[MCQ] Acute and Chronic Pancreatitis- Part 4

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Acute and Chronic Pancreatitis- Part 4

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Congratulations - you have completed Acute and Chronic Pancreatitis- Part 4. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which test is more sensitive for identifying gallstones and sludge and for detecting bile-duct dilatation ?

A	Transabdominal ultrasonography
B	CT abdomen
C	MRI abdomen
D	ERCP

Question 2

Transabdominal ultrasonography is insensitive for detecting ?

A	Gallstones and sludge
B	Bile-duct dilatation
C	Stones in the distal bile duct
D	Stones in the proximal bile duct

Question 3

Which of the following genes may predict severity of acute pancreatitis ?

A	RET
B	MCP-1
C	MEN-1
D	VHL

Question 4

Recognized markers of risk of severe acute pancreatitis include all except ?

A	Elevated C-reactive protein
B	Ranson’s & APACHE II scores
C	Obesity
D	High reticulocyte index

Question 5

Biliary sludge is associated with which of the following ?

A	Total parenteral feeding
B	Long-lasting fast
C	Distal bile duct obstruction
D	All of the above

Question 6

Risk factors for post-ERCP pancreatitis include all except ?

A	Old age
B	Female sex
C	Number of cannulation attempts of papilla
D	Poor emptying of pancreatic duct after opacification

Question 6 Explanation:

Risk of acute pancreatitis is higher when ERCP is done to treat Oddi sphincter dysfunction than to remove bile duct stones. Other risk factors for post-ERCP pancreatitis include young age, female sex, number of cannulation attempts of papilla before success & poor emptying of pancreatic duct after opacification.

Question 7

The median prevalence of organ failure in necrotizing pancreatitis is ?

A	~ 25 %
B	~ 50 %
C	~ 75 %
D	~ 95 %

Question 7 Explanation:

The median prevalence of organ failure is 54% in necrotizing pancreatitis

Question 8

The mortality in acute pancreatitis with single organ system failure is ?

A	~ 5 %
B	~ 10 %
C	~ 25 %
D	~ 50 %

Question 9

The mortality in acute pancreatitis with multisystem organ system failure is ?

A	~ 5 %
B	~ 10 %
C	~ 25 %
D	~ 50 %

Question 9 Explanation:

With single organ system failure, the mortality is 3–10% but increases to 47% with multisystem organ failure.

Question 10

What proportion of patients with acute pancreatitis have necrotizing pancreatitis ?

A	~ 5 %
B	~ 10 %
C	~ 25 %
D	~ 50 %

Question 10 Explanation:

Necrotizing pancreatitis occurs in ~10% of all patients with acute pancreatitis

Question 11

Necrosis is present in what percentage of patients with acute pancreatitis ?

A	5 - 10 %
B	12 - 20 %
C	25 - 45 %
D	50 - 70 %

Question 11 Explanation:

Necrosis is present in 12 - 20% of patients with acute pancreatitis.

Question 12

In what proportion of acute pancreatitis, the disease is selflimited and subsides spontaneously ?

A	~ 25 %
B	~ 50 %
C	~ 75 %
D	~ 90 %

Question 12 Explanation:

In most patients (85 - 90%) with acute pancreatitis, the disease is self-limited and subsides spontaneously, usually within three to seven days after treatment is instituted.

Question 13

In pancreatitis, oral intake is started by considering all of the following factors except ?

A	Resolution of abdominal pain
B	Patient is hungry
C	Organ dysfunction
D	Elevated levels of serum amylase/lipase

Question 13 Explanation:

Inflammatory changes on CT scan or persistent elevations in serum amylase/lipase may not resolve for weeks to months & should not discourage feeding a hungry asymptomatic patient of pancreatitis

Question 14

Which of the following antibiotic is recommended in necrotizing acute pancreatitis ?

A	Ciprofloxacin
B	Metronidazole
C	Imipenem cilastin
D	Aztreonam

Question 14 Explanation:

Current recommendation in necrotizing acute pancreatitis is imipenem cilastin, 500 mg thrice daily for 7 days.

Question 15

Lexipafant is best related to ?

A	Protease inhibitor
B	Platelet-activating factor inhibitor
C	Antibiotic
D	Fungicide

Question 15 Explanation:

Platelet activating factor (PAF) enhances polymorphonuclear leukocyte (PMN) superoxide production, CD11b expression & elastase release, all essential components in the pathophysiology of multipleorgan failure. Lexipafant (BB-882) is a potent & specific PAF antagonist. It fits in PAF receptors on the surface of cells & blocks activation of these receptors by PAF itself.

Question 16

Which of the following is used in the management of pancreatitis ?

