Pancreas MCQ 1-5

Free Pancreas MCQs with Explanations | Surgery Exam Preparation

Free Pancreas MCQs with Explanations

These are 6 free pancreas MCQs with detailed explanations. The remaining 70 MCQs and mock tests on the pancreas are available in the premium section.

Q1. Which of the following is least associated with development of cancer of pancreas?
a) Smoking
b) BRCA 2 gene mutation
c) Lynch Syndrome
d) Diabetes Mellitus
Ans 1.d In adenocarcinoma of pancreas both environmental and genetic factors play a causative role.

✅ The most commonly associated risk factor for adenocarcinoma of the pancreas is smoking. 🔸 Incidence is directly related to the number of pack years smoked.

❓ Diabetes Mellitus and Chronic pancreatitis are doubtful etiological factors.

Somatic genetic drivers of PDAC mutations: - KRAS (90%) - TP53 (75%) - SMAD4 (55%) - CDKN2A (80%)

Hereditary cases of PDAC are associated with susceptibility genes: BRCA2, ATM, BRCA1, PALB2, CDKN2A, STK11, PRSS1, SPINK1

Diabetes does not have a direct causative role in carcinoma pancreas.
📖 Source: Blumgart, 7th edition, p.845
Q2. Not true regarding blood supply of pancreas?
a) Pancreas receives blood supply from coeliac trunk and superior mesenteric artery
b) Body and tail of pancreas is supplied by Splenic artery
c) Posterior superior pancreaticoduodenal artery is a branch of Superior mesenteric artery
d) All major pancreatic arteries lie posterior to pancreatic ducts
Ans 2.c Pancreatic blood supply: - Anterior & Posterior Superior Pancreaticoduodenal arteries → from coeliac artery - Anterior & Posterior Inferior Pancreaticoduodenal arteries → from Superior Mesenteric Artery - Splenic artery → supplies body & tail of pancreas

The dorsal pancreatic artery usually arises from the splenic artery, near its origin from the celiac trunk. - A right branch of dorsal pancreatic artery supplies the head of pancreas and usually joins the posterior arcade.

The gastroduodenal artery gives rise to: - Supraduodenal artery - Retroduodenal artery - Posterior Superior Pancreaticoduodenal (PSPD) artery
Gastroduodenal artery ends by dividing into: - Right gastroepiploic artery - Anterior Superior Pancreaticoduodenal (ASPD) artery

❌ PSPD artery is a branch of gastroduodenal artery, not of SMA.
Q3. Most common cause of death in early acute pancreatitis is:
a) Renal Failure
b) Cardiac Failure
c) Respiratory Failure
d) Uncontrolled Coagulopathy
Ans 3.cRespiratory failure is the most common cause of death in the early phase (within 7 days) of acute pancreatitis.

Pulmonary manifestations include: - Atelectasis - Acute lung injury - Acute Respiratory Distress Syndrome (ARDS) due to systemic inflammation

🔸 Late phase mortality is usually due to infective complications.
❗ Renal failure may occur, but respiratory failure remains the leading early cause of death.
Q4. All of the following have been used in management of Acute Pancreatitis except?
a) Interleukin-10
b) Gabexate
c) Somatostatin
d) Peritoneal dialysis
Ans 4.a Tried therapies in acute pancreatitis: - Peritoneal dialysis - Gabexate - Lexipafant (anti-PAF factor) - Somatostatin
❌ These have all been studied but found to have no proven benefit.

🔸 IL-10 is raised in pancreatitis but has no therapeutic role.
Q5. Which of the following is not true for ectopic pancreas?
a) Stomach and duodenum are the most common site
b) Ectopic pancreas appears as a submucosal irregular nodule in the wall
c) Islet tissue is present in all the organs where ectopic pancreas is present
d) Ulceration, bleeding and obstruction are the most common symptoms
Ans 5.c Ectopic pancreas: - Most common sites → Stomach, Duodenum - Other sites → Ileum, Colon, Gall bladder, Meckel's diverticulum, Mesentery - Appears as a submucosal nodule in the wall

Islet tissue is present only in stomach & duodenum, not in all sites.

Symptoms: - Ulceration - Bleeding - Obstruction (ectopic pancreas may act as a lead point for intussusception)
Q6. Nealon's classification is used for:
a) Acute pancreatitis
b) Chronic pancreatitis
c) Pseudocyst pancreas
d) Alcoholic pancreatitis
Ans 6.c Nealon’s classification → Pseudocyst pancreas with duct relation

Types: - Type I: Normal duct / No communication with cyst - Type II: Normal duct + duct-cyst communication - Type III: Normal duct + stricture / No communication - Type IV: Normal duct + stricture + communication - Type V: Normal duct + complete cut-off - Type VI: Chronic pancreatitis / No communication - Type VII: Chronic pancreatitis + duct-cyst communication

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