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NMC original Video- Meet about Next held today in detail
Correct Answer - B
Ans. is 'b' i.e., Excretion of less than 500 ml in 24 hrs
(Note that Bailey & Love 25/e p1279 (24/e p 1300 & 23/e p 1168)
write Oliguria to be less than 300 ml in 24 hrs, but we would follow
Harrison & CMDT; Note that Smith's Urology 17/e p531 (16/e, p538)
write it to < 400 ml/day!! what an utter confusion.)
@/surgeryvideos
Correct Answer - B
Ans. is 'b' i.e., Neuroblastoma
Opsoclonus is a disorder of eye movement characterized by
involuntary, chaotic saccades that occur in all directions of gaze. It is
frequently associated with myoclonus and ataxia.
Opsoclonus-myoclonus may be cancer-related or idiopathic.
When the cause is paraneoplastic, the tumors involved are usually
cancer of the lung and breast in adults and neuroblastoma in
children.
@surgeryvideos
Correct Answer - A
Answer- A. Tension Pneumothorax
Tension pneumothorax air become trapped in pleural space under pressure.
It develop one way valve air leak from either from chest wall or lung.
Causes are
.Penetrating chest trauma
.blunt chest trauma
. iatrogenic lung puncture(ie due to subclavian Venepuncture)
.postive mechanical ventilation pressure
Clinical
.dyspnea,tachypnea , hypotension, diaphoresis, distended neck vein.
@surgeryvideos
Correct Answer - A
Ans: A. Partial nephrectomy
Partial nephrectomy is now being used as primary surgical therapy
for patients with a tumor less than 4 cm in size. Earlier Radical
nephrectomy was the treatment of choice for tumors of any size.
Classic radical nephrectomy consists of removal of the kidney,
perirenal fat, adrenal gland, and regional lymph nodes. Most stage I
and stage II tumors.
Partial nephrectomy- is indicated for patients with a T1 tumor
(according to the UICC TNM staging system) and a normal
contralateral kidney.
Intervention should be considered for growth to >3-4cm or by
>O.5cm per year.
Stage T1aN0M0
Partial nephrectomy recommended. This can be done via
open/laparoscopic/robotic procedures
Stage T1bN0M0
PN (open/laparoscopic/robotic) in cases where technically feasible
Laparoscopic RN should be offered if a PN is not feasible
Open RN if laparoscopic surgery is not possible.
Stage T2N0M0
RN – open/laparoscopic/robotic
PN – open/laparoscopic/robotic
Stage T3
RN – open, laparoscopic or robotic-assisted
Resection of vascular thrombosis when applicable (usually open)
Resection of all gross disease including hilar or retroperitoneal
extension
PN may be attempted in highly selected cases by experienced
surgeons
Ref- Bailey and Love, Short practice of surgery, 27th edition
published in 2018 Pg 1420
@surgeryvideos
Correct Answer - B
Answer- B. Endoscopic dilation
The symptom & sign complex indicates diagnosis of Achalasia.
One of the treatment modalities for achalasia cardia is endoscopic
dilation.
@surgeryvideos
Correct Answer - A
Answer- A. Leukemia
Artificial T cell receptors (also known as chimeric T cell receptors,
chimeric immunoreceptors, chimeric antigen receptors (CARs)) are
engineered receptors, which graft an arbitrary specificity onto an
immune effector cell. Typically, these receptors are used to graft the
specificity of a monoclonal antibody onto a T cell.
Two CAR-T therapies have been granted three total FDA approval
for the treatment of patients with hematologic malignancies.
The most advanced data to date concern CAR T therapies for the
treatment of patients with multiple myeloma and chronic lymphocytic
leukemia.
Among the first studies investigating anti-CD19 CAR T therapeutic efficacy was a case report treating a patient with CLL
@surgeryvideos
Correct Answer - C
Ans. C. Superior Gluteal
A positive Trendelenburg is relatively non-specific and may
indicate:
Pain (e.g. due to osteoarthritis of the hip joint)
Weak hip abductors (gluteus medius, gluteus minimus)
Short femoral neck/ fracture of neck
Dislocation or subluxation of the hip
Neuropathy
Gluteus medius and minimus are supplied by Superior Gluteal
nerve.
