2) Abdomen Flashcards
Hernia Surgery under G/A. Contraindicated in which patient?
a) CABG 3 Months Earlier
b) Patient On Warfarin
b) Patient on Warfarin
Patient presenting after CABG or PCI, these patients should be assessed in the same way as patients with Angina.
The risk of Peri-operative MI increases in patients with previous H/O MI. In these patient, elective surgeries should be postponed for 6 months. & Urgent surgeries can be postponed for 3 months.
Burst Abdomen Scenario with 1 cm Abdominal Defect. Treatment?
a) Retention Suture
b) Abdominal Binder
c) Open Stitches and do dressing
d) Absorbable Synthetic Mesh
e) Laparostomy
b) Abdominal Binder
1cm defect non symptomatic: conservative
1cm defect with pain surgery
1cm with signs of incarcerated hernia, emergency surgery
More than 1cm: surgery
Lumber Region mass increasing in size 12x12 cm lying posterior to the kidney with increased vascularity on U/S. FNAC showing malignant cells. Diagnosis?
a) Liposarcoma
b) Lymphosarcoma
c) Rhabdomyosarcoma
d) Ganglionoma
a) Liposarcoma
A 30 years male patient with umbilical pus discharge. Investigation of choice?
a) Sinogram
b) MRI
c) U/S
d) CT - Scan
a) Sinogram
Femoral Hernia palpable behind the femoral vessel is known as?
a) Laugier
b) Narath
c) Cloquet
d) Femoral Hernia
b) Narath Hernia
Bilateral Inguinal Hernia. Treatment of choice?
a) Laparoscopic Repair
b) Open Repair
c) Desarda Repair
a) Laparoscopic Repair
An obese patient with a huge Ventral Hernia is operated. He has H/O Hypertension. Now complaining of SOB. How to increase the Functional Capacity?
a) Raise Head side of bed + Chest Physiotherapy
b) Left Lateral Position
c) Analgesics
d) Facemask Ventilation
e) ETT
a) Raise Head side of bed + Chest Physiotherapy
A 2-year-old child having umbilical hernia. When to do surgery:
a) At 5 years of age
b) After few months
c) Observation
b) After few months
Post-perforated appendix laparotomy. Sero-sanguinous discharge after 1 week. O/E, there is 3 cm gap with gut loops visible. Management?
a) Bagota Bag
b) Wound Dressing with guaze
c) Abdominal Binder
d) Tension Sutures with Non-absorbable suture
e) Interrupted Sutures with Non-absorbable suture
d) Tension Sutures with Non-absorbable suture
In repair of inguinal hernia laparoscopically, we cover?
a) Femoral Ring
b) Myopectinate Line
c) Deep Ring
d) Myopectinate Orifice
d) Myopectinate Orifice
A patient presented with Obstructed Herina. Intra-operative findings show that gut is compromised. Best treatment:
a) Resection Anastomosis
b) Diverting Stoma
c) Herniorrhaphy
a) Resection Anastomosis
A female patient presented with sudden onset of pain in the groin which exacerbates on flexion & External Rotation of hip?
a) Obturator Hernia
b) Inguinal Hernia
c) Femoral Hernia
d) Perianal Hernia
a) Obturator Hernia
Female patient having a mass on lateral border of rectus sheath which decrease in size on lying down?
a) Spigelian Hernia
b) Rectus Sheath Hematoma
c) Lipoma
a) Spigelian Hernia
Newborn with Inguinoscrotal swelling on crying which reduces by itself. When to operate?
a) At 3 years of age
b) At 1 year of age
c) At 3 months
d) When have a weight of 10kg
c) At 3 Months
There is increased risk of strangulation so inguinal hernia should be repairs as soon as possible.
Laparotomy burst abdomen with gut lying the wound. Best treatment option?
a) Bogota Bag
b) Tension relieving suture
c) Simple Dressing
d) Skin Closure only
b) Tension Relieving Suture
Hernia Repair in which fascia transversalis is stitched to Cooper ligament?
a) Marcy Repair
b) Bassini Repair
c) Shouldice Repair
d) Mcvay Repair
e) Halsated Repair
d) McEvary Repair
- Marcy Repair: Fascia narrows the Deep Inguinal Ring
- Bassini Repair: Conjoined Ligament to Inguinal Ligament
- Shouldice Repair: Triple Layer Repair with Sutured Fascia Transversalis
- McEvary Repair: Fascia Transversalis with Copper Ligament
Guy with abdominal mass, raynauds phenomena, ureters pulled medially & hypertension. Deranged creatinine. Diagnosis?
a) Retroperitoneal Fibrosis
b) Scleroderma
c) SLE
a) Retroperitoneal Fibrosis
After Hernia Repair, patient presents with numbness on medial aspect of thigh & anterior scrotum. Nerve Injured?
a) Ilioinguinal Nerve
b) Genital branch of Genitofemoral Nerve
c) Femoral Nerve
A) Ilioinguinal Nerve
In totally extra-peritoneal inguinal hernia repair [TEP], the most important place to cover to prevent recurrence is:
a) Femoral Ring
b) Ilio-pectinate Line
c) Pubic Tubercle
d) Myopectinal Orifice of Fruchaud
d) Myopectinal Orifice of Fruchaud
In component separation, wound infection & early recurrence can be reduced by:
a) Preserve Rectus Perforators
b) Onlay Mesh
c) Inlay Mesh
d) Sublay Mesh
e) Large Subcutaneous flaps lateral to fascial defect
a) Preserve Rectus Perforators
Anterior Component separation involves creating space between:
a) Rectus and Anterior Rectus Sheath
b) External Oblique & Internal Oblique
c) Internal Oblique & Transverse Abdominis
d) Transverse & Peritoneum
e) Subcutaneous plane & External Oblique
b) External Oblique & Internal Oblique
In component separation, an incision is made over the bilateral external oblique aponeuroses forming musculofascial advancement flaps —> Allowing up to 10 cm of medial mobilization.
