Latest DNB Questions 


DNB General Surgery 1-10         Q11-16        Q17-20            21-30 Neurosurgery (in progress)    31-40      41-50 


Q 51) Thoracic esophagus blood supply (DNB 2018) 
A. Inferior thyroid
B. Aorta and bronchial artery
C. Inferior phrenic 

D. Left Gastric


Q52)  Length of D2 (2nd part of duodenum) 
A. 2.5cm
B. 5
C. 7.5
D. 10


Q53) Correct statement about Boerhaave syndrome is
A. May present with peritonitis
B. Forceful vomiting against open glottis
C. MOst common in upper 1/3 rd of esophagus
D. Most are managed conservatively


Q54) Most common diaphragmatic hernia in a new born infant
A. Bochdoleck
B. Morgagni
C. Paraesophageal I
D. Paraesophageal III


Q55) Adenocarcinoma of esophagus is associated with which of the following? (DNB 2018)

a) Achalasia cardia

b) Barrett's disease

c) Human Papilloma virus (HPV)

d) Alcohol use


Q56) GIST >10CM High-risk cases, imatinib therapy is for
A. 1 year
B. 2 years
C. 3 years
D. 5 years


Q57 ) Gastric ulcer type III is located in?
A. Lesser curvature
B. Body of stomach
C. Prepyloric
D. GE junction


Q 58) What is Ogilivie syndrome?
A. Acute Colonic Pseudo Obstruction
B. Chronic Colonic Pseudo Obstruction
C. Fecal obstruction
D. Intussusception


Q 59) Drug causing pancreatitis
A. L-Asparginase
B. Metronidazole
C. Ciprofloxacin
D. Penicillin


Q 60 Double duct sign seen in
A. Periampullary carcinoma
B. Chronic Pancreatitis
C. HCC
D. GB carcinoma


Answer

51) b

Blood supply esophagus
Blood Supply esophagus

52) c

7.5 cm

D2 extends from GB neck to Lumbar vertebra 4. It is a retroperitoneal structure. 

Shackelford page 824


53) A

Boerhaave syndrome is forceful vomiting against a closed glottis. The obstruction at both ends leads to perforation at the weakest point in the lower esophagus. The contents mostly perforate in the mediastinum and pleural cavity but can cause peritonitis

Due to excessive chemical irritation, there is very limited role of conservative management.

Ref : Bailey page 992


54) a

Bochdalek hernia comprises of 85% of congenital diaphragmatic hernias. 80% of these are left sided. Most are repaired in children.  Congenital hernias develop  because of incomplete embryological development of diaphragm.  

Morgagni hernias (retrosternal or Larry's hernia) occur in triangular space between muscle fibres that make up the diaphragm extending from xiphisternum and costal cartilage to the central tendon of diaphragm. 90% are right sided as on the left pericardium prevents the herniation.

Ref Shackelford page 506


55) b

Association of carcinoma esophagus is with a number of risk factors. Both squamous cell carcinoma and adenocarcinoma of esophagus have different etiologies

Risk factors for Adenocarcinoma are                                                        Risk factor for Squamous cell carcinoma are

  1. Tobacco                                                                                                   1. Alcohol
  2. GERD                                                                                                       2. tobacco 
  3. Obesity                                                                                                     3. Achalasia
  4. Barrett                                                                                                      4. Caustic injury of esophagus
  5. H/o previous radiation for breast cancer                                         5. Previous radiation of CA breast                

                                                                                                                              6. H/o head and neck cancer

                                                                                                                              7. Plummer vinson and tylosis


56) c 3 years

Scandinavian sarcoma group trial recommendations for Imatinab

a) 3 year course after resection of high grade GIST

b) Imatinab as neo adjuvant therapy in locally advanced GIST

c) Metastatic disease and resected primary with high risk of recurrence- Indefinite therapy

Image result for imatinib side effects

Ref Sabiston page 1230


57) c

Discussed previously here


58) A

acute pseudo obstruction

X ray abdomen shows colonic obstruction with caecal distension

Caecal perforations are  known to occur if caeacal diameter is more than cm

Mechanical cause needs to be ruled out by colonoscopy or single contrast water soluble enema

Treat the cause or give neostigmine

Ref Bailey 28 1998


59) a

Important drugs that cause pancreatitis are 

Corticosteroids

Azathioprine

Asparaginase

Valproic acid

Thiazides

Estrogen


60) a

 

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