Surgery Questions

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Surgery Quiz

 

Daily new questions  posted on this first page .

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Hydatid cyst liver

Q. Disadvantage of capitonnage after removal the  contents in hydatid cyst cavity  is
a) It can obliterate potential bile duct orifices
b) Closure of cavity is not adequate
c) The procedure is not possible in rigid or calcified cyst
d) It can be easily done in cyst close to diaphragm

Q) Which of the following liver resections have the least chances of bleeding?

a) Previous history of TACE

b) A patient with splenomegaly

c) The patient with Platelet count 25000

d) Patient with grade III esophageal varices

Answer

Caustic injuries to esophagus

Q) Which of the following is not true about reconstruction in caustic injuries to esophagus

a) Caustic injuries to esophagus have 1000 times more risk of developing malignancy

b) Right colon replacement is definately better than left colon

c) The only indication for elective surgery is refractory strictures and possibility of malignancy

d) Most of the surgeons prefer bypass over resection of esophagus

Premium Answer

Esophageal hiatus hernia

Q) Many structures routinely pass through esophageal hiatus. What is type III esophageal hernia? 

a) Paraesophageal hiatus hernia

b) Sliding hiatus hernia

c) Both sliding and paraesophageal hernia

d) Large part of stomach in the mediastinum with pylorus near the esophageal hiatus

Answer  c

Hiatal hernias are protrusion of stomach through a defect in the esophageal hiatus into the mediastinum.

They are of two types

  1. Sliding - GE junction migrates to the mediastinum and rests superior to the diaphragm.
  2. Paraesophgaeal - Part of stomach migrates through the esophageal hiatus into the mediastinum with GE junction remaining at its normal position.

paraesophgeal hiatus hernia

  1. There are IV types of hiatal hernia

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Significance of MELD Scoring in Liver Transplant

Q) The significance of MELD Scoring in Liver transplant is :

a) Less ill patients are given more priority in liver transplant

b) Set threshold for patients who are too ill to undergo transplant.

c) To access  mortality in the waiting list.

d) To list patients in cadaveric deceased donor program

Answer Free 

d

MELD score takes into account  three factors. Bilirubin, INR and creatinine. Recently MELD Na is also included. Model for end stage Liver Disease (MELD) was initially developed to evaluate three months prognosis in patients undergoing TIPS. 
It ranges from 6 (3 months survival = 90%) to 40 (3 months survival =7%).

In countries where DDLT is more common MELD Score is used to allot grafts to people in the cadaveric list. More severe is the MELD, earlier is the allotment of cadaveric graft.

Sicker patients are given priority