Dedicated to care of patients with evidence based medicine

1.) A patient presents with severe upper abdominal pain radiating to back to the left side for last 12 hrs, pt is alcoholic, acute pancreatitis is suspected but serum amylase and lipase levels are normal, next thing to be done

  1. a) USG Whole abdomen
  2. b) Repeat serum amylase and lipase level after 12 hrs
  3. c) Repeat serum amylase and lipase level after 24 hrs
  4. d) CECT whole abdomen

2.) A patient presented with hematochezia, nasogastric tube aspirate is clear, next to do

  1. a) Upper GI Endoscopy
  2. b) Colonoscopy
  3. c) Conventional Angiography
  4. d) CT Angiography

3.) A patient presented with melena, nasogastric tube aspirate is clear, next to do

  1. a) urgent upper GI endoscopy
  2. b) urgent colonoscopy
  3. c) Upper GI endoscopy
  4. d) Colonoscopy

4.) Coronary artery disease patient presented with massive lower GI bleed, On evaluation found to have colonic diverticular bleed but stopped, next to do

  1. a) Recurrent bleeding incidence is low so nothing to be done
  2. b) Recurrent bleeding incidence is low but still require colonic resection
  3. c) Recurrent bleeding incidence is high but still nothing to be done as high risk for surgery
  4. d) Recurrent bleeding incidence is high require colonic resection

5. ) Known case of chronic liver disease with portal hypertension patient presented with melena true is

  1. a) Variceal bleed is most common cause
  2. b) variceal bleed is most common cause, variceal bleed medical therapy should be started before endoscopy
  3. c) Non-variceal bleed is most common cause, no variceal bleed medical therapy should be started before endoscopy
  4. d) Non-variceal bleed is most common cause, still variceal bleed medical therapy should be started even before endoscopy

6.) True Paraesophageal hernia is

  1. a) Type I sliding hernia
  2. b) Type II sliding hernia
  3. c) Type III sliding hernia
  4. d) Type IV sliding hernia

7.) Paraesophageal hernia start from in relation to hiatus

  1. a) Right anterior
  2. b) Left anterior
  3. c) Right posterior
  4. d) Left posterior

8.) Which type of hiatus hernia is mixed hernia

  1. a) Type i
  2. b) Type II
  3. c) Type III
  4. d) Type IV

9.) The manometric abnormality diagnostic of achalasia is

  1. a) Lack of peristalsis of esophageal body
  2. b) Impaired LES relaxation
  3. c) Impaired LES relaxation with swallowing
  4. d) Hypertensive LES

10.) The main limitation of salvage transplantation in HCC is

  1. Early detection of recurrence
  2. High recurrence rate
  3. Non-availability of organ
  4. Cost

11.) Screening for recurrence after resection in salvage transplantation is done by

  1. USG every 3 months
  2. USG every 6 months
  3. CT every 3 months
  4. CT every 6 months

 

12.) Salvage transplantation is best for

  1. Single lesion Hepatitis B without cirrhosis
  2. Single lesion Hepatitis B with cirrhosis
  3. Two lesion Hepatitis B without cirrhosis
  4. Two lesion Hepatitis B with cirrhosis

13.) Most common site of adenomatous polyp

  1. Ascending colon
  2. Descending colon
  3. Sigmoid colon
  4. Rectum

14.) Most common colonic polyp

  1. Hyperplastic polyp
  2. Inflammatory polyp
  3. Hamartomatous polyp
  4. Adenomatous polyp

15.) Which one of the following polyp have the highest risk of lymph node metastases

  1. Level 4 pedunculated polyp rectum
  2. Sessile polyp sigmoid colon
  3. Level 3 pedunculated polyp sigmoid colon
  4. Sessile polyp ascending colon

16.) Pancolitis in UC is defined by colitis involving

  1. All the segment of colon
  2. All the segment of colon extending up to terminal ileum
  3. Proximal to the transverse colon
  4. Proximal to the splenic flexure

17.) False regarding cancer in ulcerative colitis

  1. Not evenly distributed throughout the colon
  2. Higher likelihood of synchronous tumors
  3. Mucinous and poorly differentiated
  4. No significant differences between sporadic and UC-related CRC with respect to prognosis

18.) Patient of acute pancreatitis present with organ failure, you will classify and treat as

  1. Mild pancreatitis
  2. Moderately severe pancreatitis
  3. Severe pancreatitis
  4. Can be classified only after 24 hrs of observation

19.) Mutation analysis is most helpful in

  1. localized gastric GIST
  2. localized small bowel GIST
  3. advanced gastric GIST
  4. advanced small bowel GIST

20.) Wild type GIST include

  1. GIST negative for KIT
  2. GIST negative for PDGFRA
  3. GIST negative for both KIT and PDGFRA
  4. GIST negative for both KIT and PDGFRA but sensitive to imatinib

