Carcinoid Syndrome

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Q) Carcinoid syndrome wrong statement is?
a) 40 % Right  heart dysfunction in carcinoid syndrome

 

Petrosphenoidal syndrome

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Q) In Nasopharyngeal carcinoma, Petrosphenoidal syndrome involves which cranial nerves ( Aiims onco 2020) ?

a) VII- X

b) I-III

Genes and Cancers

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In This post I will be adding most commonly associated genetic abnormalities and changes

MEN2 syndrome is caused by gain of function mutations in the RET  gene.

Li-Fraumeni syndrome is associated with mutation of P53.

Mutations in p16 is associated with melanomas, pancreas, esophagus, head and neck, stomach, breast, and colon.

BRCA1 is associated with breast and ovarian carcinoma. 

Blood supply of bile duct

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Q)Blood supply of biliary tract? Which is false

a) 2% blood supply is  nonaxial
b) Downward 38% from RHA
c) GB venous drainage directly to Portal vein
d) Main artery supply to retro pancreatic CBD is retroduodenal artery

Alveolar Hydatid disease

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Q45)  All are true for alveolar hydatid disease except?

1) Caused by E. Multilocularis

2) Common in liver

Gold Standard Investigations in GI Surgery and Onco Surgery

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Esophagus

Ambulatory pH monitoring is the gold standard for the diagnosis of GER. ( SKF 61)

Esophageal high-resolution manometry (HRM) is currently the gold standard for the evaluation of esophageal motility ( SKF 11)

The current gold standard for the operative treatment of GERD is the laparoscopic Nissen fundoplication. ( SKF 234)

Body Response to Injury

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Q Which is not a metabolic response to injury ( Similar Questions) 
A) Increased nitrogen requirements
B) Insulin resistance and glucose intolerance
C) Preferential oxidation of lipids
D) Decreased gluconeogenesis

This Question discusses and enumerates the metabolic responses to trauma and sepsis

Gastrinoma diagnosis

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Q) Gastrinoma false is (AIIMS GI 2020) 
a) Fasting sG 1000 g/ml
b) Duodenotomy should be done in all cases
c) Diarrhea most common symptom
d) SRS can localize 80% cases

Ans  )  c -

Duodenotomy detects 25% to 30% of tumors not seen on preoperative imaging.

Gastrin  levels higher than 1000 pg/mL are strongly suggestive of gastrinoma, provided that the patient demonstrated increased gastric acid  secretion ( gastric secretion ph should be less than 2) 

Most common is abdominal pain ( 75%) In 10% to 20% of patients, diarrhea is the only symptom ( Saby page 954) 

SRS should be performed because almost all gastrinomas express somatostatin receptors.

2nd primary tumors

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Q) In buccal mucosa cancer after surgery and CRT, after 2 year patient developed cancer at base of tongue with N3 nodes positive. Best line of management
A .Palliative RT
B. CTRT
c. Rehabilitation
D.  Surgery followed CTRT

There are two parts to this questions 

a) Second Primary tumor (SPM)

b) Management of Base of tongue tumors with N3

Both are discussed here ---