Abdomen Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Abdomen. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Abdomen Indian Medical PG Question 1: Which of the following are features of umbilical hernia in adults?
1. Patients are commonly overweight with a thinned and attenuated midline raphe.
2. Most patients are asymptomatic or present with a painless swelling.
3. Men are affected more than women.
4. Hernia repair can be done by the technique described by Mayo.
Select the correct answer using the code given below.
- A. 2, 3 and 4
- B. 1, 2 and 3
- C. 1, 3 and 4
- D. 1, 2 and 4 (Correct Answer)
Abdomen Explanation: ***1, 2 and 4***
- **Overweight patients** often have increased intra-abdominal pressure and weakened abdominal walls, contributing to the development of an umbilical hernia and a **thinned midline raphe**.
- **Most adult umbilical hernias are asymptomatic** or present as painless swellings; patients typically notice a bulge that may increase with coughing or straining. Pain usually indicates **complications** such as incarceration or strangulation.
- The **Mayo repair** is a classic technique specifically designed for umbilical hernias, involving the overlapping of the rectus sheath for a strong repair.
*2, 3 and 4*
- While patients are often **asymptomatic** (statement 2 correct) and the **Mayo repair** is standard (statement 4 correct), statement 3 is incorrect; **women are more commonly affected** by umbilical hernias than men.
*1, 2 and 3*
- Patients are commonly **overweight** (statement 1 correct) and often **asymptomatic** (statement 2 correct), but statement 3 is incorrect as umbilical hernias are seen **more often in women** than men.
*1, 3 and 4*
- Patients are commonly **overweight** (statement 1 correct) and the **Mayo repair** is a recognized technique (statement 4 correct), but statement 3 is incorrect because **women are more affected** than men. Statement 2 is also correct as most patients are asymptomatic.
Abdomen Indian Medical PG Question 2: In pediatrics, differential diagnoses for acute appendicitis include all EXCEPT:
- A. Gastroenteritis
- B. Volvulus
- C. Trauma (Correct Answer)
- D. Torsion
Abdomen Explanation: ***Trauma***
- While trauma can cause abdominal pain, it is **not typically a differential diagnosis for acute appendicitis** as the mechanism of injury and clinical presentation are distinct.
- Appendicitis involves inflammation of the appendix, whereas trauma involves direct injury to abdominal organs or tissues.
*Gastroenteritis*
- **Gastroenteritis** can present with diffuse abdominal pain, nausea, vomiting, and fever, mimicking early symptoms of appendicitis.
- However, appendicitis pain often localizes to the right lower quadrant, unlike the more generalized pain of gastroenteritis.
*Volvulus*
- **Volvulus**, especially in infants and young children, presents with severe, colicky abdominal pain, bilious vomiting, and signs of intestinal obstruction, which can overlap with appendicitis symptoms.
- Unlike appendicitis, volvulus involves the twisting of a bowel loop, leading to vascular compromise and often requiring urgent surgical intervention.
*Torsion*
- **Ovarian torsion** or **testicular torsion** can cause acute, severe unilateral lower abdominal or pelvic pain, mimicking appendicitis due to proximity and similar pain presentation in children.
- These conditions are distinct from appendicitis as they involve the twisting of adnexal structures or testes, leading to ischemia.
Abdomen Indian Medical PG Question 3: Consider the following findings with reference to a diagnostic peritoneal lavage (DPL) in a case of abdominal trauma :
1. 10 ml of gross blood on aspiration
2. W.B.C. count more than 500/cu mm
3. Amylase level more than 175 IU/dL
4. R.B.C. count more than 100,000/cu mm The criteria for a positive DPL are :
- A. 1 and 2 only
- B. 3 and 4 only
- C. 1, 2 and 3 only
- D. 1, 2, 3 and 4 (Correct Answer)
Abdomen Explanation: ***1, 2, 3 and 4***
- A **positive DPL** is indicated by any of these findings: gross blood on aspiration (≥10 mL), WBC count >500/mm³, amylase level >175 IU/dL, or RBC count >100,000/mm³.
- All four criteria listed are standard indicators for a positive DPL, suggesting significant intra-abdominal injury requiring further intervention.
*1 and 2 only*
- While **gross blood aspiration** and an **elevated WBC count** are indeed criteria for a positive DPL, this option is incomplete as it omits other critical indicators.
