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AMC MCQ > Gastroenterology by Dr Cintia > Flashcards

Gastroenterology by Dr Cintia Flashcards

1
Q

Diseases of the Small and Large Intestines

A
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2
Q

Crohn Dx CLINICAL FEATURES

A
  • Pain is more common, affects all colon except for rectum, skip lesions, transmural inflammation, causes fistulas, fissures, noncaseating granulomas, perianal disease.
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3
Q

Crohn Dx FIRST INVESTIGATION

A

-Stool sample faecal calprotectin (Neutrophil derived biomarker)
-CXR, AXR to see complications of peritonitis or toxic megacolon.

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4
Q

Crohn Dx BEST INVESTIGATION

A
  1. Biopsy (Cobblestone sign)
  2. MRI for perianal dx in Crohn.
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5
Q

Crohn Dx TREATMENT

A

1.Mild Crohn: Budesonide enteric- coated.
2.Diffuse Crohn: Oral Prednisolone.
3.Methotrexate
4.Azathioprine - Infliximab good for Crohn w/ perianal fistula

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6
Q

Ulcerative Colitis CLINICAL FEATURES

A
  • Bleeding is more common, only affects the mucosa, but all the colon with rectal involvement, loss of haustra, crypt abscesses and ulcers, can cause toxic megacolon, perforation, Assoc w Primary sclerosing cholangitis
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7
Q

Ulcerative Colitis BEST INVESTIGATION

A
  1. Biopsy
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8
Q

Ulcerative Colitis TREATMENT

A
  1. Mesalazine/Sulfasalazine (Rectal+Oral preparation)
  2. Add Steroids (Budesonide, hydrocortisone, prednisolone rectally.
  3. Add Steroids orally (Prednisolone) Methotrexate and sulfasalazine cause oligospermia. But sulfasalazine is safe
    to use in pregnancy and methotrexate not
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9
Q

syndrome diaphragmatic hernias

A
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10
Q

diaphragmatic hernia: Acquired

A
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11
Q

Congenital Malabsorption

A
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12
Q

Coeliac disease

A
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13
Q

Lactose intolerance

A
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14
Q

Diseases of the liver

A
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15
Q

Liver Function Test

A
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16
Q

Jaundice

A
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17
Q

drug-induced liver injury: Khat herbal leaves

A
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18
Q

Fatty liver (hepatic steatosis) Non-alcoholic fatty liver disease

A
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19
Q

Non-alcoholic steatohepatitis

A
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20
Q

Alcoholic hepatitis CLINICAL FEATURES

A
  • Marked neutrophilia, fever, hepatic pain, tenderness, encephalopathy
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21
Q

Alcoholic hepatitis FIRST INVESTIGATION

A
  • Inc AST>ALT, GGT
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22
Q

Alcoholic hepatitis TREATMENT

A

If encephalopathy->Prednisolone.
If CI (untreated inf)-> Oxpentifylline (CI in allergy to caffeine or theophylline)

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23
Q

alcoholic liver disease

A
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24
Q

Autoimmune hepatitis CLINICAL FEATURES

A
  • Cx by infliximab, nitrofurantoin, minocycline
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25
Q

Autoimmune hepatitis BEST INVESTIGATION

A

Abs:
- ANA (cheaper)
- SMA (Smooth muscle ab) - anti-LKM1 (anti liver kidney microsomes)-assoc w/poor response to tx

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26
Q

Autoimmune hepatitis TREATMENT

A

Prednisolone + Azathioprine

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27
Q

Haemochromatosis CLINICAL FEATURES

A

AR. Multiple symptoms.
Accumulate in pituitary (Libido, impotence with low FSH and LH), skin (dark skin), joint
(Polyarthritis), Pancreas (DM), Liver (Chronic hepatitis).
- MC Heart manifestation: CHF
- MCC death: Cirrhosis

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28
Q

Haemochromatosis FIRST INVESTIGATION

A
  1. Ion studies- Transferrin saturation>70% (Check transferrin and ferritin e/2y)
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29
Q

Haemochromatosis BEST INVESTIGATION

A
  1. HFE gene (C282Y gene- 80-90% pts in Oz are homozygous for this mutation). If Hets pts will not develop symptoms.
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30
Q

Haemochromatosis TREATMENT

A
  1. Serial venesection until ferritin is <50ugs. Maintenance venesection 3x/year to keep ferritin<100
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31
Q

Primary Biliary Cirrhosis FIRST INVESTIGATION

A

-AMA Abs (Antimitochondrial)

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32
Q

Primary Biliary Cirrhosis BEST INVESTIGATION

A

Biopsy. - Transient elastography to stage severity of dx

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33
Q

Primary Biliary Cirrhosis TREATMENT

A

Ursodeoxycholic acid for pruritus, LFTs and survival.

