Surgery videos & books

Ans is d

Ans is c

Correct Answer - C Total gastrectomy with adjuvant chemotherapy is the treatment of choice [Ref: Sabiston 18/e p1269 (17/c p1312); Harrison 17/e, p 573; Schwartz 9/e p935 (8/e, p981)] Stomach is the most common extranodal site of lymphoma. It is of two types - Primary & Secondary Primary gastric lymphoma - is lymphoma of the stomach which exhibits no evidence of liver, spleen, mediastinal lymph nodes or bone marrow involvement at the time of diagnosis (regional lymph node involvement may be present) Primary gastric lymphoma is mainly (>95%) Non-Hodgkin's lymphoma of B cell origin. Most of the primary lymphomas (about 60%) arise in MALT (mucosa associated lymphoid tissue). MALT is usually associated with chronic H. pylori infection. So low-grade MALT lymphomas are thought to arise because of chronic H. pylori infection. These low grade lymphomas may later on degenerate to high grade lymphomas Immunodeficiency and H. pylori infection are risk factors for B cell lymphoma. Most common site of involvement (like that of adenocarcinoma) is gastric antrum. Secondary gastric lymphoma Stomach is the most common extranodal site of systemic lymphoma. Almost all of them are Non-Hodgkins types Treatment The role of gastric resection is controversial. Recent studies have shown similar disease free 5 year survival rates in patients treated with surgery+chemotherapy+radiotherapy and patients treated with chemotherapy+ radiation therapy alone. (Most patients with high grade gastric lymphomas are now treated with chemoradiation alone, without surgical resection. For disease limited to the stomach and regional nodes, radical subtotal gastrectomy may be performed, esnecially for bulky tumors with bleeding and/or obstruction.) ommon chemotherapeutic regimen is - CHOP plus rituximab 5/676 stands for cyclophosphamide, doxorubicin, vincristine, & prednisole

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Correct Answer - C Ulcerated sebaceous cyst [Ref. Love & Bailey 23/e page 173, 595; Das text book of Surgery3/e p81] Repeat from May 04 Cock's peculiar tumour is a sebaceous cyst linked growth that can resemble a squamous cell carcinoma. The proliferating cyst is usually solitary, but it often arises from a simple trichilemmal cysts in the hair follicle epithelium

Correct Answer - D Pulsed dye Laser REF: Roxburgh's common Skin Diseases 17th edition page 194 & 205, Clinical Dermatology by John Hunter, John Savin & Mark Dahl 3' edition page 275 "Selective Photothermolysis or Pulsed dye laser is the treatment of choice for Portwine hemangioma" Port-wine stains are crimson blotches in which there is marked capillary dilatation compared to a capillary angioma, which is a red nodule or plaque containing proliferating endothelial cells. The latter tend to flatten and disappear at puberty. Larger ones may cause problems from bleeding and/or erosion. Cavernous haemangiomata are larger and compressible, containing large vascular spaces. Occasionally a port-wine stain of the trigeminal area is associated with a vascular malformation of the leptomeninges on the same side, which may cause epilepsy or hemiparesis (the SturgeWeber syndrome), or with glaucoma. Excellent results have been obtained with careful and time- consuming treatment with a 585-nm flashlamp-pumped pulsed dye laser. Treatment sessions can begin in babies and anaesthesia is not always necessary. If a trial patch is satisfactory, 40-50 pulses can be delivered in a session and the procedure can be repeated at 3-monthly intervals.

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Correct Answer - C Total gastrectomy with adjuvant chemotherapy is the treatment of choice [Ref: Sabiston 18/e p1269 (17/c p1312); Harrison 17/e, p 573; Schwartz 9/e p935 (8/e, p981)] Stomach is the most common extranodal site of lymphoma. It is of two types - Primary & Secondary Primary gastric lymphoma - is lymphoma of the stomach which exhibits no evidence of liver, spleen, mediastinal lymph nodes or bone marrow involvement at the time of diagnosis (regional lymph node involvement may be present) Primary gastric lymphoma is mainly (>95%) Non-Hodgkin's lymphoma of B cell origin. Most of the primary lymphomas (about 60%) arise in MALT (mucosa associated lymphoid tissue). MALT is usually associated with chronic H. pylori infection. So low-grade MALT lymphomas are thought to arise because of chronic H. pylori infection. These low grade lymphomas may later on degenerate to high grade lymphomas Immunodeficiency and H. pylori infection are risk factors for B cell lymphoma. Most common site of involvement (like that of adenocarcinoma) is gastric antrum. Secondary gastric lymphoma Stomach is the most common extranodal site of systemic lymphoma. Almost all of them are Non-Hodgkins types Treatment The role of gastric resection is controversial. Recent studies have shown similar disease free 5 year survival rates in patients treated with surgery+chemotherapy+radiotherapy and patients treated with chemotherapy+ radiation therapy alone. (Most patients with high grade gastric lymphomas are now treated with chemoradiation alone, without surgical resection. For disease limited to the stomach and regional nodes, radical subtotal gastrectomy may be performed, esnecially for bulky tumors with bleeding and/or obstruction.) ommon chemotherapeutic regimen is - CHOP plus rituximab 5/676 stands for cyclophosphamide, doxorubicin, vincristine, & prednisole

Tomosynthesis (3D mammography) performed along with conventional 2D mammography has high detection rates for breast carcinoma. Hence, among the given options, this is the best method. Breast Tomosynthesis: It is typically performed in conjunction with conventional mammography. Hence, the radiation dose is doubled. However, the accuracy is improved and false positives are lesser. It can be used for dense breasts and those with high risk factors. Screen-film mammography is the conventional 2D mammography. Digital mammography/full-field digital mammography uses digital technology instead of films. The diagnostic accuracy is similar to that of screen-film mammography. A minor advantage is the greater accuracy in predicting lesions in dense breasts. Note: Overall, the best modality for detecting breast carcinoma is MRI.

Category/score 0 in BIRADS suggests incomplete assessment.