Q) Which of the following is true about giant gastric ulcer?
a) 70-80% of these ulcers are malignant
b) By definition giant gastric ulcer is more than 1.5 cm in size
c) Medical therapy can heal 80% of such ulcers
d) They are more common on the greater curvature and invade surrounding organs like spleen, liver etc
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Q) In a patient with a bleeding peptic ulcer, endoscopy is done. Which of the following findings on endoscopy predicts the highest rate of re bleed?
a) Non bleeding vessel
b) Adherent clot
c) Flat pigmented spot
d) Clean base ulcer
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a) Non bleeding vessel IIA - Out of the choices given
Bleeding peptic ulcer is mostly from the posterior surface of the lesion and can be sometimes lethal
Forrest classification is used to grade the risk of re bleeding in peptic ulcers.
According to the stigmata of recent bleed, the chances of re bleed increase.
Ia - Active Spurting
Ib- Active oozing
IIa Non bleeding vessel 50% chance of rebleed
IIB Adherent clot
IIC Flat Pigmented spot
III Clean based ulcer
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Q) Regarding gastrinoma what is true? ( # Questions on Endocrine Surgery)
a) All gastrinomas express SRS receptors
b) In 30 % of cases gastrinomas are not localized intra operatively
c) Levels of serum gastrin more than 100pg/ml are strongly suggestive of gastrinoma
d) Angiography with secretin stimulation is required in all cases for localization of gastrinoma
Q) Which of the following is true about dumping syndrome
a) Somatostatin analogues are effective in controlling symptoms
b) Symptoms always include flushing and tachycardia
c) Diarrhea is always part of dumping syndrome
d) Part of treatment includes combining solids with liquids in frequent small meals
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Q) In gastric cancer, lymph node station 12 corresponds to
a) Common hepatic
d) Superior Mesenteric
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Q) What is true regarding complications of Billroth 2 surgery?
a) It has less complications than Billroth 1 surgery
b) Recurrent ulceration is more common in the afferent limb as compared to efferent limb.
c) Afferent loop obstruction is more common after Billroth 2 surgery
d) Billroth I operation is preferred in scarred duodenum
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Q) Billroth 1 gastrectomy all are true except-
a) Normal anatomy of duodenum is preserved
b) ERCP can still be performed
c) Avoiding efferent and afferent limb problem
d) No risk for gastric cancer because of decreased alkaline reflux