Neuroendocrine tumors

Q)  DVT, Depression, Dermatitis, Diarrhoea seen in
A. Glucagonoma
B. VIPoma
C. Somatostatinoma
D. Gastrinoma

Answer 

Amoebic liver abscess

Q)  Treatment of choice in amoebic liver abscess 4 cm in Right lobe of liver with fever and pain abdomen

a) Metronidazole

b) Aspiration

c) Pig tail insertion

d) Surgery

Answer

Question discusses 

INdications of aspiration 

Indications of Percutaneous drainage

Role of Surgery 

Priapism

Q) What is the cause of priapism in a patient with trauma

a) Penile rupture

b) Dorsal vein of penis thrombosis

c) Spinal cord injury

d) Sickle cell anemia

Answer 

Most common cause of priapism is sickle cell anemia, but in the setting of trauma....

Read on  Q 86

Tropical Pancreatitis

Q) All are true about tropical pancreatitis except?

a. Associated with Tapioca.
b. Patients have  large stones with fibrosis.
c. It is Pre Cancerous

d) Onset of disease at 50 years 


  Free. See here for answers to other  questions and this question

Answer -d )Onset is at young age

Tropical pancreatitis

is an  idiopathic disease which begins in teens.  It has a high association with diabetes and Pancreatic duct calculi. It is common in South India, Asia, Africa and central America.

 

Etiology 

Malnutrition 

Cassava

Hydrocarbons exposure

It is associated with SPINK 1 mutation


It is pre cancerous

IPSG data shows the cumulative risk of Pancreatic Cancer  in patients with Chronic Pancreatitis  (predominantly of alcoholic aetiology) was reported as 1.8 % and 4 % at 10 and 20 years respectively. This risk was reported to be independent of age, sex and type of pancreatitis.

The link between CP and PC is clearer in certain subtypes of CP like tropical pancreatitis and hereditary pancreatitis.

 Augustine et al. reported a 8.3 % incidence of pancreatic cancer in patients with tropical pancreatitis, which is much higher than western figures.

Ref 

Pancreatic Cancer in Chronic Pancreatitis


Clinical Picture of tropical pancreatitis

a child, adolescent or young adult , recurrent upper abdominal pain, diabetes mellitus,  malnutrition, nutrient deficiencies, nutritional edema, cyanotic hue of the lips, parotid enlargement and pancreatic calculi on plain abdominal X ray  

Ref https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1742869/pdf/v079p00606.pdf

 

Lymphatic right adrenal

Q) Lymphatic drainage of Right adrenal gland is to 
a. Para aortic group
b. Inter Aortocaval
c. Pre aortic.
d. Para Caval

Answer free 

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)