Upper GI surgery MCQs
1. An 18 year old presented with vomiting after eating.
Investigations confirmed achalasia of the cardia. What is
the most appropriate investigation that confirms the
diagnosis?
a. Upper GI endoscopy
b. Endoscopic biopsy of lower oesophagus
c. 24 hour pH measurement of oesophagus
d. Esophageal manometry
e. Barium swallow
2. Causes for GERD
a. Obesity
b. Smoking
c. Metochloropramide
d. Achalasia cardia
e. Scleroderma
4. 40 years old female complains of dysphagia of 2 years
duration. She has no LOW. UGI endoscopy shows dilated
oesophages with no mucosal abnormalities. What is the
most appropriate to confirm the diagnosis?
a. Barium swallow
b. Endoluminal USS
c. MRI scan of chest
d. Oesophageal manomatry
e. 24hr pH monitoring
5. 45 year old woman presented with dysphagia & clinical
examination became normal. What can be the reason:
a. Goitre
b. Oesophageal varices
c. Oesophageal carcinoma
d. Achalasia of cardia
e. Barret's oesophagus
6. 55yr female present with gastric regurgitation for 10
month. On upper GI endoscopy reveal esophagitis. No
evidence of dysplasia. What is the best initial Mx?
a. Endoscopic ballooning
b. Endoscopic laser
c. Lifestyle modification and start PPI
d. Reassurance and review at 3mmonths
e. Nissen fundoplication
7. A 55y old female with 5 months history of gastro-
oesophageal reflux disease.Endoscopy- mild oesophagitis;
no dysplasia :What is the most appropriate management?
a. Endoscopic balloon dilatation
b. Medical and life style modifications
c. Heller's cardiomyotomy
d. Nissen fundoplication
e. Reassurance
8. Regarding Achlasia Cardia, -
a. 24 hour monitoring of oesophageal pH is indicated.
b. Rat tail appearance of barium swallow is characteristic.
c. Diagnosis is confirmed by oesophagealmanometry.
d. Dysphagia is more for liquid.
e. Treated by cardiomyotomy
9. A 60 year old male underwent UGIE for epigastric pain
and LOA for 2 months. UGIE showed an ulcer in the
antrum with elevated margins. Biopsy was taken and it
came as not malignant. What is the best option of
treatment?
a. H.pylori eradication Rx
b. Prepare him for gastrectomy
c. Reassure the patient
d. Repeat UGIE biopsy
e. Start PPI
10. Tests to diagnose H.pylori
a. Serology
b. Fecal antigen test
c. Nitrogen breath test
d. Rapid urease test
e. Histology
11. Regarding Duodenal Ulcers;
a. Most commonly occur in 2nd part of Duodenum
b. If untreated leads to carcinoma in long term
c. Bleeding from Gastroduodenal artery
d. If not due to NSAIDS, treatment is effective with
antibiotics
12. The following are most appropriate investigation
a. Oesophageal carcinoma -Upper GI endoscopy
b. GORD - 24 hr pH monitoring
c. Pancreatic carcinoma - U/S abdomen
d. Transmural involvement- Endoscopic U/S
e. Pneumo peritoneum- Erect CXR
13. T/F
a. Perforated peptic ulcer is a common cause of acute
abdomen in the elderly
b. Acalculous cholecystitis has a higher mortality
c. Glycopeptides is used to treat MRSA
d. Oral metronidazole is contraindicated in a patient with
chronic liver dysfunction
e. Post op second day fever after thyroidectomy - RTI is a
common cause
14. A 60y old male with peptic ulcer disease for 18
months, presented with progressive abdominal fullness
distended epigastrium and non-bilious vomiting. On
examination- epigastric tenderness with succussion
splash .What is the diagnosis?
a. Gastric antral tumour
b. Oesophageal carcinoma
c. Peri-ampullary carcinoma
d. Chronic pancreatitis
e. Pyloric stricture
15. 45 year old man presented with episodic
haematemesis. Endoscopy was done &identified
oesophageal varices. What is the best next step of
management?
a. Balloon tamponade
b. Band ligation
c. IV terlipressin
d. Oral propranolol
e. Sclerotherapy
16. Regarding independent risk factors of mortality in
upper GI bleeding
a. Shock at presentation
b. Old age
c. Malloy Weiss tear
d. Number and severity of co-morbid diseases
e. Clot overlying the base of a peptic ulcer
17. 30 years old female presented with anemic features.
She has a history of tarry stools. USS reveals presence of
fatty liver. What is the most likely diagnosis?
a. Atrophic gastritis
b. Gastric CA
c. GORD
d. Oesophageal varices
e. Peptic ulcer disease
18. In the acute management of haematamesis in a 50 year
old patient with cirrhosis, the following are used
a. Fluid and blood resuscitation
b. Octreotide
c. Upper Gl endoscopy
d. IV antibiotics
e. TIPS
19. What is the most likely artery that gives rise to
bleeding in a man presented with massive hematemesis.
Upper GI endoscopy revealed bleeding. duodenal ulcer.
a. Gastroduodenal artery
b. Right gastric artery
c. left gastric artery
d. Right gastrosplenic artery
e. Superior pancreaticoduodenal artery
20. UGIE;
a. Lignocaine Spray reduces risk of aspiration
b. Varices are seen in lower Oesophagus
c. J manuovre is used to visualize the fundus
d. Biopsy of diagnosis of Helicobactor Pylori is taken from
2nd part of duodenum
e. Duodenal rupture is a recognized complication
21. Patient on warfarin present with upper Gl bleeding.
WOTF is the best way to achieve rapid reversal of
warfarin induced anticoagulation?
a. Cryo poor plasma
b. Cryo precipitate
c. FFP
d. Platelet concentrate
e. Vit K injection
Upper GI surgery topics
Benign and Malignant oesophageal disorders
Gastritis and peptic ulcer disease
Gastric CA
Upper GI bleeding
Gastric outlet obstruction
