This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Paralytic ileus is seen in -a) Spinal cord injuryb) Hypocalcemiac) Hypermagnesemiad) Uremia \nSelect and explain. \nA. b, B. ad, C. ac, D. ab', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Causes of Paralytic ileus \nPostoperative - a degree of ileus usually occurs after any abdominal procedure and is self-limiting, with a variable duration of 24-72 hrs. Post op ileus may be prolonged in the presence of hypoproteinemia or metabolic abnormality.\n\nInfection\n\nPeritonitis\nIntrabdominal abscess\nSepsis\nPneumonia\n\nElectrolyte abnormalities\n\nUremia\nHypokalemia\nHyponatremia\nHypomagnesaemia\nHypermagnesemia\n\nMedication\n\nAnticholinergics\nOpiates\nPhenothiazines\nCalcium channel blocker\nTricyclic antidepressants\n\nSpinal cord injury\n\nRetroperitoneal hemorrhage\n\nMyocardial infarction\nMesenteric ischemia\nHypothyrodism\nUreteric colic\n\n\nParalytic ileus is a state in which there is failure of transmission of peristaltic waves secondary to neuromuscular failure.\nThe resultant stasis leads to accumulation of fluid and gas within the bowel with associated distention, vomiting, absent or diminished bowel sounds and absolute constipation.\nRadiological picture shows dilated gas filled bowel loops with multiple air-fluid level.\nThe picture is similar to mechanical small bowel obstruction; the only differentiating point is presence of gas in colon and rectum in paralytic ileus.\nOther clinical differentiating features of paralytic ileus from mechanical small bowel obstruction are.\n\n\nPain - Pain is colicky in mechanical obstruction. Pain is not a feature of paralytic ileus and if present is a steady, diffuse pain.\nBowel sounds - Bowel sounds are hypoactive or absent in paralytic ileus in contrast to hyperactive bowel sounds in mechanical obstruction.', 'role': 'assistant'}]