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) 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
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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. ....
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Q . Wrong about post gastrectomy syndromes (AIIMS MCQ 2018 GI)
A. Early dumping syndrome occurs after 1 hour
B. Early dumping syndrome has less cardiac and more gastrointestinal symptoms
C. Anastomotic ulcer is more after billroth II
D. Post gastrectomy syndromes are common in billroth II than roux en Y anastomosis
Answer for premium members
Q) . Restrictive strategy of transfusion in acute GI bleed all are true except?
A. Should be started at a hemoglobin < 7 g/dl
B. Will not alter the risk of rebleed
C. Child A and B patients had significantly lower morbidity
Answer is free here (Misc Question)
Q. Which is false about crystalloid solutions?
A. NS has Sodium 154 meq/l
B. NS has Chloride 154 mEq/l
C. RL contains Lactate but doesn’t contain calcium
D. RL contains sodium potassium calcium and lactate
Q ) Hereditary diffuse Gastric carcinoma is associated with which breast cancer
A. Ductal carcinoma NOS subtype
B. Lobular carcinoma
D. Metaplastic carcinoma
Answer for Q 79
Majority of Gastric Cancers are sporadic,
1–3% of GCs arise as a result of inherited cancer predisposition syndromes.
Li-Fraumeni syndrome, Lynch syndrome, Peutz-Jeghers syndrome, hereditary breast and ovarian cancer,1MUTYH-associated adenomatous polyposis (MAP), familial adenomatous polyposis, juvenile polyposis syndrome and PTENhamartoma tumour syndrome (Cowden syndrome).
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Q) True about retained antrum syndrome after gastrectomy are all except
a) It is a persistent hypergastrinemic state
b) It is only seen after Billroth II Gastrectomy
c) Technetium labelled food is not helpful in diagnosing this condition
d) Serum gastrin is usually less than 1000 pg/ml
After billroth II gastrectomy, if a cuff of gastric mucosa remains with duodenum, this entity is called as retained antrum syndrome. This cuff of gastric mucosa is cut off from the proximal stomach and inhibitory effect of hormones such as VIP (Vasoactive Intestinal Peptide) leading to a persistent hypergastrinemic state. ALso this gastric mucosa is continuously bathed by the alkaline contents of duodenum , which further increases the acid formation.
Both Basal and maximal gastric acid outputs increase but it is not as high as seen in zollinger ellison syndrome. Typically less than 1000 pg/ml
This condition can present as recurrent and persistent ulcerations. Technetium scanning is the diagnostic modality of choice. Treatment is re do surgery and antral excision.
Technetium pertechnate imaging has a sensitivity of 73% and specificity of 100%
More about retained antrum syndrome
Q) Regarding minimal access cholecystectomy all are true except?
a) NOTES can be done transvaginally and transgastrically
b) Transgastric route is preferred
c) SILS is done through single port with multiple instruments avoiding multiple ports
d) SILS has difficulty with triangulation and retraction
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Answer is B
Natural orifice transluminal endoscopic surgery (NOTES), which uses natural orifices (transgastric, colonic, urethral, vagina) to introduce an endoscope, has been reported since early 2000 as a less invasive approach to laparoscopy. The first human NOTES transvaginal cholecystectomy was reported in 2007, and later the report of a hybrid combination of flexible scope by a transvaginal approach in combination with an umbilical needle or port for laparoscopic instruments for retraction, dissection, or clips application. This hybrid technique allowed for a quicker and safer procedure; the present deficiency is in the proper endoscopic instrumentation. For the trans vaginal approach, a Foley catheter is placed, a dissection is performed in the posterior vaginal cul-de-sac to allow a port placement, and when the case is over, the closure is easier than a transgastric or transcolonic approach, which continues to be an issue.
Q) Most common diaphragmatic hernia in a new born infant
C. Paraesophageal I
D. Paraesophageal III
Q Cause of mortality in Ludwig’s angina
Ludwig's angina is an inflammatory condition of the neck which is due to
- Streptococcal infection
- Anaerobic infection
- Infection of malignancy in the neck
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Indications for adjuvant radiotherapy in Head &Neck cancer are all except
A. Multiple LN disease
B. Extranodal involvement
C. Lymphovascular invasion
Diuelafoy lesion which is false? (AIIMS 2018)
A. Most of the bleed cannot be visualised due to small mucosal defect lies over large arterial
B. Large 1-3 mm artery in the submucosa is the source
C. MC in the greater curvature
D. Found within 6 cm from GEJ