A	Nafamostat
B	Pentamidine
C	Tacrolimus
D	Aliskiren

Question 16 Explanation:

Nafamostat, a protease inhibitor is utilized in the management of pancreatitis, disseminated intravascular coagulation, and extracorporeal circulation (ECC), such as during hemodialysis therapy (HD), plasmapheresis, and cardiopulmonary bypass. It inhibits aldosterone-induced proteases that activate ENaC by proteolytic cleavage. It may cause hyperkalemia.

Question 17

Besides its use in acute pancreatitis, Lexipafant is also used in ?

A	Asthma
B	Glaucoma
C	Alopecia
D	Peripheral arterial disease

Question 17 Explanation:

Inflammatory agent PAF is implicated in the causation of pancreatitis and asthma.

Question 18

Aprotinin is best related to which of the following drugs ?

A	Lexipafant
B	Calcitonin
C	Gabexate mesilate
D	Octreotide

Question 18 Explanation:

Aprotinin & gabexate mesilate are broad spectrum antiprotease drugs that reduce pancreatic damage but have no effect on mortality rate in pancreatitis.

Question 19

Preferred method of nutritional support in patients of necrotizing pancreatitis is ?

A	Total parenteral nutrition (TPN)
B	Feeding with a nasogastric tube
C	Enteral-feeding with a nasojejunal tube
D	PEG

Question 19 Explanation:

Enteral-feeding with a nasojejunal tube has fewer infectious complications than with total parenteral nutrition (TPN) and is the preferred method of nutritional support. Also, enteral feeding helps to maintain integrity of the intestinal tract during severe acute pancreatitis.

Question 20

What proportion of patients of acute pancreatitis have a recurrence ?

A	~ 25 %
B	~ 50 %
C	~ 75 %
D	~ 90 %

Question 20 Explanation:

~25% of patients who have had an attack of acute pancreatitis have a recurrence.

Question 21

Which of the following occult biliary tract diseases can lead to acute pancreatitis ?

A	Microlithiasis
B	Pancreatic cancer
C	Pancreas divisum
D	All of the above

Question 21 Explanation:

If a cause could not be found in patients with recurrent pancreatitis, occult biliary tract disease should be looked at. These include microlithiasis, hypertriglyceridemia, drugs, pancreatic cancer, sphincter of Oddi dysfunction, pancreas divisum, cystic fibrosis, hereditary pancreatitis, choledochocele; ampullary tumors, pancreatic duct stones, stricture, and tumor.

Question 22

Necrotic pancreas becomes secondarily infected with ?

A	Gram-positive bacteria of alimentary origin
B	Gram-negative bacteria of alimentary origin
C	Gram-positive bacteria of hematogenous origin
D	Gram-negative bacteria of hematogenous origin

Question 22 Explanation:

Necrotic pancreas becomes secondarily infected in 20-35% of patients, 7–10 days after the onset of acute pancreatitis, most frequently with gram-negative bacteria of alimentary origin.

Question 23

Pancreatic abscess following acute pancreatitis develops after ?

A	1 weeks
B	2 weeks
C	3 weeks
D	6 weeks

Question 23 Explanation:

Pancreatic abscess following acute pancreatitis develops usually after 6 weeks.

Question 24

“Walled-off Necrosis” occurs how many weeks after necrotizing pancreatitis ?

A	1 to 3 weeks
B	3 to 6 weeks
C	6 to 12 weeks
D	12 to 24 weeks

Question 24 Explanation:

Necrotizing pancreatitis is always associated with peripancreatic necrosis involving the fat around the pancreas. After 3 to 6 weeks, the pancreatic necrosis and peripancreatic fat necrosis fuse together encapsulated by fibrous tissue, adjacent to pancreas. “Walled-off necrosis” refers to this conjoint structure.

Question 25

Which of the following is false about pancreatic pseudocysts ?

A	Extrapancreatic
B	Collections of pancreatic fluid with pancreatic enzymes
C	Do not have an epithelial lining
D	None of the above

Question 25 Explanation:

Pseudocysts of the pancreas are extrapancreatic collections of pancreatic fluid containing pancreatic enzymes and a small amount of debris. In contrast to true cysts, pseudocysts do not have an epithelial lining. The walls consist of necrotic tissue, granulation tissue, and fibrous tissue.

