[MCQ] Approach to the Patient with Pancreatic Disease

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1. How much of pancreas must be damaged before maldigestion
of fat and protein is manifested ?
A. ~ 25 %
B. ~ 50 %
C. ~ 75 %
D. ~ 90 %

2.Patients with proven pancreatitis have spuriously low levels
of amylase in ?
A. Incomplete ductal obstruction
B. Pseudocyst formation
C. Hypertriglyceridemia
D. All of the above

3. In acute pancreatitis, serum amylase rises within ?
A. 24 hours
B. 36 hours
C. 48 hours
D. 72 hours
4. In acute pancreatitis, serum amylase remains elevated for ?
A. 1 – 3 days
B. 3 – 7 days
C. 7 – 9 days
D. 9 – 14 days

5. Hyperamylasemia is found in ?
A. Acute Pancreatitis
B. Diabetic ketoacidosis
C. Perforated peptic ulcer
D. All of the above
6. Hyperamylasemia is found in which of the following ?
A. Carcinoma of lung
B. Carcinoma of esophagus
C. Breast carcinoma
D. All of the above

7.Hyperamylasemia is found in which of the following ?
A. Pregnancy
B. Aortic aneurysm
C. Morphine
D. All of the above
8. The newer lipase assays relate best to which of the following ?
A. Trypsin
B. Chymotrypsin
C. Colipase
D. Phospholipase A2

9.Which of the following blood test is reliable for diagnosis of
acute pancreatitis in patients with renal failure ?
A. Serum amylase
B. Serum lipase
C. Serum trypsinogen
D. None of the above

10. Serum amylase levels are elevated when creatinine clearance
is less than ?
A. < 100 mL / minute
B. < 85 mL / minute
C. < 75 mL / minute
D. < 50 mL / minute

11.In acute pancreatitis, serum amylase values are highly specific
if they are more than ?
A. Two times normal
B. Three times normal
C. Four times normal
D. Five times normal

12. How much exocrine function of pancreas must be lost before
secretin stimulation test is abnormal ?
A. ~ 15 %
B. ~ 20 %
C. ~ 40 %
D. ~ 60 %

13. Enzyme trypsinogen is present in which of the following ?
A. Gall bladder
B. Pancreas
C. Intestine
D. All of the above
14. Normal serum trypsinogen level is ?
A. 18 – 28 ng/mL
B. 28 – 58 ng/mL
C. 60 – 98 ng/mL
D. 100 – 158 ng/mL

15. “Sentinel loop” refers to a localized ileus of which part of
intestine in acute pancreatitis ?

A. Duodenum
B. Jejunum
C. Ileum
D. Colon

16. “Colon cutoff sign” refers to isolated distention of which part
of intestine in acute pancreatitis ?
A. Ascending colon
B. Transverse colon
C. Descending colon
D. Sigmoid colon

17.  In chronic pancreatitis, pancreatic calcification on radiological
examination is superimposed on which lumbar vertebra ?

A. I
B. II
C. III
D. IV