TEF

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Q) which of the following statement is false with respect to most common type of TEF(tracheoesophageal fistula)?
A) type C with female predominance
B )proximal blind pouch ends one or two vertebral bodies from distal TEF
C) distal TEF is located 1cm above Carina
D) polhydraminos is often with isolated proximal atresia.

 

Post Whipple’s Bleeding

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Free MCQ
Q) A 50-year-old male undergoes Whipple pancreaticoduodenectomy. On post-op day 4, he develops fever, tachycardia, and pain. Ultrasound shows a collection in the lesser sac, which is drained percutaneously. On post-op day 10, 100 ml of frank blood is noted in the drain. What is the next best step?
✅ Correct Answer: a. CT angiography

🔍 Explanation:
This is an extraluminal bleed on the 10th POD, likely due to a pancreatic fistula. The earlier POD 4 symptoms indicate a leak, which can lead to pseudoaneurysm formation. CT angiography is crucial to identify the bleeding source and evaluate for vascular injury or pseudoaneurysm, which may be amenable to embolization.

- Emergency laparotomy is reserved for unstable patients or failed embolization.
- Flushing the drain or observation are inappropriate and potentially harmful in the setting of active bleeding.

🔗 For more MCQs on the pancreas, visit: www.mcqsurgery.com/pancreas

Acute Gastric dilatation

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Q) Not true about acute gastric dilatation (AGD) 

a) AGD is encountered most often as a postoperative complication in abdominal surgery 

b)Also seen in other  disorders, such as anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus 

c) When intragastric pressure from gastric distension exceeds 20 cm H2O gastric necrosis starts

d)  Clinical features are pain abdomen and effortless vomiting

 

VON Hipple

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Q)Von Hippel Lindau (VHL) causes all except
1. breast cancer
2. pancreas cancer
3. renal
4. hemangioma of cerebellum

 

Surgical Management of Zenker’s diverticulum

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Q) What is not true about management of Zenker's diverticulum

a) Both endoscopic and surgical repair give equivalent results

b) In complete  diverticulectomy, myotomy is not necessary

c) If diverticulum is less than 2 cm, myotomy is sufficient

d) In   diverticulopexy suture the diverticulum to the posterior pharynx as opposed to the prevertebral fascia 

Similar Question on zenker's diverticulum here

 

 

Post op pancreatic fistula

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Premium MCQ
Q) Regarding postoperative pancreatic fistula (POPF), which of the following is TRUE?
🔒 This answer and explanation are available to Premium Members only.
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Tumor lysis syndrome

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Q)Tumor lysis  syndrome which is not seen? (# Electrolytes MCQ) 

a. Hyperkalemia

b Hypocalcemia

c. Hypophosphatemia

d. Hyperuricemia

Ans is c

This syndrome  releases, various intracellular  metabolites such as uric acid, potassium and phosphorous which overwhelm the excretory capacities of the kidney.

The metabolic anomalies are

Hyperuricemia

Hyperkalemia

Hyperphosphatemeia

Hypocalcemia

It mostly occurs in poorly differentiated leukemias and lymphomas

Other facts

Tumor Lysis Syndrome Tumor lysis syndrome (TLS) is a life-threatening condition that can occur when cancer cells die. As the cells die, they release their contents into the bloodstream, which can lead to a number of complications.

TLS is most likely to occur in people with rapidly growing cancers, such as leukemia, lymphoma, and multiple myeloma. It can also occur in people with solid tumors, such as breast cancer, lung cancer, and pancreatic cancer.

 

Budd chiari syndrome

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Q  BCS true is

a) Hepatic venography needed for diagnosis

b) Triad of pain hepatomegaly and jaundice

c) Mesocaval graft thrombosis precludes liver transplant

d) In IVC  stenosis, splenorenal shunt can be used

Electrolytes

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Q) Chovstek sign with normal calcium seen in
a) Hypomagnesemia
b) Hypermagnesemia
c) Hyperphosphatemia

d) Hypokalemia