AIIMS MCQ

Colonoscopic stenting in Colon cancer

January 26, 2019 admin

Q) . Not a risk factor in colonoscopic stenting in colonic cancer causing obstruction
A. Short stricture of length <10 cm
B. Extrinsic compression
C. Treatment with bevacizumab
D. Strictures and obstructions at multiple levels

Answer

Complete mesocolic excision

January 22, 2019January 25, 2019 admin

Q) All are true regarding complete mesocolic excision except

a) Hohenberger et al introduced it

b) It is based on ligation of central artery

c) Increases yield of lymph nodes and has decreased recurrence

d) Line of resection is below Toldt's fasica

Answer

Gastric pullup

January 22, 2019January 22, 2019 admin

Q 35) Not a step in Gastric pull up mobilization?

a) Lesser sac entering

b) Posterior mobilization of the duodenum

c) dilatation of hiatus

d) ligation of lesser curve vessels
Answer 35

Stomach is the best esophageal substitute. It has a single anastomosis, consistent blood supply and is durable

Disadvantage is reflux in the long term.

Check the answer to the question on gastric pull up in the answer

Caustic Injury to esophagus

January 21, 2019February 6, 2019 admin

Q ) False regarding Caustic injury to Esophagus

a) Gastric lavage not done as it increases the chances of more injury

b) Neutralising agents not given as it produces more injury than preventing it

c) Milk and albumin not given as it causes more damage

d) Activated charcoal not given as it doesn’t effectively absorb alkali

Check one more question on caustic injuries to esophagus here

Answer

In caustic injuries to the esophagus, early decisions have to be taken. The involvement of surgeon should be done early and patient should be placed under close monitoring.

Blind nasogastric and orogastric tubes should not be inserted and initially CT of chest and abdomen with contrast should be done to guide the subsequent procedures. Read on

Siewert

January 3, 2019January 25, 2019 admin

Q) False regarding CA Esophagus
a) Siewert I treated as Esophageal cancer
b) Siewert III treated as Gastric cancer
c) Siewert II treated as Esophageal cancer or Merindino surgery
d) Proximal margin in Esophagus is determined routinely to alter the management
Answer

Bariatric Surgery

January 1, 2019January 1, 2019 admin

Q) False regarding Bariatric surgery

a) VBG produces less weight loss when compared to RYGB

b) Jejuno-ileal by-pass not done nowadays.

c) Dumping is due to non- compliance of dietary advice

d) LAGB requires once a 4-6wk follow up

Answer (free)

Calorie restriction is responsible for long term weight loss and its beneficial effects such as control of diabetes, dyslipidemia, hypertension and other metabolic abnormalities.

Restrictive procedures are LSG and LAGB which decrease the appetite and induce early satiety.

The RYGB (ROUX en Y gastric bypass ) is a malabsorptive procedure with long term sustained weight loss.

Mechanism of weight loss after bariatric surgery

Ghrelin is orexigenic gut hormone, which increases appetite. After food intake ghrelin levels fall and appetite decreases.

After restrictive surgery such as LYGB and LSG, ghrelin levels fall and appetite decreases.

Vertical Banded Gastroplasty (VBG) This procedure has been abandoned in favor of other operations because of poor long-term weight loss, a high rate of late stenosis of the gastric outlet, and a tendency for patients to adopt a highcalorie liquid diet, thereby leading to regain of weight. Choice a is correct