MCQ Extrahepatic biliary system 3

Q1 Which of the following is not associated with Primary sclerosing cholangitis?

a) Retroperitoneal fibrosis

b) Riedel's thyroiditis

c) Ulcerative colitis

d) Cholelithiasis

Q2) What is the pressure of sphincter of oddi?

a) 20 cm of water

b) 40 cm of water

c) 30 cm of water

d) 50 cm of water

Q3) What is the preferred biliary anastomosis after liver transplant?

a) Choledocho-choledochal

b) Choledochojejunostomy

c) Choledochoduodenostomy

d) All have same results

Q4) Which variety of Klatskin tumor grows in the cystic duct?

a) Nodular

b) Sclerosing

c) Papillary

d) All

Q5) Which of the following is not a criteria for papillary stenosis?

a) Pain right upper abdomen

b) Increased pressure at sphincter of oddi

c) Dilated (Common Bile duct) CBD on ERCP

d) 30 min delay in contrast

Answers

1. d)

Primary sclerosing cholangitis (PSC) is a disease of extrahepatic and intrahepatic biliary system with difuse involvement of bile ducts.

Cholangiography shows a characterstic beaded apperance.Primary sclerosing cholangitis is more common in certain HLA haplotypes such as B8/DR3 which is also common in patients with other autoimmune diseases such as insulin-dependent diabetes mellitus, Graves’ disease, Sjögren’s syndrome, and myasthenia gravis.

It has strong association with ulcerative colitis and Cholangiocarcinoma. There is no association of PSC with cholelithiasis

Refrence: Sabiston textbook of Surgery 17th edition.