GI SUrgery MCQs from AIIMS over the years
Q) Restrictive strategy of transfusion in acute GI bleed all are true except?
A. Should be started at a hemoglobin < 7 g/dl
B. Will not alter the risk of rebleed
C. Child A and B patients had significantly lower risk of gi bleed
d) None of the above
Q. Which is false about crystalloid solutions?
A. NS has Sodium 154 meq/l
B. NS has Chloride 154 mEq/l
C. RL contains Lactate but doesn’t contain calcium
D. RL contains sodium potassium calcium and lactate
Q) Absolute contraindication for left lobe LDLT is
A. Trifurcation of the portal vein
B. Bifurcation of portal vein in the right lobe of the liver
C. Aberrant right hepatic artery
D. Right Posterior duct draining into left hepatic duct
Q. CT severity score for pancreatic necrosis of more than 50%
A. 6
B. 7
C. 10
D. 5
Answer See Q 25
Q) Ideal time for CECT in severe acute pancreatitis is
A. After 72 hours
B. After 48 hours
C. 24 hours
D. At admission
Mild acute pancreatitis
Severe Acute pancreatitis
Main determinant of clinical outcome is the degree of systemic organ disturbance, particularly during the early hours and days after admission to hospital
More than half of all deaths in AP occur within the first 2 weeks of illness and are usually a consequence
of multiple organ failure
The revised Atlanta Classification
3 grades of severity of pancreatitis:
Mild AP—characterized by the absence of organ failure or local
complications
Moderately severe AP—defined by...................read on
Q) Cholangiocarcinoma type IIIB bismuth Corlette bilirubin 10, left portal vein and hepatic artery
involved. Best approach is
A. Preoperative left biliary drainage followed by resection
B. Preoperative right biliary drainage followed by resection
C. Left portal vein embolisation followed by resection
D. Palliative drainage
Q) True about retained antrum syndrome after gastrectomy are all except? ( # MCQ in Stomach 11-15)
a) It is a persistent hypergastrinemic state
b) It is only seen after Billroth II Gastrectomy
c) Technetium labelled food is not helpful in diagnosing this condition
d) Serum gastrin is usually less than 1000 pg/ml
Answer c
After billroth II gastrectomy, if a cuff of gastric mucosa remains with duodenum, this entity is called as retained antrum syndrome. This cuff of gastric mucosa is cut off from the proximal stomach and inhibitory effect of hormones such as VIP (Vasoactive Intestinal Peptide) leading to a persistent hypergastrinemic state. ALso this gastric mucosa is continuously bathed by the alkaline contents of duodenum , which further increases the acid formation.
Both Basal and maximal gastric acid outputs increase but it is not as high as seen in zollinger ellison syndrome. Typically less than 1000 pg/ml
This condition can present as recurrent and persistent ulcerations. Technetium scanning is the diagnostic modality of choice. Treatment is re do surgery and antral excision.
Technetium pertechnate imaging has a sensitivity of 73% and specificity of 100%
