Pouchitis Disease severity index

Q) Pouchitis disease activity index includes all except (AIIMS 2019)

a)  Fever
b)  Malaise
c)  Fecal urgency
d)  Bleeding PR

Pouchitis is commonly asked in AIIMS and JIPMER MCH exams. Previous year questions are here and here 

Ans b ) Malaise, Clinical data includes Frequency, urgency and rectal bleed

Summary of the PAS

Range
I. Clinical
 1. Stool frequency(0, 2, 4, 6)
 2. Fecal urgency(0, 3)
 3. Rectal bleeding(0, 3)
Maximal clinical subscore: 12
II. Endoscopic findings
 1. Oedema(0, 1)
 2. Granularity(0, 1)
 3. Friability(0, 1, 2)
 4. Erythema(0, 2, 3)
 5. Mucosal flattening(0, 2)
 6. Ulcerations/erosions(0, 2, 3)
Maximal endoscopic subscore: 12
III. Histological Acute inflammation
 1. Polymorphonuclear infiltration(0, 1, 2, 3)
 2. Ulcerations/erosions(0, 1, 2, 3)
Chronic inflammation
 1. Mononuclear infiltration(0, 1, 2, 3)
 2. Villous atrophy(0, 1, 2, 3)
Maximal (total) histological subscore: 12
Maximal total PAS: 36

 

Hypovolemic Shock

Q) Which of the following is the correct physiological change during hypovolemic shock?

A)Increased cardiac output.

B)Decreased vascular resistance.

C)Decreased venous pressure.

D)Increased venous saturation.

Healing by Primary Intention

Q)What is the false regarding the healing by  primary intention?

A)Wound edges opposed.

B)Normal healing.

C)Usually done for dirty wounds

D)Minimal scar.

Answer-C(bailey-25)

Primary intention,

Healing by primary intention is also known as healing by the first intention this occurs when there is an opposition of the wound edges

Secondary Intention

Healing occurs when the wound edges are not opposed immediately, which may be necessary for contaminated or untidy wounds.

Primary intention,

  • Would edges opposed
  • Normal healing.
  • Minimal scar.

Secondary intention,

  • Would leave open.
  • Heals by granulation, contraction and epithelialisation.
  • Increased inflammation and proliferation.
  • Poor scar.

Cystic Neoplams of Pancreas Important points

Important points on cystic neoplasms of pancreas

From NEET Questions and discussions

  1. Old age and no history of pancreatitis, it is cystic neoplasm of pancreas
  2. Most common is SCN followed by MCN and IPMN
  3. OLd patient with dilated duct, cystic neoplasm is IPMN
  4. The most important point of differentiation in cystic neoplasms is whether the epithelium is serous or mucinous.
  5. All mucinous cystic lesions should be resected; lesions < 2 cm remain controversial.
  6. Mucinous  neoplasm in middle aged female, body and tail of pancreas
  7. Creeping Resection is for IPMN Intraoperative frozen sectionsin  the management of IPMNs.  If margins are positive for adenoma or borderline atypia with minimal cytoarchitectural atypia and gastric/foveolar-type epithelium, no further resection is required. If instead they are positive for invasive carcinoma, carcinoma in situ, or borderline atypia exhibiting florid papilla formation, further resection is warranted, if feasible.In such instances, further “creeping” resection toward the head for a tail lesion, or toward the tail for a head or uncinate process lesion, can often be sufficient.

Gastrinoma

Q) True about gastrinoma is 

a) At the time of diagnosis most are benign and only 20% are malignant

b) In Pancreas most tumors  are confined to the body and tail

c) All cases of gastrinoma should be screened for MEN 1

d) They are highly malignant and even after complete resection 5 year survival is 30%

Another Mcq on gastrinoma


Abdominal Aortic Aneurysm (USMLE)

Abdominal Aortic Aneurysm (AAA) 

Splenic artery Aneurysm                         General Surgery                                   Free Questions                                           


Age - 60 years

Sex - Male

Who are at risk - Smokers, Hypertension 

Specific Questions - Associated with Ehler Danlos and MArfan Syndrome - So common in families Read More ...