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
- Retained antrum syndrome
- Afferent loop obstruction
- Duodenal stump leak (1-3%)
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Q) In terms of cure best results in inflammatory carcinoma breast are seen with-
a) Surgery alone
d) All of the above
Surgery MCQ PDF - Free Answer
Inflammatory carcinoma of the breast is a rare aggressive tumor that blocks the sub dermal lymphatics as a result of which cutaneous edema is common . Differentiating it from a breast abscess is important and biopsy is diagnostic. It is also responsible to peau d orange
Treatment is multidisciplinary and involves, chemotherapy followed by surgery followed by radiotherapy.
a) Factor II
b) Factor VII
c) Factor VIII
d) Factor IX
Answer & explanation for premium
Q) IV fluid of choice to increases calories to provide parenteral nutrition by peripheral route is:
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.
Q . Management of Multinodular goitre with dysphagia and pain neck in 35 year old lady
a) Iodine treatment
c) Thyroxine (T3 and T4)
d) FNAC and Radioactive Iodine
Q) Which of the following is true about giant gastric ulcer?
a) 70-80% of these ulcers are malignant
b) By definition giant gastric ulcer is more than 1.5 cm in size
c) Medical therapy can heal 80% of such ulcers
d) They are more common on the greater curvature and invade surrounding organs like spleen, liver etc
Answer for premium members
Q) A 45 year old male sustains 30% burns on both legs and anterior abdominal wall. There was mild inhalation injury associated with it. He initially responded well to treatment with IV fluids, Inj Tramadol and enteral feeding.
Three days after the treatment he is having slight tachypnea (30/min) pulse 110/min and BP 98/60. His temp is 97degree F and some areas of partial thickness have converted into full thickness. He is currently on Inj Magnamycin. His platelets are 70ooo, TLC is 17000 and sugar is 200 mg%. What is the next step in management?
a) Continue same management
b) Upgrade the antibiotic and send a fresh culture from skin
c) Treat it as carbon monoxide poisoning
d) Manage in lines of Acute Tubular Necrosis
Answer for premium members
Burns management involves critical care, intensive phase and rehabilitation. Loss of skin and eschar formation predispose individuals to gram positive, gram negative and fungal infections.
Q)Splenic artery aneurysm is seen in
a) Proximal 1/3rd of splenic artery
b) Proximal 2/3 of splenic artery
c) Middle 1/3 of splenic artery
d) Distal 1/3 of splenic artery
Answer for Premium members
Q) A 50 year old male undergoes pancreatectomy for Carcinoma head of pancreas. His pre op Hb was 9.2g% and during surgery he received 5 units of PRBC. In the post op period on the 2nd day he develops ECG changes. Work up is done for Myocardial Ischemia which is negative. What is the most common cause of ECG changes here
Free Answer b, Hyperkalemia
Transfusion of high volume of PRBC especially stored blood leads to hyperkalemia. In the setting of pancreatectomy in an already anemic patient, if massive blood transfusion is given, chances of hyperkalemia are there.
The ECG changes of Hyperkalemia are tall T waves, shortened QT interval and ST segment depression