Important Points

Anal malformation

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Q) Newborn with abdominal distension on day 2, not passed meconium. There is absent anal orifice. WHat is the next step? # NEET SS 22 

a) Cross table X ray

b) Invertogram

c) Anoplasty

d) Sigmoid colostomy

Ans a) Cross table X ray

1st step in such cases Rule out congenital abnormalities of spine, sacrum , kidney heart etc

2nd step Cross table x ray  If it shows Perineal fistula do ANoplasty, If x ray shows rectal gas below coccyx do PSA RP with or without colostomy, If it shows gas above coccyx with associated defects do colostomy

Table 67.14 Sabiston 

 

Paclitaxel group drugs

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Q)  Which group of drug paclitaxel belongs to ? 
a) Drugs which interfere with mitosis
b) Antimetabolites ( those which interfere with DNA synthesis)
c) Drugs which directly damage DNA

d) Inhibitor of  receptor tyrosine kinase

Check Questions from Neet onco 2020 exam

 Drugs in onco  asked in exams

Ans a )

Paclitaxel is a drug which interferes with mitosis. It is a class of drug which interferes with mitosis
Vincristine is also in the same group but it interferes with formation of microtubules ( Spindle poison)
Antimetabolites are 5 FU, Methotrexate, Gemcitabine
Drugs which damage DNA Mitomycin , Cisplatin, oxaliplatin, doxorubicin
Receptor tyrosine kinase inhibitor are Imatinib, Geftinib

Chicago classification of Achalasia

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Here I am discussing the Chicago classification and its clinical significance

 

This is based on high resolution manometry (HRM) 

Manometry evaluates the swallowing response, and weather the LES sphincter relaxation is absent or incomplete.

There are three types of Achalasia and all have incomplete LES relaxation

Type I - Body - Aperistalsis  and no pressurization

Type II Body - aperistalsis and panesophageal pressurization 

Type III - Spastic contractions and distal contractility integral (DCI) over 450 mm HG

 Type 2 achalasia had the best positive response to treatment, and type 3 the least favorable response to treatment.

The best initial treatment option for types 1 and 2 are conservative measures such as pneumatic dilatation and surgical myotomy,

while type 3 achalasia appears to respond better to initial treatment with peroral endoscopic myomectomy

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