Pressure sore

Q) Pressure sore, grade II is

a) Partial thickness skin loss, epidermis and dermis are involved

b) Full thickness skin loss, involving subcutaneous tissue but not underlying fascia

c) Non blanchable erythema, no breach in epidermis

d) Involvement of bones and tendons


Ans a

Pressure sores occurs when ext pressure exceeds the capillary occlusive pressure (30 mmHg) approximately 5% of all hospitalised patients

Stage                   Description

1                        Non-blanchable erythema without a breach in the epidermis

2                       Partial-thickness skin loss involving the epidermis and dermis

3                       Full-thickness skin loss extending into the subcutaneous tissue but not through underlying fascia

4                        Full-thickness skin loss through fascia with extensive tissue destruction, maybe involving muscle, bone, tendon or joint

Bailey - page 29

 

Suturing in vascular anastomosis

Q) True about suturing technique in vascular anastomosis

a) Anastomosis may not be completely water tight

b) To prevent intimal injury needle should be moved from with in to out

c) 4-0 suture is preferred for aorta

d) Any bio degradable suture which is monofilament can be used


Answer

b

Vessels should always be sewn with the needle moving from within to without on the downstream edge of the vessel to avoid creating an intimal flap and to fix any atherosclerotic plaque.

Tip of the needle should be at right angle to the intima and curve of the needle should be followed

Distal clamp is released first

Non absorbable sutures should be used

2-0 should be used for aorta 4-0 for femoral and 6-0 for popliteal

Only non absorbable monofilament sutures are used in vascular anastomosis

Bailey 27 page 99

 

Complications of Meckel’s diverticulum

Q. Least common complication of Meckel's diverticulum (NEET 2018) 

a) Bleeding

b) Obstruction

c) Neoplasm

d) Obstruction

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%).

Sabiston -1285