1.
Which one is not the bad prognostic sign for pancreatitis?
1. TLC>16,000/ µ
2. Calcium <8 mmol/L
3. Glucose > 200 mg%
4. Prothrombin >2 times the control
Ans(4)
2. Which of the following is not a feature of acute pancreatitis?
1. Hyperbilirubinemia
2. Hypercalcemia
3. Hyperglycemia
4. Increased serum LDH level
Ans(2)
3. A lady presents with three-day history of epigastric pain radiating to back serum amylase levels were
observed to be normal while USG abdomen reveals gallbladder stones and an enlarged pancreas. CT
scan was done which clinched the diagnosis. Which of the following is the most likely diagnosis?
1. Acute cholecystitis
2. Acute pancreatitis
3. Acute appendicitis
4. Acute peritonitis
Ans(2)
4. Which of the following is not an etiological factor for pancreatitis?
1. Abdominal trauma
2. Hyperlipidemia
3. Islet cell hyperplasia
4. Germline mutations int he cationic trypsinogen gene
Ans(3)
5. A case of Acute pancreatitis is now having refractory hypoxia. Finding that will be there in X-ray Chest:
1. Bilateral infiltrates
2. Pneumatoceles
3. Ground glass appearances
4. Hilar lymphadenopathy
Ans(1)
6. Which of the investigation can itself lead to acute pancreatitis?
1. USG
2. CT scan
3. ERCP
4. MRI scan
Ans(3)
7. All of the following structures are removed in Whipple’s procedure except:
1. Pylorus
2. Proximal Jejunum
3. Neck of Pancreas
4. CBD
Ans(3)
8. False about Zollinger Ellison Syndrome:
1. It is due to the presence of a Gastrinoma
2. Gastrin provocation tests are a part of the diagnostic workup
3. It might be associated with ulcers in unusual locations in GIT
4. They may be associated with Insulinomas
Ans(4)
9. Acute pancreatitis most diagnostic test:
1. Secretin stimulation test
2. Serum lipase
3. Impaired glucose tolerance
4. Serum amylase
Ans(2)
10. Not a contraindication for resection of the head of pancreatitis:
1. Liver metastasis
2. Ascites
3. Peritoneal seedings
4. Involvement of major artery < 180 degree
Ans(4)
11. In Pylorus preserving the type of Pancreatic duodenum structure not resected is:
1. Pyloric antrum
2. CBD
3. Duodenum
4. None
Ans(1)
12. The most common site for carcinoma pancreas is:
1. Head
2. Body
3. Tail
4. Neck
Ans(1)
13. Chronic pancreatitis complications include all except:
1. Renal artery stenosis
2. Pseudocyst
3. Splenic vein thrombosis
4. Fistulas
Ans(1)
14. Gold standard investigation for chronic pancreatitis is :
1. MRI
2. ERCP
3. Pancreatic function tests
4. Fecal fat estimation
Ans(2)
15. Gold standard test for Insulinoma is:
1. 72-hour fasting sugar
2. Plasma insulin levels
3. C-peptide levels
4. Low glucose levels < 30mg/dl
Ans(1)
16. Most common complication of pseudocyst of the pancreas is
1. Rupture into peritoneum
2. Hemorrhage
3. Infection
4. Rupture into colon
Ans(3)
17. All of the following are symptoms of VIPomas except:
1. Watery diarrhea
2. Hypokalemia
3. Flushing
4. Hypotension
Ans(3)
18. False about Pancreatic Injury:
1. Penetrating injuries are common
2. Commonly isolated injuries occur
3. Serum amylase is raised
4. Peritoneal lavage is not helpful for diagnosis
Ans(2)
19. Treatment of choice for Cancer head of pancreas?
1. Radiotherapy
2. Chemotherapy + Radiotherapy
3. Whipple’s Surgery
4. Resection of the entire pancreas with adjuvant chemotherapy.
Ans(3)
20. A patient with acute pancreatitis develops sudden onset breathlessness with a CVP< 15 mm Hg. The
chest x-ray shows bilateral infiltrates. The possible diagnosis is:
1. ARDS
2. Myocardial infarction
3. Congestive left heart failure
4. Pulmonary embolism
Ans(1)
21. A 35 years old male came to casualty with complaints of fever, abdominal pain, and binge drinking.
On examination PR-120/min, BP 90/60 mm Hg, RR -34/min. SpO2 – 88% and his creatinine were 2.1. The
diagnosis is:
1. Acute pancreatitis
2. Liver abscess
3. Severe acute pancreatitis
4. Acute pyelonephritis
Ans(3)
22. Borders of Gastrinoma triangle are all except:
1. Cystic dust CBD junction
2. Duodenum 2nd and 3rd part junction
3. Tail of pancreas
4. Neck of pancreas
Ans(3)
23. A 41-year-old male presents with acute epigastric pain. Serum amylase is 1874 U/L (Normal 60-180
U/L) Which of the following factor is used for risk stratification of acute pancreatitis using he modified
Glasgow scale?
