Ulcerative colitis Surgery in Young female

Q) Which surgery would be preferred to be done in young unmarried  female with steroid refractory Ulcerative colitis  and 15 bloody bowel movements per day? 

a) TPC with IPAA

b) TPC with EI ( end ileostomy) 

c) TAC with EI ( end ileostomy) 

d) TAC with IRA ( Ileo rectal anastomosis) 

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Colon

Ans b

The risk of infertility following IPAA was estimated to be approximately 50% compared with 15% among medically treated patients.
Given these data, many surgeons advocate for a three-stage procedure in which subtotal colectomy with end ileostomy is performed and IPAA is deferred until childbearing is
completed.
SKF 8th page 1936

Spontaneous Pneumothorax

Q) 15 year old boy, with Spontaneous pneumothorax. He is  dyspneic with increased RR

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a) Vats and pleurodesis

b) Needle aspiration

c) Tube thoracostomy

d) Any of the above

Ans c

Primary spontaneous pneumothorax occurs in young patients without significant lung disease, whereas secondary spontaneous pneumothorax occurs in patients with COPD.

The most common cause of primary spontaneous pneumothorax is rupture of small apical blebs. Tube thoracostomy with water seal drainage is the usual first-line treatment of a moderate-to-large pneumothorax in a patient with a first-time occurrence

Fuel for colonocytes

Q) Primary fuel for colonocytes is 

a) Glucose

b) Lactate

c) Butyrate

d) Fats

Ans c ) Butyrate

Butyrate For the fermentable complex carbohydrates available, colonic flora produce short-chain fatty acids (SCFAs).

Butyrate, an SCFA, is the principal source of nutrition for the colonocyte.
Mammalian cells do not produce butyrate, the colonic epithelium and luminal bacteria form an essential and elegant symbiotic relationship.

Antibiotics disrupt this cohabitation—decreased bacteria leads to less butyrate, which, in turn, negatively affects colonocyte function leading to diarrhea.