Trendelenburg test
Normally when a person is made to stand on one leg, the hip
abductors of the ipsilateral side raise the opposite and the
unsupported side of the pelvis. If the abductor mechanism is
defective, the unsupported side of the pelvis drops and this is known
as positive Trendelenburg test.
@surgeryvideos
Correct Answer - D
Ans. is D
'a', 'b' & 'c' i.e. Duodenal atresia, Duodenal stenosis and Volvulus
Double bubble sign is seen in duodenal atresia, duodenal web,
deudenal stenosis, Ladd's band, Annular pancreas, Malrotation of
gut, preduodenal vein.
Distal gas is more often seen with midgut volvulus, duodenal
stenosis and duodenal web
@surgeryvideos
Correct Answer - D
Postoperative adhesions
"The most common cause of small-bowel obstruction (SBO) is
postsurgical adhesions"
The most common causes of intestinal obstruction in adults are:
Intestinal adhesions — bands of fibrous tissue in the abdominal
cavity that can form after abdominal or pelvic surgery
In children, the most common cause of intestinal obstruction is
telescoping of the intestine (intussusception).
Correct Answer - A
Answer- A. Palms and soles
The scalp, scrotum, shoulders, neck, and back are the common
sites, but they can occur wherever there are sebaceous glands.
There are no sebaceous glands on the palms of the hands and soles
of the feet, thus sebaceous cysts are not found in these locations.
Correct Answer - A
Answer- A. Doppler stethoscope evaluation
Acute onset painful scrotal swelling in 12 years old preadolescent male is most probably due to torsion of testis. In suspected cases of torsion of testis or testicular appendage a doppler stethoscope should be used to evaluate blood flow to the testicles.
Correct Answer - A
Answer- A. Insert wide bore needle in 2nd intercostal space
First line of management in tension pneumothorax: Insert wide bore
needle in 2nd intercostal space.
Correct Answer - D
Ans. is d i.e., Diffuse Esophageal spasm
Radiological appearances of diffuse esophageal spasm have been
described as:
curling esophagus
Corkscrew esophagus or
- pseudodiverticulosis
Diffuse esophageal spasm is a motor disorder of esophagus
characterized by repetitive simultaneous non-peristaltic contractions.
Symptoms are substernal chest pain and/or dysphagia
Diagnosed by manometry
Also know Nutcracker esophagus
also known as 'supersqueezer' esophagus
- it is characterized by extremely high-amplitude peristaltic
contraction
- Symptoms are pain and dysphagia
Diagnosed by manometry study which shows peristaltic esophageal contractions with peak amplitudes greater than two standard deviations above the normal values.
@surgeryvideos
Correct Answer - A
Ans is A ie Serum TSH Level
"A normal TSH Level excludes primary (but not secondary)
hypothyrodism. If the TSH is elevated a free T4 level is needed to confirm the presence of clinical hypothyrodism, but free T4 is inferior to TSH when used as a screening test, as it will not detect
subclinical or mild hypothyroidism. Circulating free T3 levels are
normal in about 25% of the patients, reflecting adaptive respose to hypothyroidism. T3 measurements are therefore not indicated." -
Harrison "Among the various available serum thyroid function tests, TSH is the most useful to assess gland dysfunction."
Endocrine Surgery of Head & Neck, p 83
@surgeryvideos
Correct Answer - D
The nerve commonly damaged during McBurney's incision is Iliohypogastric Nerve.
Damage to this nerve result in the development of right inguinal hernia.
Mc Burney’s incision/ grid iron incision is commonly done for appendectomy.
In this an oblique incision is made in the right iliac fossa about 5cm above and medial to the
anterior superior iliac spine at right angle to the spino umbilical line.
Ref: Anatomy of Abdomen and Lower Limb By Singh, Page 46
@surgeryvideos.
