Month: October 2018

Acute mesenteric ischemia

Acute mesenteric ischemia

Q)  All are  findings in acute mesenteric ischemia findings except?

a) Slow filling intramural vein

b) Spasm of arterial arcade / distal vessels

c) String of sausages/beaded appearance

d) Dilated and ring enhancement of SMV in CT

Answer 


 

Acute diverticulitis

Acute diverticulitis

Q) False regarding the management of Acute Diverticulitis. Sigmoid colon inflammation and Fat stranding in CT with initiation of IV antibiotics,

a) Outpatient treatment

b) Do a colonoscopy after the resolution of acute symptoms

c) Elective Colectomy to be done

d) IV antibiotics

Answer Free  c

Sigmoid diverticulitis can be complicated and uncomplicated

Complicated means diverticulum associated with abscess, perforation, obstruction, fistula 

This question is about an uncomplicated acute diverticulitis 

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SMA syndrome

SMA syndrome

Q True in SMA syndrome

  1. Causes Medial Arcuate Ligament syndrome
  2. Causes nut cracker syndrome
  3. Low AM distance and Narrow AM angle <25 degree is sensitive finding
  4. It can be treated by releasing the DJ and keeping duodenum to the right of the artery

Answer 


 

GIST Stomach

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. 

natural history breast cancer

natural history breast cancer

Q. True about breast cancer is?

a) Doubling time of breast tumor is 1 month

b) Skip metastasis in level iii lymph nodes is common

c) Lungs are commonly involved by direct invasion

d) Dimpling of skin is due to shortening of cooper's ligaments

Ans 

Vascular

Vascular

Q  Engorged dilated Riolan arc vessel with retrograde flow suggests

a) SMA occlusion

b) IMA occlusion

c) Normal flow

d) Iliac artery occlusion

Answer

 

Hyperbaric oxygen

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.

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Esophagus Perforation

Esophagus Perforation

Q )  Esophageal perforation true is

a) Contrast esophagogram in upright position is better

b) Massive hematemesis

c) Mid esophageal perforation causes right pneumothorax

d) More than 80% crepitus seen


Answer 

 

Gastric Lymphoma

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

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