Previous Years AIIMS GI Surgery Questions 2018

AIIMS 2018 GI Surgery - 40 questions

These are Previous Years aiims GI Surgery MCQ . These will be visible to premium members who have logged in. First few questions are for everybody.


1. Diuelefoy lesion which is false?
A. Most of the bleed cannot be visualised due to small mucosal defect  which lies over large arterial
bleed.
B. Large 1-3 mm artery in the submucosa is the source
C. MC in the greater curvature
D. Found within 6 cm from GEJ

Answer 



2. Oropharyngeal dysphagia false is
A. Nasal twang in voice
B. Treatment is most often not satisfactory if conservative
C. Associated with myesthenia gravis and Parkinsonism
D. Water brasch and regurgitation presentation

Answer



3.  True about choledochal cysts ? (AIIMS GI 2018) 
A. Upto 90% is associated with APBJ
B. 30% are associated with chronic pancreatitis
C. Most common association in adults is cholecystolithiasis
D. Malignancy risk is eliminated by cyst excision

Answer



4. All of the following predisposing syndromes for pancreatic adenocarcinoma are AD except
A. PJS (Peutz Jeghers) 
B. CFTR (Cystic fibrosis) 
C. HNPCC
D. FAMMM

Answer


5. Blood supply to rectum - all are true except
A. Inferior rectal artery pierces the levator ani to supply the distal rectum
B. Middle rectal artery is a branch of hypogastric
C. Arc of riolan is an anastomosis between ascending branch of IMA and Middle Colic Artery
D. Left Colonic Artery arises 3-4 cm distal to the IMA origin

Answer



6. Genetically inherited gastric Carcinoma all are true except
A. FAP is at low risk
B. HNPCC is at higher risk
C. E-cadherin is almost always involved
D. Diffuse gastric cancer is poorly differentiated

Answer 


7. Gallstones are formed most commonly in 

A. Gastrinoma
B. VIPoma
C. Somatostatinoma
D. Glucagonoma

Answer


8. In Carcinoma esophagus all are true except
A. Distal Tumors have better prognosis than proximal  tumors
B. Tumors are more common  in the proximal part of esophagus
C. Dysphagia is the most common symptom 
D.

Answer

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Answer


17. All are true about immunology of the liver except
A. Effector cells are NK cells etc
B. TNF alfa is responsible for innate immunity
C. IL1 supports adaptive immunity
D. Kupffer cells and dendritic cells are APCs

 

Answer


18. Cholangiocarcinoma type IIIB bismuth Corlette bilirubin 10, left portal vein and hepatic artery
involved. Best approach is
A. Preoperative left biliary drainage followed by resection
B. Preoperative right biliary drainage followed by resection
C. Left portal vein embolisation followed by resection
D. Palliative drainage

Answer 


19. Ideal time for CECT in severe acute pancreatitis is
A. After 72 hours
B. After 48 hours
C. 24 hours
D. At admission

Answer 


20. CT severity score for pancreatic necrosis of more than 50%
A. 6
B. 7

C. 10
D. 5

Answer 


21. Absolute contraindication for left lobe LDLT is
A. Trifurcation of the portal vein
B. Bifurcation of portal vein in the right lobe of the liver
C. Aberrant right hepatic artery
D. Right Posterior duct draining into left hepatic duct

Answer 


22. Wrong about post gastrectomy syndromes
A. Early dumping syndrome occurs after 1 hour
B. Early dumping syndrome has less cardiac and most gastrointestinal symptoms
C. Anastomotic ulcer is more after bII
D. More in bilroth II than roux en Y anastomosis

Answer 


23. Which is false about crystalloid solutions?
A. NS has Sodium 154 meq/l
B. NS has Chloride 154 mEq/l
C. RL contains Lactate but doesn’t contain calcium
D. RL contains sodium potassium calcium and lactate

Answer 


24. False about surgical safety checklist
A. Confirmation of functioning pulse oximeter before induction
B. Confirmation of antibiotic prophylaxis and radiological film display prior to induction 
C. Labelling of surgical specimen before patient leaves the OT
D. Introduction of team members by themselves before induction of anaesthesia by themselves


Answer b

Antibiotic  prophylaxis and radiology is not before induction, its after that 

Bailey 27 th  page 183


25. All are true about disinfection except
A. Povidone iodine needs to dry up prior to its action
B. Alcohol disinfectants act against all organisms except clostridium difficile
C. Single dose of first generation cephalosporin should be givens prophylaxis for vascular
procedures and bladder catheterisation
D. Chlorhexidine is bactericidal, viricidal, fungicidal, and has rapid onset of action and persistent
duration

Answer


26. False about ARDS
A. Mortality 50%
B. PaO2/FiO2 <= 200
C. Should rule out cardiogenic pulmonary edema prior to its diagnosis
D. Steroids if given early in the course of the disease, have better prognosis and less mortality

Answer 26) d

Mortality is 50% and 90% with sepsis

Steroids have no clear role

Three of the most common manifestations of acute respiratory failure are pulmonary
edema, acute lung injury, and ARDS.

