Gastro-intestinal surgery MCQ 68+

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• A discharging umbilicus
  ক

  May indicate patent vitello-intestinal duct

  খ

  May indicate patent urachus

  গ

  At the time of menstruation

  ঘ

  it indicates endometriosis

  ঙ

  In neonate

  চ

  has no clinical significance

  ছ

  Excision of umbilicus is the treatment of choice
• The following are diseases of the umbilicus
  ক

  Omphalitis

  খ

  Raspberry tumour

  গ

  Exomphalos

  ঘ

  Gastroschiasis

  ঙ

  Persistent vitello-intestinal duct
• Abdominal signs of acute pancreatitis are
  ক

  Grey turner’s sign

  খ

  Cullen’s sign

  গ

  Boas sign

  ঘ

  Rovsing’s sign

  ঙ

  Murphy’s sign
• Causes of acute pancreatitis includes
  ক

  Gall stones

  খ

  Alcohol abuse

  গ

  Hyperlipidaemia

  ঘ

  Hypocalcaemia

  ঙ

  Spironolactone therapy
• Features of acute pancreatitis include
  ক

  Increased blood urea nitrogen

  খ

  Hypocalcaemia

  গ

  Hypoglycaemia

  ঘ

  Hemoconcentration

  ঙ

  Hypokalemia
• Features of acute pancreatitis includes
  ক

  Hypocalcaemia

  খ

  Increase LDH

  গ

  Hypoglycaemia

  ঘ

  Hypokalaemia

  ঙ

  Hyperlipidaemia
• Complications of hemorrhoids include
  ক

  Strangulation and thrombosis

  খ

  Ulceration

  গ

  Portal pyaemia

  ঘ

  Malignant transformation

  ঙ

  Complete rectal prolapse
• A pilonidal sinus
  ক

  Is best treated by primary excision and closure

  খ

  Affects man more than women

  গ

  Often present as an acute abscess

  ঘ

  Is usually congenital

  ঙ

  Frequently presents at puberty
• The followings are the features of generalized peritonitis
  ক

  Board like rigidity

  খ

  Rebound tenderness

  গ

  Abdominal distension

  ঘ

  Borborygmy

  ঙ

  Scaphoid abdomen
• Toxic megacolon is a feature of
  ক

  Ulcerative colitis

  খ

  Amoebic

  গ

  Transverse myelitis

  ঘ

  Scleroderma

  ঙ

  Crohn’s disease
• Regarding colorectal cancer
  ক

  Left sided tumours are likely to obstruct than right sided tumours

  খ

  Villous adenomas have a greater malignant potential than tubular adenomas

  গ

  Most tumours occur in the right colon

  ঘ

  Neo-adjuvant radiotherapy has no role in the management of rectal tumours

  ঙ

  Colorectal cancers are associated with a diet high in fiber and low in saturated fat
• Regarding large intestine
  ক

  The upper third of the rectum is covered in front and on both sides by peritoneum

  খ

  A faecolith in appendix is seen in 15% of live normal population

  গ

  The proximal third of the transverse colon is supplied by the middle colic artery

  ঘ

  The gas-filled large bowel on plain radiographs demonstrates the haustral pattern of complete septation

  ঙ

  The anal canal is well visualized during a barium enema
• There is recognized association between carcinoma of caecum and colon
  ক

