Achalasia pressures

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Premium Surgery MCQ | mcqsurgery.com
Q) All are true about achalasia except
A. Type 1 Achalasia is characterized by 100% failed contractions (DCI<100) and no esophageal pressurisation
B. Type 3 Achalasia has premature contractions in at least 20% swallows
C. IEM (Ineffective esophageal motility) is characterized by >20% ineffective swallows (DCI<450)
D. Patients with type 2 achalasia have the best response to therapy
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Juvenile Polyposis Coli

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Juvenile Polyposis Syndrome MCQ | NEET SS Surgery
COLORECTAL SURGERY MCQ | NEET SS

Juvenile Polyposis Syndrome

A 12-year-old boy presents with recurrent episodes of painless rectal bleeding and anemia. Colonoscopy reveals multiple juvenile hamartomatous polyps throughout the colon. Which of the following statements regarding this syndrome is FALSE?

A. It may be associated with a SMAD4 mutation.
B. It is associated with an increased risk of gastrointestinal malignancy.
C. The polyps are most commonly located in the ileum.
D. It is inherited in an autosomal dominant pattern.

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Juvenile Polyposis Syndrome: Important Exam Notes

Juvenile polyposis syndrome is an inherited gastrointestinal polyposis condition characterized by multiple juvenile hamartomatous polyps. Patients may present with rectal bleeding, anemia, abdominal symptoms, or complications related to polyp burden.

Genetics and inheritance

The principal genes associated with juvenile polyposis syndrome include SMAD4 and BMPR1A. The syndrome usually follows an autosomal dominant inheritance pattern.

Malignancy risk

JPS is associated with an increased risk of gastrointestinal malignancy, particularly colorectal cancer. Gastric cancer risk may also be increased. Appropriate surveillance and specialist assessment are important parts of management.

NEET SS exam takeaway

When a question describes a child with recurrent rectal bleeding and multiple juvenile hamartomatous polyps, consider juvenile polyposis syndrome. Remember the association with SMAD4 and BMPR1A, autosomal dominant inheritance, and increased gastrointestinal cancer risk.

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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?
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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