GI GI Surgery and Interventional Procedures 2

Question 1

Laparoscopic cholecystectomy is the gold standard for symptomatic cholelithiasis; which intraoperative injury is the most feared complication?

Accepted Answer

Common bile duct injury

Answer

Common bile duct injury occurs in approximately 0.3–0.5% of laparoscopic cholecystectomies and can cause biliary stricture, cholangitis, and significant morbidity.

Question 2

Endoscopic mucosal resection (EMR) is appropriate for polyp removal when the lesion is confined to which layer of the GI wall?

Accepted Answer

Mucosa and superficial submucosa (sm1)

Answer

EMR safely resects lesions confined to the mucosa and superficial submucosa (sm1) where lymphovascular invasion risk is low; deeper invasion requires surgery.

Question 3

Ileostomy output exceeding 1,500–2,000 mL/day places patients at risk for which metabolic complication?

Accepted Answer

Hyponatremia, hypokalemia, and dehydration

Answer

High-output ileostomy causes loss of sodium-rich intestinal fluid, leading to hyponatremia, hypokalemia, and volume depletion with pre-renal azotemia.

Question 4

Which endoscopic technique involves injecting a submucosal fluid cushion before resecting a large flat lesion en bloc?

Accepted Answer

Endoscopic submucosal dissection (ESD)

Answer

ESD uses submucosal injection to lift the lesion and specialized knives to dissect along the submucosal plane, enabling en bloc resection of large lesions.

Question 5

A patient undergoes total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis; what is the most common late complication of the pouch?

Accepted Answer

Pouchitis

Answer

Pouchitis, a non-specific inflammation of the ileal reservoir, occurs in up to 50% of patients with IPAA and is the most common long-term complication.

Gastrointestinal GI Practice Practice Test

Gastrointestinal GI Practice Practice Test

GI GI Surgery and Interventional Procedures 2