Bile leak after lap Cholecystectomy
Q) 60 year old female undergoes lap cholecystectomy and is discharged She comes back 8 days later with pain abdomen, distension, fever and tachycardia. USG shows a 500 ml collection in Morrisons Pouch. Next step?
a) Conservative, I V antibiotics
b) USG guided drainage
c) LAP exploration and ligation of cystic duct stump
d) CECT followed by open exploration
# Free Questions on Bile ducts
Ulcerative colitis Surgery in Young female
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.
Pyoderma Gangrenosum
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
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
Medullary thyroid cancer – Management
Biopsy shows medullary carcinoma. No neck nodes are seen on USG. What is the management?
Carcinoma Breast with brain metastasis
Q) Known case of Ca breast presents with headache and signs of raised ICT. Solitary brain metastasis is confirmed on CT scan. How will you manage initially
a) Steroids
b) Mannitol
c) Surgery
d) Both steroid and Mannitol
Carcinoma Breast and Pregnancy
🔍 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
Epigastric mass
Q) 8year old male child with h/o fall 2 months back with epigastric mass now. What is the likely diagnosis ? # NEET SS 22
a) Peritoneal inclusion cyst
b) Gastric duplication cyst
c) Liver haemangioma
d) Pseudocyst of pancreas
Anal malformation
🔍 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