Finals 2nd Sem Flashcards

1
Q

The most accurate evaluation procedure in the study of colon and rectum

A. Occult blood test in the stools
В. X-rays
C. Endoscopy
D. Digital rectal exam

A

Endoscopy

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2
Q

Characterized by polyps carpeting the entire colon:

A. Hamartomatous polyps
B. Juvenile Polyposis Coli
C. Adenomatous Polyp
D. Inflammatory Polyp

A

Juvenile polyposis coli

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3
Q

Elderly and malnourished patients are susceptible to this condition:
A. Amebic Colitis
B. Radiation Colitis
C. Ischemic Colitis
D. Pseudomembranous Colitis

A

Pseudomembranous colitis

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4
Q

This condition commonly occurs in elderly individuals:
A. Pseudomembranous colitis
B. Amebic Colitis
C. Ischemic Colitis
D. Radiation Colitis

A

Ischemic Colitis

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5
Q

Characterized by bright red, painless rectal bleeding
A. Internal Hemorrhoids
B. External Hemorrhoids
C. Rectal cancer
D. Anal cancer

A

Internal Hemorrhoids

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6
Q

Located above the dentate line:
A. Internal Hemorrhoids
B. Extemal Hemorrhoids
C. Fistula-in-ano
D. Anal cancer

A

Internal Hemorrhoids

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7
Q

The rule which guides the location of the internal sphincter in Fistula- in-ano is:
A. Benedicts rule
B. Hendelsonn’s rule
C. Goodsall’s rule
D. none of the above

A

Goodsall’s rule

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8
Q

The most common location of colorectal cancer is:
A. Rectum
B. Recto-sigmoid
C. Transverse Colon
D. Left Colon

A

Recto-sigmoid

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9
Q

Which of the following is characterized by an outpouching of the entire wall of the colonic wall?
A. False Diverticulum
B. True Diverticulum
C. Diverticulitis
D. Angiodysplasia

A

True Diverticulum

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10
Q

The following is/ are cause of occult lower-GI bleeding:
A. volvulus
B. cancer of the right colon
E. diverticulosis
D. colitis

A

Cancer of the right colon

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11
Q

Which of the following is a precancerous polyp?
A. Adenomatous Polyp
B. Inflammatory Polyp
C. Hamartomatous Polyp
D. A & C

A

Adenomatous polyp

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12
Q

Inverted U or bent inner tube sign on abdominal x-ray of a patient with abdominal pain and distension is a characteristic of
A. Diverticulitis
B. Colon Cancer
C. Volvulus
D. none of the above

A

Volvulus

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13
Q

The Criminal Nerve of Grassi is a branch of:
A. Anterior vagus
B. Posterior vagus
C. Vagal trunk
D. Diaphragmatic trunk

A

Posterior vagus

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14
Q

Helicobacter pylori contributes in the development of peptic ulcer by inhibiting:
A. ECL cells
B. Parietal cells
C. D cells
D. G cells

A

D cells

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15
Q

76 year old/M,, slightly pale complained of epigastric pain, your primary clinical impression is:
A. Gastric carcinoma
B. Peptic ulcer disease
C. Gastric ulcer
D. Gastrointestinal stromal tumor

A

Peptic ulcer disease

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16
Q

Patient admitted because of diffuse board like abdomen, to help confirm impression you request:
A. CT scan
B. Ultrasound
C. Endoscopy
D. Chest x-ray upright

A

Chest x-ray upright

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17
Q

Which part of ulcer surgery will address gastrin stimulus:
A. Antrectorny
B. Truncal vagotomy
C. Highly selective vagotomy
D. Pyloroplasty

A

Antrectomy

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18
Q

Patient is diagnosed to have gastric carcinoma with an intraoperative findings of aG cm mass at the antrum, no lymph nodes noted, surgical procedure should be:
A. Radical Subtotal Gastrectomy
B. Radical Total Gastrectomy
C. Subtotal Gastrectomy
D. Antrectomy

A

Radical Subtotal Gastrectomy

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19
Q

Which bleeding artery of the stomach would require surgery once seen by endoscopy ?
A. Short gastric
B. Mucosal artery
C. Right gastroepiploie
D. Left gastroepiploic

