Correct Answer - A
Infants with cystic fibrosis have characteristic pancreatic enzyme
deficiencies and abnormal chloride secretion in the intestine that
result in the production of viscous, water-poor meconium.
Meconium ileus occurs when this thick, highly viscous meconium
becomes impacted in the ileum and leads to high-grade intestinal
obstruction.
@surgeryvideos
Correct Answer - A
Answer- A. Ventriculoperitoneal shunt
Congenital Hydrocephalus - Treatment Options
1. Ventriculoperitoneal shunt
2. Endoscopic third ventriculostomy
3. Lumbar puncture (temporary measure till a shunt is put)
@surgeryvideos
Correct Answer - D
Ans. d. Subarachnoid hemorrhage
The most likely diagnosis here is a subarachnoid bleed (SAH).
The most common cause is trauma and is managed conservatively.
The second most common cause is a rupture of a berry aneurysm.
The typical presentation of a subarachnoid hemorrhage includes a ‘thunderclap’ headache.
Meningitic features of neck stiffness and photophobia often
develop over hours.
Computed tomography (CT) is the investigation of choice.
Lumbar puncture should be performed if the CT scan fails to
establish the diagnosis of SAH; it shows a xanthochromic blood
picture.
Delayed ischemic neurological deficit (DIND) is attributed to
vasospasm of the cerebral vasculature typically developing 3–10 days following ictus. It is the main cause of a poor outcome
Endovascular treatment ("coiling") is generally preferred over
craniotomy and clipping for aneurysms amenable to this approach.
@surgeryvideos
Correct Answer - C
Ans. C: S.lipase
Serum markers for diagnosis of acute pancreatitis:
Alanine transaminase-Associated with gallstone pancreatitis; three
fold elevation or greater in the presence of acute pancreatitis has a positive predictive value of 95 percent in diagnosing acute gallstone pancreatitis
Amylase
Most accurate when at least twice the upper limit of normal; amylase
levels and sensitivity decrease with time from onset of symptoms
C-reactive protein
Late marker; high levels associated with pancreatic necrosis
Lipase
Increased sensitivity in alcohol-induced pancreatitis; more
specific and sensitive than amylase for detecting acute pancreatitis
Phospholipase A2
Associated with development of pancreatic necrosis and pulmonary
failure detection of severity; high concentrations in infected necrosis
Trypsinogen activation peptide
Early marker for acute pancreatitis and close correlation to severity
@surgeryvideos
Correct Answer - D
Answer: D. Skin+subcutaneous tissue+Superficial fascia+deep
fascia
Fasciotomy or fasciectomy is a surgical procedure where complete
opening of all fascial envelope is done to relieve tension or pressure
commonly to treat the resulting loss of circulation to an area of tissue or muscle.
Fasciotomy is a limb-saving procedure when used to
treat acute compartment syndrome.
@surgeryvideos
Correct Answer - C
Answer- C. Duct papilloma
The final diagnosis is made by excising the involved duct
(Microdochotomy) and any underlying mass if present and
subjecting them for a histopathological diagnosis
@surgeryvideos
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Correct Answer - C
Ans. is 'c' i.e., 7"' day
Burst abdomen occurs mostly between the 7" and 10th day after
operation (but may occur anytime after surgery from 1 to more than
20 days)(ref Sabiston 18/e )
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Correct Answer - C
Ans is 'c'
Whipples operation (Pancreaticoduodenectomy)
is the most commonly performed operation for carcinoma of head of
pancreas.
It includes resection of:
- distal stomach - duodenum
- gall bladder - proximal jejunum
- CBD - regional lymphatics
- head of pancreas
Restoration of gastrointestinal continuity requires -
pancreaticojejunostomy choledochojejunostomy &
- gastrojejunostomy
@surgeryvideos
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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
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Correct Answer - C
Answer- C. 24-hour pH recording and electrical impedance
measurement
The most sensitive test for diagnosis of GERD is 24-h ambulatory pH monitoring.
Endoscopy is indicated in patients with reflux symptoms refractory to
antisecretory therapy; in those with alarming symptoms such as
dysphagia, weight loss, or gastrointestinal bleeding; and in those with recurrent dyspepsia after treatment that is not clearly due to reflux on clinical grounds alone pH was less than 4
@surgeryvideos
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Correct Answer - A
Answer- A. Indirect
"Most strangulated hernias are indirect inguinal hernias, however,
femoral hernias have the highest rate of strangulation (15-20%) of all
hernias".
@surgeryvideos
Correct Answer - C
Ans. is 'c' i.e., Voiding Cystogram
Voiding cystourethrography is the best method to visualize posterior
urethra.
Remember,
Urethra can be imaged radiographically in two ways.
Anterograde techniques —> Best for visualization of posterior
urethra. (This is done along with voiding cystourethrography or with
voiding following excretory urography)
Retrograde technique —> Best for examining the anterior (penile) urethra (Contrast is injected through tip of urethra).
@surgeryvideos
Answer- A. Intravenous urography
IVP remains the primary modality used to image the patients with
renal, ureteric, and bladder tuberculosis. Early findings are best detected on IVP. It is the investigation of choice for urinary TB.
@surgeryvideos
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Correct Answer - B
Ans is 'b' ie Indirect Inguinal hernia
In Indirect inguinal hernia the contents of the abdomen enter the
deep inguinal ring and traverse the whole length of the inguinal
canal to come out through the superficial inguinal ring.
It is the most common of all forms of hernia.
It is most common in the young (cf a direct hernia is most common
in the old)
Femoral hernias occur most commonly in women but lower
incidence overall than inguinal hernias.
@surgeryvideos
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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
