AIIMS MCQ

GI SUrgery MCQs from AIIMS over the years

Whipple’s triad

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Q) Whipple's triad is seen in which pathological condition?

a) Insulinoma

b) Glucagonoma

c) VIPOma

d) Somatostatinoma

 

Answer 

a) Insulinoma

Whipple's triad is seen in pancreatic insulinoma and consists of 

a) Symptoms of hypoglycemia

b) Fasting sugar less than 50 mg%

c) Relief of symptoms with administration of dextrose solution

Other Points

  • Insulinoma is the most common functioning pancreatic neuroendocrine tumor
  • Symptoms are present for many years before diagnosis
  • Weight gain is common
  • Distribution of insulinomas is equal in body head and tail
  • Average size of insulinoma is 1-1.5 cm

Symptoms of Insulinoma

The neuroglycopenic symptoms of insulinoma included confusion, visual change, and unusual behavior

Sympathoadrenal symptoms may include palpitations, diaphoresis, and tremulousness.

Whipple's triad is just a part of Insulinoma and is not pathognomic of it. This entity may also be seen in other hyperinsulinemic conditions.

For endogenous Insulinoma, following tests are done

Proinsulin above 5.0 pmol/L

insulin above 3.0 pmol/L,

C-peptide above 0.2 nmol/L

all demonstrate endogenous hyperinsulinemia

In Memoriam: Allen O. Whipple, M.D

Choledochal cyst

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Q What is the management of choledochal cyst (bile duct cyst) adherent to portal vein?
a) Excision and Roux en y hepaticojejunostomy
b) Internal drainage into roux en y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the  external portion of the cyst wall intact.
 

Surgical Gastro NEET type Exam Questions

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Q) Type II gastric ulcer as described by Johnson  is 

a) Pre pyloric

b) Ulcer on body of stomach combined with duodenum

c) High on lesser curvature

d) Ulcer near the antrum

Devices for Surgeons

Answer b

Type II gastric ulcers, as described by Johnson, refer to:

b) Ulcer on body of stomach combined with duodenum

Type II ulcers are characterized by the presence of both gastric ulcers and duodenal ulcers.

In Johnson’s classification of peptic ulcers, Type II gastric ulcers are those that occur in both the stomach and the duodenum simultaneously. Here are the details:

  • Location: The gastric ulcer typically occurs in the body of the stomach, usually on the lesser curvature, while the duodenal ulcer is found in the first part of the duodenum.
  • Pathophysiology: This type of ulcer is associated with increased gastric acid secretion, which contributes to the development of both gastric and duodenal ulcers. The co-occurrence is often due to the same underlying factors like Helicobacter pylori infection or hyperacidity.

Living Donor liver transplant

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Q) Living donor liver transplant (LDLT) is done in centers where cadaveric donations are few. Which of the following is true about it?

a) Only right lobe of the donor can be used

b) Only left lobe can be used

c) In LDLT bile leak is more than cadaveric donor

d) Small for size liver is defined as liver size less than 0.5% of recipient BSA

Answer