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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Correct Answer - A
Answer- A. Release of epinephrine

The major hemodynamic abnormality in hypovolemic shock is decrease in preload.

The immediate physiological response of the body to the sudden decrease in volume (preload), is a release of catecholamines (epinephrine, norepinephrine).

The subsequent increase in heart rate and contractility help maintain
cardiac output

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Correct Answer - D
Answer is 'd' i.e. Fluid loss

Postgastrectomy complications

Anemia as a result of vitamin B12 or iron malabsorption and
osteoporosis.

Iron deficiency anemia develops because removal of the stomach
often leads to a marked decrease in the production of gastric acid.

Osteoporosis develops as a result of poor calcium absorption,
another problem that occurs after gastric surgery.

Dumping syndrome
Diarrhoea- may be due to different reasons. associated with
dumping syndrome post-vagotomy diarrhoea associated with fat
malabsorption.

Fat malabsorption leading to steatorrhoea occurs due to acid
inactivation of pancreatic enzymes or poorly coordinated mixing of
food & digestive juices. Fat malabsorption leads to malabsorption of fat soluble vitamins i.e. A,D,E & K.

Pushing food from your stomach to your small bowel too quickly
(dumping syndrome)
Acid reflux
Chest infections, including bronchitis and pneumonia
Internal bleeding
Nausea and vomitingStomach acid leaking into your esophagus, causing scarring and narrowing (stricture)
Vitamin deficiencies
Weight loss

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Correct Answer - C
Ans. C: S.lipase

Serum markers for diagnosis of acute pancreatitis:
Alanine transaminase-Associated with gallstone pancreatitis; three
fold elevation or greater in the presence of acute pancreatitis has a positive predictive value of 95 percent in diagnosing acute gallstone pancreatitis

Amylase
Most accurate when at least twice the upper limit of normal; amylase
levels and sensitivity decrease with time from onset of symptoms

C-reactive protein
Late marker; high levels associated with pancreatic necrosis

Lipase
Increased sensitivity in alcohol-induced pancreatitis; more

specific and sensitive than amylase for detecting acute pancreatitis

Phospholipase A2
Associated with development of pancreatic necrosis and pulmonary
failure detection of severity; high concentrations in infected necrosis

Trypsinogen activation peptide
Early marker for acute pancreatitis and close correlation to severity

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