NEET 2018

Bleeding on Clopidogrel

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Q)  Patient on Clopidogrel has  Intraop bleeding  Which component will you transfuse to control it? ( #NEET 2018)

a) Platelets
b) FFP
c) Cryoprecipitate

d) PRBC

Ans ) A, platelets

Patients on clopidogrel who are actively bleeding and undergoing major surgery may require almost continuous infusion of platelets during the course of the procedure. Arginine vasopressin or its analogues (DDAVP) have also been used in this patient group

Platelet shelf life is 5 days and stored at temp of -24

Bailey 27th 

 

Bile duct injuries in cholecystectomy

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Q True about Bile duct injuries in cholecystectomy

a) Only 15% are recognized at the time of surgery

b)Routine  Operative cholangiography  definitely reduces the incidence of bile duct injury

c) In incomplete obstruction of bile duct,  jaundice occurs early

d) Surgical outcome depends on timing of surgery

Answer for premium members

After cholecystectomy complications can occur in 15%. Identification and management of bile duct injuries is very important. This question and subsequent discussion has been routinely asked in many exams

FNH _ Focal Nodular hyperplasia

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Q) Which of the following statements about focal nodular hyperplasia (FNH) of the liver is true?

a) A central scar is present in all cases
b) Fine-needle aspiration cytology (FNAC) is usually diagnostic in doubtful cases
c) Resection is recommended due to risk of malignant transformation
d) Asymptomatic patients with typical radiologic features usually do not require treatment

d) Asymptomatic patients with typical radiologic features usually do not require treatment

  • Focal Nodular Hyperplasia (FNH) is a benign liver lesion, often found incidentally.

  • a) Central scar is present in all cases – Incorrect. While a central stellate scar is characteristic of FNH, it is not present in all cases (seen in ~50-70% on imaging).

  • b) FNAC is usually diagnostic – Incorrect. FNAC often provides inconclusive results in FNH. Histological diagnosis requires tissue architecture, which FNAC can't reliably provide.

  • c) Resection is recommended due to risk of malignant transformation – Incorrect. FNH has no malignant potential and rarely causes complications. Surgery is not routinely recommended unless symptomatic or diagnosis is uncertain.

  • d) Asymptomatic patients with typical radiologic features usually do not require treatment – Correct. FNH with typical imaging features (especially on MRI with hepatobiliary contrast agents) does not require biopsy or surgical intervention.

Carcinoid appendix

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Q) In Carcinoid appendix, False  statement is

a) It is the most common tumor of the appendix

b) Less than 1% of the overall  appendectomy specimens have carcinoid tumor

c) Size of the lesion is a good predictor of  malignant behavior

d)  Mostly carcinoid appendix are seen in the base of appendix

Answer

 

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