Malabsorbtive procedure in bariatric Surgery

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Malabsorptive Procedure in Bariatric Surgery | MCQSurgery
Q) Malabsorbtive procedure in bariatric Surgery
a) Biliopancreatic division
b) Roux en Y Gastric bypass
c) Sleeve gastrectomy
d) LAp band
Answer available only for Premium Members. Upgrade here.
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Colonoscopic stenting in Colon cancer

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Q) . Not a risk factor in colonoscopic stenting in colonic cancer causing obstruction
A. Short stricture of length <10 cm
B. Extrinsic compression
C. Treatment with bevacizumab
D. Strictures and obstructions at multiple levels

Answer

Bleeding on Clopidogrel

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Q)  Patient on Clopidogrel has  Intraop bleeding  Which component will you transfuse to control it? ( #NEET 2018)

a) Platelets
b) FFP
c) Cryoprecipitate

d) PRBC

Ans ) A, platelets

Patients on clopidogrel who are actively bleeding and undergoing major surgery may require almost continuous infusion of platelets during the course of the procedure. Arginine vasopressin or its analogues (DDAVP) have also been used in this patient group

Platelet shelf life is 5 days and stored at temp of -24

Bailey 27th 

 

Gastric pullup

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Gastric Pull-Up Mobilization MCQ | Esophageal Surgery

Gastric Pull-Up Mobilization MCQ – Esophageal Reconstruction

📘 Theme: Esophageal Surgery – Gastric Conduit Mobilization (NEET SS / INI-CET High Yield)

Gastric Pull-Up Surgical Technique MCQ

Which of the following is NOT a routine step in gastric pull-up mobilization during esophageal reconstruction?

A. Entering the lesser sac
B. Posterior mobilization of the duodenum
C. Dilatation of the esophageal hiatus
D. Ligation of the lesser curvature vessels

Answer: B. Posterior mobilization of the duodenum

Explanation

Gastric pull-up involves mobilization of the stomach to create a well-vascularized conduit for esophageal replacement. Important steps include entering the lesser sac, dividing relevant gastric attachments and vessels while preserving the right gastroepiploic vascular arcade, and enlarging the esophageal hiatus when necessary to facilitate passage of the conduit.

Posterior mobilization of the duodenum, performed by the Kocher manoeuvre, is not a routine essential step in standard gastric conduit mobilization. It may be performed selectively when additional duodenal mobilization is required.

Why other options are incorrect

  • A. Entering the lesser sac: Helps mobilize the greater curvature and provides access to the posterior surface of the stomach.
  • C. Dilatation of the esophageal hiatus: The hiatus may need enlargement to allow safe passage of the gastric conduit into the chest without compression.
  • D. Ligation of the lesser curvature vessels: Division of the left gastric vessels and relevant lesser-curvature attachments facilitates mobilization while preserving the right gastroepiploic artery as the principal blood supply to a standard gastric conduit.

High-yield teaching points

  • The right gastroepiploic artery is the principal vascular supply of a standard gastric conduit.
  • The left gastric vessels are divided during routine conduit preparation.
  • The Kocher manoeuvre mobilizes the duodenum and is performed selectively, rather than routinely, during gastric pull-up.
  • Avoid twisting, tension, or compression of the conduit during its passage through the hiatus.

Practice More Surgery MCQs

Caustic Injury to esophagus

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Q ) False regarding Caustic injury to Esophagus

a) Gastric lavage not done as it increases the chances of more injury

b) Neutralising  agents not given as it produces more injury than preventing it

c) Milk and albumin not given as it causes more damage

d) Activated charcoal not given as it doesn’t effectively absorb alkali

Check one more question on caustic injuries to esophagus here

Answer 

In  caustic injuries to the esophagus, early decisions have to be taken. The involvement of surgeon should be done early and patient should be placed under close monitoring.

Blind nasogastric and orogastric tubes should not be inserted and initially CT of chest and abdomen with contrast should be done to guide the subsequent procedures. Read on

 

Bile duct injuries in cholecystectomy

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Q True about Bile duct injuries in cholecystectomy

a) Only 15% are recognized at the time of surgery

b)Routine  Operative cholangiography  definitely reduces the incidence of bile duct injury

c) In incomplete obstruction of bile duct,  jaundice occurs early

d) Surgical outcome depends on timing of surgery

Answer for premium members

After cholecystectomy complications can occur in 15%. Identification and management of bile duct injuries is very important. This question and subsequent discussion has been routinely asked in many exams