PPT4
問題一覧
1
1. Esophageal atresia occurs due to failed separation of trachea and esophagus during:
A. 2nd–3rd week fetal life
B. 4th–6th week fetal life
C. 8th–10th week fetal life
D. After birth
2. The most common symptom of esophageal atresia in newborns is:
A. Projectile vomiting
B. Excessive drooling and choking during feeding
C. Bloody stool
D. Constipation
1b 2b
2
3. The safest imaging sign for esophageal atresia diagnosis is:
A. Barium swallow
B. Contrast CT
C. NG tube coiling on X-ray
D. Endoscopy
4. The most common type of tracheoesophageal fistula (TEF) is:
A. Upper pouch connected to trachea
B. Lower esophagus blind ending
C. Esophageal atresia with distal TEF
D. Both ends blind
3c 4c
3
5. The main danger in TEF is:
A. Malnutrition
B. Aspiration pneumonia
C. Diarrhea
D. GERD
6. Ileal atresia typically presents with:
A. Bilious vomiting and no meconium
B. Projectile vomiting only
C. Bloody diarrhea
D. Hematemesis
5b 6a
4
7. Radiographic hallmark of duodenal atresia is:
A. Coiled spring sign
B. Bird beak sign
C. Double bubble sign
D. Cotton tuft sign
8. Imperforate anus is best evaluated by:
A. Barium swallow
B. Cross-table lateral rectum X-ray
C. CT abdomen
D. Ultrasound pelvis
7c 8b
5
9. The most common gender affected by hypertrophic pyloric stenosis is:
A. First-born males
B. Females equally
C. Twins
D. Premature infants only
10. Classic sign of hypertrophic pyloric stenosis on physical exam is:
A. Palpable “olive” mass in RUQ
B. Peristalsis absent
C. Bloody stool
D. Bluish skin discoloration
9a 10a
6
11. Imaging modality of choice for hypertrophic pyloric stenosis:
A. CT scan
B. Ultrasound
C. MRI
D. Barium swallow
12. Malrotation with volvulus can lead to:
A. GERD
B. Obstruction and bowel ischemia
C. Hypertension
D. Peptic ulcer
11b 12b
7
13. Hirschsprung disease is due to:
A. Abnormal pyloric muscle growth
B. Failure of ganglion cell migration (Meissner and Auerbach plexus absence)
C. Congenital atresia of stomach
D. Vitelline duct remnant
14. Common site of Hirschsprung disease:
A. Duodenum
B. Rectosigmoid region
C. Cecum
D. Esophagus
13b 14b
8
15. Definitive diagnostic test for Hirschsprung disease:
A. Barium enema
B. CT abdomen
C. Rectal suction biopsy
D. Upper GI series
16. Meckel diverticulum arises from:
A. Failure of vitelline duct closure
B. Malrotation
C. Incomplete cloacal rupture
D. Genetic duplication
15c 16a
9
17. The most common symptom of Meckel diverticulum in children is:
A. Projectile vomiting
B. Painless rectal bleeding
C. Severe diarrhea
D. Hematemesis
18. Imaging used to detect Meckel diverticulum with ectopic gastric mucosa:
A. Ultrasound
B. Tc-99m pertechnetate scan
C. Barium swallow
D. CT colonography
17b 18b
10
19. Gluten-sensitive enteropathy is triggered by:
A. Lactose
B. Gliadin component of gluten
C. Protein in milk
D. Bacterial infection
20. Definitive diagnosis of celiac disease is made by:
A. Small bowel biopsy
B. Ultrasound
C. Barium enema
D. CT scan
19b 20a
11
21. Carbohydrate intolerance due to lactase deficiency leads to:
A. Constipation
B. Osmotic diarrhea
C. Malrotation
D. Dysphagia
22. Imaging hallmark of lactose intolerance:
A. Double bubble
B. Cotton tuft sign
C. Rapid barium transit (dilution effect)
D. Bird beak sign
21b 22c
12
23. Esophageal strictures are commonly caused by:
A. Caustic ingestion, GERD, trauma, or tumors
B. Vitamin deficiency
C. Viral infections only
D. Poor diet
24. Best position to view esophageal strictures:
A. RAO
B. AP supine
C. Lateral decubitus
D. PA prone
23a 24a
13
25. GERD occurs due to:
A. Overactive pyloric sphincter
B. Weak lower esophageal sphincter
C. High gastric motility
D. Bacterial overgrowth
26. Best surgical option for severe GERD:
A. Colectomy
B. Ladd’s procedure
C. Nissen fundoplication
D. Pyloromyotomy
25b 26c
14
27. Peptic ulcers are most commonly found in:
A. Duodenal bulb and lesser curvature of stomach
B. Rectum and sigmoid colon
C. Cecum and appendix
