Radical Cholecystectomy

March 18, 2019 admin

Q) Radical cholecystectomy includes all except

a) Segment IVb and Va

b) 2cm wedge resection

c) Rt Extended Hepatectomy

d) Paraaortic lymphnodes

Answer and Explanation here

History of Radical Cholecystectomy

Early 20th century removal of gall bladder and wedge of liver ( No lymphadenectomy)
In 1954, Glenn et al - radical resection procedure with intended regional lymphadenectomy (portal lymph node dissection), designated as “radical cholecystectomy” (Glenn operation)
Fahim et al in 1962 advocated radical resection consisting of hepatectomy and portal lymph node dissection

Read on for full answer - Premium members only

Borderline resectable pancreatic malignancy

March 5, 2019April 18, 2019 admin

Q)False in Borderline resectable Pancreatic malignancy

a) Solid tumor contact with the IVC <180

b) Solid tumor contact with the SMA of ≤180 degree

c) Solid tumor with CHA involvement of 2.5 CM

d) Solid tumor contact with the SMV or PV of >180 degrees

Answer - Click here

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Pancreatic ascitis

March 3, 2019April 18, 2019 admin

Q) Pancreatic ascites false is

a) Fluid albumin is >3 g/dl

b) Metaplastic mesothelial cells seen

c) In children it is most commonly due to Chronic pancreatitis with Ductal disruption

d) Serum and fluid amylase levels are always well correlated

Answer

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Blood transfusion

February 28, 2019February 28, 2019 admin

Q ) In trauma what is the ratio of PRBC: FFP to be transfused?

a) 1:1

b) 1:2

c) 1:3

d) 1:4

Ans a

When there is requirement of more than 6 units of PRBC, FFP and other blood products are required. Read on ....

Ref Sabiston 72

Benign polyps of esophagus

February 25, 2019April 18, 2019 admin

Q ) False regarding Benign lesion of esophagus

a) Fibrovascular polyps are seen in mid and lower two third

b) Leiomyoma and Leiomyosarcoma have same distribution.

c)Leiomyoma enucleation is sufficient

d) Leiomyoma are the most common benign tumors of esophagus

Ans-

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PET scan in Ca esophagus

February 21, 2019 admin

Q1) False about role of PET scan in Ca esophagus

a) Upstages disease in 15% cases

b) Used to assess response to pre op chemo radiation

c) Used for selecting patients for surgery after neoadjuvant chemo Rt

d) Assessment of response is seen after 2 weeks of pre op chemo RT

Answer

Pouchitis after IPAA in ulcerative colitis

February 15, 2019April 18, 2019 admin

Q) Which of the following is Not a risk factor for pouchitis post IPAA in ULcerative colitis

A) Smoking
B ) NSAIDs use post op
C) Elderly patients
D) UC with extra intestinal manifestation

Ans a

Pouchitis is the complication of Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative colitis. The incidence of pochitis for the same proedure for familial Adenomatous polyposis is less than 10% but for ulcerative colitis can go as high as 50%.

Risk factors for development of pouchitis are

Previous extra intestinal manifestations of IBD especially arthritis
ANCA positive cases of UC
NOD2insC positive patients
Smoking prevents the development of puchitis after IPAA in ulcerative colitis.

5. Other reported factors that may associate with pouchitis include extent of UC, thrombocytosis,and PPI use with NSAId

Ref - https://onlinelibrary.wiley.com/doi/full/10.1111/den.12744