Parenteral nutrition

Q) IV fluid of choice to increases calories to provide parenteral nutrition  by peripheral route is:

a) DNS

b) Lipid Emulsions

c) Arginine in DNS

d) 25% dextrose

Answer (FREE)  b

Lipid Emulsions can be given by peripheral route. They are the highest source of energy and calories.  25% dextrose, although a good source of energy has high concentration of glucose which can cause thrombophelebitis.

DNS will provide just basic calories and will not cause any increase in calorie intake.

Addition of arginine, which is an amino acid will not increase the energy intake.

 

 

Duodenal atresia

Question on Duodenal atresia was asked in AIIMS 2017 in April

Q) An infant presents with duodenal atresia. Which of the following is true about this condition?

a) It is the most common GI atresia

b) It presents soon after birth with non bilious vomiting

c) Pre natal detection of duodenal atresia is common

d) Gastro jejunostomy is the procedure of choice to bypass the obstruction

Answer (free) 

C- Commonly detected in the pre natal ultrasound

Duodenal atresia is seen in 1:5000 live births and most common atresia is jejunoileal (1in 2000). It is associated with lot of other congenital malformations like Down's,  prematurity, biliary atresia etc.

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Blood Supply of Stomach

Q) True about blood supply of stomach

a) Right gastric artery is the largest artery to the stomach

b) At least three out of four arteries of the stomach can be ligated and blood supply to the stomach may remain preserved.

c) Right gastric artery originates from splenic artery

d) Aberrant left hepatic artery arises from splenic artery

Answer

b

Blood supply of stomach is mostly consistent and there are four named arteries.

Left gastric artery is the largest artery to the stomach and in 15-20% cases, there is an aberrant left hepatic artery which arises from it. 

At least three arteries of the stomach can be safely ligated if the arcades on the greater and lesser curvatures are preserved and vascularity of whole of stomach may be preserved.

Right gastric artery is the branch of common hepatic artery or Gastro duodenal artery

Aberrant left hepatic artery is the branch of Left gastric artery. It is seen in 15-20% cases.

Right gastro epiploic artery is the branch of Gastro duodenal artery and left gastro epiploic from splenic artery

Blood supply of stomach