21.) Mutation in GIST involve

  1. juxtamembrane domain of CD117 (c-kit) resulting activation of the c-kit receptor tyrosine kinase
  2. juxtamembrane domain of CD117 (c-kit) resulting deactivation of the c-kit receptor tyrosine kinase
  3. juxtamembrane domain of CD119 (c-kit) resulting activation of the c-kit receptor tyrosine kinase
  4. juxtamembrane domain of CD119 (c-kit) resulting deactivation of the c-kit receptor tyrosine kinase

22.) A patient underwent wedge resection of stomach for GIST, histopathology margins came out positive what will u do next

  1. Re-exploration and re-gastrectomy with wider margins of 5cm
  2. Re-exploration and re-gastrectomy with margin of 2cm
  3. Re-exploration and re-gastrectomy with frozen biopsy of margins
  4. Re-assurance to patients it does not affect survival

23.) Most common mesenchymal tumor of esophagus

  1. GIST
  2. Leiomyoma
  3. Inflammatory polyp
  4. Neurofibroma

24.) The least common site of adult GIST

  1. Stomach
  2. Rectum
  3. Colon
  4. Esophagus

25.) The limiting factor of imatinib therapy

  1. Primary resistance
  2. Secondary resistance
  3. Drug toxicity
  4. Patient compliance

26.) Only Tumour size and mitotic count are included in which criteria to estimate risk of recurrence after GIST surgery

  1. National Institutes of Health (NIH) consensus criteria
  2. Armed Forces Institute of Pathology (AFIP) criteria
  3. Modified NIH criteria
  4. Modified Armed Forces Institute of Pathology (AFIP) criteria

27.) Which of the following criteria is not used to estimate risk of recurrence after GIST surgery

  1. National Institutes of Health (NIH) consensus criteria
  2. Armed Forces Institute of Pathology (AFIP) criteria
  3. Modified NIH criteria
  4. Modified Armed Forces Institute of Pathology (AFIP) criteria

28.) FAP is characterized by all except

  1. dominantly inherited syndrome
  2. occurrence of 1 in 10,000 live births
  3. most common inherited colorectal cancer (CRC) syndrome
  4. median age for adenoma development is 17 years.

29.) Most common location of the appendix

  1. Pelvic
  2. Subcecal
  3. Preileal
  4. Retroileal

30.) Fold of Treves aid in the identification of

  1. Appendix
  2. Cecum
  3. Sigmoid colon
  4. Duodenal-jejunal junction

31.) FAP patients should undergo prophylactic procto-colectomy by the age of

  1. 10 years
  2. 20 years
  3. 30 years
  4. 35 years

32.) Most common associated second malignancy in patients with neuro-endocrine tumors

  1. Adenocarcinoma small bowel
  2. Adenocarcinoma large bowel
  3. Leiomyoma small bowel
  4. Leiomyoma large bowel

33.) False regarding Pancreatic-cancer associated diabetes mellitus

  1. Frequently new-onset (<2 yr. duration)
  2. Associated with tumor stage (Stage I/ II vs. III/IV)
  3. Not associated with location (head vs. body/tail)
  4. Nearly 60% who underwent pancreaticoduodenectomy had resolution of their DM following tumor resection

34.) Screening for HCC is done by

  1. Annualy USG
  2. Annualy USG + AFP
  3. 6 monthy USG
  4. 6 monthly USG + AFP

35.) Surveillance for early detection of HCC is not recommended in

  1. Non-cirrhotic Hepatitis B
  2. Cirrhotic Hepatitis B Child-Pugh class C
  3. Cirrhotic Hepatitis C Child-Pugh class B
  4. Alcoholic cirrhotic Child-Pugh class A

36.) False regarding Pancreatic-cancer associated diabetes mellitus

  1. Frequently new-onset (<2 yr. duration)
  2. Associated with tumor stage (Stage I/ II vs. III/IV)
  3. Not associated with a location (head vs. body/tail)
  4. Nearly 60% who underwent pancreaticoduodenectomy had a resolution of their DM following tumor resection

37.) Clinical portal hypertension is defined by all except

  1. Esophageal varices
  2. Thrombocytopenia
  3. Splenomegaly
  4. Ascites

38.) The incidence of invasive carcinoma in a polyp is not dependent on

  1. size
  2. histology
  3. Sessile
  4. none of the above

39.) Which of the following is non-neoplastic polyp

  1. Serrated polyp
  2. Tubular polyp
  3. Hamartoma
  4. All are non-neoplastic

40.) A person has a history of colorectal malignancy in second degree relative at age of 35 years; This person has

  1. Average risk for colo-rectal malignancy
  2. High risk and colonoscopy at age of 40 year and thereafter every 10 year
  3. High risk and colonoscopy at age of 40 year and thereafter every 5 year
  4. Low risk and colonoscopy at age of 45 year and thereafter every 10 year