegaly
b) Signs of hypersplenism
c) Diagnosing and staging of isolated splenic disease

d) All are indications for splenectomy

Ans  Free

BISAP Score In Pancreatitis

BISAP Score In Pancreatitis

Q) All are components in BISAP score except?

a) Age more than 60 years

b) WBC more than 16000

c) GCS <15

d) BUN > 25 mg/dl


Ans

)b

The Bedside Index of Severity in Acute Pancreatitis  BISAP is a more-recent score than the older Ranson's Criteria. It predicts mortality risk in pancreatitis with fewer variables than Ranson's.

It does not require data points from 48 hours into a patient's hospital admission.

It includes

BUN > 25 mg/dL (8.9 mmol/L) :
Abnormal mental status with a Glasgow coma score < 15 :
Evidence of SIRS :
> 60 years old :
Pleural effusion :
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