Q) Metabolic abnormality in Hypertrophic pyloric stenosis
a) Hypercholermic metabolic acidosis
b) Hypochloremic Hypokalemic metabolic alkalosis
c) Hyperkalemic alkalosis
d) Hypochloremic Hypokalemic acidosis
Ans b
Blood tests may reveal a hypochloraemic metabolic alkalosis if the vomiting is long standing
Metabolic alkalosis will have a high bicarbonate and a high base excess (> +2 mmol)
Fluid of choice 1/2 NS with KCL and dextrose
Q) IV fluid of choice in infantile hypertrophic pyloric stenosis is
a) 5% dextrose 0.9% saline and kcl
b) 5% dextrose .45% saline and kcl
c)
Ans
In most babies, the dehydration and alkalosis can be corrected by giving 150–
180 mL/kg/day of 0.9% saline with 0.15% KCl in 5% glucose
Bailey page 128
Esophagus
Q) In lap fundoplication what maneuver is used?
a) Heaney
b) Shoeshine
c) Pringle
d) Heimlich
Ans
B ) Shoeshine
The “shoeshine maneuver” involves sliding the fundoplication back and forth behind the esophagus to confirm good position. One purpose of this maneuver is to confirm that no redundant fundus lies posterior to the esophagus on creation of the fundoplication.
The Heaney maneuver is performed by clamping both the suprahepatic and infrahepatic inferior vena cava while simultaneously applying the Pringle maneuver
Q) WHat is the next line of management in a patient diagnosed to have low grade MALT lymphoma
a) Surgery
b) chemotherapy CHOP
c) Antibiotics
d) Surgery plus chemotherapy
Ans
c Antibiotics
Gastric MALToma, treatment of choice is H.pylori eradication if the patient tests positive for H. pylori. Four weeks after the completion of H. pylori eradication therapy, testing is necessary to confirm the elimination of infection.
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