Q) Which of the following does not form part of gastrinoma triangle
b) Junction of body and neck of pancreas
c) Cystic duct and CBD junction
d) Junction of 2nd and 3rd part of duodenum
Q) Whipple's triad is seen in
Whipple's triad is seen in pancreatic insulinoma and consists of
a) Symptoms of hypoglycemia
b) Fasting sugar less than 50 mg%
c) Relief of symptoms with administration of dextrose solution
- Insulinoma is the most common functioning pancreatic neuroendocrine tumor
- Symptoms are present for many years before diagnosis
- Weight gain is common
- Distribution of insulinomas is equal in body head and tail
- Avg size of insulinoma is 1-1.5 cm
Q1. Risk of Colon Cancer in Adenomatous polyp is related to all except
Q) All are true about hydatid cyst except?
a) Liver is the commonest site followed by lung
b) Most commonly presents as painless abdominal mass
c) Anaphylaxis can occur if there is spillage during surgery
d) Dog is the definitive host
Q) The significance of MELD Scoring in Liver transplant is :
a) Less ill patients are given more priority in liver transplant
b) Set threshold for patients who are too ill to undergo transplant.
c) To access mortality in the waiting list.
d) To list patients in cadaveric deceased donor program
MELD score takes into account three factors. Bilirubin, INR and creatinine. Recently MELD Na is also included. Model for end stage Liver Disease (MELD) was initially developed to evaluate three months prognosis in patients undergoing TIPS.
It ranges from 6 (3 months survival = 90%) to 40 (3 months survival =7%).
In countries where DDLT is more common MELD Score is used to allot grafts to people in the cadaveric list. More severe is the MELD, earlier is the allotment of cadaveric graft.
Sicker patients are given priority
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
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
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.
Q) Which of the following statement is true about appendicitis in pregnancy?
a) Typical symptoms of appendicitis are seen in more than 90% of patients.
b) 50% cases of appendicitis occur in 2nd trimester
c) Rate of negative explorations remain low based on clinical presentation alone
d) The sensitivity and specificity of ultrasound diagnosis remain the same in appendicitis in pregnancy
Appendicitis the most common non obstetric emergency in pregnancy. The diagnosis is difficult because the symptoms of pain abdomen, nausea, vomiting, anorexia, raised TLC are common in pregnancy. Appendicitis has a typical presentation in only 50% to 60% cases.
If untreated preterm labor and even fetal loss can occur due to the complications.
Based on clinical presentation alone, the incidence of negative exploration is as high as 25-50%
Ultrasound with graded compression is still a good imaging option but has lower sensitivity and specificity than in normal clinical situation. If ultrasound is equivocal the next best option is MRI which is safe.
Ref Sabiston 20th edition