In contrast to pulmonary edema, which is associated with increased pulmonary capillary wedge pressure (PCWP) and right-sided heart pressure, acute lung injury and ARDS are associated with hypo-oxygenation because of a pathophysiologic inflammatory response that leads to the accumulation of fluid in the alveoli as well as thickening in the space between the capillaries and the alveoli.

Acute lung injury is associated with a PaO2/fraction of inspired oxygen (FIO2) ratio of less than 300, bilateral infiltrates on chest radiograph, and PCWP less than 18 mm Hg. 

ARDS has PaO2/FIO2 ratio of less than 200 and has bilateral infiltrates
and PCWP less than 18 mm Hg.

REF Sabiston page 293


27. All are true regarding malignancy in UC except
A. Increased risk with pancolitis and increased duration
B. Screening for malignancy should start 8-10 yrs after onset of symptoms
C. Poorly differentiated
D. Surveillance should start as soon as remission occurs to pick up missed colon cancer

Answer 

Explanation here  Similar question on  website discussed previously


Q 28. Treatment of choice for anal canal high grade lymphoma on a young immunocompromised male?
A. Chemoradiation
B. APR
C. Local excision followed by chemotherapy
D. Local excision

Answer 


29. All are false about adenomatous polyposis syndrome except
A. 25% do not have family history
B. Attenuated FAP has less than 100 polyps and delayed onset (34-44 yrs)
C. More than 20 rectal polyps have to be operated as there is high risk of Carcinoma
D. Attenuated FAP don’t have extracolonic manifestations and carry APC mutation

Answer


30. Hyperbaric oxygen therapy in radiation proctitis all are true except
A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis
B. Oxygen increases the growth of residual tumor and hence tumor should be completely
resected
C. Complications include Parkinsonism, barotrauma
D. Usually 30-40 sessions are required for treatment

Answer


31. Not a risk factor in colonoscopic stenting in colonic cancer causing obstruction
A. Short stricture of length <10 cm
B. Extrinsic compression
C. Treatment with bevacizumab
D. Strictures and obstructions at multiple levels

Answer

 


32. Which is false with respect to fulminant colitis in UC
A. Transverse colon of >8 cm diameter in abdominal X-ray is diagnostic of toxic megacolon
B. Conservative management after 5 days if not responsive, Surgery should be done
C. 20-30% of fulminant colitis need surgical intervention
D. Severe colitis affects 5-15% of patients with Ulcerative  colitis

 


33. False about risk of rebleed in endoscopic finding of ulcer is
A. Active spurter - high risk of bleed
B. Active oozer - high risk of bleed
C. Adherent clot - intermediate risk of bleed
D. Dark spot - intermediate risk of bleed

 


34. Habr gamma approach is
a) Neoadjuvant chemoradiation followed by surgery
b) Neoadjuvant followed by wait and watch
c) Surgery followed by adjuvant chemoRT
d)

Ans b 

At present, no predictive factors exist to determine which patients will respond to CRT based on preoperative data.

However, pCR is not an appropriate primary endpoint to guide clinical decision-making because it depends on the pathological results after radical surgery. Habr-Gama et al

developed the “watch and wait” protocol by creating a new endpoint: cCR.

Based on a strict surveillance protocol, patients are determined to be responders once they have no evidence of tumor on: (1) DRE; (2) endoscopic assessment; and (3) imaging


35. cervicogastric anastomosis
a) Fever ,fluctuant swelling s/o anastomotic leak
b) Cervical leak go to chest
c) Cervical leak >>>intrathoracic leak
d) Barium miss rate for leak is <10%


36. Borchardt triad
A. Acute gastric volvulus
B.
C.
D.

.
37. CRM increased recurrence all true except
a) Size>2 cm
b) Lymph nopdal involvement of primary
c) Disease free survival >>>1 year
d) CEA >200


38. Enteric hormones all true except
a) Peptide YY released by distal small intestine in response to peptides
b) VIP secretion stimulated by peptides and fats
c) Enteroglucagon increases insulin release and reduces glucagon level
d) Neurotensin sec by N cells stimulate large bowel mucosa

39. Rome III criteria in constipation includes all except
a) <3 bowel movements in a week
b) Manual evacuation

c) Symptoms>3 months
d) Paradoxical increase in PR muscle activity

40. Retained antrum syndrome all true except
a) Tc 99 scan not useful
b) BILLROTH 1 prevents the occurrence of Retained antrum
c) Retained antrum is the reason for 10% recurrences in surgery for peptic ulcer disease
d) Even occurs with resection distal to pyloric


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