MCQS 1.

The best root for nutrition in a stroke patient who requires feeding for more than four weeks is a. feeding jejunostomy b. TPN c. Percutaneous endoscopic gastrostomy feeding d. nasogastric feeding 2. A 45 year old obese man is undergoing laproscopic cholecystectomy. The abdomen has been rapidly insufflated with Carbon di oxide. The anaesthetist alerts you to a sudden and rapid drop in blood pressure and increase in heart rate.This event occurred most likely due to a.Carbon di oxide embolus b. pneumothorax c. reduced venus return d.respiratory compromise 3. A 56 year old woman presents with a two weeks history of increasing jaundice and pruritis. Further questioning reveals that she has vague epigastric pain radiating to the back for last few months.On examination gall bladder is palpable with no obvious hepatomegaly.The most likely diagnosis is a. cholangiocarcinoma b. pancreatic carcinoma c. carcinoma of gal bladder d. hepatocellular carcinoma 4. A 60 year old man presents to the emergency department with a three weeks history of right upper quadrant pain, weight loss and abdominal distension.Examination reveals jaundice, a nodular and enlarged liver and presence of shifting dullness. The most likely diagnosis is a. hydatid disease

Her abdomen appears mildly distended. cholecystitis . gastric perforation d.pancreatic fistula 6. Ac. emphysematous gall bladder 7.cronhns’ disease b. On examination he is pale dehydrated and has marked tenderness in epigestric region. A 27 year old man presents with a 7 days history of abdominal pain which radiates through to the back. basal atelectasis c. gallstone ileus d. cirrhosis of liver 5.Ac.Examination reveals temperature of 38. worse on respiration on 7 th post-op day of splenectomy. The most likely diagnosis is a. Ch.6 C. A 42 year old woman complains of left side chest and abdominal pain. pancreatitis c.b. cholecystitis b. volvulus c. subphrenic abscess b.decrease air entry and left upper quadrant tenderness. A 60 year old woman presents with a two day history of vomiting and colicky central abdominal pain.He has been vomiting conituously for last 2 days and has been unable to take any fluid. HCC d. liver abscess c. Which complication of splenectomy comes in your mind a.His bowels open regularly with no history of stetorrhoea. There is no history of similar episodes in the past.diverticular disease e.The most likely diagnosis is a. Abdominal film shows dilated small bowel and air in the biliary tree.

laproscopic colecystectomy +CBD exploration d. The treatment of choice for a 80 years old diabetic patient.d.000 a. thickening of gall bladder wall and common bile duct diameter of 5 millimeter. percutaneous gall bladder drainage 9. White cell count is 21. The management plan for a 45 years old woman who presents with a 2 days history of right upper quadrant pain. Ragarding liver function test. open colecystectomy +CBD exploration d. interval laproscopic colecystectomy d. early laproscopic colecystectomy + per operative cholangiography c. open colecystectomy b. percutaneous gall bladder drainage b. belirubin and alkaline phosphatase are markedly raised. . a. laproscopic colecystectomy c. ERCP and sphincterotomy c. ERCP and sphincterotomy b. rigors nausea and vomiting. open colecystectomy +CBD exploration 11. cystic fibrosis e. a.Ultrasound demonstrates a CBD diameter of 14 mm with multiple stones present. The treatment of choice for a patient who presents with worsening pain in right upper quadrant associated with nausea and vomiting.An ultrasound reveals gall stones. early laproscopic colecystectomy 10. who presents with a 3 days history of progressive right upper quadrant pain. . perforated deuodenal ulcer 8. She is febrile and has yellowish discoloration of body. She is neither clinically nor bio chemically jaundiced but is febrile. On examination he is septic and has a tender mass in right upper quadrant.

16 12. Internal jugular vein 13. vein on fore arm b.US b. jaundice d. the preferred vain is a. casoni’s skin test 15.Nutritional impairment is present when BMI is below a. 18 d. 20 c.US .For TPN.22 b. fever and chills c. To exclude onset of HCC in cirrhotic liver the test of choice is a. right subclavian vein d. vein on anticubital fossa c. Diagnosis of hydrated liver disease is by all except a. obliterated biliary channels in US 14. biliary colic b. left subclavian vein e.The common symptoms and signs of cholangitis are all except a. CT scan c. needle aspiration d.

amnd gall stones should be investigated for a.5 % b. A young child having enemia. none of above 16. Kehr sign in splenic trauma refers to a. 10% c. Alpha fetoprotein d. pain and hyperaesthesia in right shoulder c. 40% 19. CT scan . malaria d. The primary investigation of choice in gall stone disease is: a. bruising around left 10th and 11th ribs d. hiccup and haemoptysis on leg elevation 17. primary sclerosing cholangitis 18. 20% d.plain X-ray b. CT c.b.cystic fibrosis b. Gall stones are radioopaque in a. congenital spherocytosis c.pain and hyperaesthesia in left shoulder b.

may cause bacterial over growth in gut b.alcohol b. radionuclide scan e. CT scan d. cystic fibrosis c. 23. A 25 year old obese woman who denies any history of alcohol intake presents with severe abdominal pain radiating to back. cholelithasis 22. USG abdomin d. The most significant presentation of carcinoma of body of pancreas is a. serum amylase b. mumps d. pain . is less expensive than TPN d. All of the following are true for entral root of nutrition except: a. MRCP 20. Symptomatology alone 21.c.Labortory results indicate an increase in serum amylae and lipase with marked decrease in serum calcium. reduces stress ulceration c. Pancratitis is best diagnosed from a. decreases the incidence of cholestasis by promoting biliary flow. which of the following has likely caused this condition a. amylase clearance c.

The WBC is 11. oral cholecystography c. metronidazole c.The cholangiographic findings indicate that she has a cancer of the lower end of the CBD. radionuclide scan d. A 45 year old male is suspected of having an amebic abscess of the liver. enlarged pancreas d. A 67 year old woman is evaluated for obstructive jaundice. palpable tumer 25. anorexia d. shrunken pancreas e.enlarged gall bladder b. colon resection . none of above 26. sulfonamides and penicillin e.US b.cortisone b. The investigation of choice in acute cholecystisis is a. Clinical examination would most probably reveal which of the following a. jaundice 24. shrunken gall bladder c. weight loss c.Serum bilirubin is mildly elevated. surgical excision d.b.000 but there is eosinophilia.The initial line of treatment involves which of the following: a.

Normal saline contains all of the following except: a. The classic triade of pain right hypochondrium. What organism is most likely involved in the pathogenesis of ascending cholangitis? a.000 and a plain film of abdomen and CT scan shows evidence of intramural gas in the gall bladder. Sclerosing cholangitis d. ataphylococcus aureus 30. virchow’s triade . 20 mille mole per liter potassium 28. A 70 year old male presents with a clinical diagnosis of acute cholangitis. chaort’s triade c.callot’s triade b. acalculous cholecystitis c.27.water b. clostridia d. fever with rigor and chills and jaundice is known as: a. A 60 year old man is admitted to hospital with adiagnosis of acute cholecystitis . gallstone ileus 29. 150 mille mole per liter chloride d. 150 mille mole per liter sodium c. emphysematous gallbladder b. colonorchis sinensis b.The WBC count is 28. saint’s triade d. What is the most likely diagnosis? a. escherichia coli c.

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