  Anaemia

  খ

  Intussusception

  গ

  Appendicitis

  ঘ

  Steatorrhoea

  ঙ

  Haematuria
• Following are the common complications of colostomy
  ক

  Bleeding

  খ

  Parastomal hernia

  গ

  Skin excoriation

  ঘ

  Colonic perforation

  ঙ

  Malignancy
• Complications of Ulcerative Colitis
  ক

  Perforation

  খ

  Toxic megacolon

  গ

  Cancer colon

  ঘ

  Internal fistula formation

  ঙ

  Perianal fistula
• Gangrene of the gut can occur in
  ক

  Volvulus of sigmoid colon

  খ

  Intestinal obstruction due to bands and adhesions

  গ

  Mesenteric vascular occlusion

  ঘ

  Intestinal polyp

  ঙ

  Paralytic ileus
• Uretero-colic anastomosis may be associated with
  ক

  Ascending pyelonephritis

  খ

  Absorption of ammonium salt

  গ

  Absorption of urea from colon

  ঘ

  Metabolic alkalosis

  ঙ

  Hyperkalaemia
• Ureterocolic anastomosis may lead to
  ক

  Hypokalaemia

  খ

  Hypernatremia

  গ

  Increased renal bicarbonate excretion

  ঘ

  Metabolic alkalosis

  ঙ

  Hypochloraemia
• Risk factors of colorectal cancers include
  ক

  Obesity

  খ

  Saturated animal fat

  গ

  Adenomatous polyp

  ঘ

  Dietary calcium

  ঙ

  Dietary selenium
• Conditions that may lead to development of colon cancer:
  ক

  Crohn disease

  খ

  Ulcerative colitis

  গ

  Sessile serrated adenoma of colon

  ঘ

  Colonic diverticula

  ঙ

  Amoebiasis
• The followings are recognized risk factors for colorectal cancer
  ক

  Familial adenomatus polyposis coli (FA

  খ

  Crohn's disease

  গ

  Ulcerative colitis

  ঘ

  Diverticular discase

  ঙ

  Angiodysplasia
• Regarding Zollinger- Ellison syndrome
  ক

  It is peptic ulcer

  খ

  Gastrimoma may be associated

  গ

  It may occur outside the stomach

  ঘ

  Associated with diarrhoea

  ঙ

  It in not fulminating type
• The Zollinger-Ellison syndrome is associated with
  ক

  Chronic duodenal ulcer

  খ

  Choleriform diarrhoea

  গ

  Parathyroid adenomata

  ঘ

  β-cell tumours of the pancreas

  ঙ

  Pheochromocytoma
• Subtotal villous atrophy is present in
  ক

  Celiac disease

  খ

  Zollinger Ellison syndrome

  গ

  Dermatitsherpetiformis

  ঘ

  Giardiasis

  ঙ

  Crohn’s disease
• Neoplastic polyps of intestine are to
  ক

  Adenoma

  খ

  Adenocarcinoma

  গ

  Carcinoid tumor

  ঘ

  Juvenile polyp

  ঙ

  Peutz Jegher's polyp
• In acute appendicitis
  ক

  Marked leucocytosis occur

  খ

  Typhlitis is the differential diagnosis in both sex

  গ

  Age is not an important factor

  ঘ

  Ultrasound study (USis necessary for all patients

  ঙ

  Appendicectomy is the treatment of choice in all situations
• Causes of paralytic ileus include
  ক

  Uraemia

  খ

  Pancreatitis

  গ

  Mesenteric ischaemia

  ঘ

  Hyperkalaemia

  ঙ

  Use of tricyclic antidepressants
• Intestinal obstruction leads to
  ক

  Hypovolumic shock

  খ

  Electrolyte imbalance

  গ

  Paralytic ileus

  ঘ

  Abdominal distension

  ঙ

  Overhydration
• Common causes of small gut obstruction in young adult are
  ক

  Obstructed inguinal hernia

  খ

  Bands & adhesions

  গ

  Ascariasis

  ঘ

  Malignancy

  ঙ

  Patent vitello-intestinal duct
• Regarding intestinal stomas
  ক

  Ileostomy should have a spout

  খ

  A right sided stoma is invariably an ileostomy

  গ

  A Hartmann’s procedure involves resection of a segment of colon and formation of an ileostomy.

  ঘ

  A loop ileostomy is usually permanent.

  ঙ

  A defunctioning stoma is performed to protect an anastomosis proximal to the stoma