AIIMS MCQ

GI SUrgery MCQs from AIIMS over the years

Blood supply to rectum

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Q) Blood supply to rectum - all are true except
A. Inferior rectal artery pierces the levator ani to supply the distal rectum
B. Middle rectal artery is a branch of hypogastric
C. Arc of riolan is an anastomosis between ascending branch of IMA and Middle Colic Artery
D. Left Colonic Artery arises 3-4 cm distal to the IMA origin

Answer to Q14 

 

Hereditary Pancreatic Cancer

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Q. All of the following predisposing syndromes for pancreatic adenocarcinoma are AD except? ( # Pancreas Q 21-25) 
A. PJS (Peutz Jeghers) 
B. CFTR (Cystic fibrosis) 
C. HNPCC
D. FAMMM

Points : Several hereditary cancer syndromes (e.g., Peutz-Jeghers syndrome, familial atypical mole and multiple melanoma syndrome, hereditary breast and ovarian cancer syndrome) are known to be associated with increased risk of pancreatic cancer

Oropharyngeal dysphagia

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 Q) Oropharyngeal dysphagia false is
A. Nasal twang in voice, ptosis
B. Treatment is most often not satisfactory if conservative
C. Associated with myesthenia gravis and Parkinsonism
D. Water brasch and regurgitation presentation

Answer 

CEA

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True regarding CEA is 

  1. Low specificity
  2. Falls after 1 week of surgery to baseline
  3. Preoperative high value is good prognostic marker
  4. Follow up, first test of CEA in 8-10 days followed by weekly tests thereafter

Answer after Q 20

Dieulafoy lesion

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Q) Dieulafoy lesion which is false? (AIIMS 2018)

A. Most of the bleed cannot be visualised due to small mucosal defect lies over large arterial bleed.
B. Large 1-3 mm artery in the submucosa is the source
C. MC in the greater curvature
D. Found within 6 cm from GEJ

Chronic pancreatitis enzymes

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Q . All are true regarding enzyme supplementation in chronic pancreatitis except 

a) Lipase to be given 30000U before or after meal

b) H2 blocker is mandatory with enteric coated tablets

c) Main cause of failure is inadequate dosage

d) In cases of failure of enzyme replacement feeding of medium chain Triglycerides are  helpful

Ans

Indications of enzyme supplementation are -

  1. Weight loss, steatorrhea (15g/day ) or both
  2. Dyspepsia, Diarrhoea, bloating, malabsorption of proteins  and carbohydrates
  3. Pain abdomen

Read on for ans Q 23 

Islet cells

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Q  Regarding islet cell of pancreas true is (AIIMS, JIPMER) 

a) Cells in descending order of frequency is B,D,A,F

b) B cells are more common in the periphery of islets

c ) Peri islet acinar cells same as acinar cells else where

d) Portal flow from islet to acinar cell helps to control secretions

Answer 

Pouch design

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Q. False statement about pouch design is-

a) S pouch is  preferred when length is  not available

b) J pouch is the  most preferred

c) W pouch has  more chances of diarrhoea than J pouch

d) Volume of the pouch is inverse proportional to the no. of bowel movements

Answer 

Pouchitis in chronic ulcerative colitis

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Q. In patients undergoing restorative proctocolectomy for chronic ulcerative colitis, which of the following statements regarding pouchitis is TRUE?

a) More common in females
b) Positively associated with smoking
c) Associated with primary sclerosing cholangitis
d) Associated with p-ANCA positivity

Show Answer & Explanation

Correct Answer: c) Associated with primary sclerosing cholangitis

True is association with PSC

Incidence of pouchitis after restorative proctocolectomy is 16-48%. It increases over time.

Risk of pouchitis is more after surgery for Chronic Ulcerative colitis (CUC) than FAP.

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