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
Answer : Save time!! Be a premium member and get access to all questions and answers
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
Read on ......
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
Q) Penetrating injury to the abdomen, with BP 84/60, Pulse 116/min, what is the next best step in management?
b) CT Abdomen with contrast
c) Ultrasound abdomen
d) Take to OT
Answer for premium
Q) Out of the following which will require Spinal immobilization most?
a. 22 yr Female had a high-speed motor vehicle collision who complains of backpain and no
b.16 yr male jumped from 6ft landed on both foot denies back pain and weakness
C. Gunshot injury
D. Abdominal injury
Answer is free
Spinal cord injuries are a common cause of morbidity and expenditure. Mortality is associated with cervical injuries but not lower spinal cord injuries.
Motor vehicle accidents are the most common cause and gunshot injuries the least common for spinal cord injuries.
Mechanism of injury
- Blunt trauma - Direct impingement, Ischemia, compression or bleeding
- Penetrating - Laceration of spinal cord
Chance fracture - is a type of spinal cord fracture in which there is transverse fracture of all vertebral elements
1 Complete immobilisation
2. Management of associated neurogenic shock ( due to loss of sympathetic tone) with vasopressors and fluids
Sabiston page 420
Q) Commonest cause of breathing difficulty in unconscious patient is
a) Foreign body
d) Impacted teeth
Be a premium member for answer -
Q. Harmonic scalpel frequency of vibration is
Q) Which of the following is a clinical marker of myocardial ischemia
a) Troponin I
c) Alkaline phosphatase
d) CPK MB
Myocardial ischemia (MI) is an adverse risk factor precluding any major surgery. MI can be STEMI (ST segment elevated MI) or NSTEMI ( Non ST segment elevated MI) .................
Read On Q108
Q ) On T2 W MRI image, what appears bright
Q) Lymphatic drainage of Right adrenal gland is to
a. Para aortic group
b. Inter Aortocaval
c. Pre aortic.
d. Para Caval
a) Para-aortic lymph node.
Small lymphatic channels from both cortex and medulla drain into the hilum, from where larger calibre lymphatic emerge to drain directly into the lateral group of para-aortic lymph nodes
- arterial supply is via three adrenal arteries
- superior adrenal artery (from inferior phrenic artery)
- middle adrenal artery (from abdominal aorta)
- inferior adrenal artery (from renal artery)
- venous drainage
- adrenal veins emerge from the hilum and drain to different veins depending on the side:
- left adrenal vein drains to the left renal vein
- right adrenal gland drains to the IVC
( Grays anatomy)