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Acute dilutional hyponatremia

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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

Splenic cyst

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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

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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

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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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Bariatric in Special cases

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📘 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
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Dumping Syndrome

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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

Answer: C

  • Octreotide alleviates both early and late dumping symptoms through inhibition of hormone mediators.
  • It also delays gastric emptying time and inhibits splanchnic vasodilation.

Shack, 8th, 722.

  • These peptides not only inhibit gastric emptying but also affect small bowel motility so that intestinal transit of the ingested meal is prolonged.

Sabistan, 21st, 1217.

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

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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.

AIIMS 2017 Questions

Gall bladder MCQS  

Amylase and Lipase in Acute pancreatitis

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Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase

MCQs on Pancreatitis 

Q) Why does amylase and lipase increase in pancreatitis?

A) They are released from the acinar cells of pancreas during injury

Q) When does serum amylase rise in acute pancreatitis?

A) Within the first 12 hours