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 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 Q) Initializing mutation in Carcinoma head of pancreas is of which gene a) p53 b) Kras c) CDKN 2A d) DPC 4 Answer Q ) Not a component of Whipple triad a) Symptoms f hypoglycemia after fasting b) Plasma Insulin more than 100 mIU/l c) Plasma glucose less than 2.8 mmol/l d) Relief of symptoms after IV glucose' Answer to 43 Q) All are true about annular pancreas except ( AIIMS GI Surgery Question bank)
a) They are mostly asymptomatic
b) It has equal incidence in children and adults
c) Treatment of choice is duodenojejunostomy
Annular pancreas is a congenital malformation but manifestations can appear in the adult life.
Annulus means a ring of pancreatic tissue around the duodenum. For annular pancreas to be diagnosed, this ring can be complete or incomplete.
Normally the ventral buds of pancreas and dorsal bud fuses together. Non rotation and fusion of these two leads to the formation of annular pancreas. It envelops the duodenum.
Age of presentation
Incidence is equal in both adults and children
Presentation in children is congenital anomalies and dudenal obstruction
Presents in adults as pancreatitis usually in 3rd or 4th decade
Association with other pancreatic conditions
1. Pancreas divisum 35- 40%
2. Chronic pancreatitis 45- 50%
It is duodenal bypass and not resection of duodenum as duodenum excision can lead to pancreatitis
in children its duodeno - duodenostomy
in adults duodenoduodenostomy which has now replaced duodenojejunostomy
Q) All are components in BISAP score except?
a) Age more than 60 years
b) WBC more than 16000
c) GCS <15
d) BUN > 25 mg/dl
The Bedside Index of Severity in Acute Pancreatitis BISAP is a more-recent score than the older Ranson's Criteria. It predicts mortality risk in pancreatitis with fewer variables than Ranson's.
It does not require data points from 48 hours into a patient's hospital admission.
BUN > 25 mg/dL (8.9 mmol/L) : No Yes Abnormal mental status with a Glasgow coma score < 15 : No Yes Evidence of SIRS : No Yes > 60 years old : No Yes Pleural effusion : 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 c 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. Non contrast phase used for Read More ... Q. CT severity score for pancreatic necrosis of more than 50% A. 6 B. 7 C. 10 D. 5 Answer See Q 25 Q) Ideal time for CECT in severe acute pancreatitis is A. After 72 hours B. After 48 hours C. 24 hours D. At admission Answer for premium members Mild acute pancreatitis enlargement of the pancreas with loss of definition of the borders of the pancreas. Thickening of the right or left anterior pararenal fascia Severe Acute pancreatitis Main determinant of clinical outcome is the degree of systemic organ disturbance, particularly during the early hours and days after admission to hospital More than half of all deaths in AP occur within the first 2 weeks of illness and are usually a consequence of multiple organ failure The revised Atlanta Classification 3 grades of severity of pancreatitis: Mild AP—characterized by the absence of organ failure or local complications Moderately severe AP—defined by................... read on
Q Most common symptom in periampullary carcinoma a) Pain b) Pruritis c) Jaundice d) Clay coloured stools Answer