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Chronic pancreatitis enzymes

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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 -

  1. Weight loss, steatorrhea (15g/day ) or both
  2. Dyspepsia, Diarrhoea, bloating, malabsorption of proteins  and carbohydrates
  3. Pain abdomen

Read on for ans Q 23 

Islet cells

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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

Answer 

GCS

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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:

  1. 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.
  2. 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.
  3. 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.

 

Pouch design

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Q. False statement about pouch design is-

a) S pouch is  preferred when length is  not available

b) J pouch is the  most preferred

c) W pouch has  more chances of diarrhoea than J pouch

d) Volume of the pouch is inverse proportional to the no. of bowel movements

Answer 

Priapism

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Q) What is the cause of priapism in a patient with trauma

a) Penile rupture

b) Dorsal vein of penis thrombosis

c) Spinal cord injury

d) Sickle cell anemia

Answer 

Most common cause of priapism is sickle cell anemia, but in the setting of trauma....

Read on  Q 86

Spinal cord injury

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Spinal Immobilization MCQ | Free NEET SS Surgery Question
Q) Out of the following, which patient requires spinal immobilization the most?
✅ Answer: A. 22-year-old female involved in a high-speed motor vehicle collision with back pain

🔍 Explanation:
Spinal immobilization is most indicated when there's a high-risk mechanism of injury with suggestive symptoms, such as midline spinal pain or neurological signs.

A involves a high-energy mechanism (MVC) and reported back pain, which is a clear indication for spinal immobilization per NEXUS and Canadian C-spine rules.

B has a lower-risk mechanism and no symptoms; thus, spinal immobilization is generally not needed.

C – Gunshot wounds may or may not need spinal immobilization depending on location and neurological findings; not always indicated unless spinal structures are involved.

D – Isolated abdominal trauma is not an indication for spinal immobilization unless there’s evidence of spinal involvement.

⚡ Mechanism of Injury:
• Blunt trauma – Direct impingement, ischemia, compression or bleeding
• Penetrating trauma – Laceration of spinal cord

🩻 Chance fracture: A transverse fracture of all vertebral elements.

🩺 Management:
1. Complete immobilisation
2. Management of associated neurogenic shock (due to loss of sympathetic tone) with vasopressors and fluids

📘 Recommended Reading: Get Surgery Essentials