Q. WDHA syndrome is associated with
Q. WDHA syndrome is associated with
Q. Not seen in ulcerative colitis?
a) Anal fistula
b) Association with primary sclerosing cholangitis
c) Superficial epithelial involvement
d) Backwash ilieitis
Q) Choledochocele is type
Todani Classification of Alonso Lez Modification in Choledochal cyst
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%
Q) Duplication of the intestine associated with
A. Heterotopic mucosa
B. Smooth muscle component
C. Associated with spinal / vertebral defects
D. All are correct
Q Meckel’s diverticulum true is
A. Mc congenital anomaly of the intestine
B. Always heterotopic mucosa
D. Located on mesenteric border
Q . Best investigation to diagnose Colonic diverticulitis
A. Ba enema
B. CT scan
Q) All are true in Milan criteria except?
A. Single lesion <5cm
B. 3 nodules <3cm
C. >5 nodules
D. No extrahepatic disease
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.
d) Contains columnar, transitional and squamous epithelium
Q) Not included in MELD Score
Q ) Not indicated in anal fissure
A. Inj BOTOX
B. Topical steroids
C. Topical CCB
D. Topical Nitro glycerine
Q) Hypersplenism criteria are all except?
a) Splenectomy cures it
b) Hypercellular or normal marrow