Oxford University Press | Online Resource Centre

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Question 1

Which of the following is correct regarding gastro-oesophageal reflux disease?

a) The classical symptom is a burning retrosternal pain.

b) Even mild degrees of reflux give rise to symptoms.

c) Most patients with a hiatus hernia suffer symptoms of reflux.

d) It increases the risk of the development of achalasia.

Question 2

Which of the following is correct regarding Barrett's oesophagus?

a) It is defined by the presence of macroscopically visible areas of squamous metaplasia of the oesophagus.

b) It requires biopsy of an area of endoscopic Barrett's to confirm the diagnosis.

c) It increases the risk of the development of oesophageal squamous cell carcinoma.

d) All patients found to have Barrett's oesophagus should be entered into a surveillance programme.

Question 3

Which of the following is correct regarding oesophageal carcinoma?

a) The incidence of oesophageal adenocarcinoma is falling.

b) Oesophageal squamous cell carcinoma is associated with heavy smoking and a high alcohol intake.

c) Most patients present with dysphasia.

d) Most patients are suitable for surgical resection at the time of diagnosis.

Question 4

Which of the following is correct regarding Helicobacter pylori infection of the stomach?

a) Following infection, the organisms localize to the body of the stomach.

b) Most patients develop a symptomatic gastritis.

c) Patients with corpus predominant gastritis are at increased risk of duodenal ulceration.

d) A small percentage of patients develop marginal zone B cell lymphoma of the stomach.

Question 5

Which of the following is correct regarding gastric carcinoma?

a) Most arise from adenomatous polyps.

b) The intestinal type of gastric carcinoma is characterized by gland formation by the malignant cells microscopically.

c) Early gastric cancers are those confined to the mucosal or submucosal layer without lymph node involvement.

d) Most gastric cancers are amenable to curative surgical resection at the time of diagnosis.

Question 6

Which of the following is correct regarding gluten-sensitive enteropathy (coeliac disease)?

a) The incidence is approximately 1 in 1000 people in the UK.

b) Most adults present with persistent diarrhoea.

c) The presence of IgA endomysial antibodies is diagnostic.

d) The typical histological findings on a duodenal biopsy are villous atrophy, crypt hyperplasia, and an increase in intraepithelial lymphocytes.

Question 7

Which of the following is correct regarding Crohn's disease?

a) The distal small bowel and colon are most commonly involved.

b) The typical macroscopic features are fat wrapping, thickening of the bowel wall, and patchy transmural inflammation.

c) Granulomas must be seen microscopically to make the diagnosis.

d) Extraintestinal manifestations include reactive arthropathy and erythema nodosum.

Question 8

Which of the following is correct regarding ulcerative colitis?

a) The rectum is often spared.

b) The characteristic microscopic feature is diffuse mucosal inflammation.

c) Inflammatory polyps in ulcerative colitis may show dysplasia.

d) There is a well recognized association with primary biliary cirrhosis.

Question 9

Which of the following is correct regarding colorectal carcinoma?

a) It occurs when severely dysplastic glands breach their basement membrane and invade the lamina propria of the colorectal mucosa.

b) Right-sided colonic tumours often present with iron deficiency anaemia.

c) A rectal tumour that has infiltrated through the muscularis propria into mesorectal fat is a T4 tumour in the TNM staging system.

d) The national bowel screening programme aims to use colonoscopy as a screening test for colorectal carcinoma.

Question 10

Which of the following is correct regarding diverticular disease?

a) The diverticula contain all the layers of the bowel wall.

b) The rectum and sigmoid colon are the typical sites of involvement.

c) Acute diverticulitis is a common cause of acute left iliac fossa pain in the elderly.

d) There is an increased risk of the development of colonic adenocarcinoma.

Oxford University Press, Online Resource Centre, Chapter 08.

Chapter 08

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