THE vs TTE

by

Q. Trans hiatal esophagectomy as compared to trans thoracic anastomosis-
A More pulmonary complications
B Less  anastomotic leak
C ) Two field resection possible in THE

d) More pain

 

Colon Transposition

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Q . In colon transposition after esophageal resection which of the following is false? (AIIMS 2018)

a) It has a more robust blood supply

b) Chances of anastomotic leak are more

c) Ischemia at tip

d) Becomes redundant in long run

Pouchitis Disease severity index

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Q) Pouchitis disease activity index includes all except (AIIMS 2019)

a)  Fever
b)  Malaise
c)  Fecal urgency
d)  Bleeding PR

Pouchitis is commonly asked in AIIMS and JIPMER MCH exams. Previous year questions are here and here 

Ans b ) Malaise, Clinical data includes Frequency, urgency and rectal bleed

Summary of the PAS

Range
I. Clinical
 1. Stool frequency (0, 2, 4, 6)
 2. Fecal urgency (0, 3)
 3. Rectal bleeding (0, 3)
Maximal clinical subscore: 12
II. Endoscopic findings
 1. Oedema (0, 1)
 2. Granularity (0, 1)
 3. Friability (0, 1, 2)
 4. Erythema (0, 2, 3)
 5. Mucosal flattening (0, 2)
 6. Ulcerations/erosions (0, 2, 3)
Maximal endoscopic subscore: 12
III. Histological Acute inflammation
 1. Polymorphonuclear infiltration (0, 1, 2, 3)
 2. Ulcerations/erosions (0, 1, 2, 3)
Chronic inflammation
 1. Mononuclear infiltration (0, 1, 2, 3)
 2. Villous atrophy (0, 1, 2, 3)
Maximal (total) histological subscore: 12
Maximal total PAS: 36

 

Hypovolemic Shock

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Q) Which of the following is the correct physiological change during hypovolemic shock?

A)Increased cardiac output.

B)Decreased vascular resistance.

C)Decreased venous pressure.

D)Increased venous saturation.

Healing by Primary Intention

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Q)What is  false regarding the healing by  primary intention? ( # Gen surgery Wound Healing) 

A)Wound edges opposed.

B)Normal healing.

C)Usually done for dirty wounds

D)Minimal scar.

Answer-C

Primary intention,

Healing by primary intention is also known as healing by the first intention this occurs when there is an opposition of the wound edges

Secondary Intention

Healing occurs when the wound edges are not opposed immediately, which may be necessary for contaminated or untidy wounds.

Primary intention,

  • Would edges opposed
  • Normal healing.
  • Minimal scar.

Secondary intention,

  • Would leave open.
  • Heals by granulation, contraction and epithelialisation.
  • Increased inflammation and proliferation.
  • Poor scar.