Intra Abdominal pressure

Q) Which of the following is not true about Intra abdominal pressure (IAP) 

a) Normal Intra abdominal pressure in most people is less than 5 mmHg

b) After non complicated surgery  IAP remains less than 5mm Hg

c) IAH (Intra abdominal hypertension) is IAP more than 12 mmHG

d) ACS is IAP more than 20 mm Hg

Question on Management of Abdominal Compartment Syndrome

Allograft Rejection

Q) Which of the following is false regarding HLA in graft rejection? 

a) HLA (Human leucocyte antigen) is the most common cause of graft rejection

b) They mainly serve as antigen recognition unit

c) HLA also serve as effector cells 

d) They are highly polymorphic

Corrosive Stricture esophagus

Q) Which has no part in management of corrosive injury of esophagus? ( MCQs in Esophagus) 

a) Repeated Endoscopies routinely

b) Esophagectomy in some cases

c) Early emergency surgery routinely

d) Steroid use routinely

C

Other than the need for emergency surgery for bleeding or perforation, elective oesophageal resection should be deferred for at least 3 months until the fibrotic phase has been established.

Oesophageal replacement is usually required for very long or multiple strictures. Resection can be difficult because of perioesophageal inflammation in these patients.

Regular endoscopic examinations are the best way to assess stricture development (Figure 62.12). Significant stricture formation occurs in about 50% of patients with extensive mucosal damageo Corrosives can cause significant pharyngolaryngeal oedema

In unusual circumstances, e.g. with extensive necrosis after corrosive ingestion, emergency oesophagectomy may be necessary.

Bailey 27th page 1075

Association of carcinoma pancreas

Q) Least common association of Carcinoma Pancreas is with 

a) Smoking

b) Male gender

c) Obesity

d) Lynch Syndrome

Severe Pancreatitis – Scoring

Q) Not a consistent feature of  severe acute pancreatitis 

a) Persistent organ failure

b) CRP more than 150 mg/dl at 48 hours

c) Single organ failure

d) LDH >350 U /L


Another question on severe pancreatitis

Gastric lymphoma

Q ) Treatment of Primary Gastric Lymphoma is 

a) Surgery

b) chemotherapy

c) Radiotherapy

d) Both chemo and radiotherapy

Haemorrhoidectomy

Q) Not an indiction of haemorrhoidectomy 

a) Persistent Second degree haemorrhoid 5 days after sclerotherapy

b) 3rd degree haemorrhoid

c) Fibrosed  haemorrhoid

d)  Interno-external haemorrhoids when the external haemorrhoid is well defined.

Ans a

haemorrhoids can persist for 10 days after sclerotherapy

The indications for haemorrhoidectomy include:

● third- and fourth-degree haemorrhoids;

● second-degree haemorrhoids that have not been cured by non-operative treatments;

● fibrosed haemorrhoids;

● interno-external haemorrhoids when the external haemorrhoid is well defined.

Four degrees of haemorrhoids ●●

First degree – bleed only, no prolapse ●●

Second degree – prolapse but reduce spontaneously ●●

Third degree – prolapse and have to be manually reduced ●●

Fourth degree – permanently prolapsed

BAiley page 1357

 

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