Spontaneous Pneumothorax

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Q) 15 year old boy, with Spontaneous pneumothorax. He is  dyspneic with increased RR

Next best step #AIIMS GI 2022

a) Vats and pleurodesis

b) Needle aspiration

c) Tube thoracostomy

d) Any of the above

Ans c

Primary spontaneous pneumothorax occurs in young patients without significant lung disease, whereas secondary spontaneous pneumothorax occurs in patients with COPD.

The most common cause of primary spontaneous pneumothorax is rupture of small apical blebs. Tube thoracostomy with water seal drainage is the usual first-line treatment of a moderate-to-large pneumothorax in a patient with a first-time occurrence

Fuel for colonocytes

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Q) Primary fuel for colonocytes is 

a) Glucose

b) Lactate

c) Butyrate

d) Fats

Ans c ) Butyrate

Butyrate For the fermentable complex carbohydrates available, colonic flora produce short-chain fatty acids (SCFAs).

Butyrate, an SCFA, is the principal source of nutrition for the colonocyte.
Mammalian cells do not produce butyrate, the colonic epithelium and luminal bacteria form an essential and elegant symbiotic relationship.

Antibiotics disrupt this cohabitation—decreased bacteria leads to less butyrate, which, in turn, negatively affects colonocyte function leading to diarrhea.

Claudication pain

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Q) 70 year old male has pain in right buttock on standing and gets relieved on sitting. What will be the next relevant  test to be ordered in him?

a) Doppler B/l lower limbs

b) MRI spine

c) Echo cardiography

d) Ankle Brachial Index

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