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34
Q

Wilson’s Dx CLINICAL FEATURES

A

AR. Confusion, dysarthria, wide based gate, acute change of personality + cirrhosis - Kayser Fleischer rings

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35
Q

Primary Sclerosing Cholangitis CLINICAL FEATURES

A

-Assoc w CU.
- stricturing in intra and extrahepatic bile ducts

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36
Q

Wilson’s Dx FIRST INVESTIGATION

A
  1. Serum Ceruloplasmin (low) and high 24 hour urinary copper excretion 2. Slip lamp examination (Kayser Fleisher rings)
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37
Q

Hepatitis B CLINICAL FEATURES

A

-30% likely to pass it if needle injury. Compared to 3% in HCV and 0.03% in HIV.
- Sex is MCC of transmission.
- If HBsAg>6 months: Chronic Hep B

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38
Q

Hepatitis B FIRST INVESTIGATION

A

-HBsAg: aCute, Chronic, Carrier.
-Anti-HbsAb: cleAred, vAccination.
-Anti-HBcIgM: Acute hep
-Anti-HBcIgG: Chronic, Carrier, Cleared
-HBeAg. Acute&Chronic

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39
Q

Hepatitis B TREATMENT

A

Chronic:
-Interferon weekly injs for 48w. Not in decompensated liver dx-Do Child Pugh Score)
-Entacavir, tenofovir: Once daily lifelong tx.

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40
Q

Hepatitis C CLINICAL FEATURES

A

-#1 cx: needle sharing.
-No vaccine available.
-Chronic (>6m).
-10-30% of pts develop Cirrhosis in 20yrs. Compared to HepB that goes to cirrhosis faster

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41
Q

Primary Sclerosing Cholangitis FIRST INVESTIGATION

A
  1. US/P-ANCA
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42
Q

Primary Sclerosing Cholangitis TREATMENT

A

Ursodeoxycholic acid also reduce risk of CRC.

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43
Q

Hepatitis C BEST INVESTIGATION

A

Liver biopsy looking for cirrhosis

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44
Q

Primary Sclerosing Cholangitis BEST INVESTIGATION

A

MRCP

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45
Q

Hepatitis A TREATMENT

A
  • Ig useful if immunocompromised and <12months babies. - Vaccine
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46
Q

Primary Biliary Cirrhosis CLINICAL FEATURES

A
  • Pruritus, fatigue, cholestasis in biochemistry
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47
Q

Hepatitis A CLINICAL FEATURES

A

-Not chronic, travel Hx, endemic in Queensland and NT.
-Exclusion for 7 days after appearance of jaundice OR until resolution of symptoms
-NOTIFIABLE Dx

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48
Q

Hepatitis C TREATMENT

A

-Sofospuvir/Ledipasvir
-Peginterferon but causes BM supression (Do FBC monthly), depression (give it with low dose
SSRI)
-Do SVR12 (means cure).
Undetectable HCV RNA by PCR 12 weeks after end of tx

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49
Q

Hepatitis D CLINICAL FEATURES

A

Uncommon in Oz. From migrants If infectious is at the same time with HBV: Fulminant hepatitis. If superinifection-> Chronic hepatitis

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50
Q

Hepatitis D TREATMENT

A

Peginterferon for at least 48 weeks

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51
Q

Hepatitis C FIRST INVESTIGATION

A

-Anti HCV
-HCV RNA
-Serial ALT (3x in 6m) to see progression

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52
Q

Hepatitis E CLINICAL FEATURES

A

Dangerous in prEgnancy, oldEr pts, and preExisting liver dx-> acute liver failure

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53
Q

Hepatitis E TREATMENT

A

Ribavirin

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54
Q

Liver Tumors Simple

A
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55
Q

Liver cysts Benign: Hepatic Adenoma CLINICAL FEATURES

A

Young pts with benign tumour linked to OCPs or fertile women. - Pain, spontaneous rupture and haemorrhage are complications (esp in pregnancy).