D. Jejunum
28. Most common infectious cause of peptic ulcers:
A. H. pylori
B. Candida
C. Salmonella
D. Streptococcus
27a 28a
15
29. Most life-threatening complication of peptic ulcer:
A. Gastritis
B. Perforation with peritonitis
C. Constipation
D. Diarrhea
30. Gastroenteritis due to bacterial contamination often comes from:
A. Poultry, eggs, dairy
B. Fruits
C. Rice only
D. Bottled water
29b 30a
16
31. Typical duration of infectious gastroenteritis:
A. 12 hours
B. 1–2 days
C. 3–4 days
D. 1 week minimum
32. Crohn disease most often affects:
A. Rectum
B. Ileum and cecum
C. Duodenum
D. Pancreas
31c 32b
17
33. Gold standard imaging for Crohn disease:
A. Capsule endoscopy
B. Small bowel series / enteroclysis
C. MRI
D. Ultrasound
34. Crohn disease “skip lesions” and transmural inflammation lead to:
A. Strictures, fistulas, obstruction
B. Malrotation only
C. Liver cirrhosis
D. Simple constipation
33b 34a
18
35. Most common cause of appendicitis:
A. Tumors
B. Fecalith obstruction
C. Malrotation
D. Viral infection
36. Classic presentation of appendicitis:
A. Initial epigastric pain shifting to RLQ
B. Painless rectal bleeding
C. Projectile vomiting
D. Constipation only
35b 36a
19
37. Definitive treatment for appendicitis:
A. Antibiotics
B. Appendectomy
C. Pyloromyotomy
D. Ladd’s procedure
38. Ulcerative colitis begins in:
A. Cecum
B. Rectum
C. Duodenum
D. Appendix
37b 38b
20
39. Toxic megacolon is a serious complication of:
A. Crohn disease
B. Ulcerative colitis
C. Meckel diverticulum
D. GERD
40. Imaging contraindicated in toxic megacolon:
A. Ultrasound
B. Barium enema
C. CT
D. MRI
39b 40b
21
41. Esophageal varices are caused by:
A. Cirrhosis with portal hypertension
B. Bacterial infection
C. Malrotation
D. GERD
42. Major risk of esophageal varices:
A. Dysphagia
B. Massive hemorrhage on rupture
C. Bloating only
D. Constipation
41a 42b
22
43. Emergency treatment for variceal bleeding:
A. Ladd’s procedure
B. TIPSS
C. Appendectomy
D. Herniorrhaphy
44. Long-term monitoring of TIPSS is done with:
A. Doppler ultrasound
B. MRI
C. CT scan
D. Barium enema
43b 44a
23
45. A hernia is defined as:
A. Bowel inflammation
B. Bowel protrusion through abdominal wall weakness
C. Tumor growth in stomach
D. Malrotation of intestine
46. Emergency surgery is required for:
A. Reducible hernia
B. Strangulated hernia
C. Sliding hiatal hernia
D. GERD hernia
45b 46b
24
47. Hiatal hernia occurs when:
A. Cecum is displaced
B. Part of stomach pushes through diaphragm
C. Appendix migrates
D. Rectum prolapses
48. Sliding hiatal hernia is associated with:
A. GERD
B. Appendicitis
C. Crohn disease
D. Toxic megacolon
47b 48a
25
49. Radiographic sign of Schatzki ring is seen in:
A. Sliding hiatal hernia
B. Rolling hiatal hernia
C. Crohn disease
D. GERD only
50. Rolling (paraesophageal) hernia is more dangerous due to risk of:
A. Simple reflux
B. Strangulation and volvulus
C. Appendicitis
D. Fistulas
49a 50b
26
51. Mechanical bowel obstruction is caused by:
A. Tumors, adhesions, hernias, volvulus, intussusception
B. Low potassium only
C. Food intolerance
D. Celiac disease
52. Radiographic hallmark of mechanical obstruction:
A. Silent abdomen
B. Multiple air-fluid levels
C. Gas in biliary tree only
D. Normal bowel sounds
51a 52b
27
53. Strangulated obstruction results in:
A. Simple constipation
B. Ischemia and necrosis
C. GERD
D. Liver damage
54. Volvulus is twisting of bowel, commonly in:
A. Rectum
B. Sigmoid colon and ileocecal junction
C. Duodenum
D. Gallbladder
53b 54b
28
55. Intussusception shows what sign radiographically?
A. Bird beak sign
B. Coiled spring appearance
C. Double bubble sign
D. Cotton tuft sign
56. Gallstone ileus may show which finding?
A. Air in biliary tree
B. Coiled spring sign
C. Olive mass
D. Schatzki ring
55b 56a
29
57. Paralytic ileus is caused by:
A. Post-surgical state, low potassium, opioids
B. Tumors
C. Crohn disease
D. Lactose intolerance
58. Radiographic hallmark of paralytic ileus:
