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Obscure occult Gi bleed

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Q Not true about Obscure occult GI bleed

a) RBC scintigraphy scan has high accuracy

b) Capsule endoscopy can not be done in obstruction

c) Mesenteric Angiography is best for angiodysplasia

d) Intraoperative enteroscopy should be the last resort

 

Crohn Extraintestinal manifestations

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Q) Extra intestinal manifestation of Ulcerative Colitis  not cured by surgery

a) PSC

b) Sacro ileitis

c) Episcleritis

d) Erythema nodosum

Questions on colon 21-30

Ans ) a PSC 

Arthritis,  ankylosing  spondylitis,  erythema  nodosum,  and  pyoderma  gangrenosum  typically  improve  or  completely  resolve after  colectomy.

PSC  occurs  in  5%  to  8%  of  patients  with  ulcerative  colitis. 

HLA-B8  or HLA-DR3  haplotype  are  10  times  more  likely  to  develop  PSC. 

The  risk  for  colon  cancer   in these  patients  is  up  to  five  times  greater   than  in  patients  with ulcerative  colitis  alone.  These  tumors  are  more  likely  to  arise proximal  to  the  splenic  flexure . Colectomy  has  no  effect  on  the course  of  PSC.

 

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Pudendal nerve terminal latency

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Q .PNTL prolonged in all the following except

a) Traumatic injury to anal sphincter

b) Prolonged labor

c) Long standing Rectal prolapse

d) Straining

Answer for premium members (Q4) 

The nerve latency is measured by an electrode which is worn on the finger. It stimulates the pudendal nerve and calculates the conduction time to the anal sphincter

Trauma

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Q) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious,  BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not raised and heart sounds are normal. Respiratory rate is 22/min

What does he have

a) Left heart failure

b) Fat Embolism

c) Pneumothorax

d) Fluid loss

ERCP in pancreatitis

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Q) All are true about ERCP in pancreatitis except

a) Not useful in patient with multiple strictures and stones

b) Ductal stenting associated with changes of c/c pancreatitis in 50%

c) In pts with pancreas divisum minor duct sphincterotomy causes significant pain relief irrespective of size of duct

d) Pain relief with endoscopic intervention occurs irrespective of relief of ductal pressure/ decrease in duct size

Answer for premium members  ( Please log in to see) 

Pancreatic  ductal  obstruction  by  fibrotic  stenoses  and/or  calculi are  the  most  frequent  indications  for  endoscopic  therapy.

Multiple strictures and stones are not amenable for endoscopic therapy ....................

Harmonic Scalpel

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Q. Harmonic  scalpel frequency of vibration is ?
A. 20000-50000
B. 50000-80000
C. 80000-100000
D. >100000

Ans a

The harmonic scalpel transduces high-frequency ultrasonic energy through a metallic jaw to generate mechanical vibration. It has an active and an inactive blade When in contact with tissue, the vibration of a single blade against a static blade results in vaporization and coagulation.

Harmonic scalpel also called ultrasonic scalpel cuts through tissues and causes coagulation by protein denaturation caused by vibrating force. As compared to electro cautrey harmonic scalpel

  1. takes longer time 
  2. produces less smoke
  3. Cause less tissue edema, swelling

Glucagonoma

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Q) All are true about Glucagonoma except

a) Usually seen  in middle age and elderly

b) Usually > 5cm at presentation

c) Skin lesions preceed tumor detection by 6-8yrs

d) Often associated with ketoacidosis

Glucaonoma is an endocrine tumor characterized by increased levels of serum glucaogon. It is seen in the age group ............... Read on   (Question 8) 

For other questions on endocrine tumors