Blunt colon injury

by

Q) 45 year old male with 24 hour  old blunt colon injury is explored and found to have limited spillage of contents. There is no other intra abdominal injury. Haemodynamically stable.  He has received three units of blood transfusion. Ideal management at surgery would be ?

a) Resection and Anastomosis

b) Resection anastomosis with loop ileostomy

c) Resection and Hartmanns

d) Ileostomy

INI GI Surgery

Sabiston page 422

Distributive Shock

by

Q) What is not seen in Distributive Shock?

a) High central venous pressure

b) High Cardiac output

c) High Base deficit

d) High Mixed Venous Saturation

MCQs on Shock and Body Response 

Ans a 

In Distributive shock Systemic vascular resistance and venous pressure are low ( because of vasodilation)

All other parameters are high

Distributive Shock Symptoms

Vasodilation

Warm peripheries

Hypotension

Causes of Distributive Shock are

  1. Anaphylaxis
  2. High spinal cord injury
  3. Septic shock
  4. Toxic Shock Syndrome
  5. The distributive shock from adrenal insufficiency occurs due to decreased alpha-1 receptor expression on arterioles secondary to cortisol deficiency, which results in vasodilation. This is seen in patients on chronic steroids that are stopped suddenly.

 

Thyroid storm

by
Q) 40 year old lady was on anti thyroid medications which she stopped for 2 weeks.

She presented in emergency with high grade fever and hypotension (Thyroid Storm).

What is not a part of further management?
a) Oxygen
b) Beta blockers
c) Radio active Iodine
d) Lugol's iodine

Staging in Adenocarcinoma lung

by

Q) Patient with 2cm lung nodule , biopsy proven adenocarcinoma. CT shows hilar lymph node 1.5cm and left pleural effusion. Pleural fluid cytology is positive for malignant cells. What is the stage?

a. T1N1M0
b. T1N2M1
c. T4N1M0
d. T1N1M1