A. Diffuse gas in both small and large bowel
B. Coiled spring
C. Double bubble
D. Bird beak
57a 58a
30
59. Best treatment for paralytic ileus:
A. NG suction and electrolyte correction
B. Appendectomy
C. Surgery always
D. Ladd’s procedure
60. Achalasia is caused by:
A. Weak LES
B. Failure of LES to relax due to nerve loss
C. Crohn inflammation
D. GERD damage
59a 60b
31
1. Alcohol-induced liver disease progresses in the following order:
A. Cirrhosis → Hepatitis → Fatty liver → HCC
B. Fatty liver → Hepatitis → Cirrhosis → HCC
C. Hepatitis → Fatty liver → Cirrhosis → HCC
D. Fatty liver → Cirrhosis → Hepatitis → HCC
2. The toxic metabolite of alcohol that damages hepatocytes is:
A. Acetone
B. Acetaldehyde
C. Lactic acid
D. Ammonia
1b 2b
32
3. Fatty liver due to obesity and diabetes is classified as:
A. Alcoholic fatty liver
B. Nonalcoholic fatty liver disease (NAFLD)
C. Post-surgical fatty liver
D. Autoimmune fatty liver
4. The imaging modality most sensitive for detecting early fatty liver is:
A. Ultrasound
B. CT Scan
C. MRI
D. Nuclear scan
3b 4c
33
5. Enlargement of the liver is called:
A. Cirrhosis
B. Hepatomegaly
C. Splenomegaly
D. Steatosis
6. Cirrhosis is considered:
A. A reversible disease
B. An acute inflammatory condition
C. A chronic, irreversible liver disease
D. A metabolic syndrome
5b 6c
34
7. Which complication of cirrhosis results from increased portal vein pressure?
A. Hepatic encephalopathy
B. Portal hypertension
C. Hepatocellular carcinoma
D. Coagulopathy
8. Wormlike filling defects on barium swallow suggest:
A. Esophageal varices
B. Hemangioma
C. Splenic varices
D. Ascites
7b 8a
35
9. Ascites is defined as:
A. Fat accumulation in the liver
B. Fluid accumulation in the abdominal cavity
C. Enlarged spleen
D. Fibrosis of the pancreas
10. The gold standard for diagnosing viral hepatitis severity is:
A. CT Scan
B. Ultrasound
C. Liver biopsy
D. MRI
9b 10c
36
11. Which hepatitis virus is spread via fecal-oral route and does not become chronic?
A. HAV
B. HBV
C. HCV
D. HDV
12. Hepatitis B is transmitted through:
A. Contaminated food
B. Contaminated water
C. Blood and body fluids
D. Mosquito bites
11a 12c
37
13. The first-line imaging modality for detecting gallstones is:
A. CT Scan
B. MRI
C. Ultrasound
D. HIDA Scan
14. Acute cholecystitis is best confirmed by:
A. Ultrasound
B. HIDA scan
C. CT scan
D. MRI
13c 14b
38
15. The most common cause of acute pancreatitis is:
A. Viral infection
B. Gallstones and alcohol abuse
C. Autoimmune reaction
D. Trauma
16. Chronic pancreatitis is often associated with:
A. Bacterial infection
B. Alcohol abuse
C. Hepatitis A
D. Gallbladder polyps
15b 16b
39
17. Jaundice is caused by the accumulation of:
A. Hemoglobin
B. Bilirubin
C. Lipase
D. Bile salts
18. Which type of jaundice is due to bile duct obstruction?
A. Medical (nonobstructive)
B. Surgical (obstructive)
C. Hemolytic
D. Autoimmune
17b 18b
40
19. A benign liver tumor related to oral contraceptives is:
A. Hepatocellular carcinoma
B. Hemangioma
C. Hepatocellular adenoma
D. Metastatic tumor
20. The most common benign liver tumor composed of blood vessels is:
A. Adenoma
B. Hemangioma
C. Carcinoma
D. Metastasis
19c 20b
41
21. The most common primary malignant tumor of the liver is:
A. Hemangioma
B. Hepatocellular carcinoma
C. Gallbladder carcinoma
D. Pancreatic carcinoma
22. Which of the following is more common than primary liver cancer?
A. Hepatocellular adenoma
B. Metastatic liver disease
C. Hemangioma
D. Cholecystitis
21b 22b
42
23. Gallstones are made of cholesterol, bile pigments, and:
A. Sodium chloride
B. Calcium salts
C. Potassium
D. Ammonia
24. Carcinoma of the gallbladder is strongly associated with:
A. Gallstones
B. Hepatitis C
C. Alcoholism
D. Diabetes
23b 24a
43
25. The strongest risk factor for pancreatic carcinoma is:
A. Diabetes
B. Gallstones
C. Cigarette smoking
D. Obesity
26. A 60-year-old alcoholic presents with cirrhosis and confusion. The likely complication is:
