MCQs Gastroenterology

Regarding IBD which is FALSE

Erythema nodosum tends to correlate well with the activity of the underlying
bowel disease

UC commonly involves the colon but not the anus

Smoking worsens Crohns disease

Nephrolithiasis occurs more commonly with UC

Answer

Regarding hepatitis B infection which is FALSE?

HBsAG with normal liver enzymes suggests a healthy carrier

IgM anti-HBc is used to identify chronic hepatitis

Anti-HBs imply prior infection and immunity

In patients who are HBV DNA positive, transplantation may be followed by

severe recurrent disease

Answer

Which is the BEST marker of liver function in acute liver failure?

Prothrombin time

Albumin

Plasma ammonia

Bilirubin

Answer

Which of the following is NOT a feature of Acute Liver Failure

Raised ALT

Jaundice

Encephalopathy

Centrilobular or panacinar necrosis

Answer

Which of the following is TRUE regarding Boerhaaves syndrome?

Diagnosis and surgery within 48 hours has a survival rate of greater than
50%

Barium oesophagram is an appropriate investigation

Haematemesis is unusual

90% of erect chest xrays are initially normal

Answer

Which statement is TRUE re: inflammatory bowel disease?

Bowel resection in Crohns disease is curative

Toxic megacolon is indicated by a transverse colon diameter > 10 cm

> 10 motions/day is indicative of fulminant disease in ulcerative colitis

Episcleritis is the most common extra-intestinal manifestation

Answer

Which statement is FALSE regarding Button battery ingestion?

Esophageal perforation has occurred within 6 hours post ingestion

Mercuric poisoning is a possibility but no clinical case has been recorded

Around 1/3 of patients may be asymptomatic with the battery lodged in the
oesophagus

The discharge state (power remaining) of the battery correlates with

outcome

Answer

The following about ingestion of strong acids / alkali is true EXCEPT

The oesophagus may have significant burns with normal lips and oral cavity
on examination

Endoscopy within 24 hrs is indicated for all symptomatic patients, patients

with visible oropharyngeal burns and all patients with intentional ingestions

The use of corticosteroids following alkali ingestion prevents the formation of

strictures

Ingestion of strong alkali cause liquefying necrosis with high penetration of

tissues

Answer

Regarding causes of oesophageal obstruction, which one is TRUE

Median survival for oesophageal cancer is < 1 year

Treatment of a Schatzki ring is endoscopic excision

Oesophageal webs are usually found in the distal oesophagus

Oesophageal obstruction in children is often caused by oesophageal

diverticula

Answer

10

Which of the following is NOT an extra intestinal manifestation of IBD

Uveitis

Erythema nodosum

Pancreatitis

Alopecia

Answer

11

Regarding ingested foreign bodies

10 to 20 % of swallowed foreign bodies require some sort of intervention

Button batteries may be observed for 24 hours if lodged in the oesophagus

Coins will show up on xray in the sagittal plane if stuck in the oesophagus

50% of adults who present with meat impaction in the oesophagus harbour
pathogenic oesophageal conditions

Answer

12

Oesophageal foreign bodies can be treated with all of the following

EXCEPT:

tartaric acid

glucagon

Papain

sodium bicarbonate

Answer

13

With respect to gastrointestinal bleeding which ONE of the following

statements is TRUE

The oesophageal balloon should be inflated first in a Minnesota tube

Somatostatin has been proven to decrease mortality

Colonic angiodysplasia is a rare cause of lower GI bleeding in the elderly

Complications commonly occur in endoscopic sclerotherapy

Answer

14

With respect to fulminant acute liver failure which ONE of the following
statements is TRUE?

Cerebral oedema is an unusual cause of death

Late administration of glutathione is unwarranted in paracetamol induced

hepatic failure

Renal failure rarely occurs in paracetamol induced hepatic encephalopathy

INR is a sensitive index of liver function

Answer

15

Regarding inflammatory bowel disease, which ONE of the following

statements is TRUE?

Toxic megacolon is always treated surgically

Thromboembolic disease is a leading cause of death in Crohns disease

Perianal fistula/abscess is unusual in Crohn's disease

Bloody diarrhoea is typical of Crohns disease

Answer

16

Regarding peptic ulcer disease, which of the following are true

Given the good correlation between dyspeptic symptoms and gastrooesophageal disease, early empirical treatment of dyspepsia is reasonable

In patients with non ulcer dyspepsia, H2 blockers are significantly more

effective than PPIs in reducing symptoms

The urea breath test have poor sensitivity for the presence of H. pylori

The majority of people with H. pylori will be found to have PUD

Answer

17

Regarding oesophageal perforation, which of the following is TRUE?

Gastrograffin swallow demonstrates the perforation in nearly 100% of cases

Mortality in blunt trauma is approximately 50%

Pleural effusion is more commonly right sided

Diagnosis of perforation due to blunt trauma is delayed in 2/3

Answer

18

In the pharmacological treatment of acute variceal bleeding, which

intravenously administered drug has been shown to have a reduction in
mortality when used in comparison with a placebo?

Somatostatin

Vasopressin

Terlipressin

Octreotide

Answer

19

All of the following are true with regards to treatment with H2 antagonists,
EXCEPT:

Their dose should be adjusted in patients with significant liver dysfunction

For non-ulcer dyspepsia, they are more effective at reducing symptoms than
proton pump inhibitors

In most patients they are effective in reducing both gastric and duodenal
ulceration within 8 weeks

Food does not reduce their absorption

Answer

Answers
1.
2.
3.
4.
5.
6.
7.
8.
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11.
12.
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18.

D
B
A
D
C
C
D
C
A
D
A
C
D
D
B
B
C
C

19. A

Iannou et al: Terlipressin for acute oesophageal variceal haemorrhage :

Cochrane System Review 2003
rd
Textbook of Adult Emergency Medicine (Cameron et al), 3 ed., p. 341