- A **high amylase level** and **RBC count >100,000/mm³** are also definitive signs of a positive DPL.
*3 and 4 only*
- Although an **elevated amylase level** and a **high RBC count** are valid criteria, this option is insufficient because it excludes the important findings of gross blood aspiration and an elevated WBC count.
- A comprehensive assessment requires considering **all definitive indicators** for a positive DPL.
*1, 2 and 3 only*
- This option includes gross blood aspiration, elevated WBC count, and elevated amylase level, which are all positive indicators.
- However, it incorrectly excludes an **RBC count >100,000/mm³**, which is a crucial and widely accepted criterion for a positive DPL.
Abdomen Indian Medical PG Question 4: Abdominal compartment syndrome is characterized by the following except:
- A. Hypotension due to decrease in venous return
- B. Oliguria due to ureter obstruction (Correct Answer)
- C. Hypoxia due to increased peak inspiratory pressure
- D. Hypercarbia and respiratory acidosis
Abdomen Explanation: ***Oliguria due to ureter obstruction***
- **Oliguria** in abdominal compartment syndrome is primarily due to **renal hypoperfusion** caused by increased intra-abdominal pressure compressing renal vasculature and reducing kidney blood flow, **not ureter obstruction**.
- Increased intra-abdominal pressure can also cause direct **renal parenchymal compression** and activation of neurohormonal mechanisms, leading to reduced urine output.
*Hypotension due to decrease in venous return*
- Increased intra-abdominal pressure compresses the **inferior vena cava**, leading to reduced **venous return** to the heart.
- This decreased preload results in a lower cardiac output and subsequent **hypotension**.
- This is a **true characteristic** of abdominal compartment syndrome.
*Hypoxia due to increased peak inspiratory pressure*
- Elevated intra-abdominal pressure pushes the diaphragm upwards, leading to reduced **lung compliance** and **tidal volume**.
- This increases the **peak inspiratory pressure** required to ventilate the lungs and can result in **hypoxia**.
- This is a **true characteristic** of abdominal compartment syndrome.
*Hypercarbia and respiratory acidosis*
- The combination of **diaphragmatic splinting** and **reduced lung compliance** leads to impaired ventilation.
- This causes inadequate carbon dioxide excretion, resulting in **hypercarbia** (elevated CO2) and subsequent **respiratory acidosis**.
- This is a **true characteristic** of abdominal compartment syndrome.
Abdomen Indian Medical PG Question 5: Which intervention should Nurse Bryan include in the care plan for Pierre, a client diagnosed with acute pancreatitis under his care?
- A. Administration of vasopressin and insertion of a balloon tamponade
- B. Preparation for a paracentesis and administration of diuretics
- C. Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day
- D. Maintain NPO status and use an NG tube. (Correct Answer)
Abdomen Explanation: ***Maintain NPO status and use an NG tube.***
- Maintaining **NPO (nil per os) status** is crucial in acute pancreatitis to **rest the pancreas** and prevent further stimulation of enzyme secretion [1].
- An **NG tube** may be used for **gastric decompression** in cases of severe nausea, vomiting, or paralytic ileus to reduce abdominal distention and discomfort.
*Administration of vasopressin and insertion of a balloon tamponade*
- **Vasopressin** and **balloon tamponade** are interventions typically used for **esophageal variceal bleeding**, not directly for acute pancreatitis.
- While pancreatitis can sometimes cause complications that might affect the gastrointestinal tract, these are not initial or direct treatments for the pancreatitis itself.
*Preparation for a paracentesis and administration of diuretics*
- **Paracentesis** and **diuretics** are interventions primarily used to manage **ascites**, which is fluid accumulation in the peritoneal cavity.
- While severe pancreatitis can sometimes lead to ascites, these are not primary treatments for acute pancreatitis itself but rather for a specific complication.
*Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day*
- A **low-fat diet** is appropriate for long-term management of chronic pancreatitis or after recovery from acute pancreatitis, but not during the **acute NPO phase**.
- While **fluid intake** is important to prevent dehydration, the specific amount of **2,000 ml/day** may not be sufficient or appropriate depending on the patient's hydration status and fluid loss, and it doesn't address the immediate need for pancreatic rest.
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