Ulcerative colitis Surgery in Young female

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Ulcerative Colitis Surgery Choice
#AIIMS 2022 April
Q) Which surgery would be preferred to be done in young unmarried female with steroid refractory Ulcerative colitis and 15 bloody bowel movements per day?
a) TPC with IPAA
b) TPC with EI (end ileostomy)
c) TAC with EI (end ileostomy)
d) TAC with IRA (Ileo rectal anastomosis)
Ans b

The risk of infertility following IPAA was estimated to be approximately 50% compared with 15% among medically treated patients.

Given these data, many surgeons advocate for a three-stage procedure in which subtotal colectomy with end ileostomy is performed and IPAA is deferred until childbearing is completed.
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Pyoderma Gangrenosum

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Q) Which of the following systemic disease is not associated with Pyoderma Gangrenosum ?

a) Rheumatoid arthritis

b) Inflammatory bowel disease

c) Non Hodgkin disease

d) Sjogern syndrome

Pancreas transplant

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Q) Most common indication for pancreas transplant

a) Type II DM 

b) Type II DM with nephropathy

c) Type I DM

d) Type I DM with nephropathy

d) Type I DM with nephropathy

Pancreas transplantation is typically performed for individuals with Type 1 diabetes who also have end-stage renal disease, often requiring kidney dialysis. This combination of kidney failure and Type 1 diabetes makes pancreas transplantation a viable treatment option.

SPK is the most frequently performed procedure for patients with type 1 diabetes and renal failure due to diabetic nephropathy.

There is a small population of patients with type 1 diabetes with renal failure due to primary renal disease or non-diabetic causes and they are also included in this group.

 

Medullary thyroid cancer – Management

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Thyroid MCQ
Q) 42 year old Male patient with 1 cm nodule in Right side of Thyroid.

Biopsy shows medullary carcinoma. No neck nodes are seen on USG. What is the management?
a) Total thyroidectomy
b) Total thyroidectomy with central node dissection
c) Total thyroidectomy with lateral and central neck dissection
d) Right hemithyroidectomy
Thyroid MCQs Thyroid Mock test 1 Thyroid Mock test 2 Thyroid 3
Answer

Carcinoma Breast and Pregnancy

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MCQ on Breast Cancer Management in Pregnancy
Q) A 30-year-old female in the 2nd trimester of pregnancy has a 2 cm breast carcinoma with no axillary lymph nodes. What should be the management?
✅ Answer: D. Lumpectomy + axillary dissection + chemo

🔍 Explanation:
In this case, lumpectomy followed by axillary dissection and chemotherapy is the preferred management.

- Axillary dissection is ideally done after Sentinel Lymph Node Biopsy (SLNB) - Radiotherapy can be given after the termination of pregnancy if necessary. - Hormonal therapy can also be started after pregnancy if required. - There is no need to terminate the pregnancy unless absolutely necessary, as modern treatments can be administered with careful planning.

🧠 Key Point: **Axillary dissection** and **chemotherapy** are preferred, with the option for hormonal therapy after pregnancy.

📘 Reference: NEET SS 2022 Paper

Anal malformation

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MCQ on Newborn with Abdominal Distension
Q) Newborn with abdominal distension on day 2, not passed meconium. There is absent anal orifice. What is the next step? # NEET SS 22
✅ Answer: A. Cross table X ray

🔍 Explanation:
The first step in such cases is to rule out congenital abnormalities of the spine, sacrum, kidneys, and heart.

- The second step is a Cross-table X-ray. If the X-ray shows perineal fistula, perform Anoplasty.
- If the X-ray shows rectal gas below the coccyx, perform a PSARP (Posterior Sagittal Anorectoplasty) with or without a colostomy.
- If the X-ray shows gas above the coccyx with associated defects, perform a colostomy.

🧠 Key Point: Cross-table X-ray is crucial to determine the presence of rectal gas and other associated defects, guiding the next step in management.

📘 Reference: Table 67.14 Sabiston