course 2 4 of Crohn's disease st mucosal sthogene ermeability inp A. There isa increased & nearly i e of extra lumi cd passag’ nes, such’ as interle’ inal antigens ed and There is increase nd PDGF are F ry eyroki Proinflammeator akin 3 the inflammatory be associated with in intestinal response. in suppressor T-cells initiat p. cDis suggested & yw that the increase an increase activity permeability is.a cat E. Itisbelieved not nan a consequence 8. Colonoscopy and bicisy has key 7012 In O13ET™ management of | A. Toestablish the extent of inflammation Diagnosis and assessment of severe Acute colitis. B. C. Todistinguish between UC and Crohn’ s colitis, oD. itor the response to treatment 3s for malignant change. E. To assess longstanding ¢a: adenomatous polyposis, except: s regarding Familial 100 colorectal attenomas ncevof more than 1 he adenomatous polyposis coli (APC) re true statement ined clinically by the prese wwe mutations in A. ise! majority of cases ha 8 on the short arm of chromosome 5. c ome risk of colorectal cancer is 100% >. May prese omas ernative screening too! be used as alt E, CHRPE .ctal tumours except .e to obstructive symptoms arding pathology of col ty tends to give rs jar varie e present with Bh of cases. rectum represent the neoplasm is 3 ¢ ar cell adenacarcinoma picroscapically, orn a (tin late cases nign polypUPS Ter-1 i 7:27 PM All Mucom MCQs.pdf 2016-201 54iud) Aylgs Aa yal) :3.Lall Chel SOG cid gt GDR pia, 12 GlyVi ave :Abbadle eget thy Sal pla 515 eb IS / Spatial dest Department of surgery 4" year 2016-2015 inal Agi / Kal ja ed Final examination2015-2016 QI: (30 Marks) Choose the MOST appropriate single answer for ques 1. Which of the following predisposing factors for hernia is WRONG? A. Basic design weakness B. Weakness at points where structures enter or leave the abdomen C, Muscular hypertrophy in athlets D. Sharp and blunt trauma to the abdominal wall E, Weakness due to ageing and pregnaney 2. Regarding a strangulated hernia; an INCORRECT statement is A. Ahernia can strangulate at any time B. Among groin hernias; strangulation is more common in a femoral hernia >. Strangulation can be exeluded by elinieal exami D. Strangulation can oceur in a sliding herni E, The possibility of strangulation is inversely proportional to the diameter of the neck 3. Operative repair for abdominal hernia may include the following surgical steps EXCEPT A. Reduction of the hernia contents into the abdominal cavity B, Excision and closure of the peritoneal sac if present C. Re-approximation of the walls of the neck of hernia if possible ). Using synthetic absorbable sutures with tension is advised Permanent reinforcement of the abdominal wall defect with sutures or mesh 4, Which fact is INCORRECT with respect to a femoral hernia? ‘A. Usually; there is no sac B. It is more common in females C. ft-cam occur in males D. The contents is usually a small bowel E, The hernial bulge enlarge in an upward and lateral direction 5. Concerning a Paraumblical Hernia; which statement is TRUE? ‘A. Itusually starts as a small protrusion through a weakness in the umbilical scar B. Inreducibility is infrequent C. Recurrence is symptomless in the vast majority of cases D. Strangulation is infrequent E, Polypropylene mesh is inappropriate for repair 6. Factors responsible for burst abdomen (dehiscence) DO NOT include: ‘A. Upper abdominal surgery in an obese patient B. Continuous in contrast 10 interrupted closure of the abdomen C. Closure under tension . The use of corrugated versus tube drains Prolonged postoperative ileus7 Gastric conditions ; 20. Which of the following statements are true? _A. Gastrointestinal stromal tumours (GIST) af associated with tyrosine kinase c-kit oncogene mutation. B GIST tumours show a poor response to imatinib. C Gastric lymphoma is more common in young people. . Primary gastric lymphomas are V-cell-derived and arise from ad MUCOsa-associated lymphoid issue - MALT). —"> 3. Gastric conditions A Trichobezoar B GIST C Mallory-Weiss tear D Dieulafoy's lesion E Gastric lymphoma Gastrinoma Gastric volvulus 1 Gastric cancer | Gastric Polyps» Gastric cancer 14. Which of the following yin the causation of gast “a AH. pylori infection B Gastric atrophy C Pernicious anaemia D Previous gastric So : ‘Smoking.Oesophageal emergencies 4. Which of the following statements are true? x A In a suspected foreign body (FB) in the oesophagus, water-soluble contrast examination should be carried out. —8 When a food bolus is stuck in the oesophagus, always suspect an underlying disease. “C Most iatrogenic perforations of the oesophagus can be treated conservatively, D Most spontaneous perforations of tie oesophagus (Boerhaave’s syndrome) ___ fequire an_operatiPi ie x atch + Loose and matcn Ul he correct diagnosis with each of the descriptions given below 1 cells terochromaffin cells hypertension ar and n and hypokalaemia Choose a n @ Ce ose and match the correct