Q. Least common complication of Meckel's diverticulum (NEET 2018)
Answer is free 7) c Neoplasm
The most common clinical presentation of Meckel’s diverticulum is gastrointestinal bleeding, which occurs in 25% to 50% of patients who present with complications
intestinal obstruction occur as a result of a volvulus of the small bowel around a diverticulum associated with a fibrotic band attached to the abdominal wall, intussusception, or, rarely, incarceration of the diverticulum in an inguinal hernia (Littre hernia)
Diverticulitis accounts for 10% to 20% of symptomatic presentations.
Neoplasms can also occur in a Meckel’s diverticulum, with NET as the most common malignant neoplasm (77%). Other histologic types include adenocarcinoma (11%), which generally originates from the gastric mucosa, and GIST (10%) and lymphoma (1%).
Hyperbaric oxygen therapy in radiation proctitis all are true except A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis B. Oxygen increases the growth of residual tumor and hence tumor should be completely resected C. Complications include Parkinsonism, barotrauma D. Usually 30-40 sessions are required for treatment
Answer free for all
Hyperbaric oxygen overcomes chronic tissue hypoxia in radiation damaged tissues and with repeated sessions induces growth of regenerative tissue, capillaries, and epithelium. Successful therapy may take multiple sessions. 18 to 60 treatments
Ref Shackelford page 2211
HBO treatments for hypoxic wounds are usually delivered at 1.9 to 2.5 atm
for sessions of 90 to 120 minutes each. Treatments are given once daily, five to six times per week and should be given as an adjunct to surgical or medical therapies. Clinical evidence of wound improvement should be noted after 15 to 20 treatments.Read More ...
Q) All are true about pancreatic protocol CT except (AIIMS 2012)
a) > 90% unresectable lesions picked up by CT
b) Dual phase CT with cuts taken at 40 secs and 70 secs
c) Liver metastasis detected in early arterial phase
Answer is free for all
Pancreatic protocol CT involves imaging at the pancreatic phase (i.e., approximately 45 seconds after contrast administration) and at the portal venous phase (i.e., approximately 70 seconds after contrast administration). It is useful for detection of adenocarcinoma of pancreas.
Metastatic lesions are seen in the portal venous phase, because the lesions are not typically well vascularized.
Arterial phase images are principally used to distinguish metastatic disease from benign vascular lesions, such as hemangiomas, or to better define the arterial anatomy of the liver.
Q) All are true about disinfectants in surgery except A. Povidone iodine needs to dry up prior to its action B. Alcohol disinfectants act against all organisms except clostridium difficile C. Single dose of first generation cephalosporin should be givens prophylaxis for vascular procedures and bladder catheterisation D. Chlorhexidine is bactericidal, viricidal, fungicidal, and has rapid onset of action and persistent duration.
Povidone-iodine solution is used for surgical site preparation, it must be allowed to dry for microbicidal effect.
Chlorhexidine is a phenol which is used in concentrations of 0.5% to 4.0% alone or in lower concentrations in combination with an alcohol as a skin antiseptic. ....
Q) . Restrictive strategy of transfusion in acute GI bleed all are true except? A. Should be started at a hemoglobin < 7 g/dl B. Will not alter the risk of rebleed C. Child A and B patients had significantly lower morbidity
Q) Absolute contraindication for left lobe LDLT is A. Trifurcation of the portal vein B. Bifurcation of portal vein in the right lobe of the liver C. Aberrant right hepatic artery D. Right Posterior duct draining into left hepatic duct
Trifurcation of portal vein is not a contraindication of left lobe liver transplant as we will get a single portal vein on the left side
Bifurcation of portal vein in right lobe does not matter because we are leaving the right lobe behind
Again right aberrant artery does not matter because that segment is left behind
Right post duct draining into left duct gives rise to two ducts on the left or a single duct which is quite high.
Q) True about retained antrum syndrome after gastrectomy are all except
a) It is a persistent hypergastrinemic state
b) It is only seen after Billroth II Gastrectomy
c) Technetium labelled food is not helpful in diagnosing this condition
d) Serum gastrin is usually less than 1000 pg/ml
After billroth II gastrectomy, if a cuff of gastric mucosa remains with duodenum, this entity is called as retained antrum syndrome. This cuff of gastric mucosa is cut off from the proximal stomach and inhibitory effect of hormones such as VIP (Vasoactive Intestinal Peptide) leading to a persistent hypergastrinemic state. ALso this gastric mucosa is continuously bathed by the alkaline contents of duodenum , which further increases the acid formation.
Both Basal and maximal gastric acid outputs increase but it is not as high as seen in zollinger ellison syndrome. Typically less than 1000 pg/ml
This condition can present as recurrent and persistent ulcerations. Technetium scanning is the diagnostic modality of choice. Treatment is re do surgery and antral excision.
Technetium pertechnate imaging has a sensitivity of 73% and specificity of 100%