April 2019 – Surgery SuperSpeciality MCQs for MCH

Delayed complications of loop gastrojejunostomy

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Q) Most common delayed complication of loop gastrojejunostomy

a) anemia

b)) gastric reflux

c) stricture

d) malignancy

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Risk factors for Ca gall bladder

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Q) Risk factor for CA GB are all except
A. Multiple polyp
B large gall stone >3 cm
C PSC
D pigment stone same risk as cholesterol stone

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MCN

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Q) All about MCN of pancreas are true except?
1.Presence of eggshell calcification in CT is suggestive of malignancy
2.cyst fluid analysis can diagnose accurately in 80%
3.invasive MCN is very aggressive with 30% 5YR Survival compared to adeno carcinoma
4. If MCN is non invasive, surgery is curative

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GIST

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Q) True statement regarding GIST is (AIIMS 2019)

a) 80% of GIST arise from stomach

b) ILeal GIST is resistant to Imatinab

c) Leiomyosarcomas do not express CD 117

d) Prognosis of GIST does not depend on the site of lesion

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They can appear anywhere within the GI tract, although they are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%).

Development of imatinib mesylate has significantly altered previous treatment strategies. Imatinib mesylate is a tyrosine kinase inhibitor that blocks the unregulated mutant c-kit tyrosine kinase and inhibits the BCR-ABL and PDGF tyrosine kinases.

Current guidelines suggest that patients with high-risk disease should receive 3 years of adjuvant therapy at all sites

Sabiston page 1280

Ileal GIST are more malignant than stomach GIST

Leiomyosarcomas

Among the gastric tumors, there were no examples of true leiomyosarcomas, whereas there were four small intestinal, four colonic, and two rectal tumors that histologically showed features of differentiated smooth muscle cells with blunt-ended nuclei and eosinophilic, sometimes granular, cytoplasm. These tumors were, by definition, all positive for SMA, and seven also were positive for desmin. Although all leiomyosarcomas were generally negative for CD117, scattered large neoplastic spindle cells (less than 1% of tumor cells) in two intestinal leiomyosarcomas showed strong cytoplasmic positivity; these four tumors were negative for CD34.

Ref https://www.nature.com/articles/3880210

Thyroid cancer USG

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Q) Feature on USG that has the highest sensitivity to predict thyroid carcinoma consistently across studies? ( Head and Neck Onco)
a)Microcalcifications
b)More tall than wide