Incarcerated hernia. Treatment of choice?
a) Resection & Anastomosis
b) Stoma Formation
c) Herniorrhaphy
a) Resection & Anastomosis
In a case of strangulated femoral hernia, the best approach is?
a) McEvedy Approach
b) Inguinal Approach
c) Lockwood Approach
a) McEvedy Approach
Also known as High Approach
1) McEvedy Approach/ High Approach: TOC in Strangulated Femoral Hernia
2) Lockwood Approach/ Low Approach: TOC in Simple Femoral Hernia [No risk of Bowl resection]
3) Lotheissen Approach/ Inguinal Approach:
Type fo Inter-parietal hernia?
a) Ritcher’s Hernia
b) Naraths Hernia
c) Spigelian Hernia
c) Spigelian Hernia
Interparietal hernias are rare abdominal defects where intraabdominal contents protrude between layers of the abdominal wall. Interparietal hernias present a diagnostic challenge because the superficial layers of the abdominal wall remain intact and obscure the physical exam.
A Patient with hernia PF2. What does it tells?
a) Primary Femoral with defect of 3 cm
b) Primary Femoral with defect of 2 cm
c) Primary Female Femoral with defect of 3 cm
d) Primary Female Femoral with defect of 2 cm
a) Primary Femoral with defect of 3 cm
A 55 year-old-male came to your clinic with H/O Recurrent B/L inguinal hernia. He was initially operated in a DHQ Hospital. Now the patient wants surgery at any cost. What is the treatment of choice?
a) Lap Hernia Repair
b) Open Hernia Repair
c) Dessarda Repair
d) Stoppa’s Repair
A) Lap Hernia Repair
History of Abdominal Trauma, Intra-abdominal pressure is 25 mmHg. Best treatment option?
a) Tension Relieving Suture
b) Facial Closure
c) Bogota
d) Left Open Vac dressing
c) Bogota
Patient underwent laparotomy. Postoperatively he developed wound dehiscence with small bowel visible at lower most part. Appropriate Management:
a) Daily Dressing
b) Mesh Application
c) Exploration under G/A
d) Bogota Bag
e) VAC Dressing
e) VAC Dressing
You are doing surgery for strangulated hernia and once you saw the sac, you find constriction is at external inguinal ring. Now what will you do next?
a) Open the External Ring
b) Open the Sac
c) Open Inguinal Canal
d) Open Deep Ring
b) Open the Sac
A patient presented with H/O GERD. On OGB, Squamo-columner Juction has moved 3 cm proximally. Diagnosis is?
a) Sliding Hiatal Hernia
b) Barret’s Oesophagus
b) Barret’s Oesophagus
A patient presented with CA Oesophagus. CT-Scan shows that there is 90 Degree Aorta Effacement. This means that?
a) Involved
b) Not Involved
a) Involved
Patient with Oesophageal mass abutting 90 degree of Aorta. T Stage will be?
a) T3
b) T4a
c) T4b
c) T4b
A patient presented with Oesophageal CA which is located 22-23 cm from the incisors. What will be the appropriate surgical technique for this patient?
a) Ivor Lewis Oesophagectomy
b) Mckeown Oesophagectomy
c) Transhiatal Oesophagectomy
b) Mckeown Oesophagectomy
Treatment of choice for Achalasia?
a) Laparoscopic Heller’s Myotomy
b)Botulinum Toxin Injections
c) CCB
a) Laparoscopic Heller’s Myotomy
A patient with Oesophageal Perforation. Diagnostic Investigation is?
a) Barium Swallow
b) Endoscopy
c) CECT
c) CECT
During left thoracotomy for Oesophagectomy, Diaphragm is divided:
a) Circumferentially
b) Axially
c) Not Divided
a) Circumferentially
Retrosternal Pain after heavy meal is most likely due to?
a) Boerhaeve Syndrome
b) Cardiac MI
a) Boerhaeve Syndrome
A 40-Year-old patient presented with dysphagia to both solids & liquids, More to liquids. Contrast studies showing Bird-beak appearance. Treatment would be:
a) Botulinum Toxin
b) Ballon Dilatation
c) Cardiac Myotomy
c) Cardiac Myotomy
A 75-Year-old lady presented to you at your clinic with the Oesophageal Carcinoma involving the lower one third. The patient also have comorbids. The management would be:
a) Stenting
b) Total Esophagectomy
c) Total Esophagectomy & Gastrectomy
a) Stenting
During esophagectomy, diaphragm is divided circumferentially to avoid injury to:
a) Vagus Nerve
b) Celiac Plexus
c) Phrenic Nerve
c) Phrenic Nerve
Barrett’s Oesophagus management is?
a) Endoscopic mucosal Resection
b) Surveillance Endoscopy
c) RFA
d) PPI Only
b) Surveillance Endoscopy after every 2 years.
Vomiting & Oesophageal tenderness + Subcutaneous Emphysema. Likely Diagnosis?
Oesophageal Perforation