GIT pathologies

Question 1

what type of hernia is medial to inferior epigastric vessels?

Answer 1

direct inguinal hernia

Question 2

what type of hernia is lateral to inferior epigastric vessels?

Answer 2

indirect inguinal hernia

Question 3

which structure is compressed in nutcracker syndrome?

Answer 3

left renal vein by SMA

Question 4

what symptoms are seen in nutcracker syndrome?

Answer 4

1. varicocele
2. haematuria
3. left flank and testicular pain
4. nausea and vomiting

Question 5

what is cryptorchidism?

Answer 5

undescended testis

Question 6

what is the common cause of indirect inguinal hernia?

Answer 6

patent processus vaginalis

Question 7

what causes GORD?

Answer 7

poor LOS closure

Question 8

what does oesophageal varices indicate?

Answer 8

portal hypertension

Question 9

what are oesophageal varices?

Answer 9

abnormally dilated sub-mucosal veins between anastomosis of systemic (oesophageal v.) and portal (left gastric v.) circulation

Question 10

what are the risk factors of PUD?

Answer 10

helicobacter pylori infection
NSAID use

Question 11

which type of peptic ulcer pain worsens with food?

Answer 11

gastric ulcer

Question 12

which type of peptic ulcer is more common?

Answer 12

duodenal ulcer

Question 13

which type of oesophageal hiatal hernia does not present with reflux?

Answer 13

paraoesophageal hernia

Question 14

which oesophageal hiatal hernia is more common?

Answer 14

sliding hernia

Question 15

what is portal hypertension?

Answer 15

portal venous system BP > systemic circulation BP

Question 16

what would ruptured oesophageal varices cause?

Answer 16

upper GI bleed –> haematemesis, melaena

Question 17

what would ruptured anorectal varices cause?

Answer 17

lower GI bleed –> haematochezia (passage of fresh blood through anus)

Question 18

what symptoms make up Charcot’s triad?

Answer 18

fever, jaundice, RUQ pain

Question 19

what symptoms make up Reynold’s pentad?

Answer 19

fever, jaundice, RUQ pain, septic shock, confusion

Question 20

what is the most common cause of acute pancreatitis?

Answer 20

gallstones

Question 21

what condition involves a build up of fluid in the tunica vaginalis?

Answer 21

hydrocele

Question 22

Acquired metaplasia of columnar epithelium in lower oesophagus.
What condition is this?

Answer 22

Barrett’s oesophagus

Question 23

what is achalasia?

Answer 23

rare oesophageal motor disorder where LOS fails to relax and there is loss of oesophageal peristalsis

Question 24

what is brown granular/coffee ground vomit associated with?

Answer 24

peptic ulcer disease

Question 25

what are the charcot's triad and reynold's pentad symptoms suggestive of?

Answer 25

ascending cholangitis

Question 26

what is cullen's sign?

Answer 26

discolouration around umbilicus

Question 27

what is grey turner's sign?

Answer 27

discolouration around flanks

Question 28

what are cullen's sign and grey turner's sign indicative of?

Answer 28

acute pancreatitis

Question 29

what is the most common congenital defect of GIT?

Answer 29

meckel's diverticulum

Question 30

what causes meckel's diverticulum?

Answer 30

incomplete obliteration of vitelline duct

Question 31

what is crohn's disease?

Answer 31

inflammatory bowel disease typically affecting the terminal ileum but can be anywhere along the GIT

Question 32

what is ulcerative colitis?

Answer 32

inflammatory bowel disease affecting colon only (only mucosa layer)

Question 33

what causes infectious inflammatory diarrhoea?

Answer 33

bacteria (shigella, salmonella, E.coli, etc.)

Question 34

what causes infectious non-inflammatory diarrhoea?

Answer 34

viruses (norwalk), parasites (giardia), bacteria pre-formed toxins

Question 35

what does elevated ALP and GGT levels indicate?

Answer 35

cholestatic/obstructive/post-hepatic jaundice

Question 36

what does elevated AST and ALT levels indicate?

Answer 36

intrahepatic/mixed jaundice

Question 37

what does AST/ALT > 2 indicate?

Answer 37

alcoholic hepatitis

Question 38

what is the most common cause of pre-hepatic jaundice?

Answer 38

haemolytic anaemia

Question 39

which of the following clinical findings is not indicative of liver cirrhosis? a) Dupuytren's contracture b) spider naevi c) clubbing d) gynaecomastia

Answer 39

a) dupuytren's contracture

Question 40

what condition causes compression of duodenum as it crosses the abdominal aorta?

Answer 40

SMA syndrome

Question 41

which arteries are susceptible to injury in gastric ulcers?

Answer 41

left and right gastric arteries

Question 42

which type of hernia protrudes despite occlusion of deep inguinal ring?

Answer 42

direct inguinal hernia (does not pass through deep inguinal ring)

Question 43

in paraesophageal hernia, the fundus may herniate ____ (with/without) the cardia and ____ (with/without) the gastroesophageal junction shifting superiorly resulting in ____ (yes/no) reflux

Answer 43

without without no

Question 44

where are gastric ulcers most commonly found?

Answer 44

antrum and lesser curvature of stomach

Question 45

where are duodenal ulcers most commonly found?

Answer 45

1st part of duodenum

Question 46

what is the Crigler-Najjar syndrome?

Answer 46

absence/decreased activity of glucuronyl transferase

Question 47

which of the following is not a potential cause of conjugated hyperbilirubinemia? a. primary liver tumours b. tumour of tail of pancreas c. cholelithiasis d. pregnancy

Answer 47

b. tumour of tail of pancreas (usually tumour of head of pancreas)

Question 48

Pancreatitis is characterised by: a. reduced pancreatic trypsin levels b. steatorrhoea c. intermittent abdominal pain d. weight gain

Answer 48

b. steatorrhoea (pale, foul-smelling stools due to malabsorption)

Question 49

what is the most common cause of acute appendicitis in adults?

Answer 49

faecolith impaction

Question 50

what is the most common cause of acute appendicitis in children?

Answer 50

lymphoid hyperplasia

Question 51

spontaneous bacterial peritonitis in children is associated with ______

Answer 51

nephrotic syndrome

Question 52

what is a risk factor of spontaneous bacterial peritonitis?

Answer 52

chronic liver disease (ESLD, cirrhosis)

Question 53

which is the most common bacteria causing SBP?

Answer 53

E. coli

Question 54

what are the most common causes of small bowel obstruction?

Answer 54

1. bowel adhesions from past abdo surgeries 2. incarcerated hernias

Question 55

what are the most common causes of large bowel obstruction?

Answer 55

1. malignant tumours 2. volvulus 3. diverticulitis

Question 56

what are the 3 types of intestinal ischaemia?

Answer 56

1. acute mesenteric ischaemia 2. chronic mesenteric ischamia 3. ischaemic colitis