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56
Q

Liver cysts Benign: Hepatic Adenoma TREATMENT

A

Resection before pregnancy should be indicated.

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57
Q

Liver cysts Benign: Hemangioma

A
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58
Q

Malignant - HEPATOMA or hepatocellular carcinoma HCC CLINICAL FEATURES

A
  • Cx: Chronic alcoholism, Hep B C D infection, obesity, DM, smoking
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59
Q

Malignant - HEPATOMA or hepatocellular carcinoma HCC FIRST INVESTIGATION

A

Surveillance:
-Nodule<10mm: US e/3m
-Nodule>10mm: Contrast CT/MRI.
-Tumour marker: AFP

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60
Q

Malignant - HEPATOMA or hepatocellular carcinoma HCC BEST INVESTIGATION

A

Biopsy

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61
Q

Malignant - HEPATOMA or hepatocellular carcinoma HCC TREATMENT

A

Qx resection is not advised
- Sorafenib can prolong survival

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62
Q

Secondary liver cancer (Metastatisis)

A
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63
Q

Cirrhosis CLINICAL FEATURES

A
  • Low albumin is best indicator of cirrhosis
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64
Q

Cirrhosis FIRST INVESTIGATION

A
  1. LFTs, FBE: Thrombocytopaenia, altered IRN, low albumin
  2. US.
  3. CT/MRI
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65
Q

Cirrhosis BEST INVESTIGATION

A

Liver Biopsy

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66
Q

Portal hypertension

A
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67
Q

Gastro-oesophageal Varices

A
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68
Q

Ascites

A
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69
Q

Hepatorenal syndrome (HRS)

70
Q

Hepatic Encephalopathy TREATMENT

A
  1. Lactulose
  2. Rifaximin
71
Q

Hepatic Encephalopathy CLINICAL FEATURES

A
  • Changes in personality, sleep, disorientation, flapping tremor, impaired ability to draw 5-point star
72
Q

Portal vein thrombosis

73
Q

Spontaneous Bacterial Peritonitis CLINICAL FEATURES

A
  • MCC: E. coli, Klebsiella.
  • Ascitic pt that deteriorates with altered mental status, fever, abd pain, inc WBC
  • Mechanism: Bacterial translocation from gut to mesenteric lymph node
74
Q

Spontaneous Bacterial Peritonitis BEST INVESTIGATION

A

Ascitic fluid culture: WBC>0.5 or neutrophil>0.25 is dx

75
Q

Spontaneous Bacterial Peritonitis TREATMENT

A
  • Empirical: Ceftriaxone OR Cefotaxime. If allergy to penicillin: cipro OR aztreonam.
  • Secondary prophylaxis with Bactrim
76
Q

Proton pump inhibitors

77
Q

Globus Hystericus CLINICAL FEATURES

A

Sensation of something in throat, symptoms of reflux. Nothing on PE

78
Q

Pharyngeal Pouch CLINICAL FEATURES

A

> 70yo male, normal neck, regurgitation of undigested food, halitosis, dysphagia

79
Q

Pharyngeal Pouch BEST INVESTIGATION

A
  1. Barium swallow
80
Q

Pharyngeal Pouch TREATMENT

81
Q

Eosinophilic Oesophagitis CLINICAL FEATURES

A

Hx of atopy, symptoms of GORD

82
Q

Eosinophilic Oesophagitis FIRST INVESTIGATION

83
Q

Eosinophilic Oesophagitis BEST INVESTIGATION

A

Endoscopy with biopsy

84
Q

Eosinophilic Oesophagitis TREATMENT

A
  1. PPI for 4-8 weeks
  2. Fluticasone swallowed for 8w
  3. Oral prednisolone
85
Q

Achalasia CLINICAL FEATURES

A

Dysphagia (intermittent to solids and liquids), posture to aid swallowing, food that sticks, slow eaters.

