small intestine

Question 1

Where is calcium primarily absorbed

Answer 1

duodenum

Question 2

produced by D cells

Answer 2

somatostatin

Question 3

Produced by G cells

Answer 3

Gastrin

Question 4

Produced by I cells

Answer 4

Cholecystokinin

Question 5

Produced by M cells

Answer 5

Motilin

Question 6

Produced by L cells

Answer 6

1. peptide YY

2. Glucagon like peptide

Question 7

Produced by S cells

Answer 7

Secretin

Question 8

Inhibits Gi secretion, motility and splanchnic perfusion

Answer 8

somatostatin

Question 9

Stimulates exocrine pancreatic secretion, stimulate intestinal secretion

Answer 9

secretin

Question 10

Stimulate exocrine pancreatic secretion, stimulate gallbladder emptying

Answer 10

cholecystokinin

Question 11

stimulate intestinal motility

Answer 11

motilin

Question 12

stimulate intestinal proliferation

Answer 12

glucagon like peptide 2

Question 13

inhibit intestinal motility and secretion

Answer 13

peptide YY

Question 14

Most common cause of small bowel obstruction

Answer 14

intraabdominal adhesion

Question 15

What portion of the duodenum is compressed in superior mesenteric artery syndrome

Answer 15

3rd portion of duodenum

Question 16

What is the confirmatory test of small bowel obstruction

Answer 16

abdominal series

Question 17

Triad of small bowel obstruction in radiograph

Answer 17

1. dilated small bowel loops >3 cm
2. air fluid level
3. paucity of air in the colon

Question 18

What is another name for acute colonic pseudo obstruction

Answer 18

ogilvie syndrome

Question 19

treatment of ogilvie syndrome

Answer 19

IV neostigmine

Iv atropine to counteract bradycardia

Question 20

What is the normal temporal pattern of GI motility

Answer 20

24 hours - small intestine
48 hours - gastric motility
3 - 5 days - colonic motility

Question 21

Inraoperative measure to reduce ileus

Answer 21

1. minimize handling of bowel
2. laparoscopic approach
3. avoid exxcessive intraoperative fluid administration

Question 22

Post operative measures to reduce ileus

Answer 22

1. early enteral feeding
2. epidural anesthesia, if indicated
3. avoid excessive IV fluid administration
4. correct electrolyte abnormality
5. consider M opioid antagonist

Question 23

Treatment of crohn’s disease

Answer 23

Sulfasalazine + steroids

Question 24

Treatment of ulcerative colitis

Answer 24

Sulfasalazine + steroids

Question 25

Earliest leion of crohn's disease

Answer 25

aphthous ulcer

Question 26

This is pathognomonic of crohn's disease: encroachment of mesenteric fat onto the serosal surface of the bowel

Answer 26

fat wrapping

Question 27

Lead pipe colon (lacks hautral markings)

Answer 27

ulcerative colitis

Question 28

Most common area affected by crohn's disease

Answer 28

distal ileum

Question 29

Most common cause of enterocutaneous fistula

Answer 29

iatrogenic

Question 30

What is a low output fistula

Answer 30

less than 200 ml/day

Question 31

What is a high output fistula

Answer 31

more than 500 ml/day

Question 32

90% of fistula are going to close within how many weeks interval

Answer 32

5 weeks

Question 33

Most useful initial test in a fistula

Answer 33

CT scan

Question 34

Fistula usually manifest in how many post operative days

Answer 34

5th to 10th post operative day

Question 35

What are the factors that inhibit closure of fistula?

Answer 35

FRIEND

Question 36

Most common benign neoplasm of small intestine

Answer 36

Adenoma

Question 37

Most common location for primary adenocarcinoma and adenoma in small bowel

Answer 37

duodenum

Question 38

Most common location of GIST

Answer 38

stomach (60 - 70%)

Question 39

Most common mode of presentation of adenocarcinoma in the small bowel

Answer 39

Partial small bowel obstruction

Question 40

What is the most commonly affected area of radiation enteritis

Answer 40

Terminal Ileum

Question 41

Most accurate way to diagnose radiation enteritis

Answer 41

enteroclysis

Question 42

Treatment of radiation enteritis

Answer 42

supportive therapy

Question 43

Most common heterotropic muscosa of meckel's diverticulum

Answer 43

gastric mucosa (60%)

Question 44

Most prevalent congenital anomaly of the GI tract

Answer 44

Meckel's diverticulum

Question 45

Pathology of Meckel's Diverticulum

Answer 45

Failure of ophalomesenteric (vitelline) duct to undergo obliteration during the 8th week of gestation

Question 46

Most common sign of meckel's diverticulum

Answer 46

bleeding in pediatrics | intestinal obstruction in adults

Question 47

Treatment of meckel's diverticulum

Answer 47

diverticulectomy

Question 48

It is the most sensitive test to detect jejunoileal diverticula

Answer 48

enteroclysis

Question 49

Most common's of acute mesenteric ischemmia

Answer 49

1. MCC - arterial embolus 2. Most common source - heart 3. most common location - SMA

Question 50

Golder period of mesenteric ischemia

Answer 50

3 hours - intestinal sloughing | 6 hours - full thickness intestinal infarction

Question 51

Most common symptom of chronic mesenteric ischemia

Answer 51

postprandial abdominal pain

Question 52

Diagnostic exam of choice for itussuception

Answer 52

CT scan: Target Sign

Question 53

Where can the base of the appendix always be found

Answer 53

confluence of the taenia

Question 54

What is a constant symptom of appendicitis

Answer 54

anorexia

Question 55

What is the most common surgical emergency in pregnancy

Answer 55

appendicitis | -usually occurs in 2nd trimester

Question 56

Most consistent sign of appendicitis in pregnant woman

Answer 56

pain in right side of the abdomen

Question 57

Most common carcinoid appendiceal tumor

Answer 57

carcinoid - appendix (50%)

Question 58

Treatment of carcinoid tumor

Answer 58

< 2 cm at distal appendix - appendectomy | > 2 cm at base - right hemicolectomy