MCH Preparation
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
Q) Drug combination not recommended for diarrhea in the early treatment of SBS
a) Loperamide and PPI
b) Loperamide and octreotide
c) Octreotide and PPI
d) Cholestyramine and Oxalate
Q. Least common complication of Meckel's diverticulum is
a) Bleeding
b) Obstruction
c) Neoplasm
d) Obstruction
While many individuals remain asymptomatic, complications of Meckel's diverticulum can lead to significant clinical issues requiring medical intervention.
Answer is free
Ans ) 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.
Bleeding is often due to ulceration of the diverticulum. This bleeding can manifest as painless rectal bleeding
Another potential complication is intestinal obstruction, which can occur if the diverticulum becomes incarcerated or twisted. This situation may lead to bowel ischemia and perforation if not managed quickly.
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%).
Complications of Meckel's diverticulum can be recognised and managed early if there is high index of suspicion
Q) Duplication of the intestine associated with
A. Heterotopic mucosa
B. Smooth muscle component
C. Associated with spinal / vertebral defects
D. All are correct
Q Not true about Obscure occult GI bleed
a) RBC scintigraphy scan has high accuracy
b) Capsule endoscopy can not be done in obstruction
c) Mesenteric Angiography is best for angiodysplasia
d) Intraoperative enteroscopy should be the last resort
Q) Which of the following is an Adverse factor hindering spontaneous fistula closure:
a) Tract <1cm
b)Transferrin > 200
c) Location in esophagus
d) First surgery done in the same institution
Q) Most sensitive investigation for Gastrinoma ?
a)Contrast CT
b) Selective angiography
c) SRS
d) EUS