GIT Wrap It Up - MCQs Flashcards
(8 cards)
Q1. A 67-year-old man presents with a one-month history of dysphagia and weight loss of 8kg. An esophagus biopsy reveals an adenocarcinoma. Which one of the following conditions is a risk factor for oesophageal adenocarcinoma?
A. Barrett oesophagus
B. Coeliac disease
C. Oesophageal varices
D. Whipple disease
Correct Answer:
A. Barrett oesophagus
Explanation: Barrett oesophagus is a known precursor to esophageal adenocarcinoma. It occurs when chronic gastroesophageal reflux causes the normal squamous epithelium of the lower oesophagus to be replaced by metaplastic columnar epithelium.
Q2. A 28-year-old man presents with abdominal pain, nausea and heartburn. He is concerned that he may have cancer as his grandad had been diagnosed with gastric cancer. He undergoes gastroscopy and is diagnosed with chronic active helicobacter pylori gastritis. Helicobacter pylori is NOT associated with which of the following?
a. Duodenal Ulcer
b. Gastric Cancer
c. Gastro Oesophageal Reflux Disease
d. Malt Lymphoma
Correct Answer:
c. Gastro Oesophageal Reflux Disease
Explanation: Helicobacter pylori is linked to duodenal ulcers, gastric cancer, and MALT lymphoma. It is not typically associated with gastroesophageal reflux disease (GERD), and some studies suggest it may actually protect against GERD.
Q3. A 47-year-old woman presents with a 2-year history of a painless, slowly growing right parotid gland mass. Which one of the following tumors is the most common benign salivary gland tumor?
a. Basal cell adenoma
b. Duct papilloma
c. Pleomorphic adenoma
d. Warthin tumour
Correct Answer:
c. Pleomorphic adenoma
Explanation: Pleomorphic adenoma is the most common benign salivary gland tumor. It typically affects the parotid gland and has a mixture of epithelial and mesenchymal tissue types.
Q4. You are explaining aspects of his conditions to a 55-year-old man with chronic gastro-esophageal reflux disease. He asks what the normal esophagus is lined by. Which one of the following is your most likely answer?
a. Simple cuboidal epithelium
b. Stratified columnar epithelium
c. Stratified squamous epithelium
d. Transitional epithelium
Correct Answer:
c. Stratified squamous epithelium
Explanation: The normal esophageal lining is non-keratinized stratified squamous epithelium, which is suited to protect against friction from swallowed food.
Q5. A 55-year-old man undergoes an esophageal biopsy. Histological assessment confirms the presence of reflux esophagitis. Which one of the following histological features will have been noted on microscopic examination of his biopsy?
a. Basal cell hyperplasia
b. Increased lymphocytes in the epithelium
c. Shortening of vascular papillae
d. Thinning of squamous epithelium
Correct Answer:
a. Basal cell hyperplasia
Explanation: Reflux esophagitis leads to basal cell hyperplasia, elongation of lamina propria papillae, and infiltration by inflammatory cells, particularly eosinophils and neutrophils.
Q6. An 80-year-old previously well woman presents to casualty complaining of severe left iliac fossa pain for 2 days. She says she has been feeling feverish. She is passing stool and flatus. On clinical examination there is percussion tenderness in the left iliac fossa. There is no punch tenderness at the left renal angle. Which one of the following is the most likely diagnosis?
a. Acute sigmoid diverticulitis
b. Acute ulcerative colitis
c. Renal colic
d. Torsion of the left ovary
Correct Answer:
a. Acute sigmoid diverticulitis
Explanation: The most likely diagnosis is acute sigmoid diverticulitis, which typically presents in elderly patients with left iliac fossa pain, fever, and localized peritonism. Continued passage of stool and flatus suggests no obstruction.
Q7. A 27-year old man infected with human immunodeficiency virus (HIV) presents with whitish-lesions on the lateral border of his tongue. Which one of the following viruses is the most likely cause of this infection?
a. Cytomegalovirus
b. Epstein-Barr virus
c. Human herpes-7
d. Kaposi sarcoma Virus
Correct Answer:
b. Epstein-Barr virus
Explanation: Oral hairy leukoplakia, a common finding in immunocompromised individuals (especially HIV patients), is caused by Epstein-Barr virus. It presents as white, non-removable lesions on the lateral tongue.
Q8. A hemicolectomy has been done for carcinoma of the caecum. The tumor has infiltrated through the muscularis propria and has breached the serosal lining. The tumor is present in three of twelve lymph nodes. No distant metastases have been identified. What is the correct staging of this tumor?
a. Dukes A
b. Dukes B
c. Dukes C
d. Dukes D
Correct Answer:
c. Dukes C
Explanation: The Dukes staging system for colorectal cancer: Dukes A is confined to the mucosa, Dukes B invades through the bowel wall but no lymph nodes, Dukes C has lymph node involvement (as in this case), and Dukes D indicates distant metastasis.
