Q ) Hincheys grade III Diverticulitis. Management most likely to follow more interventions after an index operation is
a) Laparoscopic irrigation and exploration
b) Sigmoid Colectomy+Hartman’s
c) Primary repair with omental patch and peritoneal toilette
d )Sigmoid Colectomy with colorectal anastomosis and diverting ileostomy
Grade III diverticulitis is generalized peritonitis.
Q Warfarin sodium acts by
A. Inhibits carboxylation of Factor VII, IX, X
B. Factor X a inhibition
C. Thrombin inhibitor and X a inhibition
D. IX, XI, XII, factor and thrombin inhibition
Q) All are true about Glucagonoma except
a) Usually seen in middle age and elderly
b) Usually > 5cm at presentation
c) Skin lesions preceed tumor detection by 6-8yrs
d) Often associated with ketoacidosis
Glucaonoma is an endocrine tumor characterized by increased levels of serum glucaogon. It is seen in the age group ............... Read on (Question 8)
Q) Port placement in epigastric, suprapubic, umbilical & RIF. Most probable procedure
a) Rt Hemicolectomy
b) Lt Hemicolectomy
c) Gastrectomy
d) Anterior resection
Q) Duodenal injury management false
a ) Circumferential skeletonization is required
b ) All duodenal repairs require some form of drainage
c) All hematomas near the pancreas requires exploration to check for serosal integrity
d) Most common location is the second portion
Q) Regarding colonic volvulus all are true except
a) Sigmoid volvulus without gangrene – colonoscopic decompression is the trt of choice
b) Caecal bascule has high chance of gangrene due to torsion of mesentry
c) Splenic flexure volvulus has better prognosis than transverse colon volvulus
d) Recurrence rate after detorsion of cecal volvulus is 10-20%
Q) Tumors of Appendix. All statements are true except
a) Carinoid tumors most common
b) Adenocarcinoma better prognosis than carcinoima
c) Appendicectomy, Cytoreduction and intraperitoneal chemotherapy is the adequate treatment for adenomucinosis
Q 24 Contraindication of Fontan procedure?
a) 20 year old male
b) Severe MR
c) Right pulmonary artery stenosis
d) Left ventricular end diastolic pressure of 20 mm Hg
24) d
Fontan procedure is for tricuspid atresia and is done when there is low pulmonary vascular resistance. For the same reason it is not done in neonates.
In Tricuspid atresia, venous blood does not go to right ventricle and there is mixing of venous and arterial blood in aorta which leads to decreased oxygenation.
Most infants with tricuspid atresia have restrictive pulmonary blood flow. To improve systemic oxygentaion they undergo modified Blalock-Taussig shunt, which is a small polytetrafluoroethylene (PTFE) graft to connect the subclavian artery and a pulmonary artery.
Criteria for Fontan procedure are
Current absolute contraindications are a pulmonary vascular resistance above 4 Wood units/m2, severe hypoplasia of the pulmonary arteries, and severe diastolic dysfunction of the left ventricle.
Q) LASER used in CA urinary bladder
a) Carbon dioxide
b. Nd yag
c. Holmium yag
Q) A 68-year-old woman complains of Intestinal obstruction. Xrays reveal fluid levels and air in the biliary tree. What is the likely cause?
(A) Choledochal cyst
(B) Gallstone ileus
(C) Obstructed hernia
(D) Previous choledochoduodenostomy