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Truncus arteriosus

Q ) Which of the following statements about truncus  arteriosus is false?
A. Most infants do well without operations until late childhood.
B. Cyanosis is a late feature
C. Most infants present with congestive heart failure.
D. Repair requires a conduit from right ventricle to pulmonary arteries.

Answer 

In Truncus arteriosus there is a single arterial trunk arising from the ventricles, with single dysplastic valve with

semilunar leaflets and a subvalvular VSD..

Untreated, most infants  do not survive beyond 6 months. Cyanosis is usually not present early, because mixing
mainly occurs at VSD level and the arterial oxygen saturation is generally greater than  85%, but............Read on 

Diverticulitis

Q ) Hincheys grade III Diverticulitis. Management most likely to follow more interventions after an index operation is

a) Laparoscopic irrigation and exploration

b) Sigmoid Colectomy+Hartman’s

c) Primary repair with omental patch and peritoneal toilette

d )Sigmoid Colectomy with colorectal anastomosis and diverting ileostomy

Grade III diverticulitis is generalized peritonitis.

Answer for premium Q 10 

Chronic pancreatitis enzymes

Q . All are true regarding enzyme supplementation in chronic pancreatitis except 

a) Lipase to be given 30000U before or after meal

b) H2 blocker is mandatory with enteric coated tablets

c) Main cause of failure is inadequate dosage

d) In cases of failure of enzyme replacement feeding of medium chain Triglycerides are  helpful


Ans

Indications of enzyme supplementation are -

  1. Weight loss, steatorrhea (15g/day ) or both
  2. Dyspepsia, Diarrhoea, bloating, malabsorption of proteins  and carbohydrates
  3. Pain abdomen

Read on for ans Q 23 

Islet cells

Q  Regarding islet cell of pancreas true is (AIIMS, JIPMER) 

a) Cells in descending order of frequency is B,D,A,F

b) B cells are more common in the periphery of islets

c ) Peri islet acinar cells same as acinar cells else where

d) Portal flow from islet to acinar cell helps to control secretions

Answer 

GCS

Q. Best predictor in the GCS

A. Eye opening
B. Motor response
C. Verbal response
D. All


23) B, Motor response

Motor score is the best predictor of neurological outcome.

The m component of the GCS,  is not only linearly related to survival, but preserves almost all the predictive power of the GCS 

BAiley

Pouch design

Q. False statement about pouch design is-

a) S pouch is  preferred when length is  not available

b) J pouch is the  most preferred

c) W pouch has  more chances of diarrhoea than J pouch

d) Volume of the pouch is inverse proportional to the no of bowel movements

Answer