Question & Answer session - Quiz with keepads.

1. He who is not courageous enough
to take risks will accomplish nothing
in life.
– Muhammad Ali, Champion Boxer

2. A. B. C. D. E.
17%
8%
67%
0%
8%
? diagnosis
A. Adenocarcinoma.
B. Acute Oesophagitis.
C. Barrett’s oesophagus
D. Oesophageal varices
E. Achalasia

3. A. B. C. D. E.
33%
0%
11%
56%
0%
42 year old man, chronic alcoholic, develops intractable
hematemesis and ultimately exsanguination. Au autopsy, the
opened up oesophagus appeared like the image. What is the
most likely cause?.
A. Forced vomiting.
B. Columnar metaplasia.
C. Malignant change.
D. Portal hypertension.
E. Reflux of gastric acid.

4. A. B. C. D. E.
0%
69%
13%
0%
19%
65year old man with long standing GORD now has a 2
month history of hematemesis and dysphagia. His lower
oesophagus gross & Microscopy appears similar to the
image. What is the most likely complication?.
A. Acute oesophagitis.
B. Barrett’s oesophagus.
C. adenocarcinoma.
D. Squamous cell carcinoma.
E. Perforation.

5. 46y male chest pain. Oesophageal biopsy.
A. B. C. D. E.
7%
50%
21%
0%
21%
A. Chronic esophagitis
B. Squamous metaplasia
C. Barrett’s
D. Adenocarcinoma.
E. Squamous carcinoma

6. 58y Fem, hematemesis and hematochezia, alcoholic
cirrhosis 2y ago, Lower oesophagus biopsy. What is the
most likely Diagnosis?
1 2 3 4 5
31%
13%
6%
0%
50%
1. Mallory Weiss Syndrome.
2. Barrett’s esophagus.
3. Esophageal varices
4. Sliding Hiatus hernia
5. Acute esophagitis.

7. 56y male, abdominal pain, Gastric biopsy, ? arrow
A. B. C. D. E.
0% 0%
6%
94%
0%
A. Barrett’s.
B. H.pylori gastritis.
C. Chronic gastritis
D. Adenocarcinoma
E. Gastric metaplasia.

8. 46y male pain, hematemesis: Stomach.
1 2 3 4 5
11%
89%
0%0%0%
A. Malignant Gastric ulcer
B. Benign peptic ulcer.
C. Barrett’s
D. Adenocarcinoma.
E. Acute gastritis.

9. 46y male pain, hematemesis: Stomach.
1 2 3 4 5
0% 0% 0%0%0%
A. Malignant Gastric ulcer
B. Benign peptic ulcer.
C. Barrett’s
D. H.pylori gastritis.
E. Gastric Perforation.

10. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0%
13%13%
73%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

11. Correct statement about H.pylori?
1 2 3 4 5
23%
62%
8%8%
0%
A. Gram positive spirochete
B. Colonizes Gastric mucosa
C. Invades duodenal mucosa
D. Diagnosed by bacterial culture.
E. Complication is Duodenal cancer.

12. Common site of Peptic Ulcer?
1 2 3 4 5
18%
0%
73%
9%
0%
A. Cardiac part of Stomach.
B. Greater curvature
C. Lesser curvature
D. 2nd part of duodenum
E. 1st part of duodenum

13. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0% 0%0%0%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

14. 35y man, chronic dysphagia, regurgitate
food. Endoscopy normal. Flow studies show
lack of peristalsis. ? Diagnosis?.
1 2 3 4 5
12%
53%
18%18%
0%
1. Schatzki ring.
2. Achalasia
3. Barrett oesophagus
4. Esophageal stricture.
5. Mallory-Weiss sy.

15. 46y male chestpain,Endoscopy:oesophagus
1 2 3 4 5
0%
17%
25%
8%
50%
A. Hiatus hernia
B. Acute Oesophagitis.
C. Barrett’s oesophagus
D. Oesophageal varices
E. Mallory weiss sy.

16. 20y fem, 2y history of dysphagia, fatigue
and pallor, microcytic RBC ? Diagnosis?.
1 2 3 4 5
31%
15%
8%
23%23%
1. Barrett esophagus
2. Diverticulum
3. Esophageal web
4. Schatzki ring
5. Achalasia

17. 76y man, Sudden-onset deep burning epigastric pain
radiating to abdomen for 4 hours. Past history of coronary
artery disease, hypertension & “indigestion.” Hyperactive
bowel sounds are heard on auscultation. Xray abdomen,
? diagnosis
1 2 3 4 5
17%
0% 0%0%
83%
1.Aortic aneurysm rupture
2.Acute Pancreatitis
3.Pneumoperitoneum PUD
4.Acute coronary syndrome
5.Ruptured MI

18. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0% 0%
83%
17%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

19. 34y Male, Insomnia, heart burn, dysphagia.
Lower Esophagus
endoscopy:
• Features ?
• Etiology ?
• Clinical features ?
• Complications ?

