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Correct Answer - C
Ans. is c i.e., Develops from jugular lymphatic sequestration
Cystic hygroma
Cystic hygroma is a swelling usually occuring in the lower third of the neck
It is most commonly seen in posterior triangle of the neck, but may also occur in axilla, groin & mediastinum
It results due to sequestration of a portion of the jugular lymph sac
from the lymphatic system.
It usually manifests in the neonate or in early infancy (occasionally
present at birth) The swelling is soft and partially compressible and invariably increases in size when the child coughs or cries.
The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent.
...The cysts are filled with clear
lymph and are lined by endothelium.
Mostly these are multiple cysts but occasionally they can be
unilocular.
It may show spontaneous regression.
Treatment [Ref.: Sabiston 18/e p2053; Schwartz 9/e p1415]
There are two methods of
treatment: Surgical excision &
Sclerotherapy
Sabiston writes- "Complete surgical excision is the preferredtreatment; however, this may be impossible because of the hygroma
infiltrating within and around important neurovascular structures.
.
Because hygromas are not neoplastic tumors, radical resection with removal of major blood vessels and nerves is not indicated.
.Injection of sclerosing agents such as bleomycin or the derivative of
Streptococcus pvogenes OK-432 have also been reported to be
effective in the management of cystic hygromas. Intracystic injection of sclerosants appears to be most effective for macrocystic
hygromas, as opposed to the microcystic variety."
"The modern management of most cystic hygromas includes the
combination of surgical excision and image-guided sclerotherapy."-
Schwartz
@surgeryvideos
Correct Answer - A
Answer- A. Biliary atresia
Kasai operation is also known as hepatoportoenterostomy.
Biliary atresia is currently MC indication for pediatric liver
transplantation.
@surgeryvideos
Correct Answer - C
Answer- C. Varicose veins
Important causes of gangrene
Diabetes
PVD (Buerger's disease)
Trauma
Obesity
Atherosclerosis
Raynaud's disease
Frostibite
@surgeryvideos
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Correct Answer - D
Ans. D: Ureterocele
The term ureterocele denotes a cystic ballooning of the distal end of the ureter.
This type of ureterocele is also termed orthotopic, since it
arises from a ureter with a normal insertion into the trigone.
An intravesical ureterocele results from the prolapse of the mucosa
of the terminal segment of the ureter through the ureterovesical
orifice into the bladder.
This prolapsed ureteral mucosa carries with it a portion of the
continuous sheet of the bladder mucosa around the orifice.
The prolapsed segment thus has a wall that consists of a thin layer of
muscle and collagen interposed between the bladder uroepithelium
and the ureter uroepithelium.
Since the terminal ureteral orifice is usually narrowed and partially
obstructed, and since there is no muscle support for the double
mucosal walls of the prolapsed segment, it dilates.
This dilated segment fills with urine and protrudes into the bladder.
On excretory urography, cobra head sign is classically seen with an
intravesical ureterocele.
@surgeryvideos
Correct Answer - D
Ans. is 'd' i.e., Spontaneous rupture of oesophagus
Chilaiditi's syndrome : Condition characterised by inter position of
small or large bowel between liver and right diaphragm.
Radiologically it gives gas under diaphragm.
Iatrogenic pneumoperitoneum : Certain procedure like peritoneal
dialysis, Iatrogenically air pushed before putting PD cannula to avoid
injury of viscera in such case gas under diaphragm can be seen.
All cases when intestine or viscera preforat we can get gas under
diaphragm.
@surgeryvideos
Correct Answer - D
Answer- D. 80
Routine use of noncontast CT Scan has completely revolutionized to
imaging evaluation of renal stone disease, nearly completely
replacing plain radigrpahs and X urography for diagnosis of acute
ureteral obstruction by renal stones.
Nephrolithiasis refers to the presence of calculi in the renal collecting system.
Nearly 10 % of the population will form a renal stone in their lifetime.
Sufficient calcium oxalate and phosphate is present in 80 % of the renal calculi for them to be radio-opaque on the plain radiographs.
@surgeryvideos
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
Ans. A. Amiodarone
V-Fib or VF is the most common rhythm that occurs immediately
after cardiac arrest. In this rhythm, the heart beats with rapid, erratic
electrical impulses.
Treatment:
Shock / Defibrillation: every 2 minutes in a single one shock,
successive, shockable increments
200 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)
300 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)
360 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)
Drugs :
Give Epinephrine 1mg of a 1:10,000 solu,on every 3 to 5 minutes
[No Limit]
Give either:
Amiodarone [if not contraindicated, can be given 2x]: 300mg first
dose / 150mg second dose at 3 to
Lidocaine: First dose: 1mg/kg or 1.5 mg/kg. Can repeat it at half the
original dose up to a total of 3 mg/kg [Second and remaining doses
are given at either 0.5mg/kg or 0.75mg/kg depending on your star,ng dosage.]
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Correct Answer - D
Answer- D
Historically, the most common site of gastrointestinal (GI) carcinoid
tumors was the appendix.
Currently, however, the most common site of carcinoids in the GI tract is the small intestine (30%), followed by the rectum (19.6%).
In most studies, the appendix is only the third most common site of GI carcinoids, and in some studies, it is the fourth most common.
@surgeryvideos
Correct Answer - C
Ans. is c) i.e. depth of penetration of bowel walls
Schwartz writes
"Regional lymph node involvement is the most common form of
spread of colorectal carcinoma and usually preceeds distant metastasis or the development of carcinomatosis.
the T stage (depth of invasion) is the single most significant predictor of lymph node spread."
From the above given lines 'depth of penetration of bowel wall'
appears to be predictor of distant metastases as well.
CEA level is a marker for recurrance of colorectal ca after surgical resection.
Though its preoperative levels has some prognostic significance, it is
not a predictor for distant metastasis.
CEA level is used to follow up post operative cases of colorectal
cancer, for early detection of recurrence
@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.
@surgeryvideos