86
Q

Achalasia FIRST INVESTIGATION

A
  1. Endoscopy. If not available->Barium swallow-Bird’s beak
87
Q

Achalasia BEST INVESTIGATION

A

Oesophageal manometry (Increase pressure)

88
Q

Achalasia TREATMENT

A
  • Young: Endoscopic Pneumatic Dilation (Less invasive) or Laparoscopy Myotomy
    -Old: Nifedipine, botulin inj.
89
Q

Presbyoesophagus CLINICAL FEATURES

A

Old pts with dysphagia and low amplitude contractions on manometry

90
Q

Oesophageal Candidiasis CLINICAL FEATURES

A

In immunocompromised pts

91
Q

Oesophageal Candidiasis TREATMENT

A

-Asymptomatic and not immunocompromised-Nystatin for 14 days
- Symptomatic or Immunocompromised: Fluconazole 14-21d

92
Q

Viral Oesophagitis CLINICAL FEATURES

A

Cause: HSV, CMV

93
Q

Viral Oesophagitis BEST INVESTIGATION

A

Endoscopy w/ biopsy for pathology and PCR

94
Q

Viral Oesophagitis TREATMENT

A

Acyclovir IV followed by famciclovir/vala for 10 days

95
Q

Barrets Oesophagus CLINICAL FEATURES

A

Metaplasia (From squamous to simple columnar)
Most imp RF for Oesophageal adenocarcinoma

96
Q

Barrets Oesophagus BEST INVESTIGATION

A

Endoscopy w/ biopsy

97
Q

Barrets Oesophagus TREATMENT

A
  1. PPI
  2. Surveillance Metaplasia. Review in 3-5y if <3cm or 2-3y if ≥3cm.
    - Dysplasia- Endoscopy e/6m - High grade dysplasia: Refer.
    * PPI America recommends 3m in dysplasia
98
Q

Oesophageal Cancer CLINICAL FEATURES

A

-Adenocarcinoma (MC in Oz, assoc w/ Barret).
-SCC (MC in world. Assoc w/ SAD).
-Progressive dysphagia first to solids then liquids, hiccoughs, hoarnesess, cough

99
Q

Oesophageal Cancer BEST INVESTIGATION

A
  1. Endoscopy w/ biopsies.
    If unavailable->Barium
100
Q

Oesophageal Cancer TREATMENT

A

Surgery. CI in lesion>10cms, invasion to tracheobronchial tree and great vessels

101
Q

Mallory Weiss CLINICAL FEATURES

A

Haem stable. Asoc w/ alcoholic binge

102
Q

Mallory Weiss BEST INVESTIGATION

103
Q

Mallory Weiss TREATMENT

A

80-90% stops spontaneously

104
Q

Complete Oesophageal rupture CLINICAL FEATURES

A

Chest pain, subcutaneous emphysema, crunching sound w/ heartbeat (Hamman’s sign)

105
Q

Boerhave’s Sx CLINICAL FEATURES

A

Haem unstable. Complete transmural tear

106
Q

Boerhave’s Sx FIRST INVESTIGATION

107
Q

Boerhave’s Sx BEST INVESTIGATION

A
  1. Gastrograffin. Never Barium
108
Q

Boerhave’s Sx TREATMENT

A
  1. Atbs, fluids, Qx.
110
Q

GORD CLINICAL FEATURES

A

Belching, odynophagia

111
Q

GORD FIRST INVESTIGATION

112
Q

GORD BEST INVESTIGATION

A

> 10y with GORD: Endoscopy to r/o Barrett

113
Q

GORD TREATMENT

A

1.LSM weight loss
2.Magnesium/Aluminum hydroxide.
3.H2 blocks
4.PPI (6-8w if severe). SEs: Interstitial nephritis, alabsorption (Iron, Mg, Ca).
5.Qx: Roux-en-Y: BMI>40, or BMI>35 w/ DM, HTN. Comp of Qx: anastomotic leak (perforation)

114
Q

Upper GI Bleeding CLINICAL FEATURES

A

-MCC: PUD.
- Tachy, hypotension, sweating

115
Q

Upper GI Bleeding TREATMENT

A
  1. Admission, IV fluids, PPI IV
  2. Endoscopy to identify bleeding point
  3. Endoscopic haemostasis, Qx
116
Q

Hydatid Cyst CLINICAL FEATURES

A

Farmer, reservoir in dogs and cattle, can happen in liver (jaundice, RUQ pain, vomiting) or lung (SOB, chest pain, cough)

117
Q

Hydatid Cyst FIRST INVESTIGATION

118
Q

Hydatid Cyst BEST INVESTIGATION

119
Q

Hydatid Cyst TREATMENT

A
  • Qx w/PAIR technique (Puncture, Aspiration, Inj of hypertonic or ethanol), Reaspiration. - Albendazole for 4w after Qx. - Praziquantel if cysts are spilled during surgery or complicated cysts.
120
Q