1. PaCO2
2. Creatinine
3. Glucose
4. Alkaline phosphatase
Ans(3)
24. Gastrinoma – False statement is:
1. Elevated gastrin level and elevated gastric acid output
2. Secretin stimulation test is the most accurate test for gastrinoma
3. Localized disease-surgical resection
4. Metastatic disease-palliative Chemotherapy
Ans(4)
25. Imaging IOC for acute pancreatitis:
1. CT Scan
2. USG
3. X-ray
4. MRI
Ans(1)
1. Regarding injury to the pancreas, which is not true:
1. majority of postoperative complications are due to missed duct injury
2. Fracture is common at the junction of head and body
3. Commonly associated with vascular injury
4. peritoneal lavage is good for making the diagnosis
1. Ans(4)
2. Medical treatment of acute pancreatitis includes:
1. calcium
2. glucagon
3. Aprotinin
4. Cholestyramine
5. Antibiotics
1. Ans(1,5)
3. The advantage of bladder drainage over enteric drainage after pancreatic transplantation is
better monitoring of:
1. HBA IC levels
2. Amylase levels
3. Glucose levels
4. Electrolyte levels
1. Ans(2)
4. Hyperamylasemia is seen in all except:
1. peritonitis
2. Acute pancreatitis
3. Carcinoma esophagus
4. ruptured ectopic pregnancy
5. perforated peptic ulcer
6. none
1. Ans(6)
5. in mucoviscidosis of the pancreas the commonest defect is in the:
