AIIMS MCQ

GI SUrgery MCQs from AIIMS over the years

Colorectal Liver metastasis

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Q)  All are negative prognostic factors in liver metastasis due to colorectal cancers except

a) Size more than 4.5 cm
b) Number of tumors more than 2
c) CEA more than 200

d) Tumor recurrence within 8 mths of primary surgery

Answer

Blood supply of CBD

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Q) Supraduodenal  CBD is supplied by all except (AIIMS NOV 18)
a Cystic art
b RHA
c LHA
d Anterosuperior pancreaticoduodenal artery

Ans c

The blood supply to the right and left hepatic ducts and upper portion of the CHD is from the CA and the right and left hepatic arteries.

The supraduodenal bile duct is supplied by arterial branches from the right hepatic, cystic, posterior superior pancreaticoduodenal, and retroduodenal arteries.

arteries to the supraduodenal bile duct run parallel to the duct at the 3 and 9 o’clock positions.

Approximately 60% of the blood supply to the supraduodenal bile duct originates
inferiorly from the pancreaticoduodenal and retroduodenal arteries

whereas 38% of the blood supply originates superiorly from the right hepatic artery and CD artery

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Choledochal cyst and malignancy

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Q) Choledochal cyst  and malignancy false statement is  (AIIMS 2018 nov)

a) Highest risk of malignancy in Type 3

b) Malignancy can occur even after removal of choledochal cyst

c) Malignancy can occur anywhere in the biliary tract

d) It can take upto 15 years for malignancy to develop after excision of choledochal cyst

Answer

 

Amoebic Liver abscess

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Q) Not true about amoebic liver abscess

a) Most common liver enzyme elevated is ALT
b) Metronidazole and luminal amebicide needed in all cases
c) In peritonitis due to amoebiasis perforation of colon are less than perforation of liver
d) 5% to 15% of patients with ALA may be resistant to metronidazole

 

Answer
The cecum is the most common site of amebic colitis, and the right lobe of the liver is more commonly affected because of drainage
of the right portal branch from the right side of the colon. The condition usually starts as diffuse amebic hepatitis; liver cells
undergo liquefactive necrosis

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Colon cancer genetics

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 False in Colo Rectal Cancer  pathogenesis

a) APC mutation FOR Aberrant crytpt foci formation

b) KRAS for ACF to Early Adenom

c) DCC for Intermediate to Late Adenoma

d) P53 for Large Adenoma to CRC

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Acute mesenteric ischemia

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Q)  All are  findings in acute mesenteric ischemia findings except?

a) Slow filling intramural vein

b) Spasm of arterial arcade / distal vessels

c) String of sausages/beaded appearance

d) Dilated and ring enhancement of SMV in CT

Answer 

 

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