AIIMS GI 2020

Amylase in pancreatitis

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Q) In  acute pancreatitis all are true except :

1) Amylase is more sensitive for first 5 days than lipase

2) S. lipase remains elevated for a longer time

3) Amylase levels not included in definitive diagnostic criteria of acute pancreatitis

4) Amylase levels may not be elevated in 19 % of patients

 

Management of various Hereditary Syndromes

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Q) Total Proctocolectomy is required for which of the following ? ( MCH GI Surgery Question- Click here for all) 

a) Cowden

b) HNPCC

c) Gardner

d) PJS  

Snippet -- HNPCC- Lynch syndrome patients develop colorectal and extracolonic cancers at a young age. It accounts for approximately 3% of all CRCs, and 10% to 19% of CRCs diagnosed before age 50. Read on..........

Crohn Disease of Duodenum

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Q) In Crohns  disease of duodenum , patient has a duodenal abscess which is  drained. He develops a fistula with  ileal communication. Surgery with the least chance of success would be

a. Ileal reaction and duodenal bypass

b. Ileal resection an dudodenal HMplasty
c. Ileal freshen and closure
d. Duodenum vertical closure

Anti rejection drugs

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Q) Anti Rejection medicine which also prevents tumor recurrence? MCH Questions ...

a) M tor inhibitors

b) IL2 blockers

c) Steroids

d) Azathioprine

Ans a) mtor inhibitors 

One Question is always asked about anti rejection medicines, Salient points i am enumerating

  1. Three drug regimen is classic includes IL2 blocker, Mycophenolate and steroids which are tapered . IL 2 blocker  Tacrolimus is used more than Cyclosporine ( cyclosporine less used now). IL2 blocker side effects are hirsutism, hyperkalemia, gum hypertrophy etc) 
  2. Mycophenolate is preferred over azathioprine . Both cause fall in cell lines
  3. Steroids have many side effects like weight gain, cataract, infections and are used in tapering dose

M-tor inhibitors are sirolimus and Everolimus which are used when transplant is done for HCC, IT has anti tumor action.

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