A

Mucosal artery

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20
Q

Patient is diagnosed to have massive upper GL bleed, endoscopy showed a bleeding mucosal vessel at the proximal body, your diagnosis is:
A. gastric ulcer
B. gastric cancer
C. Dieulafoy’s lesion
D. Zolliger Ellison syndrome

A

Dieulafoy’s lesion

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21
Q

Which ulcer surgery will preserve the GI function? a.
A. Billroth I
B. Billroth II C.
C. Antrectomy + vagotomy
D. Proximal gastric vagotomy

A

Proximal gastric vagotomy

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22
Q

Patient was diagnosed to have gastric adenocarcinoma, with a 5 cm epigastric mass, and left supraclavicular lymph node. No other signs of organ metastasis. Stage is:
A. I
B. II
C. III
D. IV

A

I

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23
Q

Patient presented with gastric outlet obstruction, with a fesectable gastric adenocarcinoma with liver metastasis, you recommend:
A. Gastric bypass
B. Tube jejunostomy
C. Radical Subtotal Gastrectomy
D. Subtotal gastrectomy

A

Gastric bypass

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24
Q

A patient with a history of pancreatitis 2 weeks ago was admitted because of abdominal mass with tenderness, your impression is
A. Pancreatic cancer
B. Pancreatic Cyst
C. Pseudocyts of the pancreas
D. Pancreatic abscess

