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Quiz Questions (36 questions)
1. Roux-en-Y gastric bypass is a combined restrictive and malabsorptive bariatric procedure.
2. A patient with dumping syndrome after gastric resection is most likely to complain of severe vasomotor symptoms after eating.
3. Signet ring cells found on biopsy of the stomach, which does not distend easily, are indicative of Linitis plastica "Leather bottle stomach".
4. Roux-en-Y gastric bypass (RYGB) is primarily intended to induce weight loss through malabsorption of ingested nutrients.
5. The most appropriate initial management for a patient with a hiatal hernia presenting with heartburn and regurgitation is Lifestyle Modification.
6. A BMI (weight(kg)/height [m2]) of 40.0 and greater (Class III obesity) serves as the standard indication for bariatric surgery when medical therapy has failed and comorbid conditions exist.
7. Staple line leak is a specific complication of Sleeve gastrectomy.
8. The standard treatment for an isolated 3 cm gastrointestinal stromal tumor (GIST) in the body of the stomach is wedge resection of the stomach.
9. A patient with incessant vomiting of stale food, sunken eyes, dry tongue, loss of skin turgor, and a full epigastrium most likely has Gastric outlet obstruction.
10. Sleeve gastrectomy is mainly intended to induce weight loss through malabsorption of ingested nutrients.
11. A patient with severe upper abdominal pain and heartburn after meals, multiple duodenal, gastric, and lower esophageal ulcers, partial healing after PPI treatment, and high serum gastrin levels likely has Zollinger-Ellison syndrome.
12. The most accurate imaging modality for a patient with upper abdominal pain radiating to the back, weight loss, diarrhea, and greasy stools is Abdominal CT with IV contrast.
13. A patient with long-standing duodenal ulcer disease complaining of anorexia, nausea, weight loss, repeated vomiting of undigested food, dehydration, hypokalemia, and hypochloremic alkalosis most likely has Pyloric obstruction due to cicatricial stenosis of the lumen of the duodenum.
14. A patient with weight loss and a large palpable tumor in the upper abdomen, with an intact gastric mucosa and normal gastric mucosa on multiple biopsies, most likely has a Gastrointestinal stromal tumor (GIST).
15. Significant comorbidities are an indication for bariatric surgery for a patient with a BMI of 36 who has tried multiple diets without success.
16. Stomal stenosis is a specific complication of Roux-en-Y gastric bypass.
17. Jejunoileal bypass is purely intended to induce weight loss through malabsorption of ingested food.
18. The standard treatment for metastatic gastrointestinal stromal tumor (GIST) in the body of the stomach is Imatinib therapy.
19. The most useful investigation in the diagnosis of gastric outlet obstruction is Upper endoscopy.
20. Hypokalaemia is a metabolic abnormality typically found in the described patient.
21. Gastrointestinal stromal tumours (GISTs) may be malignant or benign.
22. Incidence of dumping syndrome is lower after highly selective vagotomy than after truncal vagotomy.
23. 5-year survival for patients with gastric adenocarcinoma confined to the mucosa with no nodal metastasis approaches 90.
24. Blood group B is not a risk factor for gastric carcinoma.
25. Cholestyramine is a treatment for post vagotomy diarrhea.
26. A patient with a history of epigastric pain relieved by milk and antacids, fullness in the epigastric area with visible peristalsis, absence of tenderness, and normal active bowel sounds most likely has Gastric outlet obstruction.
27. A patient with sudden onset of severe epigastric pain and vomiting, a history of chronic epigastric pain relieved by antacids, and pneumoperitoneum most likely has perforated duodenal ulcer.
28. The next appropriate step in management for a patient with acute onset of severe abdominal pain, a history of gnawing epigastric pain radiating to the back, and a rigid board-like abdomen with generalized rebound tenderness and hypoactive bowel sounds is to order upright chest and abdomen x-rays.
29. Gastric trauma is not a causation of gastric cancer.
30. Peptic ulcers can be healed by PPI therapy.
31. Late dumping syndrome occurring after gastric surgery is due to a sudden increased osmotic load in the small bowel.
32. Fiberoptic upper endoscopy is the most reliable method for diagnosing a gastric ulcer.
33. A 35-year-old woman who underwent a sleeve gastrectomy 3 years ago, presents with regain of weight and relapse of diabetes. She presently has a BMI of 52 and is otherwise fit and healthy. Gastric bypass is likely to benefit her most with this history.
34. Morbid obesity is defined as a BMI greater than 40 Kg/m2.
35. A BMI of 30kg/m2 is NOT a selection criterion for performing bariatric surgery as per international norms.
36. A 45-year-old man presents with a BMI of 45. He has been obese for the past 10 years without any medical comorbidity except snoring during sleep for the past 1 year. Laparoscopic Sleeve gastrectomy is best suited for his ailment.
