Surgery

Question 1

Tumour markers for ovarian, pancreas.breast, prostate

Answer 1

Ovarian → ca125 
Pancreas → ca19-9
Breast → ca15-3
Prostate → PSA
CRC → CEA
HCC→ AFP

Question 2

Ca-125 is raised in

Answer 2

Ovarian ca
Menstruation
Pregnancy
PID

Question 3

Ca-19-9 is raised in

Answer 3

Pancreatic cancer
Biliary tract cancer
Cirrhosis
Cholestasis
Cholangitis
Pancreatitis

Question 4

Difference between biliary colic & cholangitis

Answer 4

Inflammatory component in cholangitis → local peritonism, fever, elevated WBC count

Question 5

Regurgitation of stale food

Answer 5

Zenker’s diverticulum

Question 6

Grading of spleen Trauma

Answer 6

Grade I - Laceration <1cm, Subcapsular Haematoma < 10%
Grade 2- Laceration 1-3 cm, Subcapsular Haematoma 10-50%
Grade 3 - Laceration >3 cm, Subcapsular Haematoma > 50% or ruptured Subcapsular or parenchyma Haematoma
Grade 4- Segmental or Hilar Vascular Injury and Devascukarization >25%
Grade 5 - Hilar Injury or Shattered Spleen

Question 7

Management Of Spleen Trauma

Answer 7

Grade I or II - Conservative Management and monitor Vitals, Serial 24 hour CECT, Measure Haematocrit
(If Grade increases then do angioembolization and if that fails or if there is unstable contrast blush then go for surgery - spleenorrhaphy
Grade III IF STABLE THEN SAME AS GRADE I ABD IF UNSTABLE THEN SAME AS GRADE IV
Grade IV or V - most patients are unstable - do FAST and Spleenectomy

Question 8

For how many months , elective surgery should not be performed after a myocardial infarction

Answer 8

6 months

Question 9

PrenatL signs of oesophageal atresia on Ultrasound

Answer 9

Polyhydramnios

Absent feta, stomach bubble

Question 10

Clinical presentation of oesophageal atresia at birth

Answer 10

Persistent Salivation
Drooling
Cough and chokes when fed
Distended abdomen
Cyanosis
Aspiration