Hepato-biliary surgery MCQ 24+

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• Post-splenectomy septicaemia may result from infection by
  ক

  Neisseria meningitidis

  খ

  Haemophylus influenzae

  গ

  Staphylococcus aureus

  ঘ

  Streptococcus epidermidis

  ঙ

  Pseudomonas
• Indications for splenectomy are
  ক

  Hereditary spherocytosis

  খ

  Chronic idiopathic thrombocytopenic purpura

  গ

  Hairy cell leukaemia

  ঘ

  Acute lymphoblastic leukaemia

  ঙ

  Chronic myeloid leukaemia
• Complications of splenectomy
  ক

  Bleeding

  খ

  DVT

  গ

  Coagulopathy

  ঘ

  Infection by non-capsulated micro-organism

  ঙ

  Decreased platelet count
• The effects of splenectomy include
  ক

  Changes in the bone marrow

  খ

  Eosinophilia

  গ

  Immunodeficiency

  ঘ

  Hypertrophy of any splenenculi

  ঙ

  Leucopenia
• Regarding carcinoma of the gall bladder
  ক

  Porcelain gall bladder has association

  খ

  Adenomatous polyps more than 10 mm is pre-malignant

  গ

  Gall stones have been suggested as an etiological factor but relation is unproven

  ঘ

  Response to chemotherapy is excellent

  ঙ

  Curative resection is usually possible
• Causes of massive splenomegaly are
  ক

  Malaria

  খ

  Portal hypertension

  গ

  Schistosomiasis

  ঘ

  Hereditary spherocytosis

  ঙ

  Rickets
• Gall bladder is palpable in
  ক

  Mucocele of gall bladder

  খ

  Empyema of gall bladder

  গ

  Chronic cholecystitis

  ঘ

  Acute cholecystitis

  ঙ

  Cholelithiasis
• Gallstones are
  ক

  Recognized complication of chronic haemolytic anaemia

  খ

  Recognized complication of terminal ileal disease

  গ

  Usually

  ঘ

  the result of reduced hepatic bile acid secretion

  ঙ

  One of the predisposing factors is infection

  চ

  More common in Africa and in India than in Europe
• Regarding gallstone
  ক

  Most people are asymptomatic

  খ

  Gallstones cause pancreatitis by obstructing the pancreatic duct

  গ

  CT is the imaging modality of choice in diagnosing gallstones

  ঘ

  20% gallstones are radio-opaque

  ঙ

  Mirizzi's syndrome is caused by a stone in the common bile duct
• Cholesterol gallstones
  ক

  Are a recognized complication of diabetes mellitus

  খ

  May be visible on a plain abdominal x-ray

  গ

  Are usually multiples

  ঘ

  small and hard

  ঙ

  Do not form in bile that contains a molar concentration of cholesterol of about 30%

  চ

  Commonly develop in long standing haemolytic anaemia
• Complications of Gallstones include
  ক

  Acute cholecystitis

  খ

  Pancreatitis

  গ

  Subphrenic abscess

  ঘ

  Diarrhea

  ঙ

  Liver abscess
• The complications of gall stone are
  ক

  Chronic cholecystitis

  খ

  Acute pancreatitis

  গ

  Hematemesis

  ঘ

  Ascites

  ঙ

  Cirrhosis of liver
• Effects of gall stones are
  ক

  Acute pancreatitis

  খ

  Cholangitis

  গ

  Intestinal obstruction

  ঘ

  Mucocele of gall bladder

  ঙ

  Cirrhosis
• Gallstones are associated with
  ক

  Hereditary spherocytosis

  খ

  Obesity

  গ

  Virai hepatitis

  ঘ

  Liver cirrhosis

  ঙ

  Raised serum thyroglobulin
• A patient with obstructive jaundice will have the followings
  ক

  Bilirubin in the urine

  খ

  Raised serum alkaline phosphatase level

  গ

  Urobilinogen in the urine

  ঘ

  A high serum level of unconjugated bilirubin

  ঙ

  Raised level of stercobilinogen
• The following pathological conditions can result in the development of painless jaundice.
  ক

  Carcinoma of the head of the pancreas

  খ

  Cholangiocarcinoma

  গ

  Benign bile duct stricture

  ঘ

  Biliary ascariasis

  ঙ

  Choledocholithiasis
• Painless progressive jaundice is a feature of the following conditions:
  ক

  Cholangiocarcinoma

  খ

  Carcinoma of the head of the pancreas

  গ

  Biliary stricture

  ঘ

  Live round worm in common bile duct

  ঙ

  Choledocholithiasis
• Post-operative jaundice is related in
  ক

  Surgery on biliary tract

  খ

  Blood transfusion

  গ

  Premedical ion with opioid

  ঘ

  Repeated use of halothane anaesthesia

  ঙ

  Prolonged use of N20
• Obstructive jaundice due to surgical cause include
  ক

  Billiary stricture

  খ

  Stone in CBD

  গ

  Worm in small gut

  ঘ

  Mismatched blood transfusion

  ঙ

  Drug induced jaundice
• Causes of surgical jaundice are
  ক

  Biliary stricture

  খ

  Choledocholithiasis

  গ

  Choledochal cyst

  ঘ

  Dubin-Johnson's syndrome

  ঙ

  Primary biliary cirrhosis
• Surgical causes of jaundice are
  ক

  Biliary atresia

  খ

  Choledochal cyst

  গ

  Inspissated bile syndrome

  ঘ

  Cholelithiasis

  ঙ

  Neonatal hepatitis
• Causes of obstructive jaundice are
  ক

  Cholangiocarcinoma

  খ

  Carcinoma of head of the pancreas

  গ

  Worm in common bile duct

  ঘ

  Post cholecystectomy bile duct stricture

  ঙ

  Pyloric stenosis
• Surgical causes of neonatal jaundice include
  ক

  Biliary Atresia

  খ

  Choledocal cyst

  গ

  Gall stone

  ঘ

  Hepatocellular carcinoma

  ঙ

  Viral hepatitis