A. Coagulopathy
B. Hepatic encephalopathy
C. Splenic varices
D. Gallbladder carcinoma
25c 26b
44
27. A patient with cirrhosis develops collateral veins in the esophagus. What caused this?
A. Hepatitis C infection
B. Portal hypertension
C. Fatty liver
D. Gallstones
28. A cirrhotic patient presents with tense abdomen and fluid wave. Which imaging confirms ascites best?
A. CT Scan
B. Ultrasound
C. MRI
D. X-ray
27b 28b
45
29. A woman on oral contraceptives is found to have a well-defined liver mass. Likely diagnosis?
A. Hemangioma
B. Hepatocellular adenoma
C. Hepatocellular carcinoma
D. Metastasis
30. A patient with chronic hepatitis B develops a hypervascular liver mass with venous washout on MRI. This is:
A. Hemangioma
B. Hepatocellular carcinoma
C. Cirrhosis
D. Metastasis
29b 30b
46
31. A 40-year-old obese woman has RUQ pain. Ultrasound shows echogenic foci with posterior shadowing. Diagnosis?
A. Cholecystitis
B. Cholelithiasis
C. Pancreatitis
D. Hepatomegaly
32. A patient with gallstones presents with fever and RUQ pain. Ultrasound shows thickened wall and positive Murphy’s sign. Likely diagnosis?
A. Cholelithiasis only
B. Acute cholecystitis
C. Cirrhosis
D. Pancreatitis
31b 32b
47
33. A patient with chronic alcoholism presents with calcifications in the pancreas on CT. Diagnosis?
A. Acute pancreatitis
B. Chronic pancreatitis
C. Pancreatic carcinoma
D. Fatty infiltration
34. A newborn has jaundice due to immature liver function. This is classified as:
A. Surgical jaundice
B. Medical jaundice
C. Autoimmune jaundice
D. Hemolytic jaundice
33b 34b
48
35. A patient with cirrhosis develops bleeding gums and bruising. This is due to:
A. Portal hypertension
B. Coagulopathy
C. Hepatic encephalopathy
D. Splenic varices
36. A cirrhotic patient with ascites develops infection of ascitic fluid without source. Likely complication?
A. Pancreatitis
B. Spontaneous bacterial peritonitis
C. Gallbladder carcinoma
D. Hepatic adenoma
35b 36b
49
37. A patient with pancreatic carcinoma often presents late because:
A. It has no risk factors
B. It grows rapidly and is usually asymptomatic until advanced
C. It is always benign initially
D. It is easily detected by ultrasound early
38. A patient with cirrhosis has splenomegaly and dilated veins. Imaging likely shows:
A. Reversed portal vein flow
B. Increased liver echogenicity
C. Normal portal vein diameter
D. Biliary obstruction
37b 38a
50
39. In chronic hepatitis C, the most feared complication is:
A. Fatty liver
B. Cirrhosis leading to HCC
C. Hemangioma
D. Cholelithiasis
40. A cirrhotic patient develops sudden hematemesis. The most likely source is:
A. Hepatomegaly
B. Splenic varices
C. Esophageal varices rupture
D. Coagulopathy
Answer: C
39b 40c
51
41. A patient develops gallstone ileus. What imaging sign may be seen on X-ray?
A. Ground-glass abdomen
B. Calcified rim of gallbladder
C. Air in the biliary tree
D. Central bowel loops floating
42. A patient with suspected HCC has elevated AFP levels. Best next step for staging?
A. Ultrasound
B. CT scan with contrast
C. Biopsy
D. ERCP
41c 42b
52
43. A patient with cirrhosis develops progressive confusion. MRI shows cerebral edema. Diagnosis?
A. Hepatic encephalopathy
B. Coagulopathy
C. HCC
D. SBP
44. A 55-year-old male with chronic HBV has multiple hypoechoic liver lesions on ultrasound. Diagnosis?
A. Hepatocellular adenoma
B. Metastatic liver disease
C. Hemangioma
D. Fatty liver
43a 44b
53
45. Which imaging is virtually diagnostic for hepatic hemangioma?
A. CT Scan
B. Ultrasound
C. MRI
D. Nuclear RBC scan
46. A cirrhotic patient has prolonged PT/INR. This indicates:
A. Hepatic encephalopathy
B. Coagulopathy
C. Portal hypertension
D. SBP
45d 46b
54
47. Which hepatitis virus worsens HBV infection and cannot occur alone?
A. HAV
B. HCV
C. HDV
D. HEV
48. A 45-year-old man with diabetes and RUQ pain undergoes ultrasound showing biliary sludge without stones. This is due to:
