Gastrointestinal Pathology Practice Questions

Q: A Mallory-Weiss tear typically occurs at which anatomical location?

Oesophago-gastric junction. **Explanation:** **Mallory-Weiss Syndrome** refers to longitudinal mucosal lacerations at the **oesophago-gastric (GE) junction** or the gastric cardia. These tears are primarily caused by a sudden, severe increase in intra-abdominal pressure, most commonly due to forceful vomiting, retching, or coughing (often associated with chronic alcoholism or eating disorders). **Why the Correct Answer is Right:** * **Option B (Oesophago-gastric junction):** During the act of vomiting, the reflex relaxation of the gastric inlet fails to coordinate with the vigorous contraction of the abdominal wall. This creates a pressure gradient that forces gastric contents against the GE junction, causing the mucosa to stretch and tear. These tears are typically superficial (mucosal/submucosal) and account for 5-10% of upper GI bleed cases. **Why the Incorrect Options are Wrong:** * **Option A (Root of the aorta):** This is the site for **Aortic Dissection** or syphilitic aortitis, unrelated to GI barotrauma. * **Options C & D (Middle cerebral/Vertebro-basilar artery):** These are common sites for **Berry Aneurysms** (specifically the junctions of the Circle of Willis). Rupture here leads to subarachnoid hemorrhage, not GI bleeding. **High-Yield Clinical Pearls for NEET-PG:** * **Clinical Presentation:** Hematemesis following bouts of non-bloody vomiting (the "classic" history). * **Mallory-Weiss vs. Boerhaave Syndrome:** While Mallory-Weiss involves *mucosal* tears, **Boerhaave Syndrome** is a medical emergency involving *transmural* (full-thickness) esophageal rupture, usually in the distal esophagus, leading to pneumomediastinum. * **Diagnosis:** Endoscopy is the gold standard, revealing linear lacerations crossing the GE junction. * **Prognosis:** Most Mallory-Weiss tears bleed minimally and heal spontaneously without surgical intervention.

Question 1

A 25-year-old man is diagnosed with colon cancer. It is noted that several members of his family also developed colon cancer at relatively young ages. Which of the following genes is most likely to be involved?

Accepted Answer

Hereditary nonpolyposis colorectal cancer gene

Answer

p53 gene

Answer

K-ras oncogene

Answer

Mismatch repair gene

Question 2

According to epidemiological studies, which of the following factors does NOT contribute to the development of colon cancer?

Accepted Answer

High fiber diet

Answer

Low fat diet

Answer

Low selenium diet

Answer

Low protein diet

Question 3

E-cadherin is more often mutated in which of the following?

Accepted Answer

Diffuse type of gastric cancer

Answer

Carcinoid tumour

Answer

Malignant ulcer of Stomach

Answer

Erosive gastritis

Question 4

A 60-year-old woman presents with chronic diarrhoea associated with faecal urgency. She denies fever, melena, haematochezia, abdominal pain, nausea, vomiting, or weight loss. The diarrhoea persists even during periods of fasting. Random colonic biopsies demonstrate mononuclear cell infiltration of the lamina propria and a thickened subepithelial collagen band. What is the most likely diagnosis?

Accepted Answer

Microscopic colitis

Answer

Crohn disease

Answer

Ulcerative colitis

Answer

Irritable Bowel Syndrome

Question 5

Which among the following conditions is not considered pre-malignant?

Accepted Answer

Peutz-jeghers syndrome

Answer

Ulcerative colitis

Answer

Villous adenoma

Answer

Familial adenomatous polyposis

Question 6

What is the basic pathology of Barrett's esophagus?

Accepted Answer

Metaplasia of squamous cells to columnar cells

Answer

Metaplasia of columnar cells to squamous cells

Answer

Dysplasia of esophageal epithelium

Answer

Cardiac sphincter pressure disturbances

Question 7

Which of the following statements about abdominal lymphoma is FALSE?

Accepted Answer

Primary small intestinal lymphomas are most commonly located in the jejunum.

Answer

MALT lymphoma is associated with H. Pylori infection.

Answer

Angiosarcoma is the most common primary malignant neoplasm of the spleen.

Answer

The stomach is the most common site for extranodal lymphoma.

Question 8

A Mallory-Weiss tear typically occurs at which anatomical location?

Accepted Answer

Oesophago-gastric junction

Answer

Root of the aorta

Answer

Middle cerebral artery

Answer

Vertebro-basilar artery

Question 9

How is a malignant ulcer differentiated from a benign ulcer?

Accepted Answer

Heaping up of margins

Answer

Fibrous scars radiating from the crater

Answer

Induration of the base

Answer

Clean base

Question 10

Which of the following is totally sterile?

Accepted Answer

Periapical granuloma.

Answer

Periapical cyst.

Answer

Radicular cyst.

Answer

None

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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