Q True in SMA syndrome
- Causes Medial Arcuate Ligament syndrome
- Causes nut cracker syndrome
- Low AM distance and Narrow AM angle <25 degree is sensitive finding
- It can be treated by releasing the DJ and keeping duodenum to the right of the artery
Q True in SMA syndrome
Q Engorged dilated Riolan arc vessel with retrograde flow suggests
a) SMA occlusion
b) IMA occlusion
c) Normal flow
d) Iliac artery occlusion
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
C. Complications include Parkinsonism, barotrauma
D. Usually 30-40 sessions are required for treatment
Answer free for all
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. Read More ...
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
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
Q. All are false about adenomatous polyposis syndrome except
A. 25% do not have family history
B. Attenuated FAP has less than 100 polyps and delayed onset (50-55 yrs)
C. More than 20 rectal polyps have to be operated as there is high risk of Carcinoma
D. Attenuated FAP don’t have extracolonic manifestations and carry APC mutation
Answer visible here or below if you are a premium member and logged in
Q) Antral GIST 1cm incidentally found on UGIE. True regarding its management
a) Surgical resection
b) Endoscopic resection
c) Resection required if EUS suggests irregular border with cystic spaces
d) Endoscopic surveillance, if size >2cm then resect
Answer (Pemium members who are logged in can see explanation below)
Q . Treatment of choice for anal canal high grade lymphoma on a young immunocompromised male?
C. Local excision followed by chemotherapy
D. Local excision
Q) All are true about pancreatic protocol CT except (AIIMS 2012)
a) > 90% unresectable lesions picked up by CT
b) Dual phase CT with cuts taken at 40 secs and 70 secs
c) Liver metastasis detected in early arterial phase
Answer is free for all
Pancreatic protocol CT involves imaging at the pancreatic phase (i.e., approximately 45 seconds after contrast administration) and at the portal venous phase (i.e., approximately 70 seconds after contrast administration). It is useful for detection of adenocarcinoma of pancreas.
Metastatic lesions are seen in the portal venous phase, because the lesions are not typically well vascularized.
Arterial phase images are principally used to distinguish metastatic disease from benign vascular lesions, such as hemangiomas, or to better define the arterial anatomy of the liver.
Non contrast phase used for Read More ...
Q . Duodenal injury management false
a) Circumferential skeletonization is required
b) All duodenal repairs require some form of drainage
c) All hematomas near the pancreas requires exploration to check for serosal integrity
d) Most common location is the second portion
Q. All are true regarding malignancy in UC except
A. Increased risk with pancolitis and increased duration
B. Screening for malignancy should start 8-10 yrs after onset of symptoms
C. Poorly differentiated
D. Surveillance should start as soon as remission occurs to pick up missed colon cancer
Answer is D
Q) All are true about disinfectants in surgery except
A. Povidone iodine needs to dry up prior to its action
B. Alcohol disinfectants act against all organisms except clostridium difficile
C. Single dose of first generation cephalosporin should be givens prophylaxis for vascular
procedures and bladder catheterisation
D. Chlorhexidine is bactericidal, viricidal, fungicidal, and has rapid onset of action and persistent
Povidone-iodine solution is used for surgical site preparation, it must be allowed to dry for microbicidal effect.
Chlorhexidine is a phenol which is used in concentrations of 0.5% to 4.0% alone or in lower concentrations in combination with an alcohol as a skin antiseptic. ....