Cystic Neoplams of Pancreas Important points

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Important points on cystic neoplasms of pancreas

From NEET Questions and discussions

  1. Old age and no history of pancreatitis, it is cystic neoplasm of pancreas
  2. Most common is SCN followed by MCN and IPMN
  3. OLd patient with dilated duct, cystic neoplasm is IPMN
  4. The most important point of differentiation in cystic neoplasms is whether the epithelium is serous or mucinous.
  5. All mucinous cystic lesions should be resected; lesions < 2 cm remain controversial.
  6. Mucinous  neoplasm in middle aged female, body and tail of pancreas
  7. Creeping Resection is for IPMN Intraoperative frozen sectionsin  the management of IPMNs.  If margins are positive for adenoma or borderline atypia with minimal cytoarchitectural atypia and gastric/foveolar-type epithelium, no further resection is required. If instead they are positive for invasive carcinoma, carcinoma in situ, or borderline atypia exhibiting florid papilla formation, further resection is warranted, if feasible.In such instances, further “creeping” resection toward the head for a tail lesion, or toward the tail for a head or uncinate process lesion, can often be sufficient.

Gastrinoma

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Q) True about gastrinoma is 

a) At the time of diagnosis most are benign and only 20% are malignant

b) In Pancreas most tumors  are confined to the body and tail

c) All cases of gastrinoma should be screened for MEN 1

d) They are highly malignant and even after complete resection 5 year survival is 30%

Another Mcq on gastrinoma

Abdominal Aortic Aneurysm (USMLE)

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Abdominal Aortic Aneurysm (AAA) 

Splenic artery Aneurysm                         General Surgery                                   Free Questions                                           

Age - 60 years

Sex - Male

Who are at risk - Smokers, Hypertension 

Specific Questions - Associated with Ehler Danlos and MArfan Syndrome - So common in families

Read more

Intestinal Tuberculosis

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False about Intestinal TB - MCQ

Q) Which of the following statements about intestinal tuberculosis is false?

1. Hyperplastic type commonly causes colonic strictures
2. Raised inflammatory markers, anemia, and positive sputum culture support the diagnosis
3. Barium meal follow-through may show a pulled-up cecum
4. Interferon-gamma release assay is diagnostic

Answer: A) Strictures are of the small bowel, not the colon

Explanation:

Intestinal tuberculosis occurs in two main forms:

1. Ulcerative type – Characterized by transverse ulcers with undermined edges, and the serosa is studded with tubercles. This represents a more severe form of the disease.

2. Hyperplastic type – Involves hyperplasia and thickening of the terminal ileum. It leads to narrowing of the lumen, stricture formation, and fibrosis of the terminal ileum, not the colon.

Other key points:

  • Raised inflammatory markers and anemia are commonly seen.
  • Interferon-gamma release assays help in detecting subclinical infection but are not diagnostic.
  • Barium meal follow-through typically shows a pulled-up or subhepatic cecum.
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Pseudocyst Pancreas

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Q) True about pseuodocyst of the pancreas is ? ( Questions in pancreas) 

a) It is lined by epithelium and collagen

b) Spontaneous regression occurs in less than 50% of cysts

c) Symptoms occur in more than 50% of case

d) Transduodenal endoscopic drainage IS  safe and effective approaches for patients with pancreatic pseudocysts in close contact (defined as less than 2 cm) 

LES pressure

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Q) All are associated with increased LES  pressure except

a) Substance p
b) Gastrin
c) Secretin
d) Motilin

Metabolic Acidosis

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Q) Regarding Metabolic acidosis true statement is ?

a) Initial compensation is by kidneys

b) Best management is by bicarbonate infusion

c) Most common surgical cause of acidosis is hypovolemia

d) Resuscitation should be with nor adrenaline