Week 7- Small bowel- 27 Questions

1. What induces vomiting in gastric outlet obstruction:

 Pyloris and duodenal inflammation

2. Where do vagal trunks to the small bowel synapse pre- and post-fibers synaptic:
 Submucosal and myentric plexus
 NOT SM plexus

3. What disease causes increased absorption in the small bowel:

 Wilson’s disease
 NOT hypercholesterolaemia and hyperparathyroidism

4. Cycline:
 Can be used during pregnancy
 Used in chemotherapy induced nausea

5. Cause of small bowel obstruction:

 Incisional hernia
 Indirect hernia

6. How is a tumour of the small bowel most commonly diagnosed:

 Diagnosed most commonly via laparotomy

7. The most common primary malignant tumour of the small bowel?

 Lymphoma

8. At which vertebral level is the duodeno-jejunal junction?

 L2 level
9. Where is the root of the mesentery that attaches the small bowel to the posterior
abdominal wall situated?
 From the duodeno-jejunal junction the ileocaecal junction and R. sacro-iliac joint

10. Obstructed small bowel adhesions:

 Obstruction of proximal jejuna causes mild abdominal distension
 Conservative Rx is normally adequate
 Adhesive bands can cause necrosis of the small bowel

11. Rx of nausea:
 Muscarinic antagonist
 Dopamine antagonist
 Anti-histamine

12. Which test proves that malabsorption is in the small intestine?

 D-xylose test

13. Not consistent with bacterial overgrowth of the small intestine:

 Faecal osmotic gap less than 50

14. Not part of normal intestinal flora:

 Salmonelle typhi
 NOT- lactobacillus

15. Not a cause of severe secretory diarrhea:

 Pancreatic exocrine insufficiency

16. True statement of neonatal bowel obstruction:

 Atresia is a common cause of neonatal bowel obstruction
 Duodenal atresia associated with trisomy 21
 Double bubble sign on AXR indicates a high bowel obstruction
17. The rationale behind the changing of feeds after infectional enteropathy?
 Dissacharidase deficiency

18. Initial Rx of gastric outlet obstruction:

 PPI + nutrition + fluid resuscitation

19. Rx of a dehydrated patient following the vomiting of gastric content:

 Normal saline (0.9% NaCl)

20. Child presents with non-dehydrating diarrhea + impaired growth- what is the
appropriate tests:
 Stool elastase
 Food protein induced enteropathy
 Serum testing for auto-tissue transglutaminase Ab

21. Parasitic organism that causes diarrhea in children:

 Entamoeba histolytica
 Giarda lumbrica
 Cryptosporidium

22. Metabolic presentation of gastric outlet obstruction with vomiting:

 Hypokalaemic + hypochloraemic metabolic alkolosis

23. In a child- the signs of acute diarrhea with dehydration:

 Kussmaul breathing
 Decreased skin turgor

24. Incorrect statement:

 Many bacteria cross the gut mucosa thus immune mechanisms must be in place
25. Correct regarding toddler’s diarrhea:
 Undigested food in stools
 Normal growth parameters
 A family Hx of diarrhea

26. Signs of strangulating in inguinal hernia:

 Erythema in the skin overlying it
 Severe inguinal pain

27. Not true regarding celiac disease:

 Auto-immune disease caused via parietal cell auto-antibodies