Hepatic adenoma

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Q Which of the following statement about hepatic adenoma is CORRECT?

a) It is more common in males

b) Ct shows a central stellate scar

c) Associated with cirrhotic liver

d) Risk of rupture and fatal hemorrhage is present 

Giving a clinical scenario of Hepatic Adenoma 

A 37 year old lady presents with right upper quadrant pain and nausea. She is otherwise well and her only medical therapy is the oral contraceptive pill which she has taken for many years with no ill effects. Her liver function tests and serum alpha feto protein are normal. An ultrasound examination demonstrates a 4cm non encapsulated lesion in the right lobe of the liver which has a mixed echogenicity and heterogeneous texture.

Colon Diverticulitis

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Q) A  65 year old lady presents with colon diverticulitis. ON CT Scan  She has colonic wall thickening and phlegmon .

Which grade of diverticulitis is it??   # NEET SS 23 MOck tests

a) Grade 0

b) grade I a

c) Grade I b

d) Grade ii

Spontaneous Pneumothorax

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Q) 15 year old boy, with Spontaneous pneumothorax. He is dyspneic with increased RR

Next best step

a) Vats and pleurodesis

b) Needle aspiration

c) Tube thoracostomy

d) Any of the above

Ans c

Primary spontaneous pneumothorax occurs in young patients without significant lung disease, whereas secondary spontaneous pneumothorax occurs in patients with COPD.

The most common cause of primary spontaneous pneumothorax is rupture of small apical blebs. Tube thoracostomy with water seal drainage is the usual first-line treatment of a moderate-to-large pneumothorax in a patient with a first-time occurrence.

Fuel for colonocytes

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Q) The principal energy source for colonocytes is:

✔ Free for all users

A. Glucose
B. Lactate
C. Butyrate
D. Long-chain fatty acids

✅ Answer: C. Butyrate

Butyrate is the primary fuel for colonocytes. It is a short-chain fatty acid (SCFA) produced by the colonic flora when fermenting complex carbohydrates. The colonic epithelium and luminal bacteria form a crucial symbiotic relationship where bacteria produce butyrate, which provides essential nutrition to the colonocytes.

Antibiotics disrupt this balance by reducing bacteria, leading to less butyrate, which negatively affects colonocyte function, often causing diarrhea.

🧠 Key Point: Butyrate, not glucose or lactate, is the key fuel for colonocytes, and its production relies on gut bacteria.

Teaching Points

  • Short-chain fatty acids (SCFAs): butyrate, acetate, and propionate are produced by bacterial fermentation of dietary fiber.
  • Butyrate provides ~70% of the energy requirements of colonocytes.
  • It promotes mucosal integrity, anti-inflammatory effects, and epithelial repair.
  • Reduced butyrate production is implicated in:
    • Antibiotic-associated diarrhea
    • Diversion colitis
    • Inflammatory bowel disease
  • High-fiber diets increase SCFA production and improve colonic health.

Why other options are incorrect

  • A. Glucose — minimal utilization by colonocytes compared to SCFAs.
  • B. Lactate — intermediate metabolite; not the primary fuel.
  • D. Long-chain fatty acids — absorbed mainly in the small intestine.

Explore More Colorectal MCQs

Colon Rectum

Claudication pain

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Q) 70 year old male has pain in right buttock on standing and gets relieved on sitting. What will be the next relevant  test to be ordered in him?

a) Doppler B/l lower limbs

b) MRI spine

c) Echo cardiography

d) Ankle Brachial Index

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