A. Cirrhosis
B. Bile stasis
C. Hepatomegaly
D. Ascites
47c 48b
55
49. Which imaging is best for non-invasive biliary duct visualization?
A. CT
B. Ultrasound
C. MRCP
D. ERCP
50. During surgery for gallstones, intraoperative cholangiography is used to:
A. Detect ascites
B. Confirm stone clearance
C. Stage cirrhosis
D. Visualize liver tumors
49c 50b
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E · 28問 · 6ヶ月前EXAM BASED
EXAM BASED
28問 • 6ヶ月前問題一覧
1
1. Esophageal atresia occurs due to failed separation of trachea and esophagus during:
A. 2nd–3rd week fetal life
B. 4th–6th week fetal life
C. 8th–10th week fetal life
D. After birth
2. The most common symptom of esophageal atresia in newborns is:
A. Projectile vomiting
B. Excessive drooling and choking during feeding
C. Bloody stool
D. Constipation
1b 2b
2
3. The safest imaging sign for esophageal atresia diagnosis is:
A. Barium swallow
B. Contrast CT
C. NG tube coiling on X-ray
D. Endoscopy
4. The most common type of tracheoesophageal fistula (TEF) is:
A. Upper pouch connected to trachea
B. Lower esophagus blind ending
C. Esophageal atresia with distal TEF
D. Both ends blind
3c 4c
3
5. The main danger in TEF is:
A. Malnutrition
B. Aspiration pneumonia
C. Diarrhea
D. GERD
6. Ileal atresia typically presents with:
A. Bilious vomiting and no meconium
B. Projectile vomiting only
C. Bloody diarrhea
D. Hematemesis
5b 6a
4
7. Radiographic hallmark of duodenal atresia is:
A. Coiled spring sign
B. Bird beak sign
C. Double bubble sign
D. Cotton tuft sign
8. Imperforate anus is best evaluated by:
A. Barium swallow
B. Cross-table lateral rectum X-ray
C. CT abdomen
D. Ultrasound pelvis
7c 8b
5
9. The most common gender affected by hypertrophic pyloric stenosis is:
A. First-born males
B. Females equally
C. Twins
D. Premature infants only
10. Classic sign of hypertrophic pyloric stenosis on physical exam is:
A. Palpable “olive” mass in RUQ
B. Peristalsis absent
C. Bloody stool
D. Bluish skin discoloration
9a 10a
6
11. Imaging modality of choice for hypertrophic pyloric stenosis:
A. CT scan
B. Ultrasound
C. MRI
D. Barium swallow
12. Malrotation with volvulus can lead to:
A. GERD
B. Obstruction and bowel ischemia
C. Hypertension
D. Peptic ulcer
11b 12b
7
13. Hirschsprung disease is due to:
A. Abnormal pyloric muscle growth
B. Failure of ganglion cell migration (Meissner and Auerbach plexus absence)
C. Congenital atresia of stomach
D. Vitelline duct remnant
14. Common site of Hirschsprung disease:
A. Duodenum
B. Rectosigmoid region
C. Cecum
D. Esophagus
13b 14b
8
15. Definitive diagnostic test for Hirschsprung disease:
A. Barium enema
B. CT abdomen
C. Rectal suction biopsy
D. Upper GI series
16. Meckel diverticulum arises from:
A. Failure of vitelline duct closure
B. Malrotation
C. Incomplete cloacal rupture
D. Genetic duplication
15c 16a
9
17. The most common symptom of Meckel diverticulum in children is:
A. Projectile vomiting
B. Painless rectal bleeding
C. Severe diarrhea
D. Hematemesis
18. Imaging used to detect Meckel diverticulum with ectopic gastric mucosa:
A. Ultrasound
B. Tc-99m pertechnetate scan
C. Barium swallow
D. CT colonography
17b 18b
10
19. Gluten-sensitive enteropathy is triggered by:
A. Lactose
B. Gliadin component of gluten
C. Protein in milk
D. Bacterial infection
20. Definitive diagnosis of celiac disease is made by:
A. Small bowel biopsy
B. Ultrasound
C. Barium enema
D. CT scan
19b 20a
11
21. Carbohydrate intolerance due to lactase deficiency leads to:
A. Constipation
B. Osmotic diarrhea
C. Malrotation
D. Dysphagia
22. Imaging hallmark of lactose intolerance:
A. Double bubble
B. Cotton tuft sign
C. Rapid barium transit (dilution effect)
D. Bird beak sign
21b 22c
12
23. Esophageal strictures are commonly caused by:
A. Caustic ingestion, GERD, trauma, or tumors
B. Vitamin deficiency
C. Viral infections only
D. Poor diet
24. Best position to view esophageal strictures:
A. RAO
B. AP supine
C. Lateral decubitus
D. PA prone
23a 24a
13
25. GERD occurs due to:
A. Overactive pyloric sphincter
B. Weak lower esophageal sphincter
C. High gastric motility
D. Bacterial overgrowth
26. Best surgical option for severe GERD:
