MCH MCQS in Surgical GAstro
Questions from MCH
Q1. Which is not true regarding porto caval shunts
a) Used for intractable ascites
b) It can be made selective by using 8 mm interposition graft
c) It is a partial shunt
d) Distal splenorenal shunt does not involves splenectomy
Q2.Treatment of Biliary stricture following pancreatitis
b) Endoscopic stenting
c) No treatment required
Q3. Which is not a recommended treatment modality for radiation proctitis
a) Steroid enema
b) Argon beam coagulation
c) Formalin instillation
d) Hyperbaric oxygen
Q4. Treatment of duodenal varices
Varices that occur at a site other than the gastroesophageal junction are termed ectopic varices
Ectopic varices most commonly manifest with melena or hematemesis.
The common occurrence of duodenal varices in patients with portal vein obstruction probably relates to the formation of collateral vessels around the thrombosed portal vein, which connect pancreaticoduodenal veins to retroduodenal veins, which drain into the inferior vena cava.
The other common site of ectopic varices is peristomal, in patients with inflammatory bowel disease and primary sclerosing cholangitis who have undergone a proctocolectomy with creation of an ileostomy.
Anorectal varices are reported in 10% to 40% of cirrhotic patients who undergo colonoscopy and must be distinguished from hemorrhoids. Rectal varices are dilated superior and middle hemorrhoidal veins, whereas hemorrhoids are dilated vascular channels above the dentate line. Rectal varices collapse with digital pressure, but hemorrhoids do not.
Treatment of Duodenal varices
1. Vasocactive drugs
2.Endoscopic glue injection or band ligation is the preferred approach for bleeding duodenal varices.
3. For Primary prophylaxis, A surgical portosystemic shunt is recommended in patients with Child class A cirrhosis and in patients with portal hypertension from extrahepatic portal vein thrombosis in whom a vein suitable for a shunt is available. Placement of a nonselective portosystemic shunt, such as a portacaval shunt, mesocaval shunt, or central splenorenal shunt, should be carried out in a patient with stomal varices.
Q5. Prophylactic surgery in asymptomatic cholelithiasis is done in
b) Hemolytic anemia
d) stone size more than 1.5 cm
Q6. The most common complication of Bevacizumab is
d) Gastrointestinal perforations