Surgery 3. Malignant Pancreatic Disorder

Question 1

Pancreatic ductal adenocarcinoma 
Risk factor :- 
Not a risk factor :- 
MC gene mutated :- 
MC histologycal type :- 

Periampullary cancer 
Group of ,,,,cancers situated within ,,,,cm of ampullary opening :- 
1. 
2. 
3. 
4. 
MC is :-

Answer 1

333

Question 2

MC presentation of CA of head off pancreases & periampullary CA :-
1.
2.

Answer 2

334

Question 3

Courvoisers laws :- 
Exception to courvoisers law :- 
1. 
2. 
3. 
PNS seein pancreatic cancer :-

Answer 3

334

Question 4

IOC for CA pancreas :- 
On MRCP/ERCP :- 
X-ray show :- 
Duodenography shows :- 
IOC for staging :-

Answer 4

334

Question 5

CA pancreases imaging signs 
On ERCP :- 
1. 
2. 
On barium meal 
1. 
2. 
3.

Answer 5

334

Question 6

Best Tumor marker for CA pancreases :-

Answer 6

334

Question 7

Best method to obtain tissue diagnosis in CA pancreases :-

Answer 7

334

Question 8

Staging of CA pancreases :-

Answer 8

334

Question 9

Management of CA pancreases based on

1. Coeliac axis
2. Superior mesenteric artery involvement :-
3. SMV-PV junction :-
4. Common hepatic artery :-

Resectable tumor :-
Borderline resectable :-
Unresectable :-

Answer 9

335

Question 10

Surgery

1. In tail or body :-
2. In head :-
   a.
   b.

Surgery of choice for CA head of pancreases :-

Answer 10

336

Question 11

Whipples procedure 
Aka :- 
Aka :- 
Done only if 
1. 
2. 

Things removed in whipples procedure

Complication of whipples :-
MC complications :-
MC cause of death :- ,,,,,,,,MC in ,,,,,,,,
MC surgical complication :-

Answer 11

336

Question 12

Kochers Manuer :-

Answer 12

336

Question 13

Modified whipples :-
Aka :- PPPD
Aka :-

Incision given :-

Removal of
1.
2.
3.

Answer 13

336

Question 14

Chemotherapy in CA pancreases:- 
Nodal disease present :- 
T3/T4 :- 
Radiotherapy:- 
Most important prognostic factor :-

Answer 14

337

Question 15

Unresectable :- palliative in nature :-
Jaundice + pruritis :-
Jaundice + gastric outlet obstruction:-
Pain :-

Triple bypass include
1,
2,
3,

Answer 15

337

Question 16

Cystic neoplasm of pancreas,-
1.
2.

Answer 16

337

Question 17

More common in :- 
Age of female :- 
CEA :- 
Cells :- 
Cyst structure :- 
Locual :- 
Nature :- 
CT scan:- 
Management :-

Answer 17

337

Question 18

Introduction papillary mucinious neoplasm 
IPMN 
Sex :-
Triad for diagnosis :- ,,,,,,,,,,,triad 
1. 
2. 
3. 
Site mc :- 
Enzymes elivated :- 

Management l
Observation when :-
Respected when :-

Answer 18

338

Question 19

Insulinoma 
MC endocrine tumor of pancreases 
Cells :- 
Distribution:- 
Nature :- 
Encapsulated

Answer 19

338

Question 20

Triad of insulinoma is :-

Answer 20

339

Question 21

Whipples triad is for 
1. 
2. 
3. 
Gold standard for insulinoma :- 
1. 
2. 
C peptide analysis :- 
Localization best inv is :- 

Management

1. Enucleation when :-
2. If malignant than :-

Drug that decrease insulin secretion ,-

Answer 21

239

Question 22

Gastrinomas
Aka :-
MC pancreatic endocrine tumor in MEN 1 syndrome :-
MC site :-

Gastrinoma triangle aka ,,,,,,,,,,triangle :- 
1. 
2. 
3. 
Gastrinomas which lies outside :- 
% of malignant :- 

CF :- 
Zollinger Ellison triad
1. 
2. 
3. 

MC symptom 
Cause :- 
Asso with :- 
1, 
2, 
3. 
4. 

Diagnosis 
Serum gastrin level :- 
If less than :- 
Give :- 
Value :- 
Gastric ph :- 
Basal gastric output :- 

Localisation using :-
Best :-
All pt of zes should be tested for :-

Management 
Enucleation when :- 
Remove full wall thickness when :- 
Unresectable 
1,
2.
3. 

Pancreatic ZER :- large tumor :
If resectable : -

Answer 22

340

Question 23

Glucagnoma.:-
Tumor of :- 
Leads to :- 
1. 
2. 
3.
4.

Answer 23

341

Question 24

VIPoma 
Nature :- 
WDHA syndrome aka :- 
WD :- 
H:-
A:- 

Site :-

Answer 24

341

Question 25

Non functional pancreatic endocrine neoplasm :-
MC site :-
Nature :-
CF :-

Difference between functional and non functional

Management:- 
MC site of metastasis:- 
Metastatic disease :- 
1. 
2.

Answer 25

341

Question 26

Difference between pancreatic CA vs nonfunctional tumors 
Size :-
Marker :- 
Imaging feature :- 
Somatostatin receptor syntigraphy : -

Answer 26

341