Meckel’s diverticulum

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Q Meckel’s diverticulum  true is
A. Mc congenital anomaly of the intestine
B. Always heterotopic mucosa
C. Pseudodiverticula
D. Located on mesenteric border

Answer

Milan Criteria

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Q) All are true in Milan criteria except?
A. Single lesion  <5cm
B. 3 nodules <3cm 

C. >5 nodules
D. No extrahepatic disease

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NOTES

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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.

Shackelford

Anal canal

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 Q  True about anal canal anatomy are all except
a) Columns of morgagni above dentate line
b) Resting anal canal Pressure 5 – 20 mm Hg
c) Muscles are tubular with inner layer supplied by autonomic nerves

d) Contains columnar, transitional and squamous epithelium

Answer

Anal Fissure

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Q )  Not indicated in anal fissure
A. Inj BOTOX
B. Topical steroids
C. Topical CCB
D. Topical Nitro glycerine

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Amoebic liver abscess

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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 

Haemangioma Liver

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Q) False statement about haemangioma liver

a) They are the most common lesions of the liver

b) Giant haemangiomas should be resected because of malignant potential

c) Symptomaic haemangioma should be resected

d) Most of the haemangioma liver are asymptomatic

Answer

Incidence of haemangioma liver is increasing because of increased use of CT and MRI. 

Post Lap Cholecystectomy Ca Gall Bladder

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Q) Post Lap cholecystectomy, biopsy comes as Ca gall bladder with invasion of peri muscular connective tissue. Most appropriate for this patient is
A. IVB &  V resection nodal clearance
B. IV B &  V plus nodal clearance with port site excision
C. Wedge excision of liver with Lymphadenectomy
D. Wedge excision, Lymphadenectomy and Port excision