Ischemic Arterial Diseases MCQs

Phyllodes tumour (Serocystic disease of Brodie or Cystosarcoma phyllodes) - Benign Usually occur in women over the age of 40 years but can appear in younger women. They present as a large, sometimes massive tumour with an unevenly bosselated surface . Occasionally, ulceration of overlying skin occurs because of pressure necrosis. Mobile on the chest wall Only very rarely develop features of a sarcomatous tumour. These may metastasise via the bloodstream. Treatment Treatment for the benign type is enucleation in young women or wide local excision . Massive tumours, recurrent tumours and those of the malignant type will require mastectomy. Reference : Bailey & Love's short practice of surgery, chapter: 58, Edition: 28 th , Pg: 922-923

Radiology. CTE or magnetic resonance enterography (MRE) are often used as the initial assessment of Crohn disease to complement direct ileocolonoscopy. Imaging studies can provide information regarding severity of inflammation, length, and focality and identify complications (e.g., obstruction or fistula). In addition, these studies support surgical planning and the evaluation of response to medical therapy. Previously, barium enema was commonly used to identify features of Crohn For example, long lengths of narrowed terminal ileum (Kantor string sign ) may be present with long-standing disease. Segmental and irregular patterns of bowel involvement may be Fistulas between adjacent bowel loops and organs may be apparent Reference : Sabiston textbook of Surgery, chapter: 50, Edition: 21 st , Pg: 1263

Explanation: ABPI - ankle-brachial pressure index is the ratio of the systolic pressure at the ankle to that in the ipsilateral arm. It is interpreted as the highest pressure in the dorsalis pedis, posterior tibial or peroneal artery serving as the numerator, with the highest brachial systolic pressure being the denominator. Patients with an ABPI of 0.50, and a deteriorating ABI is predictive of future limb loss. Interpretation of various measurements of ABPI is as follows: ≥0.9 - normal (Option A ruled out) 7-0.9 - mild arterial disease (claudication may be absent or mild) (Option B ruled out) ~0.5 - suggests critical ischemia / rest pain may occur (Option C ruled out) It should be noted that low ABPI reflects very poor distal perfusion. When ABPI drops below about 0.3 the perfusion is insufficient to sustain tissue and necrosis/gangrene is imminent. Key takeaways: ABPI .