Q) LASER used in CA urinary bladder?
a) Carbon dioxide
b. Nd yag
c. Holmium yag
d) None
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Cholecystostomy
Q. Regarding percutaneous cholecystostomy A/E
a. Technical success in 90 – 98 % of cases
b. Indicated in Grade II cholecystitis with significant pericholecystic inflammation & GOO
c. Indicated in Gr III cholecystitis with significant comorbidity
d. In Grade III cholecystitis with biliary peritonitis, PCC results in significant improvement
Modified Nissen’s fundoplication
Q ) Modified Nissen's Fundoplication is
a) 2700 anterior wrap around esophagus
b) 2400 wrap
c) 3600 wrap over > 52 Fr for 1 – 2 cm
d) 600 wrap over 42 Fr for 4 cm
Answer
c
Nissen fundoplication is complete 360 degree but has high incidence of gas bloat. To counter, this modification done to wrap over 52 F tube for 1-2 cm
Belsey - Left thoracotomy, mobilization of distal esophagus and stomach, hiatus opened from above, fundus is brought 270 degrees around distal esophagus. Then the whole assembly is brought down and crura is repaired.
Hill procedure - No fundoplication is done
Toupet is anterior fundoplication either 240 degree or 270 degree.
Early adenocarcinoma of esophagus
Q. Early adenocarcinoma of Esophagus
a) Around one third have lymph node mets
b) EMR curative in approx 90%
c) EMR can remove all dysplastic epithelium
d) In high grade dysplasia esophagectomy reveals around 50% invasive malignancy
Premium answer
This question in another format was also discussed at www.mcqsurgery.com/esophagus4
Blood supply of esophagus
Q. Blood supply of esophagus are all except (SS 2012)
a) Inferior thyroid A
b) Middle thyroid A
c) Tracheobronchial A
d) Bronchoesophageal A
Vagal sparing esophagectomy
Q) True about Vagal sparing Esophagectomy
a) Same lymphadenectomy as THE
b) Comparable morbidity to THE
c) Usually done for T3 tumors
d)None
Foreign body esophagus
Q) True about foreign body in esophagus
a) Sharp objects should be operated and not retrieved
b) Lead batteries should be removed
c) Most common impacted foreign bodies are dentures
d) Contrast examination of esophagus should be done before endoscopy
Answer
b
Sharp objects can be removed over overtubes and not always require surgery. Lead batteries can corrode and decay in the stomach or intestine and should always be removed. Most common impacted foreign bodies are food boluses above a pathological narrowing and require endoscopic break up
Contrast examination is not always required and might complicate things
Bailey page 991
Cholelithiasis with Choledocholithiasis
Q. Patients with gallstones and choledocholithiasis in a centre with endoscopy, interventional radiology and tertiary care
a. Single setting lap chole + CBDE better than endoscopy followed by lap chole
b. In choledocholithiasis endoscopic clearance alone without lap chole can be done without any long term complication
c. For impacted ampullary stones with CBD dilatation that requires biliary enteric drainage is performed with a preferred open approach
Banff Score
Q) Banff Scoring system is for
a) Acute pyelonephritis
b) Chronic glomerulonephritis
c) Acute Rejection
d) Chronic renal graft rejection
Discuss what is banff score
What is the need of banff score
What are the components
What is the significance