Gastrointestinal Surgery Practice Questions

Question 1

A 55-year-old man develops acute mesenteric ischemia. During exploratory laparotomy, the surgeon identifies that the superior mesenteric artery is patent, but there is extensive small bowel ischemia. Sympathetic denervation of the mesenteric vessels is considered as part of treatment. Through which anatomical structure would the surgeon need to dissect to achieve complete sympathetic denervation of the midgut?

Accepted Answer

Superior mesenteric ganglion and periarterial plexus around the superior mesenteric artery

Answer

Celiac ganglion and greater splanchnic nerves bilaterally

Answer

Inferior mesenteric ganglion and hypogastric plexus

Answer

Paravertebral sympathetic chain at T10-T12 levels

Answer

Vagal trunks and esophageal hiatus structures

Question 2

In cases of severe abdominal pain, identifying the location of McBurney's point is crucial for diagnosing which condition?

Accepted Answer

Appendicitis

Answer

Pancreatitis

Answer

Gallstones

Answer

Diverticulitis

Question 3

A 28-year-old man presents with a 14-hour history of right iliac fossa pain. Initial examination reveals tenderness at McBurney's point. Four hours later, the pain becomes generalized with board-like rigidity across the whole abdomen. Heart rate is 125 bpm and temperature 38.7°C. What pathophysiological change best explains this clinical progression?

Accepted Answer

Progression from localized visceral peritoneal inflammation to generalized parietal peritonitis

Answer

Extension of inflammatory process to involve the entire small bowel

Answer

Development of paralytic ileus causing generalized abdominal distension

Answer

Thrombosis of mesenteric vessels causing widespread intestinal ischaemia

Answer

Bacterial translocation causing systemic inflammatory response syndrome

Question 4

A 38-year-old woman undergoes laparoscopic appendectomy for acute appendicitis. During dissection of the mesoappendix, the surgeon inadvertently injures the iliac vessels. Brisk bleeding obscures the field. Apply the immediate next step.

Accepted Answer

Apply direct pressure with laparoscopic instrument and convert to open

Answer

Evacuate pneumoperitoneum and apply manual external pressure

Answer

Perform laparoscopic suturing of the vessel

Answer

Apply laparoscopic clips blindly to control bleeding

Answer

Increase pneumoperitoneum pressure to tamponade bleeding

Question 5

A 72-year-old female with atrial fibrillation on warfarin presents with sudden severe abdominal pain. Examination reveals a distended abdomen and decreased bowel sounds. Laboratory results show an INR of 4.5 and hemoglobin of 9.1. Analyze and determine the diagnosis and initial treatment.

Accepted Answer

GI bleeding; hold warfarin, administer vitamin K

Answer

Acute pancreatitis; NPO, IV fluids, pain control

Answer

Perforated peptic ulcer; IV antibiotics, surgical consult

Answer

Acute mesenteric ischemia; urgent surgical intervention required

Question 6

A 40-year-old male with a history of progressive dysphagia for liquids presents with a dilated esophagus on barium meal. What is the most likely cause?

Accepted Answer

Achalasia cardia

Answer

Cancer at the cardia

Answer

Carcinoma of the esophagus

Answer

Carcinoma of the gastric fundus

Question 7

What is the most common neoplasm of the appendix?

Accepted Answer

Carcinoid

Answer

Pseudomyxoma peritonei

Answer

Adenocarcinoma

Answer

Lymphoma

Question 8

Which of the following statements about duodenal adenocarcinoma is correct?

Accepted Answer

It is the most common small bowel carcinoma.

Answer

It is a periampullary carcinoma.

Answer

Jaundice and anemia are the most common symptoms.

Answer

Local resection is curative.

Question 9

Which veins are involved in bleeding from gastro-esophageal varices?

Accepted Answer

All of the above

Answer

Short gastric veins

Answer

Right gastric veins

Answer

Left gastric veins

Question 10

A 32-year-old patient presents with diarrhea and flushing. CT scan reveals multiple lesions in the liver. The primary disease is most likely located in which of the following?

Accepted Answer

Small bowel

Answer

Esophagus

Answer

Appendix

Answer

Stomach

Gastrointestinal Surgery

Study Resources

Lessons

Questions

Flashcards

Lessons

Esophageal Disorders

Gastric Disorders

Small Intestine Pathology

Appendicitis

Inflammatory Bowel Disease

Intestinal Obstruction

Gastrointestinal Bleeding

Diverticular Disease

Anorectal Disorders

Colorectal Neoplasms

Gastrointestinal Stomas

Bariatric Surgery Principles

Practice Questions

Flashcards

About Gastrointestinal Surgery for NEET-PG

Lessons in Gastrointestinal Surgery

Master Gastrointestinal Surgery