Correct Answer - B
Ans. B: Sapheno-femoral Incompetence
A test to assess the
competence of the saphenofemoral junction.
The Brodie-Trendelenburg test is used to detect venous
incompetence and to differentiate between perforator and GSV
incompetence.
The Brodie-Trendelenburg test is highly sensitive for the
identification of superficial and perforator reflux.
SFJ (saphenofemoral junction) incompetence is diagnosed if the
distal veins fill rapidly upon release of the tourniquet.
Some textbooks refer to the Trendelenburg test and the tourniquet test interchangeab
@surgeryvideos
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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
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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
Correct Answer - A
Answer- A. Release of epinephrine
The major hemodynamic abnormality in hypovolemic shock is decrease in preload.
The immediate physiological response of the body to the sudden decrease in volume (preload), is a release of catecholamines (epinephrine, norepinephrine).
The subsequent increase in heart rate and contractility help maintain
cardiac output
@surgeryvideos
Correct Answer - A
Answer- A. Reversal of blood flow in the ipsilateral vertebral
artery
Subclavian steal syndrome may occur if the first part of the
subclavian artery is occluded.
Arm exercise causes syncope
because of reversed flow, in the vertebral artery leading to cerebral
ischemia.
It can be treated by angioplasty or surgery and is rare.
That is the result of an ipsilateral hemodynamically significant lesion
of the proximal subclavian artery
@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 - D
Answer is 'd' i.e. Fluid loss
Postgastrectomy complications
Anemia as a result of vitamin B12 or iron malabsorption and
osteoporosis.
Iron deficiency anemia develops because removal of the stomach
often leads to a marked decrease in the production of gastric acid.
Osteoporosis develops as a result of poor calcium absorption,
another problem that occurs after gastric surgery.
Dumping syndrome
Diarrhoea- may be due to different reasons. associated with
dumping syndrome post-vagotomy diarrhoea associated with fat
malabsorption.
Fat malabsorption leading to steatorrhoea occurs due to acid
inactivation of pancreatic enzymes or poorly coordinated mixing of
food & digestive juices. Fat malabsorption leads to malabsorption of fat soluble vitamins i.e. A,D,E & K.
Pushing food from your stomach to your small bowel too quickly
(dumping syndrome)
Acid reflux
Chest infections, including bronchitis and pneumonia
Internal bleeding
Nausea and vomitingStomach acid leaking into your esophagus, causing scarring and narrowing (stricture)
Vitamin deficiencies
Weight loss
@surgeryvideos
Correct Answer - D
Postoperative adhesions REF: Bailey & Love 25th edition page
1188, http://emedicine.medscape.com/article/774140overview
"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.
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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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