Q Which organism does not follow the Koch's postulates?
a) Mycobacterium tuberculosis
b) Mycobacterium Leprae
c) E coli
d) Clostridium
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Virchow’s triad
Q) Which of the following does not form a part of Virchow's triad?
a) Endothelial damage
b) Slow blood flow
c) Platelet defects
d) Hypercoagulable state
Correct Answer: c) Platelet defects
Explanation:
Virchow triad (venous stasis, endothelial injury, and hypercoagulability) describes the factors contributing to venous clot formation and thromboembolism.
Platelet defects are associated with arterial thrombosis and not venous.
Virchow is known as "the father of modern pathology" and founder of social medicine.
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Virchow’s Triad: Unraveling the Factors Behind Thrombosis
1. Endothelial Damage:
Endothelial cells line blood vessels. When injured, they expose tissue factor, initiating clot formation. Seen in atherosclerosis, sepsis, trauma.
2. Abnormal Blood Flow:
Stasis or turbulence promotes clotting. Causes include prolonged immobilization, atrial fibrillation, varicose veins.
3. Hypercoagulability:
A state of increased clotting tendency.
Causes:
• Oral contraceptives, obesity, pregnancy
• Inherited mutations (e.g. factor V Leiden)
• Smoking, malignancy
Most thrombi result from a combination of the above factors. Recognizing the triad aids in prevention and diagnosis of thromboembolic disease.
Acute dilutional hyponatremia
Q) 70 yr old male after TURP for BPH develops un resoponsiveness, slurring of speech and stroke like symptoms . Further management should be
a ) Give 3% Nacl
b) Give 0.9% Nacl
c) IV fluid restriction
d) Desmopressin
Spontaneous fistula closure
Q) 27 year old male has enterocutaneous fistula which is long standing. Which of the following is an unfavorable factor in healing?
a) Long tract, >2 cm
b) Single tract
c) Epithelialised tract
d) Origin from duodenal stump
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Splenic cyst
Q) A 35 year old asymptomatic male undergoes a routine USG which reveals a 3 cm Splenic cyst. There is a prior history of trauma 2 months back. CT Shows smooth, unilocular, thick walled lesion. What should be further management
a) Conservative
b) Partial Splenectomy
c) Total Splenectomy
d) Percutaneous Aspiration
Pancreatectomy
Q) Not true about pancreatectomy?
a) Antecolic reconstruction slows gastric emptying.
b) Drains are routinely used after pancreatic resections and currently standard of care.
c) Drains increase infections and prolong hospital stay.
d) Presence of drain fails to reduce the need for interventional radiology.
Antigen Presenting cells
Q) Most potent cells that present antigen and are distributed throughout the lymphoid and nonlymphoid tissues of the body are?
✅ Answer: A. Dendritic cells
🔍 Explanation:
Dendritic cells are specialized macrophages and are considered professional antigen presenting cells (APCs). They are the most potent APCs in the body, distributed widely in both lymphoid and non-lymphoid tissues.
🧠 NK cells are large granular lymphocytes involved in innate immunity. They have cytolytic functions but are not classified as APCs.
🧠 Macrophages and monocytes can present antigens but are less efficient compared to dendritic cells.
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🔍 Explanation:
Dendritic cells are specialized macrophages and are considered professional antigen presenting cells (APCs). They are the most potent APCs in the body, distributed widely in both lymphoid and non-lymphoid tissues.
🧠 NK cells are large granular lymphocytes involved in innate immunity. They have cytolytic functions but are not classified as APCs.
🧠 Macrophages and monocytes can present antigens but are less efficient compared to dendritic cells.
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Bariatric in Special cases
📘 High-yield question on Bariatric Surgery Eligibility.
Q) 40 year old schizophrenic man with BMI 42, ideal for weight loss is
a) Medical management
b) LRYGB
c) Duodenal switch
d) Sleeve gastrectomy
🔒 This answer is available only for Premium Members. Join Premium Surgery Course
Dumping Syndrome
Q) What is the mechanism of action of Octreotide in dumping syndrome ?
a) Acceleration of gastric emptying
b) Shortening of small bowel transit time
c) Inhibition of endocrine secretions
d) All the above
Snippets
- Late dumping occurs 1 to 3 hours after a meal and is less common.
- The basic defect of late dumping is also rapid gastric emptying; however, it is related specifically to carbohydrates being delivered rapidly into the proximal intestine.
Gall bladder cancer
Q) True about the presentation of Gall Bladder cancer is ?
a) 50% of the cancers originate in the fundus and body.
b) Nodal disease is present in 1/3 at presentation.
c) Distant metastasis is present is <1/3 of patients at presentation.
d) Acute cholecystitis due to neck mass has worse prognosis.