Weight loss surgery

Q) Which  of the following statement about Roux en Y gastric bypass is not true?

a) After weight loss it resolves symptoms of venous ulcers due to stasis

b) Symptoms of pseudo tumor cerebri are resolved

c) Heartburn is alleviated immediately

d) Protein malnutrition is a very common problem

 

Answer 

d Protein malnutrition is common in Biliopancreatic division and duodenal switch.

Essential components of successful Roux en Y gastric bypass are 

  1. Small Gastric pouch (15-20ml) made from cardia of stomach
  2. Keep the length of roux limb at around 75 cm
  3. Division of gastric pouch from distal end of stomach

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Retroperitonuem tumor

Q) A 42 year old lady undergoes exploration for a retroperitoneum mass. In OT it is suspected that this is a liposarcoma. Which of the following is  not true about liposarcoma?

a) Liposarcoma is the most common variant of sarcomas

b) They have a  pseudocapsule

c) They can grow quite large before producing symptoms

d) They are locally invasive and do not metastatize

Answer  Free

 

Atrial Septal Defect

 In exams like DNB SS questions on ASD and VSD are common. Most cardiac surgery questions are here

Q) Most common ASD is 

a) Ostium Primum

b) Ostium Secundum

C) Sinus Venosus

d) All are equal

Answer 

b

Ostium Secundum

 

ASDs
Common defects
Ostium secundum: fossa ovalis defect (approximately 70 per cent of ASDs)
Ostium primum: atrioventricular septal defect (approx imately 20 per cent of ASDs)
Sinus venosus defect: often associated with anomalous pulmonary venous drainage (approximately 10 per cent of ASDs)
Patent foramen ovale: common in isolation, usually no left-to-right shunt (not strictly an ASD)

Rarer defects
Inferior vena cava defects: a low sinus venosus defect and may allow shunting of blood into the left atrium
Coronary sinus septal defect: also known as unroofed coronary sinus with the left superior vena cava draining to the left atrium as part of a more complex lesion

 

Billroth 2 surgery

Q) What is true regarding complications of billroth 2 surgery?

a) It has less complications than billroth 1 surgery

b) Recurrent ulceration is more common in the afferent limb as compared to efferent limb.

c) Afferent loop obstruction is more common after billroth 2 surgery

d) Billroth I operation is preferred in scarred duodenum

Answer c -

In billroth 2 surgery, afferent limb obstruction is more common

In surgery for benign gastric ulcers, billroth I reconstruction is the preferred choice. Billroth II surgery has problems of

  1. Retained antrum syndrome
  2. Afferent loop obstruction
  3. Duodenal stump leak (1-3%)

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