Month: June 2018

Gastric ulcer

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Q) Gastric ulcer type III is located in? (DNB 2018) 
A. Lesser curvature
B. Body of stomach
C. Prepyloric
D. GE junction

Answer This Question was already discussed in 2009. Here is the link

High grade GIST

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Q) GIST >10CM High-risk cases, imatinib therapy is for
A. 1 year
B. 2 years
C. 3 years
D. 5 years

Answer

Association of Carcinoma Esophagus

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Q) Adenocarcinoma of esophagus is associated with which of the following? (DNB 2018)

a) Achalasia cardia

b) Barrett's disease

c) Human Papilloma virus (HPV)

d) Alcohol use

Answer - b

Association of carcinoma esophagus is with a number of risk factors. Both squamous cell carcinoma and adenocarcinoma of esophagus have different etiologies

Risk factors for Adenocarcinoma are                                                        Risk factor for Squamous cell carcinoma are

  1. Tobacco                                                                                                   1. Alcohol
  2. GERD                                                                                                       2. tobacco 
  3. Obesity                                                                                                     3. Achalasia
  4. Barrett                                                                                                      4. Caustic injury of esophagus
  5. H/o previous radiation for breast cancer                                         5. Previous radiation of CA breast                

                                                                                                                             6. H/o head and neck cancer

                                                                                                                             7. Plummer vinson and tylosis

New born hernia

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Q) Most common diaphragmatic hernia in a new born infant
A. Bochdoleck
B. Morgagni
C. Paraesophageal I
D. Paraesophageal III

Answer

Hepatic blood flow

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Q. All are true regarding hepatic blood flow except
A. Liver has dual blood supply from portal vein and hepatic artery
B. 70% of liver oxygen comes from the hepatic artery
C. 70-80% of blood supply to the liver is from portal vein

d) Liver receives 25% of cardiac output

Answer for premium

The explanation discusses how much blood and oxygen goes through portal vein and hepatic artery to the liver

What is hepatic artery buffer response

 

Esophagus Length

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Q) Length of Esophagus is 

 A. 20 cm
B. 25 cm
C. 30-35cm
D. 40cm

Length of esophagus is important in various resection surgeries as well as endoscopy

Answer

 b 25 cm

The length of esophagus  is anatomically defined as the distance between the cricoid cartilage and the gastric orifice. It ranges in adults from 22 to 28 cm (24 ± 5 SD),  last 3 to 6 cm of which are located in the abdomen.

The shortest distance between the cricoid cartilage and the celiac axis is the orthotopic route in the posterior mediastinum, being 30 cm. The retrosternal (32 cm) and the subcutaneous route (34 cm) proved to be longer

Deviations to the left 

Esophagus through out its length deviates to the left in superior mediastinum and lower posterior mediastinum.

Constrictions of esophagus

Cervical narrowest at c5/6

Thoracic T4-5

Abdominal

 

Ref Shackelford page 10