Management with each of the scenarios given below: tS with recent-onset severe hynarta, nset severe hypertension, diabetes weight gain and musepatients wno are asymptomatic. > Gastritis Which of the following statements are true? AA Type B gastritis is an autoimmune co D Haematemesis 12/Which of the following are true with regard to haematemesis? vith A-The in-patient mortality is about 5 per cent. B Oesophageal varices are the most k and common cause colic. C It is better to avoid surgery in elderly patients. B Mallory-Weiss tear is a longitudinal tear below the gastro oesophageal Junction. E Dieulafoy's lesion is a gastric arteriovenous malformation. nts ~% Gastric outlet obstruction 13.) Which of the following are true in respect of gastric outlet obstruction nely to _ (coo)? ‘ B It is most commonly associated with ng long-standing Peptic ulcer disease and sudden gastric cancer. all B The usual metabolic abnormality is hyperchloraemic alkalosis. \. Q ©_Endoscopy has no role in management ea D Surgery is the mainstay of treatment +E Aypokalaemia May occur due to by PP] paradoxical renal aciduria.~ Gastric cancer 14. Which of the following are im in the causation of gastric can A H. pylori infection ; Gastric atrophy C Pernicious anaemia Previous gastric surgery oF SmokingWhich of the following statements regarding gastric volvulus are commo C€& The con ee Organoaxial rotation. dition is usually associated with a diaphragmatic defect. —S Tie condition is usually chronic. E Management is essentially medi ledical and Snpyed symptomatic.usetul adjunct. : > Gastric conditions 20. Which of the following statements are true? cA Gastrointestinal stromal tumours (GIST) are associated with tyrosine kinase c-kit oncogene mutation, B GIST tumours show a poor response to imatinib. C Gastric lymphoma is more common in young people. Primary gastric lymphomas are T-cell-derived and arise from MUCosa-associated lymphoid tissue (MALT),pale and cacneciic. ~Y 2. Sequelae of gastric surgery A Recurrent ulceration B Early dumping syndrome C Malignancy D Late dumping syndrome E Postvagotomy diarrhoea F Vitamin B12 deficiency Choose and match the correct diagnosis with each o' | A 48-year-old male who has had previous gastric rese tremor, faintness and prostration 1.5 h after eating, Th and aggravated by exercise. py A 50-year-old male with a Previous operation for a duc symptoms for a few years but Now presents with simile abdominal pain which is burning in nature. This is epis - A 54-year-old male who has had a previous total gastrec tingling in his arms and legs. He is found to have macroExtended matching questions ~ 1. Clinical conditions affecting the rectum A Procitis B Solitary rectal ulcer C Rectal prolapse D Carcinoma of rectum E Villous adenoma F Amoebic granuloma een, Choose and match the following diagnosis with each of the scenarios given below E 1 A 45-year-old male complains of Recently this has become prof lost some weight and on rectal examination there is a fronded large growth that is pal He has a serum potassium of 2.2 mmol/L. 2! ¢ 2 A 35-year-old male complains of bleeding per rectum and tenesmus. On examination t nothing to find in the abdomen. On rectal examination, a fleshy mass is felt in the mid: On sigmoidoscopy there is a mass with an ulcerated surface, A biopsy has been taken. ago he teturned to Britain after livin in the Far East for a few years, i 3 A50-year-old female complains of bleeding from the rectum associated with defaecation During a motion she passes flatus, mucus and blood and very little faecal matter. On ted €xamination there is blood on the finger; sigmoidoscopy shows inflamed rectal mucosa tu about 15 cm without any ulceration. a 4 A 40-year-old female complains of rectal bh 5 with occasional incontinence, During this ti protruding from her anus which she can prolapse. On Sigmoidoscopy at about 10 been taken, mucous discharge from the rectum for several moni use and has made him feel very weak. On examination leeding and Passage of mucus for several mont me she has been constipated and feels a lump teduce herself, On examination she has a partial cm, there is an ulcer on the anterior wall. A biopsy — < 5A 55-year-old female complains of a lump protruding from her has to push the lump back but it reappears when she passes a has , 5 cm length of rectum outside the anus, and when it is gurgle. — anus for almost 10 months. : motion. On examination she pushed back it reduces with afor cure in a serectéa group 10714 In the staging for rectal cancer, which YF’ of the following are true? A The incidence of Dukes’ stage A is 15 per cent. B The incidence in Dukes’ stage C is 50 "per cent, C Dukes’ stage D indicates distant ~ — metastasis, usually to the liver. D In the TNM (tumour, node, metastasis) 7. staging, T3 indicates invasion through the serosa or mesorectal fascia. 4 In the TNM staging, N1 indicates the involvement of one to three lymph nodes.