1. jejunum
2. Ileum
3. Ascending colon
4. descending colon
1. Ans(2)
6. Ranson’s scoring for acute pancreatitis includes:
1. Age>55years
2. WBC>16,000/μl
3. Sequestration of fluid >6L
4. BUN >10 mg/dl
5. LDH>700 IU
1. Ans(1,2,3)
7. The neck of the pancreas is related on its posterior surface to:
1. gastroduodenal artery
2. Superior mesenteric vein
3. inferior vena cava
4. bile duct
1. Ans(2)
8. Poor prognostic factor in acute pancreatitis is:
1. increased serum amylase
2. Decreased calcium
3. decreased blood sugar
4. Decreased PaO2
1. Ans(2,4)
9. All of the following statements about Nesidioblastosis are true except:
1. Hypoglycemic episodes may be seen
2. occurs in adults more than children
3. histopathology shows hyperplasia of islet cells
4. diazoxide may be used for treatment
1. Ans(2)
10. Which of the following is associated with poor prognosis is:
1. hypocalcemia
2. Hypercalcemia
3. Hypernatremia
4. Hyperglycemia
1. Ans(1,4)
11. All the following are true about diazoxide except:
1. K+ channel opener
2. can be used as antihypertensives agent
3. causes severe hypoglycemia
4. used in insulinoma
1. Ans(3)
12. True about acute pancreatitis:
1. Alcohol is the MC cause
2. 20-25% needs surgical treatment
3. CECT is preferred over USG for diagnosis
4. Serum amylase is a diagnosis
5. Gray turner sign is seen around the umbilicus
1. Ans(3)
13. Ectopic pancreatic tissue with cells are seen in:
1. Stomach
2. Meckel’s diverticulum
3. omentum
4. Appendix
1. Ans(1)
14. True about acute pancreatitis are all except:
1. gallstones and alcohol are common
2. S.amylase levels increases after 72 hours of the attack
3. can cause secondary pleural effusion
4. can present with shock
1. Ans(2)
15. Which of the following types of islet cells secrete amylase
1. Alpha cells
2. beta cells
3. Delta cells
4. F cells
1. Ans(2)
16. Which of the following is true about acute pancreatitis?
1. pain lasts for several hours
2. Serum amylase levels correlated with severity of an attack
3. Can cause secondary pleural effusion
4. can presents with shock
1. Ans(1,3)
17. Investigation of choice to visualize pancreas is:
1. MRI
2. CT scan
3. USG abdomen
4. ERCP
1. Ans(2)
18. Which of the following is true about acute pancreatitis?
1. pain lasts for several hours
2. Serum amylase levels correlate with severity of an attack
3. common in alcoholics
4. low serum calcium levels indicate the good prognosis
1. Ans()
19. Acute pancreatitis is caused by:
1. gallstone
2. alcohol
3. starvation
4. hypercalcemia
5. hypertriglyceridemia
1. Ans(1,2,4,5)
20. Which is not a feature of pancreatic ascites?
1. Low protein
2. Somatostatin is the drug of choice
3. communication with the pancreatic duct in 80%
4. raised amylase levels
1. Ans(1)
21. pancreatitis may be produced by the following drug:
1. Colchicines
2. L-Asparaginase
3. Ciprofloxacin
4. nalidixic acid
1. Ans(2)
22. Chronic pancreatitis was seen in all except:
1. Chronic renal failure
2. intraductal mucinous carcinoma
3. Alcohol
4. Gallstones
5. pancreatic divisum
6. none
1. Ans(6)
23. Common causes(s) of acute pancreatitis is are:
1. Alcohol
2. gallstone
3. primary biliary cirrhosis
4. L-asparaginase
1. Ans(1,2)
24. The feature of chronic pancreatitis with regarding to pancreatic cancer:
1. Smooth pancreatic duct dilation with an abrupt interruption
2. calcification
3. duct penetrating sign
4. duct/gland width ration <0.5
5. Dilation of bile and pancreatic duct
1. Ans(2,3,5)
25. Pancreatitis caused by
1. ascending cholangitis
2. ↑ ed PTH
3. CBD stone
4. Alcohol
5. starvation
1. Ans(2,3,4)
26.Severity of acute pancreatitis correlate with levels of all of the following except
a) Glucose
b) Amylase
c) Transaminase
d) Calcium
Correct answer : b) Amylase
Amylase levels can be used to diagnose acute pancreatitis. But there is no
correlation between amylase levels and severity of acute pancreatitis.
What are the risk factors for developing prostate cancer?
A Sexual activity
B Age
C Smoking
D All of the above
What are common signs and symptoms of prostate cancer?
A Decreased flow when urinating
B Trouble getting an erection
C Blood in urine
D All of the above
How is prostate cancer diagnosed?
A Blood test
B Physical examination
C Both A & B
D Neither A or B
What percentage of prostate cancer diagnoses are made early?
A 90%
B 75%
C 60%
D 40%
Question 01
Risk factors for prostate cancer include which one of the following?
a) Castration before age 40 years
b) Black race
c) Asian race
d) Young age
Question 02
Which of the following is true regarding prostate cancer?
a) The lifetime risk of developing it is 10%
b) It is the most common cause of cancer death in men
c) Incidence is falling
d) It accounts for approximately 30% of all cancers in men
Question 03
In diagnosis of prostate cancer:
a) all patients should have a digital rectal examination (DRE)
b) most patients with a PSA>4ng/ml will have prostate cancer
c) urinary obstructive symptoms are highly suggestive
d) biopsy is usually by fine needle aspiration (FNA)
Question 04
Which one of the following statements is true of prostate cancer?
a) Gleason score 3 describes a poorly differentiated tumour
b) 65% of patients with Gleason score 5-7 will die from prostate cancer
within 15 years
c) PSA >50ng/ml is often associated with distant bone metastases
d) T2 describes a tumour that has extended through the capsule
Question 05
Which of the following statements is true in management of prostate cancer
which is confined to the prostate gland?
a) Active surveillance is a valid approach
b) Prostatectomy has been shown to be superior to radiotherapy
c) Radiotherapy causes impotence in 50% of patients
d) Prostatectomy leads to long term incontinence in 5% of patients
Question 06
In metastatic prostate cancer:
a) median survival is 18 months
b) hormone therapy will produce responses in around 70% of men with bone
metastases
c) the median response duration of hormone therapy is 8 months
d) chemotherapy is the most commonly used systemic treatment used
Question 07
Side effects of hormone treatment rarely include which one of the following?
a) Hot flushes
b) Loss of libido and potency
c) Osteoporosis
d) Myelopsuppression
Question 08
In treatment of hormone refractory prostate cancer:
a) docetaxel and prednisolone have been shown to increase median survival
by 2 months
b) mitoxantrone and prednisolone have been shown to increase median
survival by 1 month
c) withdrawing anti-androgen therapy confers no benefit
d) intravenous radio-isotope therapy has been shown to increase median
survival by 3 months
Question 09
Which one of the following statements is true of prostate bone metastases and
their complications?
