GI SUrgery MCQs from AIIMS over the years
Q) A 50 year old male undergoes pancreatectomy for Carcinoma head of pancreas. His pre op Hb was 9.2g% and during surgery he received 5 units of PRBC. In the post op period on the 2nd day he develops ECG changes. Work up is done for Myocardial Ischemia which is negative. What is the most common cause of ECG changes here
a) Hyponatremia
b) Hyperkalemia
Q)Which of the following is not associated with diverticulum in colon?
a) High fiber diet
b) High Intraluminal pressure
c) Disordered colon motility
d) Change in colon structure
Q. A 45 year old male has severe coughing followed by sudden Bilateral pain in lower abdomen. At the same time he develops a swelling in the mid line, lower abdomen which does not change in size on raising the leg muscles. What has really happened?
a) Ruptured aortic aneurysm
b) Obturator hernia
c) Spigelian Hernia
d) Rectus sheath hematoma
Answer
Q)Contraindications of liver transplantation have changed over the years. Which is an absolute contraindication of liver transplantation
a) Previous breast cancer
b) Portal vein thrombosis
c) Active tuberculosis
d) Active substance abuse
Q) True statement regarding complications of duodenal diverticulum is
a) Perforation is the commonest complication
b) Obstruction is caused by extra luminal duodenal diverticulum
c) Bleeding is the most common complication of duodenal diverticulum.
d) Diverticulitis is common and easily diagnosed.
Answer
c
Complications of duodenal diverticulum are rare with a reported incidence of 5-10% in those with duodenal diverticulum. Operative intervention is required in about 1% cases
Perforation is the rarest but the most severe complication of duodenum diverticulum. The most common cause of perforated duodenal diverticulum is diverticulitis. They perforate in the retroperitoneum, adding to diagnostic uncertainty. Ct Scans are most diagnostic to help in this diagnosis.
Q) Which of the following is not a cause of acalculus cholecystitis? Questions on bile duct
a) Kinking of the neck of gall bladder
b) Acalculus cholecystitis Sphincter spasm
c) Thrombosis of cystic artery
d) Over eating
Ans d
Acalculus cholecystitis can be both acute and chronic in the absence of stones. Although it can present acutely, acalculous cholecystitis typically presents more insidiously.
Mostly the acute form is recognized and chronic form is called biliary dyskinesia.
The cause of acalculus cholecystitis are
Jaundice in acalculus cholecystitis is known to occur because of ischemia and inflammation cystic duct gets obstructed due to edema
Diagnosis
Chronic acalculus cholecystitis is a cholescintigraphy nuclear scan (HIDA) with the administration of cholecystokinin (CCK). After the . A calculated ejection fraction of 35% or less may be indicative of hypokinetic functioning of the gallbladder. An ultrasound of the gallbladder may also be useful. If this shows a thickened gallbladder wall of over 3.5 mm, this may be due to cholecystitis.
Acute acalculus cholecystitis - USG CT or HIDA
BEST BOOKSMCQ practise
MRCS Part A: Essential Revision Notes: Book 2
Q) What is true about the role of EUS in Carcinoma head of pancreas.
a) It has a sensitivity of 50-60% in detecting lesions less than 3 cm in size
b) It has a high negative predictive value
c) Chronic pancreatitis can be easily differentiated from Carcinoma head of pancreas by EUS
d) Small caliber needles have low accuracy than high caliber needles in FNAC