A

Pseudocyts of the pancreas

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25
A patient with a history of pancreatitis 2 weeks ago was admitted because of abdominal mass with tenderness. What would be the diagnostic procedure that would aid in managing the case in previous number: A. ERCP B. CT scan C. MRI D. Ultrasound
CT scan
26
Diagnostic procedure revealed 4 cm pseudocyst of the pancreas with a cyst wall measuring 0.5 cm and homogenous appearance, your recommendation is A. Cysto-gastrostomy B. External drainage C. ERCP D. Observation
External drainage
27
A patient with jaundice and no complains of vomiting had a 3cm allenocarcinoma, was noted at the head of the pancreas with no lymph nodes, your recommendation is A. Pancreaticoduodenectomy B. Resection of the pancreas C. Biliary by-pass procedure D. ERCP and stenting
Pancreaticoduodenectomy
28
A 35 year old male with severe epigastric pain was admitted with the following laboratories on admission: WBC - 20,000; blood glucose - 400 Serum amylase of 1500. Physical examination he was febrile with distended and tender abdomen and discoloration on the flanks. Ct scan results with fluid collection surrounding the pancreas, you recommend (need review) A. Medical management B. Surgery C. ERCP D. Antibiotics
Surgery
29
What is the most common pancreatic endocrine tumor: A. Gastrinoma B. Insulinoma C. Somastostinoma D. Glucagonoma
Insulinoma
30
A patient with jaundice and no complains of vomiting had ag cm adenocarcinoma was noted at the head of the pancreas with no lymph nodes, your recommendation is A. Pancreaticoduodenectomy B. Resection of the pancreas C. Biliary by-pass procedure D. ERCP and stenting
Pancreaticoduodenectomy
31
A 35 year old male with severe epigastric pain was admitted with the following laboratories on admission: WBC - 20,000; blood glucose - 400 Serum amylase of 1500. Physical examination he was febrile with distended and tender abdomen and discoloration on the flanks. Ct scan results with fluid collection surrounding the pancreas, you recommend (not reviewed) A. Medical management B. Surgery C. ERCP D. Antibiotics
Surgery
32
A patient is diagnosed with biliary pancreatitis with an amylase of 3,000. , you will recommend a. Cholecystectomy b. ERCP c. Cholecystectomy, IOC, Common bile duct exploration with choledocholithotomy and t-tube insertion d. Fluids and antibiotics is sufficient
ERCP
33
68 year old, diabetic was dingnosed to have pancreatic hend carcinoma presented with jaundice without symptoms of gastric outlet obstruction, upon surgery you noted a 3 cm tumor with no involvement of other vital structures with the presence of multiple nodules on the liver, you will proceed with a. Whipples Procedure b. Cholecystojojunostomy c. Choledochojejunostomy d. Cholecytojejunostomy and gastrojejunostomy
Whipples Procedure
34
Patient with acute pancreatitis was requested with CT scan after three days of abdominal pain. CT findings showed. Definite diagnosis will be heterogenous with and non-liquid density with varying loculations. a. Surgery b. MRI c. Diagnostic laparoscopy d. Biopsy
MRI
35
What would be the recommended CT scan for Acute pancreatits A. Plain CT B. Water contrast CT C. Air contrast CT D. Intravenous contrast CT
Intravenous contrast CT
36
Patient with acute pancreatitis will have a serum amylase of at least A. 85 U/L B. 250 U/L C. 500 U/L D. 750 U/L
250 U/L
37
Patient diagnosed with a Pancreatic pseudocyst, CT scan showed a 2 cm cyst wall, you do a. Cysto-gastrostomy b. External Drainage c. Aspiration d. Cyst enucleation
Cysto-gastrostomy
38
As nutritional support for patients with acute pancreatitis you recommend A. Naso-Gastric tube B. Parenteral Nutrition C. Enteral nutrition D. Elemental diet
Enteral nutrition
39
Pancreatic tumor causing Zolinger-Ellison Syndrome is a. Gastnnoma b. Insulinoma c. Adenocarcinoma d. Glucagonoma
Gastrinoma
40
Which of the following statement is TRUE regarding characteristics of pain? (Not reviewed) A. Sensitivity to pain remains approximately the same throughout the life of an individual B. Repeated painful stimuli result in an accommodation to the stimuli and subsequent raining to the threshold C. Underlying metabolic disorders can later an individual's response to pain. D. Pain produces some degree of sympathetic response in virtually all cases
B. Repeated painful stimuli result in an accommodation to the stimuli and subsequent raining to the threshold
41
In the clinical evaluation of abdominal pain, which of the following characteristics is important to elicit? a. A. Severity B. Location C. Timing D. Aggravating and alleviating factors
Location
42
Which of statements is an appropriate principle in the management of intestinal obstruction? A. Closed-loop obstruction represents a surgical emergency B. In a partial small bowel obstruction, there is no advantage to delay in surgical intervention C. The use of "long" intestinal tube is cumbersome and time-consuming that it has no significant role in the moder management of obstruction D. Most strangulated obstruction progress sufficiently quickly that fluid and electrolyte abnormalities
A. Closed-loop obstruction represents a surgical emergency
43
