AMC MCQ Gastroenterology and Surgery 3 — Questions and Answers
Question 1: A young woman has right iliac fossa pain, anorexia, and a positive Rovsing's sign. What is the most likely diagnosis?
- Acute appendicitis (Correct answer)
- Ovarian torsion
- Ectopic pregnancy
- Mesenteric adenitis
Correct answer: Acute appendicitis
Migratory RIF pain with anorexia and Rovsing's sign is classic for acute appendicitis.
Question 2: Which type of inflammatory bowel disease characteristically shows transmural inflammation with skip lesions?
- Crohn's disease (Correct answer)
- Ulcerative colitis
- Ischaemic colitis
- Pseudomembranous colitis
Correct answer: Crohn's disease
Crohn's disease causes transmural, discontinuous (skip) lesions anywhere from mouth to anus.
Question 3: A patient with long-standing GORD has columnar metaplasia on oesophageal biopsy. What is this condition?
- Barrett's oesophagus (Correct answer)
- Achalasia
- Oesophageal candidiasis
- Plummer-Vinson syndrome
Correct answer: Barrett's oesophagus
Barrett's oesophagus is columnar metaplasia of the distal oesophagus and a precursor to adenocarcinoma.
Question 4: Which organism is most strongly associated with peptic ulcer disease and gastric MALT lymphoma?
- Helicobacter pylori (Correct answer)
- Escherichia coli
- Campylobacter jejuni
- Clostridioides difficile
Correct answer: Helicobacter pylori
H. pylori infection underlies most peptic ulcers and is causally linked to gastric MALT lymphoma.
Question 5: A 60-year-old presents with altered bowel habit, iron-deficiency anaemia, and weight loss. What is the most important diagnosis to exclude?
- Colorectal carcinoma (Correct answer)
- Irritable bowel syndrome
- Coeliac disease
- Haemorrhoids
Correct answer: Colorectal carcinoma
Change in bowel habit with iron-deficiency anaemia in an older adult mandates exclusion of colorectal cancer.
Question 6: Which finding on erect chest X-ray indicates a perforated viscus?
- Free air under the diaphragm (Correct answer)
- Widened mediastinum
- Pleural effusion
- Raised hemidiaphragm only
Correct answer: Free air under the diaphragm
Pneumoperitoneum seen as free subdiaphragmatic air indicates perforation of a hollow viscus.
Question 7: What is the most appropriate initial management of a small bowel obstruction with no signs of strangulation?
- Nasogastric decompression, IV fluids, and nil by mouth (Correct answer)
- Immediate laparotomy
- Oral laxatives
- Broad antibiotics alone
Correct answer: Nasogastric decompression, IV fluids, and nil by mouth
Uncomplicated SBO is managed conservatively with 'drip and suck' before considering surgery.
AMC MCQ Gastroenterology and Surgery 3
A young woman has right iliac fossa pain, anorexia, and a positive Rovsing's sign.
What is the most likely diagnosis?