Q) Which of the following is not a lab finding of acute mesenteric ischemia?
a) Leukocytosis
b) Acidosis
c) High Amylase
d) Transaminitis
Jejunum
Small bowel diverticulum
Q) False about epidemiology of Small bowel diverticulum ( Questions on Jejunum)
a) Duodenal diverticulum is symptomatic and appear before 40 years
b) Jejuno ileal diverticula are less than 5%
c) Most common congenital anomaly of SI is Meckel
d) All correct
Small Intestine diverticulum
Q) Small intestine diverticula true statement is
a. Meckel is Most common and jejuno ileal is least common but most symptomatic
b. Meckel is true and congenital and rest are false and acquired
c. 1-5 % Duodenal ones require endoscopic or surgical treatment
d. All Meckel’s resected unless strong Contraindication is there
Intestinal Tuberculosis
Q) Which of the following statements about intestinal tuberculosis is false?
1. Hyperplastic type commonly causes colonic strictures
2. Raised inflammatory markers, anemia, and positive sputum culture support the diagnosis
3. Barium meal follow-through may show a pulled-up cecum
4. Interferon-gamma release assay is diagnostic
Answer: A) Strictures are of the small bowel, not the colon
Explanation:
Intestinal tuberculosis occurs in two main forms:
1. Ulcerative type – Characterized by transverse ulcers with undermined edges, and the serosa is studded with tubercles. This represents a more severe form of the disease.
2. Hyperplastic type – Involves hyperplasia and thickening of the terminal ileum. It leads to narrowing of the lumen, stricture formation, and fibrosis of the terminal ileum, not the colon.
Other key points:
- Raised inflammatory markers and anemia are commonly seen.
- Interferon-gamma release assays help in detecting subclinical infection but are not diagnostic.
- Barium meal follow-through typically shows a pulled-up or subhepatic cecum.
Enteropathy in T cell lymphoma
Q. Not true about enteropathy in T cell lymphoma
a) It is an variant of intestinal lymphoma mainly in jejunum and ileum
b) Associated with coeliac disease
c) Perforation is frequently seen with ETL (Enteropathy T cell lymphoma)
d) This type of lymphoma is commonly seen
Ans. d
Enteropathy T cell lymphoma is an unusual variant of intestinal lymphoma. It is associated with celiac disease and responds to gluten free diet. It has a higher rate of perforations because of circumferential ulcers. It is commonly seen in jejunum and ileum
Ref- Schakelford Surgery of Alimentary canal pg 1205
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Indications of Small Bowel transplant
Q ) One of the following is not an indication for small bowel transplant?
a) Impending liver failure by PNALD
b) Multiple thromboses of central veins
c) Single episode of catheter-related infection requiring hospitalization in any year
d) single episode of fungal line infection
Ingested foreign bodies
Q) False statement about ingested foreign bodies is
a) Conservative management in most patients
b) Cathartic agents are part of conservative management
c) Sharp objects can cause perforation
d) Laparotom is indicated for obstruction