Which of the following statement is NOT true regarding gastrointestinal bleeding? (Not reviewed) A. The definition of hematemesis is limited to the vomiting of fresh blood from source proximal to the ligament of Treitz. (Not reviewed) B. Approximately 500 ml of gastrointestinal blood loss in required to produce melena C. The presence of occult blood in the stool may persist up to 3 weeks following an acute episode of gastrointestinal bleeding D. The hematocrit level is a reliable measure of one's blood volume during the first 6 hours following an acute gastrointestinal bleeding
Approximately 500 ml of gastrointestinal blood loss in required to produce melena
44
The following accurately characterizes the metabolic consequences of protracted vomiting ЕХСЕРТ: A. Hypovolemia B. Hypokalemia C. Hipohloremia D. Alkalosis
Hypokalemia
45
The following pathophysiologic mechanisms may result in diarrhea? A. Excessive secretion B. The presence of poorly absorbable substances within the gastrointestinal tract C. Malabsorption of ions D. All of the above
All of the above
46
Which of the statements is TRUE regarding the clinical manifestations of intestinal obstruction? (Not reviewed) A. Severe cramping pain follows the associated hyperstasis by several minutes B. Abdominal distention is not considered an carly sign of obstruction C. In long standing 1/bowel obstruction, the vomitus frequently becomes dark and malodorous representing regurgitated feces D. Vomiting is feature of all forms of bowel obstruction
In long standing 1/bowel obstruction, the vomitus frequently becomes dark and malodorous representing regurgitated feces
47
Which of the following statements is TRUE regarding the physical findings of patient with a mechanical bowel obstruction? (Not reviewed) A. Fever and tachycardia are usually resent within the first 12hours of the obstruction B. Dehydration is rarely present before vomiting develops, since, up to the point, fluid has not actually been lost from the body C. Even in the absence of peritonitis, palpation during attacks of pain may reveal tenderness and cause guarding D. Except for instances in which blockage is incomplete, auscultatory findings are sufficiently non-specific that they do not assists the evaluation of the patient with a bowel obstruction
Even in the absence of peritonitis, palpation during attacks of pain may reveal tenderness and cause guarding
48
A 35 year old man is brought to the ER due to mid-epigastric pain since 2 hours ago No anorexia or vomiting was elicited. Abdominal examination revealed "soft signs". What is the most appropriate medication than can be prescribe? (Not reviewed) A. Etoricoxib B. Celecoxib C. Tramadol D. None of the above
Tramadol
49
The best measure to resolve the above condition is: (Not reviewed) A. AGI endoscopy B. Dexametansone C. PPI's D. Stop medication
AGI endoscopy
50
Six hours upon admission, above patient was noted to have severe abdominal pain with tension in the abdominal wall. Likewise, pain in the left shoulder area was observed especially while in supine position. This sign is? A. Balance's B. Kehr's C. Toret's D. None of the above
Kehr’s
51
The most significant history to elicit in a patient with acute surgical abdomen is A. Anorexia B. Pallor C. Vomiting D. Fever
Vomiting
52
A 25 year old patient currently on her 6* month of pregnancy develops moderate to severe right uppec quadrant gain. One of the following statements maybe incorrect (Not reviewed) A. Patients on labor B. Consider torsion of the ovary C. Hydrops of the gallbladder is possible D. Appendicitis is easily ruled-out
D. Appendicitis is easily ruled-out
53
Which epithelial cell at the mucosal crypts is responsible for the secretion of grownh factors. A. Goblet cells B. Enteroendocrine cells C. Paneth cells D. Enerocytes
Paneth cells
54
A 30 year old male who had history of ruptured appendicitis 10 years ago was admitted because of vomiting and absence of bowel movement for three days. PE tachycardic, distended abdomen with sight randeres at the epigastric area. What diagnostic procedure will help you in your diagnosis? A. Chest x-ray B. Upper GI series C. Lower GI endoscopy D. Scout film of the abdomen
Scout film of the abdomen
55
A 30 year old male who had history of ruptured appendicitis 10 years ago was admited because of voming and absence of bowel movement for three days. PE taechycardic, distended abdomen with sight randeres at the epigastric area. How would you manage the case? A. Schedule for exploration B. Start pain relievers C. Insert an NGT D. Start total parenteral nutrition
Start total parenteral nutrition
56
A 28 year old female complaining of recurrent abdominal pain and diarrhea. Upper Gl endoscopy revealed a superficial ulcer with surrounding emythema at the antrum. A. Proton pump inhibitor B. Sulfasalazine C. H. pylori regimen D. Gastrectomy
H. pylori regimen
57
After exploratory laparotomy for trauma a greenish, foul smelling discharge amounting to 300 ml per day and a CT scan finding of complex mass at the right lower quadrant. The recommended management would be (Not reviewed) a. Surgical exploration e. Control of infection b. Total parenteral nutrition d. Bowel rest
Surgical exploration
58
