Secondary hemorrhage after necrosectomy

Q) A patient develops a delayed hemorrhage 3 weeks after an open necrosectomy. Which of the following best describes the pathophysiology of this complication?

# Pancreas INI CET MCQs

A) Coagulopathy from systemic inflammatory response
B) Arterial pseudoaneurysm formation and rupture
C) Disseminated intravascular coagulation (DIC)
D) Portal hypertension due to splenic vein thrombosis

Cystic lesion of pancreas

Q_ A53 -year-old woman is found to have an incidental pancreatic lesion on abdominal imaging. CT scan reveals a microcystic mass with a central stellate scar located in the body of the pancreas. Cyst fluid analysis demonstrates low viscosity, and low levels of CEA, CA 19-9, and amylase. Which of the following is the most likely diagnosis?

A. Serous cystic lesion
B. Mucinous cystic lesion
C. Intraductal pancreatic mucinous neoplasm
D. Pseudocyst

Hereditary pancreatic cancers

Hereditary pancreatic cancers questions is asked many times in NEET SS and GI and onco Surgery CET 

Please understand the difference between x% lifetime risk of pancreatic cancer and x fold increase in risk as compared to normal population

  1. PRSS & SPINK 1 - Familial pancreatitis 40% lifetime increase . 50 fold increase as compared to Normal
  2. STK 11 - Peutz Jeghers - 100 fold increase in Pancreatic cancer . Also associated with lung, ovarian, breast, uterine, and testicular cancers
  3.  CFTR - cystic fibrosis - 30 fold increase
  4. Familial atypical mole and multiple melanoma syndrome (CDKN2A gene mutation). CDKN2A - 20 fold increase
  5.  BRCA 2 - 10 fold increase
  6. Lynch Syndrome  ( MLH) ( MSH) - 8 fold increase
  7. FAP APC gene - 4 fold

Pancreatectomy

Q) Not true about pancreatectomy?

a) Antecolic reconstruction slows gastric emptying.

b) Drains are routinely used after pancreatic resections and currently standard of care.

c) Drains increase infections and prolong hospital stay.

d) Presence of drain fails to reduce the need for interventional radiology.

Amylase and Lipase in Acute pancreatitis

Q) Which of the following is false regarding amylase and lipase in acute pancreatitis?
a) Amylase more than 3 times above normal indicates acute pancreatitis
b) Normal serum amylase does not rule out acute pancreatitis
c) Serum lipase is more specific than serum amylase
d) Serum amylase is more sensitive than serum lipase

MCQs on Pancreatitis 

Q) Why does amylase and lipase increase in pancreatitis?

A) They are released from the acinar cells of pancreas during injury

Q) When does serum amylase rise in acute pancreatitis?

A) Within the first 12 hours

Association of Hereditary pancreatic cancer

Q) Pancreatic adenocarcinoma genetic risk factors least responsible is ? ( AIIMS GI 2020) 
a) Peutz jeghers syndrome
b) Hereditary pancreatitis
c) FAMMM syndrome 

d) Cowden 

Pancreas Adeno carcinoma risk factors

Q) Wrongly matched Pancreatic Duct Adeno Carcinoma  risk factors :

1) Hereditary pancreatitis - PRSS1

2) FAMMM- ATM

3) PJS - STK 11

4) Hereditary breast and ovarian cancer - BRCA 2

 

Pancreas Transplant Exocrine drainage

Q) In Pancreas transplant,  for  drainage of exocrine secretions which of the following are used? ( #Pancreas MCQs)

a) Duodenojejunostomy

b)Urinary bladder  Cystostomy

c) Direct duodenal anastomosis

d) All the above

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