A. Colectomy
B. Ladd’s procedure
C. Nissen fundoplication
D. Pyloromyotomy
25b 26c
14
27. Peptic ulcers are most commonly found in:
A. Duodenal bulb and lesser curvature of stomach
B. Rectum and sigmoid colon
C. Cecum and appendix
D. Jejunum
28. Most common infectious cause of peptic ulcers:
A. H. pylori
B. Candida
C. Salmonella
D. Streptococcus
27a 28a
15
29. Most life-threatening complication of peptic ulcer:
A. Gastritis
B. Perforation with peritonitis
C. Constipation
D. Diarrhea
30. Gastroenteritis due to bacterial contamination often comes from:
A. Poultry, eggs, dairy
B. Fruits
C. Rice only
D. Bottled water
29b 30a
16
31. Typical duration of infectious gastroenteritis:
A. 12 hours
B. 1–2 days
C. 3–4 days
D. 1 week minimum
32. Crohn disease most often affects:
A. Rectum
B. Ileum and cecum
C. Duodenum
D. Pancreas
31c 32b
17
33. Gold standard imaging for Crohn disease:
A. Capsule endoscopy
B. Small bowel series / enteroclysis
C. MRI
D. Ultrasound
34. Crohn disease “skip lesions” and transmural inflammation lead to:
A. Strictures, fistulas, obstruction
B. Malrotation only
C. Liver cirrhosis
D. Simple constipation
33b 34a
18
35. Most common cause of appendicitis:
A. Tumors
B. Fecalith obstruction
C. Malrotation
D. Viral infection
36. Classic presentation of appendicitis:
A. Initial epigastric pain shifting to RLQ
B. Painless rectal bleeding
C. Projectile vomiting
D. Constipation only
35b 36a
19
37. Definitive treatment for appendicitis:
A. Antibiotics
B. Appendectomy
C. Pyloromyotomy
D. Ladd’s procedure
38. Ulcerative colitis begins in:
A. Cecum
B. Rectum
C. Duodenum
D. Appendix
37b 38b
20
39. Toxic megacolon is a serious complication of:
A. Crohn disease
B. Ulcerative colitis
C. Meckel diverticulum
D. GERD
40. Imaging contraindicated in toxic megacolon:
A. Ultrasound
B. Barium enema
C. CT
D. MRI
39b 40b
21
41. Esophageal varices are caused by:
A. Cirrhosis with portal hypertension
B. Bacterial infection
C. Malrotation
D. GERD
42. Major risk of esophageal varices:
A. Dysphagia
B. Massive hemorrhage on rupture
C. Bloating only
D. Constipation
41a 42b
22
43. Emergency treatment for variceal bleeding:
A. Ladd’s procedure
B. TIPSS
C. Appendectomy
D. Herniorrhaphy
44. Long-term monitoring of TIPSS is done with:
A. Doppler ultrasound
B. MRI
C. CT scan
D. Barium enema
43b 44a
23
45. A hernia is defined as:
A. Bowel inflammation
B. Bowel protrusion through abdominal wall weakness
C. Tumor growth in stomach
D. Malrotation of intestine
46. Emergency surgery is required for:
A. Reducible hernia
B. Strangulated hernia
C. Sliding hiatal hernia
D. GERD hernia
45b 46b
24
47. Hiatal hernia occurs when:
A. Cecum is displaced
B. Part of stomach pushes through diaphragm
C. Appendix migrates
D. Rectum prolapses
48. Sliding hiatal hernia is associated with:
A. GERD
B. Appendicitis
C. Crohn disease
D. Toxic megacolon
47b 48a
25
49. Radiographic sign of Schatzki ring is seen in:
A. Sliding hiatal hernia
B. Rolling hiatal hernia
C. Crohn disease
D. GERD only
50. Rolling (paraesophageal) hernia is more dangerous due to risk of:
A. Simple reflux
B. Strangulation and volvulus
C. Appendicitis
D. Fistulas
49a 50b
26
51. Mechanical bowel obstruction is caused by:
A. Tumors, adhesions, hernias, volvulus, intussusception
B. Low potassium only
C. Food intolerance
D. Celiac disease
52. Radiographic hallmark of mechanical obstruction:
A. Silent abdomen
B. Multiple air-fluid levels
C. Gas in biliary tree only
D. Normal bowel sounds
51a 52b
27
53. Strangulated obstruction results in:
A. Simple constipation
B. Ischemia and necrosis
C. GERD
D. Liver damage
54. Volvulus is twisting of bowel, commonly in:
A. Rectum
B. Sigmoid colon and ileocecal junction
C. Duodenum
D. Gallbladder
53b 54b
28
55. Intussusception shows what sign radiographically?
A. Bird beak sign
B. Coiled spring appearance
C. Double bubble sign
D. Cotton tuft sign
56. Gallstone ileus may show which finding?
A. Air in biliary tree
B. Coiled spring sign
C. Olive mass
D. Schatzki ring
55b 56a
29
57. Paralytic ileus is caused by:
A. Post-surgical state, low potassium, opioids
B. Tumors
C. Crohn disease
D. Lactose intolerance
