Stomach , Duodenum and Small intestine

1. Bengin gastric ulcers:

A. Occur in the same age group as duodenal ulcers.
B. Are more common in females than males.
C. Are more common in the upper social classes.
D. Produce epigastric pain after eating food.
E. All of the above is correct.

2. Uncomplicated benign gastric ulcers: (All correct except one)

A. Occure most commonly on the greater curve of the stomach.
B. Should initially be treated medically.
C. Commonly recur after medical treatment.
D. Should receive surgical treatment if healing has not occurred after 4 to 6 weeks of medical.
E. The surgical treatment of gastric ulceris billoroth one partial gastrectomy.

3. There is an association of gastric cancer with: (All correct except one)

A. Achlorhydria of the stomach.
B. Atrophic gastritis.
C. Adenomatous gastric polyps.
D. Duodenal ulceration.
E. Chronic non healing gastric ulcer.

4. Surgical treatment of gastric cancer:

A. Should preferably be by a total gastrectomy.
B. Gives overall 5 years survival figures over 40 per cent.
C. Includes excision of the tumour as a palliative measure.
D. Should be advised for all diagnosed cases.
E. The resectability rate is over 70per cent.

5. The signs and symptoms of potentially curable gastric cancer: (All correct except one)
A. May simulate those of a benign gastric ulcer.
B. Include a hard palpable left supraclavicular node.
C. Requere investigation by a barium meal examination.
D. Requjire investigation by a gastroscopic examination even when the barium meal is normal.
E. Include a non palpable abdominal mass.

6. Gastric cancer:
A. Is most common in the fundus of the stomach.
B. Is most commonly a squamous cell carcinoma.
C. Frequently metastasises via the blood stram.
D. Is most frequently an ulcerating lesion.
E. Non of the above is correct.

1
7. Treatment of symptomatic duodenal ulcers:
A. Should include twice daily antacids.
B. Shjould include a strict dietary regime .
C. Should include anti-cholinergic drugs.
D. Should be by early surgery.
E. Non of the above is correct.

8. Duodenal ulcers:
A. Have an equal incidence in both sexes.
B. Have a clicical course characterised by long periods of remission.
C. Are characterised by postprandial pain.
D. Occur most commonly ion the duodenal cap.
E. B&D only.

9. Acute haemorrhage from a duodenal ulcer:

A. Requires no urgent diagnosis of the source of haemorrhage.
B. Requires an urgent gastroscopy.
C. Should be treated surgically as soon as the diagnosis is made.
D. Indicates the presence of a chronic duodenal ulcer.
E. C&D only.

10. Post-gastrectomy nutritional disturbances may result in:

A. Megaloblastic anaemia.
B. Steatorrhoea.
C. Iron deficiency anaeimia.
D. Osteoporosis.
E. All of the above.

11. The incidence of crohn’s disease:

A. Is not distributed evenly throughout the world’s population.
B. Is similar in the two sexes.
C. Is highest amongst young adults.
D. Is increased in the close relatives of patients with the disease.
E. All the above are correct.

12. Crohn’s disease:

A. Has an infective aetiology.
B. Is limited to the bowel mucosa.
C. Does not produce mucosal ulceration.
D. Is characterised by the absence of fibrous tissue in the affected inflamed bowel.
E. Spreads through the hole thickness of the bowel wall.

13. Patients with crohn’s disease characteristically present with:

A. Colicky abdominal pain.
B. Constipation.
C. Nutritional deficiencies.
D. Rectal bleeding.
2
 E. A&C only.
14. In the treatment of patients with crohn’s desease:
A. Medical methods have no parts to play.
B. Surgery should be the primary method of treatment.
C. Steroids may provide a remission in the progress of the disease.
D. A high bulk diet should be considered.
E. All of the above are correct.

15. Tumours of the small bowel:

A. Are common.
B. May be an inherited disorder.
C. Most commonly present with overt or occult rectal bleeding.
D. Most commonly present in childhood.
E. C&D only.

16. Carcinoid tumours of the gastrointestinal tract:

A. Are most commonly located in the appendix .
B. Are usually malignant.
C. Arise in the mucosa.
D. Are frequently the cause of gastrointestinal haemorrhage.
E. Mucosal ulceration is common.

17. The carcinoid syndrome:(all correct except one)

A. Characteristically includes abdominal cramps.
B. Is produced by the release of vasodilating substances from the tumour.
C. Occurs most commonly with metastatic carcinoid tumours.
D. Is usually cured by excision of the primary tumour.
E. May produce diarrhoea and dyspnoea.

18. Chronic radiation injury to the intestinal tract: (all correct except one)
A. Typically presents with mucosal atrophy.
B. Often presents with perforation of the bowel.
C. Frequently presents with intestinal obstruction.
D. May present with malabsorption.
E. Often produce progressive fibrosis.

19. The “blind-loop” syndrome often:

A. Presents with signs of malnutrition.
B. Presents as a complication of crohn’s disease.
C. Presents as a complication of multiple deverticuli.
D. Presents as a complication of intestinal bypass.
E. All of the above are correct.

20. A meckel’s deverticulum of the small intestine: (all correct except one)
A. Is situated at the jejuno-ileal junction.
B. Contains all coats of intestinal wall.
C. May be associated with a fibrous band connecting it to the umbilicus.
D. Most commonly presents as lower GI bleeding diverticulitis.

1 D 6 C 11 E 16 A
2 A 7 E 12 E 17 D
3 D 8 E 13 E 18 A
4 C 9 B 14 C 19 E
5 B 10 C 15 B 20 A
3
4