Racoon Eye

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Q) Racoon eye is seen in 

a) Head injury

b) Sub galeal haematoma

c) Sub conjunctival haemorrhage

d) Nasal bone fracture

Answer free

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Q. The most common complication of Bevacizumab is
a) hypertension
b) Hyperglycemia
c) Rashes
d) Gastrointestinal perforations

Answer 

Whipple’s triad

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Q) Whipple's triad is seen in which pathological condition?

a) Insulinoma

b) Glucagonoma

c) VIPOma

d) Somatostatinoma

 

Answer 

a) Insulinoma

Whipple's triad is seen in pancreatic insulinoma and consists of 

a) Symptoms of hypoglycemia

b) Fasting sugar less than 50 mg%

c) Relief of symptoms with administration of dextrose solution

Other Points

  • Insulinoma is the most common functioning pancreatic neuroendocrine tumor
  • Symptoms are present for many years before diagnosis
  • Weight gain is common
  • Distribution of insulinomas is equal in body head and tail
  • Average size of insulinoma is 1-1.5 cm

Symptoms of Insulinoma

The neuroglycopenic symptoms of insulinoma included confusion, visual change, and unusual behavior

Sympathoadrenal symptoms may include palpitations, diaphoresis, and tremulousness.

Whipple's triad is just a part of Insulinoma and is not pathognomic of it. This entity may also be seen in other hyperinsulinemic conditions.

For endogenous Insulinoma, following tests are done

Proinsulin above 5.0 pmol/L

insulin above 3.0 pmol/L,

C-peptide above 0.2 nmol/L

all demonstrate endogenous hyperinsulinemia

In Memoriam: Allen O. Whipple, M.D

Choledochal cyst

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Q What is the management of choledochal cyst (bile duct cyst) adherent to portal vein?
a) Excision and Roux en y hepaticojejunostomy
b) Internal drainage into roux en y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the  external portion of the cyst wall intact.