70 year old female was admitted because of 15 days history of moderate to high grade fever and sudden severe abdominal pain. Possible diagnosis a. Perforated peptic ulcer disease c. Ruptured generalized appendicitis b. Perforated typhoid ileitis d. Torsion of the right ovary
Perforated typhoid ileitis
59
A 65 year old male uncontrolled diabetic was admitted because of a right lower quadrant mass, he had a previous history of an epigastric pain radiating to the right lower quadrant. On physical examination he was febrile with episodes of hypotension and a direct and rebound tenderness on the right lower quadrant. Your recommendation would be A. Empiric antibiotic only B. Percutaneous drainage C. Surgical drainage D. Right hemicolectomy
Empiric antibiotic only
60
A 75 year old known diabetic and hypertensive was admitted because of severe abdominal pain. Physical examination showed slightly distended abdomen, slight tenderness on both lower quadrants, moderate grade fever and stable vital signs. (Not reviewed) Your impression would likely be A. Acute appendicitis B. Acute superior mesenteric occlusive disease C. Chrons disease D. Acute gastroenteritis
Acute appendicitis
61
A 25 year old male undergoing exploratory Japarotomy for trauma had an incidental finding of a non-obstructing 4x cm mass at the jejunum, you will: (Not reviewed) A. Do a segmental jejunal resection with 10 cm margin B. Excise the mass C. Leave the mass and do close monitoring and follow up D. Resect the mass after the patient has recovered from his injuries
C. Leave the mass and do close monitoring and follow up
62
The most common benign symptomatic tumor of the small intestine is A. Gastrointestinal stromal tumor B. Leiyomyoma C. Adenoma D. Hamartoma
Leiyomyoma
63
The largest part of the stomach is the: A. Cardia B. Fundus C. Body D. Antrum
Body
64
Which is a primary stimulus for acid production A. Parietal cells B. Acetylcholine C. ECL cells D. Vagus nerve
Acetylcholine
65
The findings of plagues on proctoscopy in a patient with watery diarhea is characteristic of: A. Amebic Colitis B. Pseudomembranous Colitis C. Amebic Dysentery D. Solitary Ulcer Syndrome
Pseudomembranous Colitis
66
Characterized by remission and exacerbation of symptoms. A.Ulcerative Colitis B. Amebic Colitis C. Ischemic Colitis D. All of the above
Ulcerative Colitis
67
Which portion of the rectum drains into the portal system? A. Superior rectum B. Middle rectum C. Lower rectum D. A and B
Superior rectum
68
Surgery may be indicated in the ff except, A. acute attack of diverticulitis B. complicated diverticulitis C. recurrent attacks of diverticulitis D. band c
acute attack of diverticulitis
69
Massive lower GI bleed is commonly caused by the ff except A. Angiodysplasia B. Diverticular disease C. Colon cancer D. None of the above
D. None of the above
70
A 60 years old male was diagnosed to have a fungating middle 3 rectal lesion. Biopsy showed poorly differentiated adenocarcinoma. Which subsequent procedures is/are options? A. Do surgery B. Do cancer staging C. Do a transrectal ultrasound D. Any of the above
Do cancer staging
71
The most accurate diagnostic procedure for the diagnosis of colorectal diseases is A. endoscopy B. radiography C. arteriography D. all of the above
endoscopy
72
The etiologic agent of Peudomembranous colitis is A. Clostridium perfringens B. Clostridium deficili C. Enterobacter D. none of the above
Clostridium deficili
73
A patient sought consultation at the emergency room for anterior chest pain. The pain is pronounced when lying down and in deep breathing. This is accompanied by fever. This is consistent with: a. Myocardial infarction b. Acute pericarditis c. Pneumonia d. Pneumothorax
Acute pericarditis
74
The most effective diagnostic procedure for pericardial effusion is: A. Electrocardiogram B. Chest x-ray C. Echocardiogram D. Ultrasound
Echocardiogram
75
The " square root" sign of ventricular pressure tracing is characteristic of: A. Myocardial infarction B. Constrictive pericarditis C. angina pectoris D. myocarditis
Constrictive pericarditis
76
Homan's sign is positive in patient with: A. Deep venous thrombosis B. pulmonary thromboembolism C. aortic aneurysm D.Varicose veins
Deep venous thrombosis
77
The basic hemodynamic problem in PDA is: A. Desaturation B. Low cardiac output C. Pressure overload D. Volume overload
Volume overload
78
10 years after biliroth II surgery for peptic ulcer disease, patient had melena and weightloss, diagnosis is A. Intrinsic factor deficiency B. Gastric carcinoma C. Recurrent peptic ulcer disease D. Acute gastritis
Recurrent peptic ulcer disease
79
The longest portion of the duodenum is A. Superior B. Descending C. Horizontal D. Ascending
Descending
80
H. pylori infection increase acid secretion in the stomach through the A. Inhibitory effect on antral D cells B. Reduce secretion of duodenal bicarbonates C. Elaboration of cagA toxin D. Elaboration of interleukin 8
A. Inhibitory effect on antral D cells
81
The largest part of the stomach is the A. Cardia B. Fundus C. Body D. Antrum
Body
82
Highly selective vagotomy means cutting the A. Main trunk of the vagus nerve B. Criminal nerve of Grassi C. Nerve of Latterjet on the lesser curvature D. Anterior vagus nerve
