Master Stomach MCQs For MCH and NEET Ss , INI SS Ace Your Medical Exam
These questions on stomach cover critical areas like gastric anatomy, surgical techniques, and common pathologies such as ulcers and cancers. By familiarizing yourself with these MCQs, you can enhance your knowledge and boost your confidence.
These are free sample questions. Rest of the questions are available for premium members
Q1. A 60-year-old female patient presents to the gastroenterology clinic with persistent abdominal pain and nausea following a Billroth I gastrectomy performed three years ago for peptic ulcer disease. Upon evaluation, she is diagnosed with alkaline reflux gastritis. In discussing her treatment options, which approach would be considered the ideal management for her condition?
a) Conversion of Billroth I gastrectomy to Billroth II surgery b) Roux-en-Y gastrojejunostomy c) Total gastrectomy d) Conservative management
1. b
Roux-en-Y gastrojejunostomy is often the preferred surgical intervention for managing alkaline reflux gastritis, as it helps to prevent bile from refluxing into the stomach, thereby alleviating symptoms and complications associated with this condition.
After Billroth I and II, bile reflux gastritis is common.
Symptoms of bile reflux gastritis are
(i) Epigastric pain
(ii) Bilious vomiting
(iii) Weight loss
Diagnosis of Bile Reflux gastritis after surgery
HIDA scans show bile in stomach or esophagus
Surgery is recommended for those who have intractable symptoms. Bilious vomiting is relieved
The surgical procedure of choice is conversion of Billroth II to Roux-en Y Gastrojejunostomy in which the Roux limb is lengthened to 60 cm
A shorter Roux limb may be preferred to minimize the risk of malabsorption, while a longer limb may reduce the likelihood of bile reflux.
Regarding the chance of recurrence of alkaline reflux gastritis, studies suggest that the recurrence rate can vary but is generally around 10-30%. Factors influencing recurrence include the surgical technique, length of the Roux limb, and patient-related factors such as anatomy and underlying conditions.
Ref - Sabiston & SKF
Q2. A 58-year-old male patient presents to the emergency department with hematemesis and severe epigastric pain. He has a history of peptic ulcer disease and is diagnosed with a bleeding large Type I stomach ulcer after an endoscopy reveals an active bleeding vessel. After multiple attempts bleeding is not controlled. Considering the surgical options for managing this condition, which treatment would be most appropriate for this patient?
a) Wedge resection of the gastric ulcer b) Oversewing the vessel at the ulcer base c) Distal gastrectomy d) Distal gastrectomy along with truncal vagotomy
2. c
Treatment of choice for a bleeding gastric ulcer Type I is distal gastrectomy followed with a Billroth I gastrojejunostomy.
Surgical Options:
Oversewing the Vessel: Direct oversewing of the bleeding vessel at the ulcer base is often performed if the ulcer is amenable to this approach.
Wedge Resection: If the ulcer is localized and accessible, a wedge resection may be performed.
Distal Gastrectomy: This may be considered for larger ulcers or when there is a risk of recurrence.
Distal Gastrectomy with Truncal Vagotomy: This is less common but may be indicated in certain cases where ulcer recurrence is a concern.
For type II and type III ulcers vagotomy is done
In sick and frail patients, figure of 8 suture at the base of vessel or wedge excision can be done
Ref Sab
Q3.Helicobacter Pylori (H.Pylori) is a known cause of peptic ulcer disease. It was discovered in Australia in 1987. Which of the following statements is not true regarding it?
a) Its infectivity is highest in developed world.
b) Person to person transmission is common
c) It is seen in populations with low socio economic status
d)H. Pylori is a gram negative microaerophilic bacteria
3. a
Shape: Spiral-shaped and flagellated, allowing it to penetrate the gastric mucosa.
Survival: It can survive in the acidic environment of the stomach by producing urease, which neutralizes stomach acid.
Transmission
Routes: It is primarily transmitted via the oral-fecal route, but it can also spread through contaminated food and water.
Prevalence: H. pylori infection is common worldwide, with higher prevalence rates in developing countries.
Q4. Which of the following hormones are not released in duodenum?
a) Gastrin
b) Motilin
c) Somatostatin
d) Pancreatic YY
4. d Peptide YY is released from ileum. Gastrin - G cells stomach Motilin- M cells from duodenum and jejunum Somatostatin - D cells in pancreas, stomach and duodenum
Q5. Treatment for bleeding duodenal diverticulum is
a) Diverticulectomy
b) Diverticulopexy
c) Diverticulization
d) Subtotal diverticulectomy
5. a
Treatment of choice in such cases is diverticulectomy.
Subtotal diverticulectomy is done if the diverticulum is very close to ampulla of vater to safeguard the bilio- pancreatic ducts.
Q) What is the difference between Billroth I and Billroth ii gastrojejunostomy?
Ans
In Billroth II gastrojejunostomy the duodenal stump is closed and a gastric continuity is established by anastomosing a loop of jejunum to the body of stomach
In Billroth I the Duodenum is anastomosed to the remaining part of stomach. It is a gastroduodenostomy and is more physiological for the body.
Billroth II is more commonly performed procedure because of its technical ease and low leak rates.
