Q . Factors that preclude the use of a single-stage arterial switch reconstruction of dextrotransposition of the great vessels include:
A. Age older than 6 weeks with a left ventricular pressure of less than 50% of systemic pressure.
B. Dynamic left ventricular outflow tract obstruction.
C. Intramural coronary artery anatomy.
D. Subpulmonary VSD.
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Anti Rejection drugs
Q) Most nephrotoxic drug is
A. Cyclosporine
B. Sirolimus
C. Azathioprine
D. Steroids
Answer
These are immunosuppressants used after solid organ transplants. These drugs have a lot of side effects.
Post transplant malignancy
Q ) Most common malignancy in post-transplant individuals
A. PTLD
B. Skin- Squamous cell carcinoma
C. Kaposi sarcoma
D. CNS Lymphoma
Parkland formula
Q ) During fluid resuscitation in a burns patient using Parkland’s formula, volume of fluid given in first 8 hours is ?
A. 50%
B. 25 %
C. 75 %
D. 100 %
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Truncus arteriosus
Q ) Which of the following statements about truncus arteriosus is false?
A. Most infants do well without operations until late childhood.
B. Cyanosis is a late feature
C. Most infants present with congestive heart failure.
D. Repair requires a conduit from right ventricle to pulmonary arteries.
Answer
In Truncus arteriosus there is a single arterial trunk arising from the ventricles, with single dysplastic valve with
semilunar leaflets and a subvalvular VSD.
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Untreated, most infants do not survive beyond 6 months. Cyanosis is usually not present early, because mixing
mainly occurs at VSD level and the arterial oxygen saturation is generally greater than 85%, but............Read on
Diverticulitis
Q ) Hincheys grade III Diverticulitis. Management most likely to follow more interventions after an index operation is
a) Laparoscopic irrigation and exploration
b) Sigmoid Colectomy+Hartman’s
c) Primary repair with omental patch and peritoneal toilette
d )Sigmoid Colectomy with colorectal anastomosis and diverting ileostomy
Grade III diverticulitis is generalized peritonitis.
Warfarin
Q Warfarin sodium acts by
A. Inhibits carboxylation of Factor VII, IX, X
B. Factor X a inhibition
C. Thrombin inhibitor and X a inhibition
D. IX, XI, XII, factor and thrombin inhibition
Chronic pancreatitis enzymes
Q . All are true regarding enzyme supplementation in chronic pancreatitis except
a) Lipase to be given 30000U before or after meal
b) H2 blocker is mandatory with enteric coated tablets
c) Main cause of failure is inadequate dosage
d) In cases of failure of enzyme replacement feeding of medium chain Triglycerides are helpful
Ans
Indications of enzyme supplementation are -
- Weight loss, steatorrhea (15g/day ) or both
- Dyspepsia, Diarrhoea, bloating, malabsorption of proteins and carbohydrates
- Pain abdomen
Islet cells
Q Regarding islet cell of pancreas true is (AIIMS, JIPMER)
a) Cells in descending order of frequency is B,D,A,F
b) B cells are more common in the periphery of islets
c ) Peri islet acinar cells same as acinar cells else where
d) Portal flow from islet to acinar cell helps to control secretions
GCS
Q. Best predictor in Glascow coma scale (GCS)
A. Eye opening
B. Motor response
C. Verbal response
D. All
Ans ) B, Motor response
In the Glasgow Coma Scale (GCS), motor response is considered the best predictor of patient outcomes, especially in assessing the severity of brain injury. This is because motor response correlates strongly with neurological function and brainstem activity, providing a more reliable indicator of the patient's level of consciousness and prognosis.
Why Other Choices Are Incorrect:
- A. Eye Opening:
Eye opening is important but is less specific as a predictor because it can be influenced by factors like sedation, drugs, or environmental stimulation. It is useful for initial assessment but not as accurate in determining long-term outcomes. - C. Verbal Response:
Verbal response can be influenced by factors like intubation, sedation, or pre-existing conditions affecting speech. It is less reliable in predicting outcomes in patients with severe head injuries, especially when they are unable to speak due to other medical interventions. - D. All:
While all components of the GCS are valuable in assessing consciousness, motor response alone has been shown to be the strongest predictor of outcome, making it the primary focus when assessing prognosis in severe head injuries.