58. Radiographic hallmark of paralytic ileus:
A. Diffuse gas in both small and large bowel
B. Coiled spring
C. Double bubble
D. Bird beak
57a 58a
30
59. Best treatment for paralytic ileus:
A. NG suction and electrolyte correction
B. Appendectomy
C. Surgery always
D. Ladd’s procedure
60. Achalasia is caused by:
A. Weak LES
B. Failure of LES to relax due to nerve loss
C. Crohn inflammation
D. GERD damage
59a 60b
31
1. Alcohol-induced liver disease progresses in the following order:
A. Cirrhosis → Hepatitis → Fatty liver → HCC
B. Fatty liver → Hepatitis → Cirrhosis → HCC
C. Hepatitis → Fatty liver → Cirrhosis → HCC
D. Fatty liver → Cirrhosis → Hepatitis → HCC
2. The toxic metabolite of alcohol that damages hepatocytes is:
A. Acetone
B. Acetaldehyde
C. Lactic acid
D. Ammonia
1b 2b
32
3. Fatty liver due to obesity and diabetes is classified as:
A. Alcoholic fatty liver
B. Nonalcoholic fatty liver disease (NAFLD)
C. Post-surgical fatty liver
D. Autoimmune fatty liver
4. The imaging modality most sensitive for detecting early fatty liver is:
A. Ultrasound
B. CT Scan
C. MRI
D. Nuclear scan
3b 4c
33
5. Enlargement of the liver is called:
A. Cirrhosis
B. Hepatomegaly
C. Splenomegaly
D. Steatosis
6. Cirrhosis is considered:
A. A reversible disease
B. An acute inflammatory condition
C. A chronic, irreversible liver disease
D. A metabolic syndrome
5b 6c
34
7. Which complication of cirrhosis results from increased portal vein pressure?
A. Hepatic encephalopathy
B. Portal hypertension
C. Hepatocellular carcinoma
D. Coagulopathy
8. Wormlike filling defects on barium swallow suggest:
A. Esophageal varices
B. Hemangioma
C. Splenic varices
D. Ascites
7b 8a
35
9. Ascites is defined as:
A. Fat accumulation in the liver
B. Fluid accumulation in the abdominal cavity
C. Enlarged spleen
D. Fibrosis of the pancreas
10. The gold standard for diagnosing viral hepatitis severity is:
A. CT Scan
B. Ultrasound
C. Liver biopsy
D. MRI
9b 10c
36
11. Which hepatitis virus is spread via fecal-oral route and does not become chronic?
A. HAV
B. HBV
C. HCV
D. HDV
12. Hepatitis B is transmitted through:
A. Contaminated food
B. Contaminated water
C. Blood and body fluids
D. Mosquito bites
11a 12c
37
13. The first-line imaging modality for detecting gallstones is:
A. CT Scan
B. MRI
C. Ultrasound
D. HIDA Scan
14. Acute cholecystitis is best confirmed by:
A. Ultrasound
B. HIDA scan
C. CT scan
D. MRI
13c 14b
38
15. The most common cause of acute pancreatitis is:
A. Viral infection
B. Gallstones and alcohol abuse
C. Autoimmune reaction
D. Trauma
16. Chronic pancreatitis is often associated with:
A. Bacterial infection
B. Alcohol abuse
C. Hepatitis A
D. Gallbladder polyps
15b 16b
39
17. Jaundice is caused by the accumulation of:
A. Hemoglobin
B. Bilirubin
C. Lipase
D. Bile salts
18. Which type of jaundice is due to bile duct obstruction?
A. Medical (nonobstructive)
B. Surgical (obstructive)
C. Hemolytic
D. Autoimmune
17b 18b
40
19. A benign liver tumor related to oral contraceptives is:
A. Hepatocellular carcinoma
B. Hemangioma
C. Hepatocellular adenoma
D. Metastatic tumor
20. The most common benign liver tumor composed of blood vessels is:
A. Adenoma
B. Hemangioma
C. Carcinoma
D. Metastasis
19c 20b
41
21. The most common primary malignant tumor of the liver is:
A. Hemangioma
B. Hepatocellular carcinoma
C. Gallbladder carcinoma
D. Pancreatic carcinoma
22. Which of the following is more common than primary liver cancer?
A. Hepatocellular adenoma
B. Metastatic liver disease
C. Hemangioma
D. Cholecystitis
21b 22b
42
23. Gallstones are made of cholesterol, bile pigments, and:
A. Sodium chloride
B. Calcium salts
C. Potassium
D. Ammonia
24. Carcinoma of the gallbladder is strongly associated with:
A. Gallstones
B. Hepatitis C
C. Alcoholism
D. Diabetes
23b 24a
43
25. The strongest risk factor for pancreatic carcinoma is:
A. Diabetes
B. Gallstones
C. Cigarette smoking
D. Obesity
26. A 60-year-old alcoholic presents with cirrhosis and confusion. The likely complication is:
A. Coagulopathy
B. Hepatic encephalopathy
C. Splenic varices
D. Gallbladder carcinoma
25c 26b
44
