Q) MC complication of kochs continent ileostomy (JIPMER)
a)Nipple valve retraction
b)Necrosis
c)Pouchitis
d)Obstruction
Head and neck SCC
Q) Which treatment regimen is commonly recommended for radiotherapy (RT) in patients with Head and Neck Squamous Cell Carcinoma (SCC)?
A. Concurrent
B. Adjuvant
C .Neoadjuvant
D. Sequential
Role Of PET Scan in CA Stomach
Q) What is not true about the role of PET scan in staging of carcinoma stomach?
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Skin grafting
Q) In preop evaluation before placing skin graft over wounded area…bacterial colony count must be less than
a) 10000
b) 100000
c) 1000000
d) 10000000
ans b) 10 raise to the power 5
In advanced surgical practice, the bacterial colony count is a critical factor when considering the placement of a skin graft over a wounded area. The threshold for bacterial contamination in the wound is typically 100,000 colony-forming units (CFU) per gram of tissue. If the bacterial count exceeds this limit, the risk of postoperative infection, graft failure, and delayed healing increases significantly.
This threshold is based on several key factors:
- Wound infection: A bacterial count above 100,000 CFU per gram is associated with a high risk of wound infection, which can lead to graft failure.
- Graft survival: A sterile or minimally contaminated wound is crucial for graft take. Any significant bacterial load can compromise the graft's survival due to the impaired healing environment.
Prerequisites for skin grafting:
The recipient site should be assessed for potential bacterial load, blood supply,
presence of devitalized tissue, and exposed vital structures.
Donor site availability
Perform recipient site tissue culture if history or concern for infection (counts <100000
CFU/g tissue for most pathogens required before grafting).
Presence of group a beta heamolytic streptococci is absolute contraindication for skin grafting
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More questions on Plastic surgery
Pancreatic Neuro Endocrine tumor (Pnet)
Q) Genetic disease not associated with Pancreatic neuro endocrine tumor is
a) MEN1
b) VON Recklinghausen disease
c) Von Hipple Lindau disease
d) Lynch Syndrome
Black Esophagus
Q) The black esophagus most commonly presents as
a) Chest pain
b) Hematemesis
c) Incidental
d) None
Highly selective vagotomy
Q) False about highly selective vagotomy? (# Gastric Surgery MCQS) (# Questions on Esophagus)
a) Highly selective vagotomy divides the vagus nerves supplying the acid-producing portion of the stomach
b) Incidence of postoperative complications is lower.
c) The criminal nerve of Grassi should be severed
d) Crow's feet nerves are severed till below the GE junction
Ans - d
Highly Selective Vagotomy (HSV) only divides the last part of the nerves which supply the part of stomach which produces acid.
Anterior and posterior nerves of Latarjet are found and their terminal branches are severed from 7 cm proximal to the pylorus to 5 cm above the GE junction
Motor function of the stomach is not affected
Criminal nerve of Grassi is branch of posterior Vagus. It should be sought and cut. This nerve derives its name from the common mistake done during vagotomy. This nerve is often missed and responsible for recurrence of symptoms of Peptic ulcer disease. MOre
Vagus Nerve branches
- Anterior trunk: Gives branch to liver GB and bile duct and goes along the lesser curvature as the anterior nerve of Latarjet
- Posterior trunk: Sends branches to the celiac plexus and continues along the posterior aspect of the lesser curvature as the posterior nerve of Latarjet.
- Criminal Nerve of Grassi: The first branch of the posterior trunk, innervates the gastric fundus. Failure to divide this nerve during an acid-reducing surgery can lead to recurrent ulcers
- Crows Foot: The most distal branches of the anterior and posterior trunks and provides innervation to the antro-pyloric region. These branches are spared in a highly selective vagotomy (HSV)
Parasympathetics are vagally mediated using acetylcholine as the primary neurotransmitter.