Quiz

Question :1 Auxillary orthotopic liver transplant is indicated donor

Metabolic liver disease
As a standby procedure until finding suitable donor
Drug induced hepatic failure
Acute fulminant liver failure for any cause

Question :2 All the following are associated with poor outcome after repair of Benign Bilairy stricture EXCEPT

Type 3 BBS
Early repair
External biliary fistula
End to end biliary anastomosis

Question :3 Following are risk factors for developing Gastric Adenocarcinoma except

Multifocal mucosal atrophy.
Intestinal metaplasia.
Partial gastrectomy.
PGDFRA mutation.

Question :4 Which of the following is not correct regarding pancreatic exocrine secretions?

Total daily volume of pancreatic secretion can be as much as 3 L.
Somatostatin inhibits pancreatic enzyme secretion.
CCK stimulates gallbladder contraction and inhibits pancreatic enzyme secretion.
Secretin released in response to duodenal acidification stimulates pancreatic water and bicarbonate secretion.

Question :5 Identify point shown below. Comment on below options

Along same line but at equal distance
At perpendicular intercept at midpoint
Lateral two-third and medial one-third
Lateral third with medial two-third

Question :6 A replaced right hepatic artery usually arises directly from

Gastroduodenal artery
Superior mesenteric artery
Right renal artery
Right gastric artery

Question :7 Favourable factors for spontaneous closure of Enterocutaneous fistula are all Except

Short tract < 2cm
Single fistula tract
Nonepithelised tract
Lateral fistula

Question :8 True statement regarding biliary ascariasis

Common in females
Antispasmodics should be avoided in acute phase as it prevents spontaneous migration of worms from biliary tree
Albendazole is the preferred antihelminthic in acute setting
Endoscopic sphincterotomy prevents reinvasion of bile ducts by worms

Question :9 SQUID is used to detect

Superior mesenteric Artery compression syndrome
Mesentric ischemia
Diverticulum
All the above

Question :10 Regarding the autoantibodies to Inflammatory bowel disease- False statement

pANCA positive for Ulcerative colitis
ASCA positive for Crohns disease
Both ASCA and PANCA will be positive for Crohns disease
Cerviciae antibody is positive in Crohns disease

Question :11 Ideal treatment for stricture in Crohns disease length more than 10 cm length is

Heincke mickulicz stricturoplasty
Finney stricturoplasty
Intestinal Bypass
Resection of segment

Question :12 Regarding metastasis in small intestine false statement is

Secondaries are more common than primary
Most common primary for extraabdominal primary is breast cancer
Small bowel involvement is by direct infiltration by other intra abdominal malignancies most commonly
Treatment is only as palliation by Bypass or resection in cases of obstruction

Question :13 Following CT scan picture showing” Whirl Pool sign” is seen in

Intusussception
Volvulus
Internal hernia
Polyp

Question :14 Type 3 Short bowel syndrome is

Jejunoileo colic anastomosis
Jejuno colic anastomosis
End jejunostomy
End Ileostomy

Question :15 With regard to adenocarcinoma of the small bowel, all of the following statements are correct except:

Small bowel adenocarcinoma is found in decreasing order of frequency in ileum, jejunum, and duodenum.
Villous adenomas of the small bowel are commonly found in the duodenum around the Ampulla of Vater.
Adenocarcinoma of the duodenum usually occurs earlier than small bowel adenocarcinoma elsewhere in the jejunum and ileum.
Villous adenomas of the duodenum are frequently associated with familial adenomatous polyposis.

Question :16 All are true statements regarding biliary atresia EXCEPT

Syndromic form of biliary atresia associated with maternal diabetes mellitus
Type III is the most common type
Affected infants characteristically have low birth weight
Triangular cord sign is 95% accurate in making the diagnosis

Question :17 Which of the following statements is true with regard to the arterial blood supply of the stomach?

Left gastroepiploic artery commonly arises from the left gastric artery.
Ligation of the left gastric artery can result in acute left-sided hepatic ischemia.
Stomach is extremely susceptible to ischemia because of poor collateral circulation.
Inferior phrenic & short gastric arteries provide significant blood supply to body of stomach.

Question :18 . Which of the following statements about a paraesophageal hernia is true?

It is associated with GERD
It does not pose a risk for incarceration and strangulation.
Diagnosis is not readily made with upper endoscopy.
It is usually caused by a traumatic injury.

Question :19 True regarding Autoimmune gastritis are all except

Antibodies to parietal cells and IF are seen in gastric secretions.
Serum pepsinogen concentration is increased.
Antral endocrine cell hyperplasia.
Achlorhydria.

Question :20 What percentage of blood flow to the liver is provided by the portal vein?

30%
50%
75%
90%

Question :21 Which of the following liver tumour has propensity to invade portal or hepatic vein ?