a) Most fractures occur as the result of trauma
b) Spinal cord compression is usually managed surgically
c) Prophylactic orthopaedic intervention may be required for bone lesions at
high risk of fracture
d) Bisphosphonates may help to reduce bone pain but do not reduce the
number of cancer-associated skeletal events
Question 10
Which one of the following symptoms is rare in patients with progressive
prostate cancer?
a) Symptomatic anaemia
b) Urinary retention
c) Sexual dysfunction
d) Haematemesis
Which of the following presentations of prostate cancer is most common?
Squamous cell carcinoma found in the peripheral zone
Acinar adenocarcinoma found in the central zone
Acinar adenocarcinoma found in the peripheral zone
Sarcoma found in the transitional zone
Which of the following combinations of imaging
studies provide good imaging of the prostate and
increase the yield of positive biopsies by targeting
abnormal areas?
MRI and CT
17%
Ultrasonography and CT
10%
MRI and ultrasonography
63%
PET and ultrasonography
Which of the following is not typically recommended
as a treatment option for locally confined, medium-risk
prostate cancer in a 69-year-old healthy man?
YOUR PEERS CHOSE:
External-beam radiation therapy
9%
Robotic prostatectomy
23%
Total androgen deprivation
39%
Watchful waiting
29%
Colorectal Cancer
Instructions
Choose your answers from a-d by clicking the radio button next to each choice and then press 'Submit'
to get your score.
Question 01
Risk factors associated with colorectal cancer include which one of the following?
a) Irritable bowel syndrome
b) Low intake of dietary fibre
c) Low intake of red meat
d) Chronic aspirin therapy
Question 02
Colorectal cancer:
a) is more common in males.
b) is the most common cancer in the UK.
c) most commonly occurs in the caecum.
d) commonly arises from pre-existing adenomas.
Question 03
Characteristic presenting features of left sided colorectal tumours include:
a) acute large bowel obstruction.
b) iron deficiency anaemia.
c) painless abdominal mass.
d) foul smelling stools which are difficult to flush.
Question 04
Features associated with poor prognosis in colorectal cancer include:
a) adenocarcinoma cell type.
b) rectal bleeding at presentation.
c) presence of involved lymph nodes.
d) lymphocytic response to tumour.
Question 05
Surgery for liver metastases from colorectal cancer is:
a) associated with a 10% mortality.
b) contraindicated if more than 1 lesion is present.
c) associated with 16-40% 5 year survival.
d) usually followed with consolidation radiotherapy.
Question 06
5 Fluorouracil based chemotherapy:
a) is indicated for all patients with Duke's B tumours.
b) in combination with capecitabine improves survival to around 18 months in metastatic disease.
c) is likely to impair quality of life when used in the metastatic setting.
d) improves 5 year survival rates for patients with Duke's C tumours by approximately 7%.
Question 07
Which of the following is a feature of colorectal cancer?
a) In Duke's A disease >90% patients are cured by surgery alone.
b) Distant metastases are present in less than 5% of patients at presentation.
c) Chemotherapy has no effect on survival.
d) In Duke's C disease
Question 08
Bevacizumab:
a) is a monoclonal antibody that targets vascular endothelial growth factor (VEGF).
b) is a monoclonal antibody that targets epidermal growth factor receptor (EGFR).
c) has no proven survival benefit in the metastatic setting.
d) is standard treatment for metastatic colorectal cancer in the UK.
Question 09
Regarding metastases from colorectal cancer and symptomatic management of them:
a) liver metastases are a rare feature.
b) hyperproteinaemia is common.
c) liver capsular pain usually responds well to non-steroidal anti-inflammatory drugs.
d) cerebral metastases are common.
Question 10
Acute bowel obstruction in advanced colorectal cancer:
a) is usually managed by surgery.
b) is usually caused by obstruction at a single site in the bowel.
c) should be treated with regular oral anti-emetics, analgesics and anti-spasmodics.
d) should be treated with using a syringe driver containing a mixture of anti-emetics, analgesics and anti-
spasmodics.
When teaching woman breast self-examination, ONE of the following statements is true
a. The best time to check is just before the period
b. Use your fingertips not the flat of your fingers
c. examine both breasts once every three months
d. Nine out of ten breast lumps found are harmless
