Q) Racoon eye is seen in
a) Head injury
b) Sub galeal haematoma
c) Sub conjunctival haemorrhage
d) Nasal bone fracture
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Q. The most common complication of Bevacizumab is
a) hypertension
b) Hyperglycemia
c) Rashes
d) Gastrointestinal perforations
Whipple’s triad
Q) Whipple's triad is seen in which pathological condition?
a) Insulinoma
b) Glucagonoma
c) VIPOma
d) Somatostatinoma
Answer
a) Insulinoma
Whipple's triad is seen in pancreatic insulinoma and consists of
a) Symptoms of hypoglycemia
b) Fasting sugar less than 50 mg%
c) Relief of symptoms with administration of dextrose solution
Other Points
- Insulinoma is the most common functioning pancreatic neuroendocrine tumor
- Symptoms are present for many years before diagnosis
- Weight gain is common
- Distribution of insulinomas is equal in body head and tail
- Average size of insulinoma is 1-1.5 cm
Symptoms of Insulinoma
The neuroglycopenic symptoms of insulinoma included confusion, visual change, and unusual behavior
Sympathoadrenal symptoms may include palpitations, diaphoresis, and tremulousness.
Whipple's triad is just a part of Insulinoma and is not pathognomic of it. This entity may also be seen in other hyperinsulinemic conditions.
For endogenous Insulinoma, following tests are done
Proinsulin above 5.0 pmol/L
insulin above 3.0 pmol/L,
C-peptide above 0.2 nmol/L
all demonstrate endogenous hyperinsulinemia
Choledochal cyst
Q What is the management of choledochal cyst (bile duct cyst) adherent to portal vein?
a) Excision and Roux en y hepaticojejunostomy
b) Internal drainage into roux en y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall intact.
Colon Cancer
Q1. Risk of Colon Cancer in Adenomatous polyp is related to all except
a) Size of the poylp
b) Number of polyps
c) Histological appearance
d) Dysplasia
Inflammatory Carcinoma breast
Q) In terms of cure best results in inflammatory carcinoma breast are seen with-
a) Surgery alone
b) Chemotherapy
c) Radiotherapy
d) All of the above
Ans wer
d)
Inflammatory carcinoma of the breast is a rare aggressive tumor that blocks the sub dermal lymphatics as a result of which cutaneous edema is common . Differentiating it from a breast abscess is important and biopsy is diagnostic. It is also responsible to peau d orange
Treatment is multidisciplinary and involves, chemotherapy followed by surgery followed by radiotherapy.
Inversion of nipple
Q) Simple nipple inversion is seen in?
a) Duct ectasia
b) Puberty
c) Peri ductal fibrosis
d) Carcinoma breast
Answer of this question is free. Click the link for more similar questions for MCH preparation
Ans is b
Inversion of nipple is seen in a lot of conditions, both benign and malignant.
Benign causes of Nipple inversion
- Duct ectasia
- After breast Surgery
- Fat necrosis
- Mondor disease
- Chronic peri ductal mastitis
Malignancy
- Carcinoma breast
Rapid unilateral development of inversion of nipple is a dangerous sign and warrants further diagnosis. Further circumferential retraction is also sign of carcinoma.
Simple nipple inversion occurring at puberty or retracted nipple is of unknown cause and is bilateral in 25%. Mostly No treatment is required for this and condition resolves spontaneously during pregnancy and lactation.
Suction pumps and cosmetic surgery can also help.
Inversion of nipple associated with malignancy may be with or without the presence of lump. Associated discharge from the nipple can point to the diagnosis.
Duct ectasia - slit like retraction of nipple . ALso seen in duct ectasia is green, black or blood stained discharge from nipple
Ref - Bailey 801
Grading of benign nipple inversions for management
In grade I, the nipple is easily pulled out manually and maintains its projection quite well. It has minimal fibrosis thus, manual traction and a single, buried purse-string suture are enough for the correction.
Grade II (majority) the nipples can be pulled out but cannot maintain projection and tend to go back again. These nipples are thought to have moderate fibrosis beneath the nipple.
In grade III, to which the least number of inverted-nipple cases belong, the nipple can hardly be pulled out manually. Severe fibrosis made it impossible to reach optimal release of the fibrotic band with the preservation of the ducts.
Ref https://www.ncbi.nlm.nih.gov/pubmed/10654681
Our Recommendations of surgery Books
BEST TEXTBOOKS FOR GENERAL SURGERY
Bailey & Love’s Short Practice of Surgery, 27th Edition
Sabiston’s Textbook of Surgery
Schwartz’s Principles Of Surgery
BEST BOOKS FOR OPERATIVE SURGERY
Operative Techniques in Surgery by Michael W. Mulholland et al
Chassin’s Operative Strategy in General Surgery
Farquharson’s Textbook of Operative General Surgery
Q) Is nipple inversion a sign of breast cancer?
A) Not always but above the danger signs and symptoms are listed
Popcorn calcification
Q) Popcorn calcification in breast is seen in which condition
a) Fibroadenoma
b) Periductal fibrosis
c) Carcinoma breast
d) Duct ectasia
Free answer to Surgery MCQs
a
Calcifications associated with fibroadenomas have been termed popcorn calcifications because of their large size and dense, coarse appearance. Calcifications in fibroadenomas usually begin at the periphery and then involve the central portion of the fibroadenoma.
Surgical Gastro NEET type Exam Questions
Q) Type II gastric ulcer as described by Johnson is
a) Pre pyloric
b) Ulcer on body of stomach combined with duodenum
c) High on lesser curvature
d) Ulcer near the antrum
Answer b
Type II gastric ulcers, as described by Johnson, refer to:
b) Ulcer on body of stomach combined with duodenum
Type II ulcers are characterized by the presence of both gastric ulcers and duodenal ulcers.
In Johnson’s classification of peptic ulcers, Type II gastric ulcers are those that occur in both the stomach and the duodenum simultaneously. Here are the details:
- Location: The gastric ulcer typically occurs in the body of the stomach, usually on the lesser curvature, while the duodenal ulcer is found in the first part of the duodenum.
- Pathophysiology: This type of ulcer is associated with increased gastric acid secretion, which contributes to the development of both gastric and duodenal ulcers. The co-occurrence is often due to the same underlying factors like Helicobacter pylori infection or hyperacidity.
Q) Which of the following liver resections have the least chances of bleeding?
a) Previous history of TACE
b) A patient with splenomegaly
c) The patient with Platelet count 25000
d) Patient with grade III esophageal varices