Q) In Crohns disease activity index all are included except?
b) Abdominal pain
d) Extra intestinal symptoms
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Crohn disease activity index is a medical tool, which helps to quantify the symptoms and problems of Crohn's disease
It helps to quantify the disease
It helps to assess.... (become a premium member to read more)
Q) For mid colonic interposition for esophageal reconstruction which artery is not ligated
b) Rt colic
c) Middle colic
d) Left colic
Q) Regarding colonic volvulus all are true except
a) Sigmoid volvulus without gangrene – colonoscopic decompression is the trt of choice
b) Caecal bascule has high chance of gangrene due to torsion of mesentry
c) Splenic flexure volvulus has better prognosis than transverse colon volvulus
d) Recurrence rate after detorsion of cecal volvulus is 10-20%
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Q) Tumors of Appendix. All statements are true except
a) Carinoid tumors most common
b) Adenocarcinoma better prognosis than carcinoima
c) Appendicectomy, Cytoreduction and intraperitoneal chemotherapy is the adequate treatment for adenomucinosis
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Q) Bowel segment showing best adaptation
Q) All are contraindication for strictureplasty in Crohn Disease except
a) Multiple stricture in short segment
b) Colonic stricture
c) Immediate recurrence with obstruction
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Q) Adverse factor for spontaneous fistula closure:
a) Tract <1cm
b)Transferrin > 200
c) Location in esophagus
d) First surgery done in the same institution
a) Tract less than 1 cm
Spontaneous fistula closure
Short-turnover protein (prealbumin, retinol-binding protein, transferrin) levels should be measured at least weekly to assess the adequacy of protein delivery. An ongoing catabolic state will adversely affect short-turnover protein levels, even with maximal protein delivery.
Failure of an enterocutaneous fistula to close spontaneously is associated with acronym FRIENDS):
the presence of a foreign body within the tract or adjacent to it, previous radiation exposure of the site, ongoing inflammation (most commonly from Crohn disease) or infection that contributes to a catabolic state, epithelialization of the fistula tract (particularly if the fistula tract is less than 2 cm long), neoplasm, distal intestinal obstruction, and pharmacologic doses of steroids.
Fistulas associated with a concurrent pancreatic fistula also have a low rate of spontaneous closure, as do those occurring in the presence of malnutrition or adjacent infection.
In general, anatomic locations that are favorable for closure are the oropharynx, esophagus, duodenal stump, pancreas, biliary tree, and jejunum.