Gastroenterology and Surgery Flashcards
7 cards from real AMC MCQ practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastroenterology and Surgery flashcards as text
A 55-year-old man presents with painless progressive obstructive jaundice, weight loss, and a palpable non-tender gallbladder. What is the most likely diagnosis?
Answer: Carcinoma of the head of the pancreas
Courvoisier's law states a palpable non-tender gallbladder with painless jaundice suggests pancreatic head malignancy rather than gallstones.
Which serum marker is most useful for monitoring pancreatic adenocarcinoma?
Answer: CA 19-9
CA 19-9 is the principal tumour marker used to monitor pancreatic adenocarcinoma response and recurrence.
A patient with severe acute pancreatitis develops a fall in serum calcium. What is the mechanism?
Answer: Saponification of calcium by released fatty acids
Lipase-mediated fat necrosis binds calcium to free fatty acids (saponification), lowering serum calcium.
Which scoring system uses CRP and is commonly applied to assess acute pancreatitis severity at 48 hours?
Answer: Glasgow (Imrie) criteria
The Glasgow/Imrie criteria stratify pancreatitis severity, and CRP >150 supports severe disease.
A 70-year-old presents with sudden severe abdominal pain out of proportion to examination findings and atrial fibrillation. What is the most likely diagnosis?
Answer: Acute mesenteric ischaemia
Pain out of proportion to signs with AF (embolic source) is classic for acute mesenteric ischaemia.
Which is the most appropriate initial imaging for suspected acute cholecystitis?
Answer: Abdominal ultrasound
Ultrasound is first-line, showing gallstones, wall thickening, and a sonographic Murphy's sign.
A patient with cirrhosis develops confusion, asterixis, and elevated ammonia. What is the first-line treatment?
Answer: Lactulose
Lactulose reduces ammonia absorption and is first-line therapy for hepatic encephalopathy.