Liver Abscess CLINICAL FEATURES

A

-MCC: Klebsiella (Risk of Endopthalmitis). In children Staph Aureus. In NA: Melioidosis (Bulkdolheria). In travellers: E. hystolytica

121
Q

Liver Abscess FIRST INVESTIGATION

122
Q

Liver Abscess BEST INVESTIGATION

A

CT (Irregular multiple). Blood cultures

123
Q

Liver Abscess TREATMENT

A

-<5cm: Close needle drainage - >5cm: Rx guided catheter.
-Empiric Atbs: Gentamicin+Amoxi+Metro for 4-6w. If CI to genta: Ceftriazone or Cefotazime.
-Confirmed Klebsiella: Ceftriazone or cefotaxime.
-If high fever, tender lymphadenopathy, effusion at base of right chest->Amebiasis. Percutaneous CT aspiration+Metro

124
Q

NASH CLINICAL FEATURES

A

Increased AST, ALT, GGT.

125
Q

NASH TREATMENT

A
  1. LSM.
  2. Statins. Metformin for DM risk
126
Q

Simple liver cysts CLINICAL FEATURES

A

Asymptomatic, or dull right upper pain, jaundice

127
Q

Simple liver cysts FIRST INVESTIGATION

128
Q

Simple liver cysts BEST INVESTIGATION

129
Q

Ascites TREATMENT

A
  • Mild: low salt. If symptomatic use spironolactone, if painful gynaecomastia use amiloride. - Moderate: Spironolactone, if insufficient add furosemide, if tense ascites paracentesis
    Refractory: Repeated paracentesis, shunt, liver transplantation
130
Q

Gastro-oesophageal varices FIRST INVESTIGATION

A

Dx endoscopy in all pts with cirrhosis looking for varices

131
Q

Gastro-oesophageal varices TREATMENT

A
  • Propranolol w or without endoscopic variceal band ligation. - Endoscopy e/ 6-12m - Acutely Bleeding:
    1.IV line + PPI
    2.Blood transfusion.
    3.Octreotide to reduce portal pressure
    4.Prophylactic Atb with Ceftriaxone OR Cipro IV
132
Q

H pylori infection CLINICAL FEATURES

A

RF for gastric cancer.

133
Q

H pylori infection FIRST INVESTIGATION

A
  1. Serology Test
134
Q

H pylori infection BEST INVESTIGATION

A

Biopsy urease testing

135
Q

H pylori infection TREATMENT

A
  • PPI+Amoxi+Clarythro. If penicillin allergy: PPI+Metro+Clarythro. - Post-tx you do Urea breath test 4 weeks after starting tx.
136
Q

Autoimmune Gastritis CLINICAL FEATURES

A

Abs against parietal cells and IF. Atrophy of mucosa of stomach

137
Q

Autoimmune Gastritis BEST INVESTIGATION

A

Endoscopy w/ biopsy

138
Q

Autoimmune Gastritis TREATMENT

A

IM Vitamin B12

139
Q

Peptic Ulcer Dx CLINICAL FEATURES

A

-Gastric has more vomiting and weight loss
-Duodenal no vomiting and no weight loss.
-Strictures as comp: If in pylorus (vomiting within 1 hour of meal), duodenal (after 1hr of meal)

140
Q

Peptic Ulcer Dx FIRST INVESTIGATION

A

Urea Breath test: To monitor response to tx of H pylori

141
Q

Peptic Ulcer Dx BEST INVESTIGATION

A

Endoscopy. Compulsory for pts>55yo w/ chronic dyspepsia to r/o Ca

142
Q

Peptic Ulcer Dx TREATMENT

A
  1. PPI IV
  2. Injection of adrenaline
143
Q

Gastric Outlet Obstruction CLINICAL FEATURES

A
  • Pt with vomiting>1hr after eating with undigested food with hx of chronic PUD
144
Q

Gastric Cancer CLINICAL FEATURES

A

-MCC: H Pylori infection
-Asymptomatic, later dysphagia, epigastric mass, Virchow’s node (left supraclavicular node), hard irregular hepatomegaly, anaemia

145
Q

Gastric Cancer BEST INVESTIGATION

A

Endoscopy+Biopsy

146
Q

IBS CLINICAL FEATURES

A

Abd pain assoc w/ change in bowel habit.

