Q) Vacuum dressings are useful in all except
b)
c)
d )
General Surgery
NEET, DNB questions from general surgery
Dumping Syndrome
Q) Late dumping syndrome is due to
a) Excessive release of insulin
b) Food bolus in jejunum
c) Release of serotonin
d) Local enteric reflexes
Answer
a, Excessive release of Insulin
Dumping syndrome are most common after billroth II gastrectomy followed by BI and Truncal vagotomy and gastro jejunostomy.
Dumping can occur 30 mins after food, (early dumping) or 2 hours after eating (late dumping). Early dumping has GI symptoms such as nausea, vomiting, epigastric fullness, diarrhea and abdominal pain.
Early dumping occurs due to rapid emptying of chyme in jejunum. This hyperosmolar fluid draws water from extracellular compartment to the lumen of small intestine causing intestinal distension and autonomic changes.Serotonin, bradykinin-like substances, neurotensin, and enteroglucagon are involved in early dumping.
Late dumping syndrome has more cardiovascular symptoms such as palpitations, light headedness, dizziness, tachycardia, diaphoresis, flushing and blurred vision.
It occurs due to delivery of carbohydrates into jejunum, their absorption causes hyperglycemia and insulin release. Excessive insulin release leads to development of symptoms.
Treatment
- Diet - Avoid carbohydrates, frequent small meals of protein and fat and separate liquids from solids
- surgery Conversion to Roux en Y
Ref Sabiston 1212
Compression pressure in lymphedema
Q) In LYMPHEDEMA STOCKING class A pressure is ?
a. 20 -30mmHg
b. 30-40 mmHg
c. 40-50 mmHg
d. 50-60
Use of compression stockings in lymphedema
Transportation of amputated finger
Q) How should you transport amputated finger?
a) Plastic bag with wet ice inside
b) Plastic bag with wet ice outside
c) Plastic bag with dry ice outside
d) Over sterile gauge
Discuss Proper method for transportation of an amputated body part to maximize replantation success.
Carbon Monoxide poisoning
Q. Carbon monoxide poisoning true is
a) It is having 10 times more affinity than oxygen
b) 60 percent is not deadly.
c) . Concentration above 10% are dangerous and need observation
d) Concentration above 10% are dangerous and need treatment with pure oxygen for more than 24 hours
Hernia Recurrence
Q) Recurrence rate in lap repair of recurrent inguinal hernias is
a. 5 %
b. 8 %
c. 10 %
d. 14 %
Discuss Recurrence rates in open and laparoscopic repairs in primary hernia
Recurrence rate of lap repair in recurrent hernia
Bleeding peptic ulcer
Q) In a patient with a bleeding peptic ulcer, endoscopy is done. Which of the following findings on endoscopy predicts the highest rate of re bleed?
a) Non bleeding vessel
b) Adherent clot
c) Flat pigmented spot
d) Clean base ulcer
Compartment syndrome of limb
Compartment Syndrome of Limb – Free Surgery MCQ
Q) All are true about compartment syndrome of limb except?
a) Diagnosis is unlikely if pulse is felt distally
b) There is pain on passive stretching of the limb
c) Pain is out of proportion to the signs
d) Muscles of calf and forearm are commonly involved
Scalp infection
Q) Most dangerous site in scalp infection is :
a) Sub glieal
b) Epicarnium
c) Loose areolar tissue
d) Aponeurosis
Strongest layer of the intestine
Q) Which is the strongest layer of the intestine?
a) Mucosa
b) Submucosa
c) Muscularis propria
d) Muscularis mucosa
Answer:
b) Submucosa is the strongest and most important layer for intestinal anastomosis. It has fibroblasts that will ultimately release collagen and hold the anastomosis together. This layer should be fully incorporated in the anastomosis.
Inverted vs everted anastomosis of intestine debate has been long going on, but now many prefer inverted because mucosa is exposed to mucosa and eventually degrades, joining the two submucosa layers together to cause healing by primary intention.