AMC MCQ Gastroenterology and Surgery 2

Question 1

A 55-year-old man presents with painless progressive obstructive jaundice, weight loss, and a palpable non-tender gallbladder. What is the most likely diagnosis?

Accepted Answer

Carcinoma of the head of the pancreas

Answer

Courvoisier's law states a palpable non-tender gallbladder with painless jaundice suggests pancreatic head malignancy rather than gallstones.

Question 2

Which serum marker is most useful for monitoring pancreatic adenocarcinoma?

Accepted Answer

CA 19-9

Answer

CA 19-9 is the principal tumour marker used to monitor pancreatic adenocarcinoma response and recurrence.

Question 3

A patient with severe acute pancreatitis develops a fall in serum calcium. What is the mechanism?

Accepted Answer

Saponification of calcium by released fatty acids

Answer

Lipase-mediated fat necrosis binds calcium to free fatty acids (saponification), lowering serum calcium.

Question 4

Which scoring system uses CRP and is commonly applied to assess acute pancreatitis severity at 48 hours?

Accepted Answer

Glasgow (Imrie) criteria

Answer

The Glasgow/Imrie criteria stratify pancreatitis severity, and CRP >150 supports severe disease.

Question 5

A 70-year-old presents with sudden severe abdominal pain out of proportion to examination findings and atrial fibrillation. What is the most likely diagnosis?

Accepted Answer

Acute mesenteric ischaemia

Answer

Pain out of proportion to signs with AF (embolic source) is classic for acute mesenteric ischaemia.

AMC MCQ Practice Test

AMC MCQ Practice Test

AMC MCQ Gastroenterology and Surgery 2