Anterior vagus nerve
83
Secretion of what substance is part of the exocrine function of the pancreas A. Cholecystokinin B. Somatostatin C. Proteases D. Insulin
Proteases
84
A 38 year old male after a drinking spree was admitted because of severe epigastric pain penetrating to the back, accompanied by jaundice, your impression would be A. Choledocholithiasis B. Pancreatitis C. Peptic ulcer disease D. Calculous cholecystitis
Pancreatitis
85
A 38 year old male after a drinking spree was admitted because of severe epigastric pain penetrating to the back, accompanied by jaundice. You would initially request for A. ERCP B. Endoscopy C. Ultrasound D. CT scan
CT scan
86
A 69 year old female admitted because of a history of vague abdominal pain with jaundice and pruritus, ultrasound only showed distended gallbladder, your impression would be A. Acalculous cholecystitis B. Choledocholithiasis C. Pancreatic cancer D. Liver cirrhosis
Acalculous cholecystitis
87
A 7 month infant was brought to the emergency room because of a days cough associated with rapid breathing. He was noted to feed poorly and diaphoretic. On physical examination, patient was noted to be small for age, tachycardic and tachypneic with basal rales and occasional rhoncitis and wheezing. There was precordial bulge and dynamic precordium. A grade 3/6 murmur was appreciated of the left lower sternal border. Peripheral pulses were equal in all extremities. The palms and soles were noted to be a bit pail and cool to touch. The most likely diagnosis is A. Atrial septal defect B. Ventricular septal defect C. Patent ductus arteriosus D. Mitral stenosis
Patent ductus arteriosus
88
The pale and cool extremities in the patient can be explained by one of the following A. Stimulation of B activity B. A-1 and angiotensin response C. Increased metabolic demand
A-1 and angiotensin response
89
A 7 month infant was brought to the emergency room because of a days cough associated with rapid breathing. He was noted to feed poorly and diaphoretic. On physical examination, patient was noted to be small for age, tachycardic and tachypneic with basal rales and occasional rhoncitis and wheezing. There was precordial bulge and dynamic precordium. A grade 3/6 murmur was appreciated of the left lower sternal border. Peripheral pulses were equal in all extremities. The palms and soles were noted to be a bit pail and cool to touch. Most important approach to the patient is A. Giving preload unloaders such as diuretics B. Giving after load unloaders to decrease left to right shunting C. Surgery D. Salt and fluid restriction
Surgery
90
The most significant hemodynamic problem in the patient is A. Increased preload B. Increased after load C. Decreased heart rate D. Decreased contractility
Increased after load
91
After their block examination, a group of medical students decided to have dinner at festive mall. After, had a brawl with a group of bystanders, one was stabbed at the left anterior chest. One should not be done to the patient A. Request for electrocardiogram B. Dress the wound and send the patient home C. Request for 2D echocardiogram D. Admit and start IVF
Dress the wound and send the patient home
92
On the way to the x- ray room, the patient became hypotensive with distended neck veins and distal heart sounds. Most probably he is A. Pulmonary contusion B. Cardiac tamponade C. Flail chest D. Myocardial infection
Cardiac tamponade
93
The resident physician performed an emergency pericardiocentesis, his attention was called for when the blood in the bottle did not clot. Which of the following statements is true A. The blood obtained is from the cardiac chamber B. The patient has coagulation problem C. He should continue the procedure until there is improvement in the vital sign D. Vit. K should be administered
He should continue the procedure until there is improvement in the vital sign
94
The triad of dyspnea, cyanosis, and heart failure is considered with (Not reviewed) A. Aortic stenosis B. Tricuspid regurgitation C. Mitral stenosis D. Pulmonary embolism
Mitral stenosis
95
Cour-en-sabot configuration is suggestive of A. TGA B. Partial anomalous pulmonary venous return C. TOF D. Tricuspid atresia
TOF
96
The patient is awakened after one hour of sleep sweeting and wheezing and relieved by sitting upright after 30 minutes. This is called A. Orthopneic B. Paroxysmal nocturnal dyspnea C. Russmuod's breathing D. Orthopnea
Paroxysmal nocturnal dyspnea
97
The smell of food stimulates gastric acid production by secreting A. Gastrin B. Acetylcholine C. Histamine D. Somatostatin
Acetylcholine
98
The gastro-esophageal junction is supplied by what artery A. Right gastric B. Left gastric C. Short gastric D. Celiac
B. Left gastric
99
The findings of plaques on proctoscopy in a patient with watery diarrhea is characteristics of A. Amebic Colitis B. Pseudomembranous Colitis C. Amebic dysentery D. Solitary Ulcer Syndrome
Pseudomembranous Colitis
100
A patient with acute pancreatitis was requested with CT scan after 3 days of abdominal pain. CT findings showed heterogenous with a non-liquid density with varying loculations. Definite diagnosis will be A. Surgery B. MRI C. Diagnostic laparoscopy D. Biopsy
MRI