Previous Exam Questions (35 questions)
1. Sleeve gastrectomy has advantages and disadvantages.
2. Specific post-gastrectomy complications exist.
3. Laparoscopic adjustable gastric banding (LAGB) can lead to complications such as gastric prolapse, erosion, reflux esophagitis, dysphagia, stoma obstruction, gastric necrosis, symptomatic gallstone disease, psychological intolerance, and esophageal and pouch dilatation.
4. A diagnostic approach exists for gastric cancer.
5. Sleeve gastrectomy leads to hormonal changes that contribute to weight loss.
6. Vitamin deficiencies can occur in patients undergoing malabsorptive bariatric surgery.
7. The likely diagnosis for a patient presenting with sudden epigastric pain, vomiting, and signs of peritonitis is a perforated intra-abdominal viscus, most commonly a perforated peptic ulcer.
8. Management of a patient with a perforated peptic ulcer involves prompt fluid resuscitation, central venous pressure monitoring, hourly urine output measurements, nasogastric intubation, broad-spectrum antibiotics, analgesia, and usually surgery after resuscitation; conservative management may be considered in patients with significant comorbidity.
9. Postoperatively, patients with a perforated peptic ulcer should receive Helicobacter pylori eradication therapy and continue on a proton pump inhibitor.
10. Endoscopy may reveal a gastric tumor.
11. Blood tests may reveal a microcytic anemia as a result of chronic blood loss from a gastric tumor.
12. Risk factors for gastric malignancy include Vitamin C deficiency, H. pylori infection, hypogammaglobulinemia, pernicious anemia, and post-gastrectomy status.
13. Patient staging for gastric cancer includes endoscopic ultrasound to assess tumor depth and nodal involvement, computerized tomography to assess nodal spread and metastatic disease, and laparoscopy to identify peritoneal seedlings.
14. Treatment options for gastric cancer include partial gastrectomy for antral tumors, total gastrectomy for tumors less than 5 cm from the gastro-oesophageal junction, and endoscopic mucosal resection for tumors less than 1 cm in size that do not extend into the submucosa.
15. A patient presenting with sensation of fullness after meals, vomiting, anorexia, and weight loss may have gastric outlet obstruction.
16. Gastric outlet obstruction can be caused by carcinoma of the stomach.
17. Gastric outlet obstruction is characterized by hyperperistalsis of the stomach, hypertrophy of the stomach musculature, and dilatation of the stomach.
18. Metabolic effects of gastric outlet obstruction include chronic dehydration, prerenal azotemia, and hypochloremic, hypokalemic metabolic alkalosis due to vomiting.
19. In the early stage of gastric outlet obstruction, loss of H+ and Cl- ions leads to hypochloremic alkalosis, and the kidneys excrete low chloride and more bicarbonate, leading to sodium loss in urine.
20. In late-stage gastric outlet obstruction, the kidney reabsorbs water and sodium due to aldosterone effect, retaining sodium in exchange for H+ and K+ ions, leading to acidic urine (paradoxical aciduria).
21. A barium-meal study can be helpful in cases of linitis plastica or when endoscopy is not feasible.
22. A patient presenting with pain in the central abdomen relieved by food intake, vomiting, heartburn, and a sensation of a rolling mass may have gastric outlet obstruction due to a chronic complication of a chronic duodenal ulcer.
23. Management of gastric outlet obstruction due to chronic duodenal ulcer includes upper gastrointestinal (GI) endoscopy to confirm the diagnosis.
24. Investigations for gastric outlet obstruction include complete hemogram, blood tests for sugar, urea, creatinine, and serum electrolytes, chest X-ray, urine analysis, stool occult blood test, and liver function tests.
25. A surgical option for gastric outlet obstruction due to chronic duodenal ulcer is truncal vagotomy and gastrojejunostomy.
26. A complete hemogram, including Hb%, TLC, DLC, and ESR, is a suggested investigation.
27. Blood sugar, urea, and creatinine levels should be measured.
28. Serum electrolyte levels, including Na, K, and Cl, should be measured.
29. A chest X-ray (PA view) is a suggested investigation.
30. Urine RE (routine examination) is a suggested investigation.
31. Stool for occult blood is a suggested investigation.
32. Liver function tests (LFT) should be performed, noting that serum protein may be low.
33. Surgical therapy is a reasonable treatment option for morbid obesity in a patient with a BMI of 47 kg/m2, type 2 DM, and a family history of coronary artery disease.
34. Truncal vagotomy and gastrojejunostomy are surgical procedures.
35. It is important to consider the complications of bariatric surgery.
Content processed on Dec 20, 2025 7:54 PM
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Alright man, let me explain some key points about the stomach, peptic ulcers, gastric outlet obstruction, tumors of the stomach, gastric operations, post-gastrectomy syndromes, and bariatric surgery. This is really important stuff. **Stomach Anatomy, Histology, and Physiology** The stomach has fiv...
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