20. 45y female, attacks of wheezing, SOB, hot flashes. Abdominal
cramps, diarrhoea, Tricuspid regurgitation, Increased urinary 5-
HIAA, CT scan shows nodule in jejunum, stomach and few
nodules in liver. ? Diagnosis.
1 2 3 4 5
8%
46%
15%
23%
8%
1. GIT Lymphoma.
2. Carcinoid tumor.
3. Mallory Weiss Syndrome.
4. Gastric carcinoma with mets.
5. Zollinger Ellison syndrome.

21. “Only a man who knows what it is like
to be defeated can reach down to the
bottom of his soul and come up with the
extra ounce of power it takes to win,
when the match is even.”
– Muhammad Ali, Champion Boxer

22. 56y male, hematemesis: Gastric biopsy, ? arrow
A. Barrett’s.
B. H.pylori gastritis.
C. Chronic gastritis
D. Adenocarcinoma
E. Gastric metaplasia.

23. 46y male pain, hematemesis: Stomach.
1 2 3 4 5
0% 0% 0%0%0%
A. Malignant Gastric ulcer
B. Benign peptic ulcer.
C. Barrett’s
D. Adenocarcinoma.
E. Acute gastritis.

24. 46y male pain, hematemesis: Stomach.
1 2 3 4 5
0% 0% 0%0%0%
A. Malignant Gastric ulcer
B. Benign peptic ulcer.
C. Barrett’s
D. H.pylori gastritis.
E. Gastric Perforation.

25. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0% 0%0%0%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

26. Correct statement about H.pylori?
1 2 3 4 5
0% 0% 0%0%0%
A. Gram positive spirochete
B. Colonizes Gastric mucosa
C. Invades duodenal mucosa
D. Diagnosed by bacterial culture.
E. Complication is Duodenal cancer.

27. Common site of Peptic Ulcer?
1 2 3 4 5
0% 0% 0%0%0%
A. Cardiac part of Stomach.
B. Greater curvature
C. Lesser curvature
D. 2nd part of duodenum
E. 1st part of duodenum

28. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0% 0%0%0%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

29. 35y man, chronic dysphagia, regurgitate
food. Endoscopy normal. Flow studies show
lack of peristalsis. ? Diagnosis?.
1 2 3 4 5
0% 0% 0%0%0%
1. Schatzki ring.
2. Achalasia
3. Barrett oesophagus
4. Esophageal stricture.
5. Mallory-Weiss sy.

30. 20y fem, 2y history of dysphagia, fatigue
and pallor, microcytic RBC ? Diagnosis?.
1 2 3 4 5
0% 0% 0%0%0%
1. Barrett esophagus
2. Diverticulum
3. Esophageal web
4. Schatzki ring
5. Achalasia

31. 76y man, Sudden-onset deep burning epigastric pain
radiating to abdomen for 4 hours. Past history of coronary
artery disease, hypertension & “indigestion.” Hyperactive
bowel sounds are heard on auscultation. Xray abdomen,
? Common cause
1 2 3 4 5
0% 0% 0%0%0%
1.Ruptured appendix
2.Ruptured cholecystitis.
3.Perforated peptic ulcer.
4.Crohn’s disease fistula.
5.Perforated diverticulitis.

32. 46y male odynophagia : Esophageal biopsy.
A. B. C. D. E.
0% 0% 0%0%0%
A. Barrett’s
B. Acute Esophagitis.
C. Squamous Carcinoma
D. Adeno Carcinoma.
E. Chronic Esophagitis.

33. 45y female, attacks of wheezing, SOB, hot flashes. Abdominal
cramps, diarrhoea, Tricuspid regurgitation, Increased urinary 5-
HIAA, CT scan shows nodule in jejunum, stomach and few
nodules in liver. ? Diagnosis.
1 2 3 4 5
0% 0% 0%0%0%
1. GIT Lymphoma.
2. Carcinoid tumor.
3. Mallory Weiss Syndrome.
4. Gastric carcinoma with mets.
5. Zollinger Ellison syndrome.

34. 34y Male, Insomnia, heart burn, dysphagia.
Lower Esophagus
endoscopy:
• Features ?
• Etiology ?
• Clinical features ?
• Complications ?

35. ? Features
? Aetiology
? Complications
Esophageal
varices

36. I hated every minute of training, but I
said, "Don't quit. Suffer now and live
the rest of your life as a champion."
– Muhammad Ali, Champion Boxer