147
Q

IBS FIRST INVESTIGATION

A

Stool examination w/ fecal calprotectin

148
Q

IBS TREATMENT

A
  1. LSM
  2. High fibre diet
  3. Loperamide, TCAs, SSRIs
149
Q

Meckel Diverticulum CLINICAL FEATURES

A
  • Lower GI bleeding, abd pain
150
Q

Meckel Diverticulum FIRST INVESTIGATION

151
Q

Meckel Diverticulum BEST INVESTIGATION

152
Q

Celiac Dx CLINICAL FEATURES

A

-Assoc w/ dermatitis
herpetiformis, thyroid dx, DM 1, IgA deficiency, primary biliary cirrhosis, lymphoma of small bowel
-Lethargy, diarrhoea, abd pain, bloating, indigestion, bleeding (Vit K def), steatorrhea
-Skinny arms with flat bum and big belly. Symptoms started by 4-5m when started Cerelac

153
Q

Celiac Dx FIRST INVESTIGATION

A

-IgA anti-tissue transglutaminase and anti-deamidated gliadin antibody.
-If pt is already on gluten free diet, give gluten for 4-6w and repeat test

154
Q

Celiac Dx BEST INVESTIGATION

A

Duodenal biopsy with villous atrophy and intra epithelial lymphocytosis

155
Q

Celiac Dx TREATMENT

A

Avoid BROW (Barley, Rye, Oats, Wheat)

156
Q

Obscure GI Bleeding CLINICAL FEATURES

A

Blood persists besides upper and lower endoscopy & Radiologic Ix

157
Q

Obscure GI Bleeding FIRST INVESTIGATION

A
  • Active: Haem Stable: CT angio Haem Unstable: Interventional
    Angiography
  • Inactive (Occult) Capsule Endoscopy
158
Q

Carcinoid Tumour CLINICAL FEATURES

A

Facial flushing, diarrhoea, wheezing, right valvular heart dx

159
Q

Carcinoid Tumour BEST INVESTIGATION

A

24hr 5-hydroxyl indole acetic acid, plasma chromogranin A

160
Q

Carcinoid Tumour TREATMENT

A
  • Octreotide to block serotonin production
  • Interferon alpha to reduce growth - Artery embolization to cut blood supply
161
Q

CRC CLINICAL FEATURES

A
  • Right: 1. Anaemia (Weakness, fatigue). 2nd Palpable mass. - Left: Pain, LB obstruction, altered bowel habits - Sigmoid Ca: Apple core deformity, napkin ring - Rectal Ca: Rectal bleeding, mass in DRE, tenesmus
162
Q

CRC FIRST INVESTIGATION

A

For screening see Page 9 of Bleeding.
- Tumour marker CEA

163
Q

CRC BEST INVESTIGATION

A
  1. Colonoscopy
164
Q

CRC TREATMENT

A

Surgery (Terminal-terminal anastomoses). If lymphoid Pos ->
Chemo, If lymphoid Neg -> Surveillance (Colonoscopies at 1, 3, 5 years +CEA).
- MC comp post-Qx->Faecal incontinence

165
Q

Adenomatous Polyps Adenomas CLINICAL FEATURES

A

Familial Adenomatous Polyposis 100% risk of Cancer

166
Q

Adenomatous Polyps Adenomas FIRST INVESTIGATION

167
Q

Adenomatous Polyps Adenomas BEST INVESTIGATION

A
  1. Colonoscopy
168
Q

Adenomatous Polyps Adenomas TREATMENT

A

Screening w/ Colonoscopy:
- 1-2 polyps & nothing else: 5y
-3-4, high grade dysplasia, villous: 3y
-5-9: Every year
->10: 6 months

169
Q

HNPCC-Lynch Syndrome CLINICAL FEATURES

A

AD. Most common hereditary form of Colon Ca. They can also have ovarian, renal, etc.

170
Q

HNPCC-Lynch Syndrome TREATMENT

A

Genetic testing

171
Q

Peutz Jeghers sx CLINICAL FEATURES

A

Benign polyps (Hamartomas) that can become malignant, freckles on lips, inside mouth, palms, soles.
- Assoc w/ ovarian Ca.
- MC site of Ca: Duodenal Ca.
- Common comp: Intussusception at any age.

AMC MCQ (59 decks)

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