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GI bleeding and dyspepsia

Total questions: 16

Worksheet time: 8mins

Name
Class
Date
1.

A 49-year-old female comes to the Emergency Department with persistent vomiting and epigastric discomfort for three weeks. She has a diagnosis of chronic gastric ulcer since five years ago but defaulted treatment. Clinically she is stable but there is a palpable vague mass at the epigastric region. What is the MOST LIKELY cause of her condition?

a)

Gastric carcinoma

b)

MALT lymphoma

c)

Chronic duodenal ulcer

d)

Zolingger Ellison syndrime

2.

A 35-year-old female presents to the Emergency Department for choking sensation, projectile vomiting and dysphagia for the past three weeks. There is a history of ingestion of paraquat two years back. She has lost 10 kg for the past three months. What is the BEST INVESTIGATION tools to construct a diagnosis ?

a)

CT Abdomen pelvis

b)

MRI thorax

c)

Barium swallow

d)

Neck x ray

3.

A 53-year-old Chinese female, presented to Emergency Department with vomiting of blood since two days ago. She claims had epigastric pain for two weeks and had been taking analgesia for her migraine attacks. Upper GI endoscopy was done shows FORREST IIA bleeding ulcer at antrum. No other mass seen.

What is the BEST ENDOSCOPIC therapeutic procedure to stop the above condition?

a)

Wash with cold saline

b)

Diluted adrenaline injection

c)

A bolus of iv tranxenemic acid

d)

Endoscopic clip ligation

4.

73 years-old-male, k/c of left hemiparesis due to cva 2 years ago. He is immobilised , presented with coffee ground vomiting since 3 weeks. On examination shows, cachexic and severe dehidration. OGDS was performed and shows no ulcer in the stomach. What is the MOST LIKELY diagnosis

a)

Antral Gastritis

b)

Dieulafoy syndrome

c)

oesophageal varices

d)

Cushing ulcer

5.

Which of the following procedure must be done urgently for a 49-year-old male patient with symptoms of acute bleeding haemorrhoid?

a)

ct angiography

b)

proctoscopy

c)

colonoscopy

d)

sigmoidscopy

6.

A 32-year-old woman comes to the clinic because she has had abdominal pain for the past 2 months. She describes the pain as a burning or gnawing sensation in her stomach. What is the additional characteristics of this patient’s pain that suggesting of duodenal ulcer ?

a)

Awaken patients at night

b)

Intermittent throught out the day

c)

not relieved by food

d)

present immediately during waking in the morning

7.

What is the most common complication of peptic ulcer disease ?

a)

GI haemorrhage

b)

Gastric outlet obstruction

c)

Confined perforation

d)

Stomach cancer

8.

Which of the following therapies is proven to reduce mortality and morbidity in bleeding peptic ulcers?

a)

Triple bismuth theraphies

b)

Long-life Proton pump inhibitor

c)

Anti-H.Pylori regime

d)

Upper GI Endoscopy

9.

What would be the most appropriate evaluation and treatment for this patient’s upper gastrointestinal (UGI) bleed?

a)

urgent upper gi endoscopy and start simultaneously oral PPI

b)

elective upper gi endoscopy and start PPI later

c)

Urgent upper GI endoscopy and start simultaneously IV PPI

d)

Urgeny upper GI endoscopy and start iv PPi if the finding shows bleeding ulcer

10.

What is the common cause of lower gi bleeding in the age under 50 years old ?

a)

anal polyp

b)

anal fissure

c)

haemorrhoid

d)

rectal prolapse

11.

What is the common cause for oesophageal perforation ?

a)

Iatrogenic cause

b)

Boerrhaave syndrome

c)

oesophageal tumor

d)

Foreign body

12.

Which of the following patients would not be considered a candidate for esophagectomy?

a)

A 55-year-old man with GEJ adenocarcinoma confined to the muscularis mucosa

b)

A 60-year-old man with a large GEJ carcinoma with invasion into the pleura without a malignant effusion

c)

47-year-old woman with mid-esophageal cancer and an involved cervical LN

d)

A 70-year-old woman with a small GEJ cancer and three pathologic LNs nearby on EUS

13.

Which of the following statements regarding the treatment of Squamous cell carcinoma of esophageal cancer is not true?

a)

in locally advacne operable cancer responding to chemoradiation, the continuation of chemoradiation is alternatove for surgery

b)

preoperative chemoradiation improves the disease free survival in operable cancer

c)

defintive chemoradiation increases survical compared with radiation alone

d)

in metastatic disease, chemotherapy provides a slight better significant increases in survival and best supportive therapy

14.

Which of the following has the greatest risk of esophageal cancer?

a)

Recently diagnosis of oesophageal varices in a 45 year-old

b)

Recently diagnosis Barret's oesophagitis

c)

Long standing of alcohol and smoking with midl dysphagia

d)

Long history of achalasia

15.

35 year-old-male no medical illness, was worried about risk of have stomach cancer as his father died due to advanced stomach cancer. What is the BEST ADVICE should be given to him ?

a)

arranged for surveillance ct abdomen pelvis

b)

Arranged for FOBT

c)

Arranged for elective barrium meal

d)

Arrange for Upper GI endoscopy and colonoscopy

16.

Which of these is not the causes of achalsia

a)

peptic ulcer disease

b)

Oesophagitis

c)

Hiatus hernia

d)

oesophageal varices