Q) Which of the following is a clinical marker of myocardial ischemia
a) Troponin I
b) LDH
c) Alkaline phosphatase
d) CPK MB
Answer
Myocardial ischemia (MI) is an adverse risk factor precluding any major surgery. MI can be STEMI (ST segment elevated MI) or NSTEMI ( Non ST segment elevated MI) .................
Q) All are true about tropical pancreatitis except?
a. Associated with Tapioca.
b. Patients have large stones with fibrosis.
c. It is Pre Cancerous
d. Onset of disease at 50 years
Answer Free
Ans: d) Onset of disease is at young age
Tropical pancreatitis is an idiopathic disease that typically begins in teenage years. It is highly associated with diabetes and pancreatic duct calculi, and is prevalent in South India, Asia, Africa, and Central America.
Etiological factors:
Malnutrition
Cassava (Tapioca)
Hydrocarbon exposure
SPINK1 mutation
It is considered a precancerous condition. The IPSG data reports a 1.8% and 4% cumulative risk of pancreatic cancer at 10 and 20 years respectively in patients with chronic pancreatitis.
Augustine et al. reported an 8.3% incidence of pancreatic cancer in tropical pancreatitis — much higher than Western data.
Typical clinical picture:
A child, adolescent, or young adult with recurrent upper abdominal pain, diabetes mellitus, malnutrition, nutrient deficiencies, parotid enlargement, and pancreatic calculi visible on plain X-ray.
Lymphatic Drainage of Right Adrenal Gland | Adrenal Surgery MCQ
Q) Lymphatic drainage of Right adrenal gland is to
a) Para aortic group
b) Inter Aortocaval
c) Pre aortic
d) Para Caval
Correct Answer: d) Para-caval for right and Para aortic for left
Small lymphatic channels from both cortex and medulla drain into the hilum, from where larger calibre lymphatic emerge to drain directly into the lateral group of para-aortic lymph nodes.
Right side adrenal → Para-caval
Left side adrenal → Para-aortic
Arterial supply:
Superior adrenal artery (from inferior phrenic artery)
Middle adrenal artery (from abdominal aorta)
Inferior adrenal artery (from renal artery)
Venous drainage:
Left adrenal vein → Left renal vein
Right adrenal vein → IVC
Understanding lymphatic, arterial and venous drainage of the adrenal gland is critical in adrenalectomy and adrenal trauma surgery.
Q ) Most Common cancer of testis in children is a. Yolk sac tumor b. Leydig cell tumor c. Seminoma testis d. Choriocarcinoma
85) a, Yolk sac tumor
yolk sac tumor is the most common testicular tumor in infants and children. Teratoma is the most common tumor in prepubertal males. Yolk sac tumor is the testicular tumor with best prognosis.
Choriocarcinoma occurs in second and third decade and is highly malignant. Leydig cell tumor is the most common non-germ cell tumor of testis with bimodal distribution, first at 5-9 yrs of age and second incidence at 25-35 yrs of age.
Coronary arteries originate from ascending aorta, above the aortic valves from the aortic sinuses. Right coronary artery passes between the right atrial appendage and pulmonary trunk in the atrio ventricular septum and continues as .......................
Q) Which of the following is false in Capsule endoscopy
A. Sedation is not required
B. Accurate localisation possible
C. Not suitable for patients with stricture
D. Can visualise entire small bowel