Cavernous hemangioma
Hepatocellular carcinoma
Focal nodular hyperplasia
Hepatic adenoma

Question :22 Sphincter of Oddi dyskinesia is characterized by all the following EXCEPT

Excessive retrograde contractions
Increase in the amplitude of contractions
Increase in the frequency of contractions
Paradoxical contractile response to cholecystokinin administration

Question :23 Not true regarding Gastric MALT lymphoma?

Gastric MALT lymphomas result from the monoclonal proliferation of B cells as a result of stimulation of a specific infecting strain of H. pylori.
Unresponsive gastric MALT lymphoma can usually be salvaged by gastric resection.
Chromosomal translocations and genetic mutations can predict failure of H. pylori treatment.
Less than 10% of gastric lymphomas have no associated H. pylori infection.

Question :24 A 42 years old male patient presents with intermittent episodes of severe, crushing chest pain that radiates to back and jaw. There was a history of dysphagia, no regurgitation & pain was showed repetitive, simultaneous, multipeaked high amplitude contractions of oesophagus. LES has normal pressure and shows normal relaxation. Most probable diagnosis is:

Zenker diverticulum
Nut cracker oesophagus
Achalasia cardia
Diffuse esophageal spasm

Question :25 False statement regarding Capsule Endoscopy is:

Able to accurately localise the disease
Visualisation of entire small bowel
Avoided in patient with small bowel strictures
Not require sedation

Question :26 A 50 years old female presents with chronic upper GI complaints. Upper GI endoscopy shows proliferating mass in the stomach and she was eventually diagnosed to have gastric carcinoma. During surgery, before approaching the stomach, lesser omentum is seen.Free edge of lesser omentum formed by:

Hepatic artery
Portal vein
Bile duct
All of the above

Question :27 Mallory Weiss syndrome mainly affects which artery?

Left gastric artery
Right gastric artery
Phrenic artery
Coronary artery

Question :28 If in inguinal hernia surgery, by mistake if mesh is sutured lateral and inferior to iliopubic tract patient presents with post-operative thigh pain on the same side? Which nerve is most commonly involved in this condition?

Lateral cutaneous nerve of thigh
Ilioinguinal nerve
Genitofemoral nerve
Obturator nerve

Question :29 Investigation of choice for acute appendicitis in children is

USG
MRI
CECT
X ray

Question :30 Venous drainage of esophagus is into

Azygous and inferior thyroid veins
Azygous, inferior thyroid and left gastric veins
Azygous, inferior thyroid and right gastric veins
Superior thyroid, inferior thyroid veins, azygous and hemi-azygous veins

Question :31 Most common variant in the blood supply of colon is

Absent right colic artery
Absent middle colic artery
Absent left colic artery
Absent superior rectal artery

Question :32 All of the following are part of mesorectal fascia except

Superior rectal vein
Inferior rectal vein
Para rectal nodes
Inferior mesenteric plexus

Question :33 Most important hormone that increases gallbladder contraction after a fatty meal is

Gastrin
Secretin
CCK
GIP

Question :34 A 50- year old male presents with large bowel type diarrhea and rectal bleeding. On sigmoidoscopy, a cauliflower like growth is seen in the rectum. Colectomy specimen on histopathology shows adenocarcinoma. Which of the following prognostic investigations is not required?

Microsatellite instability
C-MYC mutations
EGFR mutations
K-RAS mutations

Question :35 .Most common presentation of Abdominal Desmoid tumor is

Abdominal pain
Abdominal mass
Fever
Rectal prolapse

Question :36 A 60 year female presented with malabsorption. She has previous h/o radiation therapy for cervical cancer. Biopsy shows villous atrophy, crypt hypertrophy with lymphocytes in lamina propria. Most likely cause is

Celiac disease
Crohn's disease
Radiation enteropathy
Whipple disease

Question :37 A 66 year old female is posted for subtotal gastrectomy for adenocarcinoma. Important procedure related complication

Pneumothorax
Constipation
Hemolytic anemia
Bilious vomiting

Question :38 A patient with rectal carcinoma, histopathology report reads as – tumour involves muscle wall with no penetration and one of 13 lymph nodes show tumour. Modified Duke staging for this patient will be

A
B
C
D

Question :39 True about blunt abdominal injury

Small bowel is most likely to be transected in the distal ileum
Pancreatic duct injury causes raised serum amylase
Kidney is the most common organ involved
Liver laceration is rarely associated with rib fracture

Question :40 King’s criteria for poor prognosis in acetaminophen induced acute liver failure includes all except

Lactate >3.5 mg/dl
PTT >200 sec
Serum creatinine >3.4 mg/dl
pH <7.3

Question :41 Which among the following is invasive direct test to assess pancreatic function test

Fecal elastase test
Bentromide test
Lundh meal test
Pancreolauryl test

Question :42 A 33-Year-old woman presents to the emergency with diffuse, cramping abdominal pain, nausea and vomiting that began this morning. Abdominal pain is diffuse throughout and the patientalso describes her abdomen as looking slightly enlarged. She has a history of chronic pancreatitis, as well as a cholecystectomy and two cesarean sections. The patient states that she has had flatus but no bowel movements since pain began. On physical examination, there is diffuse abdominal distention and high pitched bowel sounds without rebound tenderness of guarding present. Clinical picture and upright x-ray of abdomen shown in the image. Which of the following is most likely diagnosis?