Correct Answer - B
Ans is (b) i.e. hyperalbuminemia
Thymoma is the most common Anterior mediastinal mass.
Thymomas are seen to be associated with
Myasthenia gravis
Acquired hypogammaglobulinemia
Pure red cell aplasia Grave's ds
- Pernicious anemia
- Dermatomyositis-polymyositis
- Cushing syndrome
@surgeryvideos
Correct Answer - D
Answer- D. Fever
Repeated episodes of coughing, choking and cyanosis occur on
feeding with TOF.
@surgeryvideos
Correct Answer - D
Answer-D
Pneumatocele formation occurs as a sequela to acute pneumonia,
commonly caused by Staphylococcus aureus. However,
pneumatocele formation also occurs with other agents, including
Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, group A streptococci, Serratia marcescens, Klebsiella
pneumonia, adenovirus, and tuberculosis.
Noninfectious etiologies include hydrocarbon ingestion, trauma, and
positive pressure ventilation.
In premature infants with
respiratory distress syndrome,
pneumatoceles result mostly from ventilator-induced lung injury.
@surgeryvideos
Correct Answer - C
Answer- C. Proximal cholangiocarcinoma
ERCP is not technically possible in proximal biliary obstructions.
@surgeryvideos
Correct Answer - C
Answer- C. Silk
Reaction to catgut depends on the stage of absorption and is mainly
histocytic in type. Nonabsorbable sutures are encapsulated by a rim
of connective tissue, while near the suture histocytes, giant cells and
lymphocytes are found. This is most marked with silk and cotton,
less so with Dacron, and least with nylon and wire.
@surgeryvideos
Correct Answer - B
Answer- B. H. Pylori infection is a risk factor
Stomach is the most common extranodal site of lymphoma.
It is of two types - Primary & Secondary
Most of the primary lymphomas (about 60%) arise in MALT (mucosa
associated lymphoid tissue). MALT is usually associated with
chronic H. pylori infection. So low-grade MALT lymphomas are
thought to arise because of chronic H. pylori infection. These low
grade lymphomas may later on degenerate to high grade
lymphomas.
mucosa associated lymphoid tissue. It is usually primary GI
lymphoma (4% of gastric lymphoma); of non-Hodgkin’s B cell
type.
@surgeryvideos
Correct Answer - A
Ans. is 'a' i.e., Ileocolic
Ileo-ileo-colic (-12)
Ileoileal (-5%)
Colocolic (-2%)
Multiple (1%)
Retrograde
The most common type of intussusception is ileocolic (also
known as ileocecal) (90%).
@/surgeryvideos
Correct Answer - B
Answer- B. 2 years
A patent processusvaginalis that is too narrow to prevent the
development of an inguinal hernia may nevertheless allow peritoneal
fluid to track down around the testis to form a congenital hydrocele.
The majority resolve spontaneously as the processus continues to
obliterate but surgical ligation is recommended in boys older than 2
years if they do not resolve spontaneously.
Correct Answer - A
Answer-A
Electrolyte abnormalities occur in 60% of the patients with head injury.
Patients with brain injury are at a high risk for the development of electrolyte imbalance including hyponatremia, hypocalemia, hypophosphatemia as well as hypokalemia and (to a lesser degree)
Hypomagnesemia. So the appropriate answer will be hyponatremia.
Correct Answer - A
Answer- A. Oral paracetamol for 2 - 3 days
Shoulder tip pain
The patient should be warned about this preoperatively and told that
the pain is referred from the diaphragm and not due to a local
problem in the shoulders.
It can be at its worst 24 hours after the operation. It usually settles
within 2-3 days and is relieved by simple analgesics, such as
paracetamol.
Correct Answer - D
Answer- D (Most common side effect is diarrhea and hypotension)
Celiac Plexus Block:
Located retroperitoneally at the level of Ll
Usually done bilaterallv
Useful for the painful conditions of upper abdomen
Most common side effect is diarrhea and hvpotension
