1. 60-year-old female presents with alkaline reflux gastritis after Billroth I gastrectomy. What is the ideal management?
a) Conversion to Billroth II
b) Roux-en-Y gastrojejunostomy
c) Total gastrectomy
d) Conservative management
Answer: b
Explanation: Roux-en-Y is preferred to prevent bile reflux. A Roux limb (~60 cm) reduces symptoms like epigastric pain, bilious vomiting, and weight loss. HIDA scan can confirm diagnosis. Ref: Sabiston, SKF
Explanation: Roux-en-Y is preferred to prevent bile reflux. A Roux limb (~60 cm) reduces symptoms like epigastric pain, bilious vomiting, and weight loss. HIDA scan can confirm diagnosis. Ref: Sabiston, SKF
2. A 58-year-old male with Type I bleeding gastric ulcer unresponsive to endoscopy. Best treatment?
a) Wedge resection
b) Oversewing the vessel
c) Distal gastrectomy
d) Distal gastrectomy with vagotomy
Answer: c
Explanation: Distal gastrectomy with Billroth I is ideal for bleeding Type I ulcers. Oversewing or wedge excision is for frail patients. Ref: Sabiston
Explanation: Distal gastrectomy with Billroth I is ideal for bleeding Type I ulcers. Oversewing or wedge excision is for frail patients. Ref: Sabiston
3. Which statement is NOT true about H. pylori?
a) Highest infectivity in developed world
b) Person-to-person transmission
c) Common in low socioeconomic groups
d) Gram-negative microaerophilic bacteria
Answer: a
Explanation: H. pylori is more prevalent in developing countries. It’s spiral-shaped, flagellated, and transmitted mainly via oral-fecal route.
Explanation: H. pylori is more prevalent in developing countries. It’s spiral-shaped, flagellated, and transmitted mainly via oral-fecal route.
4. Which hormone is NOT released in the duodenum?
a) Gastrin
b) Motilin
c) Somatostatin
d) Peptide YY
Answer: d
Explanation: Peptide YY is secreted from the ileum. Gastrin, motilin, and somatostatin are released in duodenum or stomach.
Explanation: Peptide YY is secreted from the ileum. Gastrin, motilin, and somatostatin are released in duodenum or stomach.
5. What is the treatment for bleeding duodenal diverticulum?
a) Diverticulectomy
b) Diverticulopexy
c) Diverticulization
d) Subtotal diverticulectomy
Answer: a
Explanation: Diverticulectomy is first-line treatment. If near ampulla, subtotal diverticulectomy is safer.
Explanation: Diverticulectomy is first-line treatment. If near ampulla, subtotal diverticulectomy is safer.
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