27. A patient with cirrhosis develops collateral veins in the esophagus. What caused this?
A. Hepatitis C infection
B. Portal hypertension
C. Fatty liver
D. Gallstones
28. A cirrhotic patient presents with tense abdomen and fluid wave. Which imaging confirms ascites best?
A. CT Scan
B. Ultrasound
C. MRI
D. X-ray
27b 28b
45
29. A woman on oral contraceptives is found to have a well-defined liver mass. Likely diagnosis?
A. Hemangioma
B. Hepatocellular adenoma
C. Hepatocellular carcinoma
D. Metastasis
30. A patient with chronic hepatitis B develops a hypervascular liver mass with venous washout on MRI. This is:
A. Hemangioma
B. Hepatocellular carcinoma
C. Cirrhosis
D. Metastasis
29b 30b
46
31. A 40-year-old obese woman has RUQ pain. Ultrasound shows echogenic foci with posterior shadowing. Diagnosis?
A. Cholecystitis
B. Cholelithiasis
C. Pancreatitis
D. Hepatomegaly
32. A patient with gallstones presents with fever and RUQ pain. Ultrasound shows thickened wall and positive Murphy’s sign. Likely diagnosis?
A. Cholelithiasis only
B. Acute cholecystitis
C. Cirrhosis
D. Pancreatitis
31b 32b
47
33. A patient with chronic alcoholism presents with calcifications in the pancreas on CT. Diagnosis?
A. Acute pancreatitis
B. Chronic pancreatitis
C. Pancreatic carcinoma
D. Fatty infiltration
34. A newborn has jaundice due to immature liver function. This is classified as:
A. Surgical jaundice
B. Medical jaundice
C. Autoimmune jaundice
D. Hemolytic jaundice
33b 34b
48
35. A patient with cirrhosis develops bleeding gums and bruising. This is due to:
A. Portal hypertension
B. Coagulopathy
C. Hepatic encephalopathy
D. Splenic varices
36. A cirrhotic patient with ascites develops infection of ascitic fluid without source. Likely complication?
A. Pancreatitis
B. Spontaneous bacterial peritonitis
C. Gallbladder carcinoma
D. Hepatic adenoma
35b 36b
49
37. A patient with pancreatic carcinoma often presents late because:
A. It has no risk factors
B. It grows rapidly and is usually asymptomatic until advanced
C. It is always benign initially
D. It is easily detected by ultrasound early
38. A patient with cirrhosis has splenomegaly and dilated veins. Imaging likely shows:
A. Reversed portal vein flow
B. Increased liver echogenicity
C. Normal portal vein diameter
D. Biliary obstruction
37b 38a
50
39. In chronic hepatitis C, the most feared complication is:
A. Fatty liver
B. Cirrhosis leading to HCC
C. Hemangioma
D. Cholelithiasis
40. A cirrhotic patient develops sudden hematemesis. The most likely source is:
A. Hepatomegaly
B. Splenic varices
C. Esophageal varices rupture
D. Coagulopathy
Answer: C
39b 40c
51
41. A patient develops gallstone ileus. What imaging sign may be seen on X-ray?
A. Ground-glass abdomen
B. Calcified rim of gallbladder
C. Air in the biliary tree
D. Central bowel loops floating
42. A patient with suspected HCC has elevated AFP levels. Best next step for staging?
A. Ultrasound
B. CT scan with contrast
C. Biopsy
D. ERCP
41c 42b
52
43. A patient with cirrhosis develops progressive confusion. MRI shows cerebral edema. Diagnosis?
A. Hepatic encephalopathy
B. Coagulopathy
C. HCC
D. SBP
44. A 55-year-old male with chronic HBV has multiple hypoechoic liver lesions on ultrasound. Diagnosis?
A. Hepatocellular adenoma
B. Metastatic liver disease
C. Hemangioma
D. Fatty liver
43a 44b
53
45. Which imaging is virtually diagnostic for hepatic hemangioma?
A. CT Scan
B. Ultrasound
C. MRI
D. Nuclear RBC scan
46. A cirrhotic patient has prolonged PT/INR. This indicates:
A. Hepatic encephalopathy
B. Coagulopathy
C. Portal hypertension
D. SBP
45d 46b
54
47. Which hepatitis virus worsens HBV infection and cannot occur alone?
A. HAV
B. HCV
C. HDV
D. HEV
48. A 45-year-old man with diabetes and RUQ pain undergoes ultrasound showing biliary sludge without stones. This is due to:
A. Cirrhosis
B. Bile stasis
C. Hepatomegaly
D. Ascites
47c 48b
55
49. Which imaging is best for non-invasive biliary duct visualization?
A. CT
B. Ultrasound
C. MRCP
D. ERCP
50. During surgery for gallstones, intraoperative cholangiography is used to:
A. Detect ascites
B. Confirm stone clearance
C. Stage cirrhosis
D. Visualize liver tumors
49c 50b