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See all quizzes of Acute and Chronic Pancreatitis at here:

1. Which test is more sensitive for identifying gallstones and
sludge and for detecting bile-duct dilatation ?
A. Transabdominal ultrasonography
B. CT abdomen
C. MRI abdomen
D. ERCP
2. Transabdominal ultrasonography is insensitive for detecting ?
A. Gallstones and sludge
B. Bile-duct dilatation
C. Stones in the distal bile duct
D. Stones in the proximal bile duct
3. Which of the following genes may predict severity of acute
pancreatitis ?
A. RET
B. MCP-1
C. MEN-1
D. VHL
4. Recognized markers of risk of severe acute pancreatitis include
all except ?
A. Elevated C-reactive protein
B. Ranson’s & APACHE II scores
C. Obesity
D. High reticulocyte index
5. Biliary sludge is associated with which of the following ?
A. Total parenteral feeding
B. Long-lasting fast
C. Distal bile duct obstruction
D. All of the above
6.Risk factors for post-ERCP pancreatitis include all except ?
A. Old age
B. Female sex
C. Number of cannulation attempts of papill

D. Poor emptying of pancreatic duct after opacification
\
7. The median prevalence of organ failure in necrotizing
pancreatitis is ?
A. ~ 25 %
B. ~ 50 %
C. ~ 75 %
D. ~ 95 %

8. The mortality in acute pancreatitis with single organ system
failure is ?
A. ~ 5 %
B. ~ 10 %
C. ~ 25 %
D. ~ 50 %
9. The mortality in acute pancreatitis with multisystem organ
system failure is ?
A. ~ 5 %
B. ~ 10 %
C. ~ 25 %
D. ~ 50 %

10.What proportion of patients with acute pancreatitis have
necrotizing pancreatitis ?
A. ~ 5 %
B. ~ 10 %
C. ~ 25 %
D. ~ 50 %
11. Necrosis is present in what percentage of patients with acute
pancreatitis ?
A. 5 – 10 %
B. 12 – 20 %
C. 25 – 45 %
D. 50 – 70 %

12. In what proportion of acute pancreatitis, the disease is selflimited
and subsides spontaneously ?
A. ~ 25 %
B. ~ 50 %

C. ~ 75 %
D. ~ 90 %

13. In pancreatitis, oral intake is started by considering all of the
following factors except ?
A. Resolution of abdominal pain
B. Patient is hungry
C. Organ dysfunction
D. Elevated levels of serum amylase/lipase

14. Which of the following antibiotic is recommended in
necrotizing acute pancreatitis ?
A. Ciprofloxacin
B. Metronidazole
C. Imipenem cilastin
D. Aztreonam

15. Lexipafant is best related to ?
A. Protease inhibitor
B. Platelet-activating factor inhibitor
C. Antibiotic
D. Fungicide

16. Which of the following is used in the management of
pancreatitis ?
A. Nafamostat
B. Pentamidine
C. Tacrolimus
D. Aliskiren

17. Besides its use in acute pancreatitis, Lexipafant is also used
in ?
A. Asthma
B. Glaucoma
C. Alopecia
D. Peripheral arterial disease

18. Aprotinin is best related to which of the following drugs ?
A. Lexipafant
B. Calcitonin
C. Gabexate mesilate
D. Octreotide

19. Preferred method of nutritional support in patients of
necrotizing pancreatitis is ?
Harrison’s 18th Ed. 2641
A. Total parenteral nutrition (TPN)
B. Feeding with a nasogastric tube
C. Enteral-feeding with a nasojejunal tube
D. PEG

20. What proportion of patients of acute pancreatitis have a recurrence ?
A. ~ 25 %
B. ~ 50 %
C. ~ 75 %
D. ~ 90 %

21. Which of the following occult biliary tract diseases can lead to
acute pancreatitis ?
A. Microlithiasis
B. Pancreatic cancer
C. Pancreas divisum
D. All of the above

22.Necrotic pancreas becomes secondarily infected with ?
A. Gram-positive bacteria of alimentary origin
B. Gram-negative bacteria of alimentary origin
C. Gram-positive bacteria of hematogenous origin
D. Gram-negative bacteria of hematogenous origin

23. Pancreatic abscess following acute pancreatitis develops after ?
A. 1 weeks
B. 2 weeks
C. 3 weeks
D. 6 weeks

24.“Walled-off Necrosis” occurs how many weeks after necrotizing
pancreatitis ?
A. 1 to 3 weeks
B. 3 to 6 weeks
C. 6 to 12 weeks
D. 12 to 24 weeks

25.Which of the following is false about pancreatic pseudocysts ?
A. Extrapancreatic
B. Collections of pancreatic fluid with pancreatic enzymes
C. Do not have an epithelial lining
D. None of the above

Acute and Chronic Pancreatitis

[MCQ] Acute and Chronic Pancreatitis- Part 4

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Acute and Chronic Pancreatitis- Part 4

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