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

Lymphatic Spread carcinoma Prostate

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MCQ on Most Common Lymph Node Involved in Prostate Carcinoma
Q) Most common lymph node involved in carcinoma prostate is
✅ Answer: A. Obturator

🔍 Explanation:
The most common lymph node involved in **prostate carcinoma** is the **obturator lymph node**.

Lymphatic spread may occur via lymphatic vessels that pass to the **obturator fossa**, along the sides of the rectum to the lymph nodes near the **internal iliac vein** and in the hollow of the sacrum.

Additionally, lymphatics pass over the **seminal vesicles** and follow the **vas deferens** for a short distance to drain into the **external iliac lymph nodes**.

From the retroperitoneal lymph nodes, the **mediastinal nodes** and occasionally the **supraclavicular nodes** may become implicated.

🧠 Key Point: **Obturator lymph nodes** are the first to be affected in prostate cancer due to the nature of lymphatic drainage from the prostate.

📘 Reference: NEET SS 2022 Paper

Testicular cancer

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Q) Which of following testicular cancer will increase Overall Survival  by Lymph Node  dissection?

a) Seminoma

b) Embryonal cell

c) Yolk Cell

d) Sertoli cell

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