Secondary hemorrhage after necrosectomy

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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
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Gall bladder stone with obstruction

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A 65-year-old male presents with abdominal pain, vomiting, and a history of multiple episodes of cholecystitis. X ray image is given below.

What is the most likely diagnosis?

Gall stone and intesinal obstruction

A. Acute cholecystitis
B. Gallstone ileus
C. Small bowel volvulus
D. Duodenal perforation

 

 

Answer: B. Gallstone ileus

Explanation:
Rigler's Triad consists of pneumobilia, small bowel obstruction, and an ectopic gallstone, which is diagnostic of gallstone ileus. This condition occurs when a gallstone enters the bowel through a biliary-enteric fistula, leading to mechanical obstruction.

A large gallstone (>2.5 cm) erodes through the gallbladder wall, creating a cholecysto-enteric fistula (most commonly into the duodenum).

The stone enters the bowel and may cause obstruction, most often at the ileocecal valve due to its narrow lumen.

The presence of air in the biliary tree (pneumobilia) results from communication between the biliary and intestinal tracts.

Surgery Instrument

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Q) Identify the instrument

 

 

 

 

 

 

 

a) Craniotome

b) Hudson Brace

c) Humby's knife

d) CUSA

Ans b

The Hudson brace is a manually operated surgical drill used in neurosurgery and orthopedic procedures. It consists of a hand-cranked mechanism with interchangeable drill bits for trephination or skull perforation.

Puzzle people by Thomas Starzl

Mitraclip

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Q ) A 68-year-old male with severe mitral regurgitation due to a prolapsed mitral valve is being evaluated for a MitraClip® procedure. Which of the following is a known limitation of the MitraClip® treatment?

A) It has a high risk of causing permanent heart valve failure.

B) Long-term durability of the device is uncertain, and its effectiveness may decline over time.

C) The MitraClip® is associated with increased risk of severe aortic stenosis.

D) The procedure is recommended for all patients with moderate to severe mitral regurgitation, regardless of surgical risk.

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Sestamibi in Parathyroid

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Parathyroid Sestamibi MCQ
Q) The sensitivity and specificity of sestamibi for parathyroid localization are reported to be 79% and 90%, respectively. Which of the following best describes a potential source of false positives in sestamibi imaging?
A) Parathyroid adenomas in patients with hyperparathyroidism
B) Thyroid nodules with high oxyphilic content, such as Hürthle cell nodules
C) Low mitochondrial content in thyroid tissues
D) Parathyroid glands in normal positions
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Theme from mock test on 16.2.25 — #parathyroid

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