Q. Which of the following is not an option for Imatinib resistant GIST
a) Increase the dose to 800 mg/day
b) Sunitinib
c) Chemotherapy with Cisplatin
d) Radiofrequency Ablation
n GIST
admin
Complications of duodenal diverticulum
Q) True statement regarding complications of duodenal diverticulum is
a) Perforation is the commonest complication
b) Obstruction is caused by extra luminal duodenal diverticulum
c) Bleeding is the most common complication of duodenal diverticulum.
d) Diverticulitis is common and easily diagnosed.
Answer
c
Complications of duodenal diverticulum are rare with a reported incidence of 5-10% in those with duodenal diverticulum. Operative intervention is required in about 1% cases
Perforation is the rarest but the most severe complication of duodenum diverticulum. The most common cause of perforated duodenal diverticulum is diverticulitis. They perforate in the retroperitoneum, adding to diagnostic uncertainty. Ct Scans are most diagnostic to help in this diagnosis.
GI Bleed
Q ) A 59 year old male alcoholic male presents with history of upper GI bleed of 1 day duration. During the day he has had three episodes of bleeding each time about 150 ml. Blood is fresh and not associated with retching. He has a history of long standing alcohol intake. What will be the most likely cause of GI bleed?
a) Mallory weiss tear
b) Esophageal varices
c) Gastric ulcer
d) Esophagitis
Causes of Acalculus Cholecystitis
Q) Which of the following is not a cause of acalculus cholecystitis? Questions on bile duct
a) Kinking of the neck of gall bladder
b) Acalculus cholecystitis Sphincter spasm
c) Thrombosis of cystic artery
d) Over eating
Ans d
Acalculus cholecystitis can be both acute and chronic in the absence of stones. Although it can present acutely, acalculous cholecystitis typically presents more insidiously.
Mostly the acute form is recognized and chronic form is called biliary dyskinesia.
The cause of acalculus cholecystitis are
- Kinking or fibrosis of neck of gall bladder.
- Thrombosis of cystic artery
- Sphincter of Oddi spasm
- Prolonged fasting
- Dehydration
- Sepsis
- Systemic diseases MODS
Jaundice in acalculus cholecystitis is known to occur because of ischemia and inflammation cystic duct gets obstructed due to edema
Diagnosis
Chronic acalculus cholecystitis is a cholescintigraphy nuclear scan (HIDA) with the administration of cholecystokinin (CCK). After the . A calculated ejection fraction of 35% or less may be indicative of hypokinetic functioning of the gallbladder. An ultrasound of the gallbladder may also be useful. If this shows a thickened gallbladder wall of over 3.5 mm, this may be due to cholecystitis.
Acute acalculus cholecystitis - USG CT or HIDA
BEST BOOKSMCQ practise
MRCS Part A: Essential Revision Notes: Book 2
Omental cyst
Q) True statement about omental cyst is ?
a) It is always unilocular
b) Commonly seen in old age group
c) Arise from acquired or congenital obstruction of the lymphtaic channels
d) Complications are more common in old age.
Answer c
Duodenal obstruction
Q) Duodenal obstruction is caused by all except (#duodenum)
a) Duodenal Diverticulum
b) Annular Pancreas
c) SMA syndrome
d) Malrotation of duodenum