EHPVO with Portal Hypertension

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Q) An young male with cholangitis, EHPVO + Portal Biliopathy was drained with a plastic biliary stent next step?

a) Repeat biliary Stenting every 3 months then followed up

b) Replace plastic to bare metal stent

c) Prepare for Lineorenal shunt surgery

d) Do MRCP and proceed accordingly


Points  about Portal Biliopathy

Portal biliopathy (PB) is a clinical condition defined as the presence of abnormalities in the biliary tree (including biliary tree and gallbladder) in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma.

The spectrum of biliary abnormalities include both  intra- and extra-hepatic biliary stenosis (single or multiple)

With or without consensual above dilation

Bile duct wall irregularity or thickening

Bile duct angulation

Varicose veins located at the ductular walls and gallbladder

 

Post gastrectomy syndrome

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Q)  False about post gastrectomy syndrome?
a) 30%incidence
b) Octreotide agonist prevent it's occurrence
c) Megaloblastic anemia due to partial gastrectomy
d) Calcium deficiency  in billroth 2

Small Intestine diverticulum

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Q) Small intestine diverticula true statement is 
a. Meckel is Most common and jejuno ileal is least common but most symptomatic
b. Meckel is true and congenital and rest are false and acquired
c. 1-5 % Duodenal ones require endoscopic or surgical treatment
d. All Meckel’s resected unless strong Contraindication is there

 

Poor prognosis in Colorectal cancer

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Q) Which of the  following is not a poor prognosis factor in  stage ii colon cancer

a) Lymphovascular invasion

b) Present with obstruction and perforation

c) Less than 12 lymph node extraction

d) Poor differentiation with chromosomal instability

 

Genetics ca rectum

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Q) Good prognosis seen in – ca rectum.

A) MSI-H

B) MSI-L

C) BRAF

D) KRAS

MELD Scoring – Liver Transplant

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Q) True about MELD scoring except

a) MELD score less than 15 not included in list

b) Additional points given for renal failure

c) Predicts mortality for 3 months

d) HCC with cirrhosis exception points are given

 

Colon Diverticulitis

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Q) True about diverticulitis in colon

a) Right sided diverticulitis is associated with colovesical fistula

b) Complication rate of 2nd attack of diverticulitis is double

c) 50% of diverticulosis develop diverticulitis

d) Diverticulosis incidence increases with age

More Questions on diverticulitis 

Drugs – Pancreatitis

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Q )  Drug associated with with pancreatitis

A) Metformin

B) Sitagliptin 

C) Vidagliptin

D) Exenetide

Indications of Liver transplant

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Q ) Orthoptic Liver Transplant  indicated in all except

A) HPS

B) Hyperbilirubinemia

C) Severe hepatic encephalopathy

D) SBP

 

Perforation during Lap cholecytectomy

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Q.     Regarding Lap Cholecystectomy false  is  (AIIMS) 

a.       GB perforation occurs in 40%

b.      Perforation occurs at time of dissection from GB bed

c.       10 – 30 % incidence of missed stones in peritoneal cavity

d.      Missed stones seldom cause any problem in the future

Neoadjuvant Response in Rectal cancer

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Q) In Regression of tumour after Neoadjuvant CTRT for rectal cancer are all except

A) Decrease in size

B) Nodal regression

C) Mucosal venous invasion in mri

D) Depth change