Q) Which of the following is true about screening in hepatocellular carcinoma (HCC Cancer)
a) Alpha feto protein should be done 6 monthly
b) Ultrasound abdomen should be done 6 monthly
c) Candidates for liver transplant should be screened every 3 months
d) Nodules more than 2 cm should be followed up more regularly
In a cirrhotic liver, hcc cancer can develop any time and a stringent screening protocols have to be followed for early detection and timely treatment. Earlier ultrasound of liver and alpha feto protein were both used as tumor markers. However in 2009 Marrero et al demonstrated the suboptimal accuracy of AFP and after that it has been removed from the screening protocol and now only ultrasound is being done.
The screening recommendation is not for those patients with severe Read More ...
Q) All are premalignant in carcinoma GB except
a. PSC ,
b. Porcelain GB
c. Multiple 2 cm stones.
d. Choledochal cyst
Q) Most common content of Morgagni hernia is :
b. Small intestine.
c. Transverse colon.
Answer is here
Foramen of morgagni is a congenital diaphramatic defect along with Bochdalek.
Morgagni was an italian anatomist
Q) Non hereditary polyp in colon
a) Peutz Jeghers Syndrome
d) Cronkhite Canada
Q. Regarding percutaneous cholecystostomy A/E
a. Technical success in 90 – 98 % of cases
b. Indicated in Grade II cholecystitis with significant pericholecystic inflammation & GOO
c. Indicated in Gr III cholecystitis with significant comorbidity
d. In Grade III cholecystitis with biliary peritonitis, PCC results in significant improvement
Q ) Modified Nissen's Fundoplication
a) 2700 anterior wrap around esophagus
b) 2400 wrap
c) 3600 wrap over > 52 Fr for 1 – 2 cm
d) 600 wrap over 42 Fr for 4 cm
Nissen fundoplication is complete 360 degree but has high incidence of gas bloat. To counter this modification done to wrap over 52 F tube for 1-2 cm
Belsey - Left thoracotomy, mobilization of distal esophagus and stomach, hiatus opened from above, fundus is brought 270 degrees around distal esophagus. Then the whole assembly is brought down and crura is repaired.
Hill procedure - No fundoplication is done
Toupet is anterior fundoplication either 240 degree or 270 degree.
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) Most common pathological finding on defecography studies is
Answer for premium
Discuss what is defecography? Diseases diagnosed by it
Q) Fibrolamellar Carcinoma of the liver
a) Occurs in the setting of cirrhosis
b) Has worse survival than Hepatocellular carcinoma
c) Can be followed up for long time
d) Seen in young females
Q) Which is the strongest layer of the intestine?
c) Muscularis propria
d) Muscularis mucosa
b) Submucosa is the strongest and most important layer for intestinal anastomosis. It has fibroblasts that will ultimately release collagen and hold the anastomosis together. This layer should be fully incorporated in the anastomosis.
Inverted Vs everted anastomosis of intestine debate has been log going on but now many prefer inverted because mucosa is exposed to mucosa and eventually degrades joining the two submuoca together to cause healing by primary intention.
REF Schakelford: page 923
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
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.
Read More ...
Q) Management of carcinoma body of stomach which on exploration is only invading the body of pancreas with no distant metastasis
a) feeding jejunostomy and closure
b) Palliative total gastrectomy
c) Total gastrectomy with ......
Further choices and answers for premium members
Q) CEA surveillance in normal person whose father and brother had colon cancer is helpful in
a) CEA is highly sensitive in picking up the diagnosis of colon cancer
b) HIGH preoperative CEA is predictive of unresectability in colon cancer
c) Increase in CEA after surgery is indicative of tumor recurrence
d) CEA is present in normal colonic mucosa
Answer for premium members