Anti Rejection drugs

Q) Most nephrotoxic drug is 

A. Cyclosporine
B. Sirolimus
C. Azathioprine
D. Steroids

Answer

These are immunosuppressants used after solid organ transplants. These drugs have a lot of side effects.

Answer is here  

 

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 

Spinal cord injury

Q) Out of the following which will require Spinal immobilization most?
a. 22 yr Female had a high-speed motor vehicle collision who complains of backpain and no
numbness
b.16 yr male jumped from 6ft landed on both foot denies back pain and weakness
C. Gunshot injury
D. Abdominal injury

Answer is free 

a) 

Spinal cord injuries are a common cause of morbidity and expenditure. Mortality is associated with cervical injuries but not lower spinal cord injuries.

Motor vehicle accidents are the most common cause and gunshot injuries the least common for spinal cord injuries.

Mechanism of injury 

  1. Blunt trauma - Direct impingement, Ischemia, compression or bleeding 
  2. Penetrating - Laceration of spinal cord

Chance fracture - is a type of spinal cord fracture in which there is transverse fracture of all vertebral elements

Management

1 Complete immobilisation

2. Management of associated neurogenic shock ( due to loss of sympathetic tone) with vasopressors  and fluids

Sabiston page 420