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Q Which of the following is not a criteria for diagnosing Sphincter of Oddi Dysfunction

a) Common Bile Duct  diameter more than 12 mm on USG

b) Decrease in Common Bile Duct  pressure after infusion of Cholecystokinin

c) Ampullary pressure more than 40 mm Hg

d) Delayed emptying of contrast from Common Bile Duct after ERCP

Answer Premium members

Strongest layer of the intestine

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Strongest Layer of Intestine MCQ - Surgery Exam Preparation
Q) Which is the strongest layer of the intestine?
a) Mucosa
b) Submucosa
c) Muscularis propria
d) Muscularis mucosa

Answer:

b) Submucosa is the strongest and most important layer for intestinal anastomosis. It has fibroblasts that will ultimately release collagen and hold the anastomosis together. This layer should be fully incorporated in the anastomosis.

Inverted vs everted anastomosis of intestine debate has been long going on, but now many prefer inverted because mucosa is exposed to mucosa and eventually degrades, joining the two submucosa layers together to cause healing by primary intention.

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Borrmann’s classification for ca stomach

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Q) According to Borrmann's Classification of Ca stomach Type II is?

a) Fungating

b) Polypoid

c) Ulcerative

d) Infiltrative

Borrmann’s pathologic classification of gastric cancer is  based on gross appearance.

Developed in 1926

Gastric carcinoma is divided into 5 types according to this classification

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Ans  c

Ulcerative with elevated borders

Borrmann’s classification is for advanced gastric tumors. 

It is useful to distinguish between advanced and early gastric tumors because in advanced tumors neo adjuvant therapy improves over all survival.

The gross appearance of advanced gastric carcinomas can be divided into

Type I for polypoid growth or fungating 

Type II for Ulcerated with elevated borders

Type III for ulcerating with invasion of wall

Type IV for diffusely infiltrating growth which is also referred to as linitis plastica 

Type V can not be classified

 

Ureteral injuries

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Q) A 24 year old male suffers low velocity gun shot wound in lower abdomen. On exploration there is a 1 cm segment loss of left ureter above the pelvic brim. Best management is :

a) Ureterocystostomy

b) Uretero ureterostomy

c) Ureterostomy

d) Ligation of ureter 

Endocrine cells of pancreas

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Q) Delta cells in the pancreas secrete

a) Insulin

b) Glucagon

c) Somatostatin

d) Secretin

Answer d

Somatostatin

Endocrine pancreas
Endocrine cells of pancreas

Pancreas- Endocrine functions

Beta cells form 65-80% of pancreatic endocrine cells and produce insulin

Alpha cells 12-20% and produce glucagon

Delta cells 3-10% and produce somatostatin

PP cells - Pancreatic polypeptide 1%

Somatostatin is an inhibitory hormone and inhibits most of the things

Esophagus perforation

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Q) A 45 year old man who has been drinking regularly for the past 15 years vomits after a large meal and complains of severe chest pain. Cardiac cause is ruled out and boerhavve's syndrome is suspected. Which of the following is not true about this condition

a) Gastrograffin tests will confirm the diagnosis

b) Perforation is most common in the left lower end

c) Exploration and full thickness suturing of perforation should be done

d) This condition has a high morbidity and mortality if not diagnosed at time

Answer for premium members  - Discussion on Boerhaave's syndrome