Colon cancer
Mesenteric ischemia
Pancreatitis
Small bowel obstruction

Question :43 A 35-year-old man is brought to the emergency department by ambulance after having a tonic-clonic seizures at work. The patient reports that he has always been healthy and has never had a seizure before. On further questioning, the patient reports that he has been having intermittent bloody stools for the past 4 months. A CT scan of the head reveals an irregular 3 x 4 cm mass extending from right to the left hemisphere. CT of the abdomen shows multiple polypoid masses in the sigmoid colon. Which of the following is the most likely diagnosis?

Gardner’s syndrome
Hereditary nonpolyposis colorectal carcinoma
Tuberous sclerosis
Turcot syndrome

Question :44 A 5 year old boy was sitting in the right rear side of a car moving at 30 mph involved in RTA. The boy was restrained by a 3 point seat belt. 0/E he is pale, there was bruising across his lower abdomen and generalized tenderness. RR-15/min. HR-100/min.Capillary refill time 3 seconds. Most likely organ injured is

Liver
Spleen
Mesentery
Abdominal aorta

Question :45 A 68-year-old man complains of recent changes in bowel habits and blood-tinged stools. Colonoscopy reveals a 3-cm mass in the sigmoid colon. Biopsy of the mass shows infiltrating malignant glands. Neoplastic cells have most likely acquired a set of mutations that cause which of the following changes in cell behavior?

Decreased cellular motility
Loss of cell cycle restriction point control
Increased cell-cell adhesion
Increased susceptibility to apoptosis

Question :46 A 65-year-old woman presents with complaints of fatigue. Laboratory studies show hemoglobin 10 g/dL, low iron, low ferritin & elevated TIBC. Her colonoscopy is negative and upper endoscopy shows red linear strips in antrum.Biopsy was performed. What is characteristic feature of this condition on biopsy?

Fibrin thrombi
Moderate to severe inflammation with neutrophilic infiltrate
Congestive vasculopathy
Superficial lamina propria hemorrhage

Question :47 Treatment of Grade 2 Abdominal compartment syndrome

Hypovolemic resuscitation
Neurovolemic resuscitation
Decompression
Immediate laparotomy

Question :48 A 40 male underwent radical right hemicolectomy for ascending colon growth with serosal extension and HPE revealed moderately differentiated adenocarcinoma with free margins and no nodes positive in the 15 nodes in resected specimen. The patient insists on chemotherapy. Which of the following is recommended?

5FU and leucovirin
FOLFOX 3 months
FOLFOX 6 months
FOLFIRI

Question :49 Following alkali ingestion: Esophagus is at its weakest point during which phase of tissue injury

Phase 1
Phase 2
Phase 3
Involves all phases

Question :50 Which one of the following parts of the gut does not possess mesentery

Rectosigmoid junction
Appendix
Jejunum
Ileum

Question :51 Algallie syndrome is associated with

Biliary atresia
Primary sclerosing cholangitis
Biliary hypoplasia
Portal hypertension

Question :52 Ideal anterior plane of dissection in males with low rectal cancer is

Posterior to Denonviller’s fascia
Anterior to Denonviller’s fascia
Anterior to Prostatic capsule
Posterior to Prostatic capsule

Question :53 Which of following statement regarding abdominal trauma is false

Zone I haematoma should always be explored
Zone II haematoma is most commonly from kidney
Zone III haematoma is difficult to control
Zone III haematoma should always be explored

Question :54 Commonly used chemotherapeutic agents for adjuvant therapy of Ca colon include all except

5FU
Oxaliplatin
Doxorubicin
Capecitabine

Question :55 Which one of the following deficiency is produced by carcinoid syndrome

Thiamine
Nicotinic acid
Pyridoxine
Cobalamine

Question :56 Erosion of splenic artery into a communicating pseudocyst of pancreas may cause Following Except

Typically cause haemosuccus pancreaticus
Presents with abdominal pain
Angiography is often diagnostic
Pancreatico-duodenectomy often results in cure page

Question :57 Treatment of choice for patients with variceal bleed & advanced liver disease is

Shunt surgery
Liver transplantation
Beta blocker
Endoscopic therapy

Question :58 In carcinoma stomach D2 gastrectomy refers to removal of lymph nodes along

Left gastric artery
Short gastric artery
Right gastroepiploic vessels
Left gastroepiploic vessels

Question :59 Enteropathy associated T cell lymphoma arises from

Intraepithelial T cells
Submucosal T cells
Intramuscular T cells
Subserosal T cells

Question :60 Demo

Demo
Demo
Demo
Demo