Surgery videos & books

2024-05-25 18:28:01 Correct Answer - C
Ans. is c i.e., Develops from jugular lymphatic sequestration


Cystic hygroma
Cystic hygroma is a swelling usually occuring in the lower third of the neck

It is most commonly seen in posterior triangle of the neck, but may also occur in axilla, groin & mediastinum

It results due to sequestration of a portion of the jugular lymph sac
from the lymphatic system.


It usually manifests in the neonate or in early infancy (occasionally
present at birth) The swelling is soft and partially compressible and invariably increases in size when the child coughs or cries.

The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent.


...The cysts are filled with clear
lymph and are lined by endothelium.

Mostly these are multiple cysts but occasionally they can be
unilocular.
It may show spontaneous regression.
Treatment [Ref.: Sabiston 18/e p2053; Schwartz 9/e p1415]
There are two methods of

treatment: Surgical excision &
Sclerotherapy

Sabiston writes- "Complete surgical excision is the preferredtreatment; however, this may be impossible because of the hygroma
infiltrating within and around important neurovascular structures.
.
Because hygromas are not neoplastic tumors, radical resection with removal of major blood vessels and nerves is not indicated.


.Injection of sclerosing agents such as bleomycin or the derivative of
Streptococcus pvogenes OK-432 have also been reported to be
effective in the management of cystic hygromas. Intracystic injection of sclerosants appears to be most effective for macrocystic
hygromas, as opposed to the microcystic variety."


"The modern management of most cystic hygromas includes the
combination of surgical excision and image-guided sclerotherapy."-
Schwartz

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2024-04-24 00:18:01 Correct Answer - A
Ans. A. Amiodarone

V-Fib or VF is the most common rhythm that occurs immediately
after cardiac arrest. In this rhythm, the heart beats with rapid, erratic
electrical impulses.

Treatment:
Shock / Defibrillation: every 2 minutes in a single one shock,
successive, shockable increments
200 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)
300 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)
360 joules - Followed by immediate CPR for 2 minutes / give and
circulate a drug(s)


Drugs :
Give Epinephrine 1mg of a 1:10,000 solu,on every 3 to 5 minutes
[No Limit]
Give either:

Amiodarone [if not contraindicated, can be given 2x]: 300mg first
dose / 150mg second dose at 3 to


Lidocaine: First dose: 1mg/kg or 1.5 mg/kg. Can repeat it at half the
original dose up to a total of 3 mg/kg [Second and remaining doses
are given at either 0.5mg/kg or 0.75mg/kg depending on your star,ng dosage.]

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2024-04-11 10:03:01 Correct Answer - A
Answer- A. Biliary atresia

Kasai operation is also known as hepatoportoenterostomy.

Biliary atresia is currently MC indication for pediatric liver
transplantation.

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2024-03-15 11:53:01 Correct Answer - D
Ans. D: Ureterocele

The term ureterocele denotes a cystic ballooning of the distal end of the ureter.

This type of ureterocele is also termed orthotopic, since it
arises from a ureter with a normal insertion into the trigone.

An intravesical ureterocele results from the prolapse of the mucosa
of the terminal segment of the ureter through the ureterovesical
orifice into the bladder.

This prolapsed ureteral mucosa carries with it a portion of the
continuous sheet of the bladder mucosa around the orifice.

The prolapsed segment thus has a wall that consists of a thin layer of
muscle and collagen interposed between the bladder uroepithelium
and the ureter uroepithelium.

Since the terminal ureteral orifice is usually narrowed and partially
obstructed, and since there is no muscle support for the double
mucosal walls of the prolapsed segment, it dilates.

This dilated segment fills with urine and protrudes into the bladder.

On excretory urography, cobra head sign is classically seen with an
intravesical ureterocele.

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2024-02-29 19:42:01 Correct Answer - D
Ans. is 'd' i.e., Spontaneous rupture of oesophagus

Chilaiditi's syndrome : Condition characterised by inter position of
small or large bowel between liver and right diaphragm.

Radiologically it gives gas under diaphragm.

Iatrogenic pneumoperitoneum : Certain procedure like peritoneal
dialysis, Iatrogenically air pushed before putting PD cannula to avoid
injury of viscera in such case gas under diaphragm can be seen.

All cases when intestine or viscera preforat we can get gas under
diaphragm.

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2024-02-20 00:03:01 Correct Answer - D
Answer- D
Historically, the most common site of gastrointestinal (GI) carcinoid
tumors was the appendix.
Currently, however, the most common site of carcinoids in the GI tract is the small intestine (30%), followed by the rectum (19.6%).
In most studies, the appendix is only the third most common site of GI carcinoids, and in some studies, it is the fourth most common.

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2024-02-16 13:35:07 Correct Answer - D
Answer- D. 80

Routine use of noncontast CT Scan has completely revolutionized to
imaging evaluation of renal stone disease, nearly completely
replacing plain radigrpahs and X urography for diagnosis of acute
ureteral obstruction by renal stones.

Nephrolithiasis refers to the presence of calculi in the renal collecting system.

Nearly 10 % of the population will form a renal stone in their lifetime.
Sufficient calcium oxalate and phosphate is present in 80 % of the renal calculi for them to be radio-opaque on the plain radiographs.

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2024-02-08 17:21:01 Correct Answer - C
Ans. is c) i.e. depth of penetration of bowel walls

Schwartz writes
"Regional lymph node involvement is the most common form of
spread of colorectal carcinoma and usually preceeds distant metastasis or the development of carcinomatosis.

the T stage (depth of invasion) is the single most significant predictor of lymph node spread."

From the above given lines 'depth of penetration of bowel wall'
appears to be predictor of distant metastases as well.

CEA level is a marker for recurrance of colorectal ca after surgical resection.

Though its preoperative levels has some prognostic significance, it is
not a predictor for distant metastasis.

CEA level is used to follow up post operative cases of colorectal
cancer, for early detection of recurrence

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