Stage II Empyema

Q) Empyema stage II management is ? # NEET SS 22

a) VATs

b) Decortication Open

c) IV antibiotics

d) Antibiotics and drainage

Ans d

ANtibiotics and drainage

60 years ago, The American Thoracic Society first described the evolution of empyema as a continuous process that subdivides into three stages.

Exudative stage -

initial bacterial infection causes an acute inflammatory response between the pulmonary parenchyma and visceral pleural.

This exudative fluid is usually free-flowing, resolves with appropriate antibiotic treatment, and does not warrant any invasive drainage.

Fibrinopurulent and Loculated stage II)  In the absence of appropriate treatment, the effusion can become complicated via deposition of fibrin clots and membranes resulting in isolated collections of fluid in the pleural space

.At this stage, bacteriology usually becomes positive, and the effusion warrants antimicrobials and drainage.

Chronic Organizational stage - if not drained, fibroblasts coalesce to form a thick pleural peel between the visceral and parietal pleura. This peel can ultimately encase the underlying lung parenchyma and can complicate the clinical course via inhibition of adequate gas exchange, trapped lung or chronic forms of empyema.

Amylase and Lipase in Acute pancreatitis

Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase

MCQs on Pancreatitis 

Q) Why does amylase and lipase increase in pancreatitis?

A) They are released from the acinar cells of pancreas during injury

Q) When does serum amylase rise in acute pancreatitis?

A) Within the first 12 hours

Lung Tumors

Q) 50-year-old male with 1 x1 cm mass in the Peripheral part of the right lung was resected with clear margins. histopathology was suggestive of Adenocarcinoma and there was no lymph nodes positive what will be the further management
A. Observe
B. Adjuvant RT
C. Adjuvant CT
D. EGFR testing


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