[MCQ] Acute and Chronic Pancreatitis- Part 2

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Acute and Chronic Pancreatitis- Part 2

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Congratulations - you have completed Acute and Chronic Pancreatitis- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

CFTR and SPINK1 genetic mutations causing acute pancreatitis are frequent in ?

A	Thalassemia patients
B	HIV-positive patients
C	COPD patients
D	Leukemia patients

Question 1 Explanation:

Genetic mutations such as those in CFTR and SPINK1 genes are frequent in HIV-positive patients with acute pancreatitis.

Question 2

CCK-releasing factor (CCK-RF) is present in ?

A	Stomach
B	Duodenum
C	Jejunum
D	All of the above

Question 2 Explanation:

Duodenum contains a peptide CCK-releasing factor that is involved in stimulating CCK release.

Question 3

Which of the following is the most common cause of acute pancreatitis ?

A	Gallstones
B	Alcohol
C	Drugs
D	ERCP

Question 3 Explanation:

Cause of acute pancreatitis include gallstones (30-60%), alcohol (15-30%), hypertriglyceridemia (1.3-3.8%), ERCP (5-20%) and drug-related (2-5%).

Question 4

Risk factors for post-ERCP pancreatitis include ?

A	Sphincter of Oddi dysfunction
B	Age < 60 years
C	> 2 contrast injections into pancreatic duct
D	All of the above

Question 4 Explanation:

Risk factors for post-ERCP pancreatitis include minor papilla sphincterotomy, sphincter of Oddi dysfunction, prior history of post-ERCP pancreatitis, age <60 years, >2 contrast injections into the pancreatic duct, and endoscopic trainee involvement.

Question 5

What level of hypertriglyceridemia causes acute pancreatitis ?

A	> 250 mg / dL
B	> 500 mg / dL
C	> 750 mg / dL
D	> 1000 mg / dL

Question 5 Explanation:

Hypertriglyceridemia can cause acute pancreatitis in 1.3 - 3.8% of cases when serum triglyceride levels are usually > 1000 mg/dL. The goal is to reduce fasting plasma triglycerides to below 500 mg/ dL to prevent the risk of acute pancreatitis.

Question 6

Which of the following statements is false ?

A	Hypertriglyceridemia can precede & cause pancreatitis
B	>80% patients of acute pancreatitis do not have hypertriglyceridemia
C	Patients with pancreatitis & hypertriglyceridemia have preexisting abnormalities in lipoprotein metabolism
D	Fasting Tg levels of < 500 mg/dL pose no risk of pancreatitis

Question 6 Explanation:

Fasting Tg levels of < 300 mg/dL pose no risk of pancreatitis.

Question 7

Drugs that can elevate serum triglycerides include all except ?

A	Progesterone
B	Vitamin A
C	Thiazide diuretics
D	Beta-blockers

Question 7 Explanation:

Drugs that can elevate serum Tg are estrogens, vitamin A, thiazides and propanolol.

Question 8

Deficiency of which of the following have an increased incidence of pancreatitis ?

A	ApoA-I
B	ApoB-100
C	ApoC-I
D	ApoC-II

Question 8 Explanation:

Both LPL & apoC-II deficiency usually present in childhood with recurrent episodes of severe abdominal pain due to acute pancreatitis. Apolipoprotein CII activates lipoprotein lipase. Triglycerides of chylomicrons are hydrolyzed by LPL, and free fatty acids are released. ApoC-II, which is transferred to circulating chylomicrons from HDL, acts as a required cofactor for LPL in this reaction.

Question 9

Deficiency of which of the following poses an increased incidence of pancreatitis ?

A	Apolipoprotein CII
B	Apolipoprotein A-I
C	Apolipoprotein A-II
D	All of the above

Question 9 Explanation:

Patients with deficiency of apolipoprotein CII have an increased incidence of pancreatitis. Apolipoprotein CII activates lipoprotein lipase, which is important in clearing chylomicrons from bloodstream.

Question 10

What percentage of acute pancreatitis are drug-related ?

A	2 to 5%
B	6 to 12%
C	15 to 20%
D	About 25%

Question 10 Explanation:

~ 2 - 5 % of acute pancreatitis are drug-related.

Question 11

Activation, chemoattraction & sequestration of neutrophils in pancreas occur in which phase of pancreatitis ?

A	Phase 1
B	Phase 2
C	Phase 3
D	Phase 4

Question 12

Cathepsin B is best related to ?

A	Fat necrosis
B	Activation of elastase & phospholipase
C	Zymogen activation
D	Chemoattraction of neutrophils

Question 12 Explanation:

Zymogen activation is mediated by lysosomal hydrolases (cathepsin B) which become co-localized with digestive enzymes in intracellular organelles leading to pancreatic acinar cell injury.

Question 13

In pancreatitis, cellular injury results in liberation of ?

A	Bradykinin peptides
B	Vasoactive substances
C	Histamine
D	All of the above

Question 14

Which of the following is an accurate predictor of severity & death when measured early in the course of acute pancreatitis ?

A	Bradykinin peptides
B	Vasoactive substances
C	Histamine
D	MCP-1 levels

Question 14 Explanation:

Monocyte chemotactic protein (MCP-1) levels measured early in the course of acute pancreatitis are an accurate predictor of severity and death.

Question 15

Which of the following susceptibility gene is a determinant of severity of inflammatory response in pancreatitis ?

A	PRSS1
B	CFTR
C	SPINK1
D	MCP-1

Question 15 Explanation:

Four susceptibility genes have been identified that can increase the susceptibility and/or modify the severity of pancreatic injury in acute pancreatitis. These are cationic trypsinogen mutations (PRSS1m, R122Hm, and N291), pancreatic secretory trypsin inhibitor (SPINK1), CFTR and monocyte chemotactic protein (MCP-1). MCP-1 may be an important inflammatory mediator in the early pathologic process of acute pancreatitis, a determinant of the severity of the inflammatory response, and a promoter of organ failure.

Question 16

Which of the following is a risk factor for severe acute pancreatitis ?

A	MCP-1 2516 G allele
B	MCP-1 2517 G allele
C	MCP-1 2518 G allele
D	MCP-1 2519 G allele

Question 16 Explanation:

MCP-1 2518 G allele polymorphism is a gain-of-function promoter that increases MCP-1 expression. MCP-1 2518 G allele is a risk factor for severe acute pancreatitis.

Question 17

Which of the following is false about abdominal pain of acute pancreatitis ?

A	Colicky
B	Radiates to back
C	More intense in supine position
D	Located in periumbilical region

Question 17 Explanation:

Abdominal pain of acute pancreatitis is steady & boring in character.

Question 18

Abdominal pain due to pancreatitis may have which of the following location ?

A	Right Upper Quadrant
B	Epigastric
C	Left Upper Quadrant
D	Any of the above

Question 19

Exudation of blood & plasma proteins into retroperitoneal space due to activated proteolytic enzymes in acute pancreatitis is termed as ?

A	Retroperitoneal abscess
B	Retroperitoneal tan
C	Retroperitoneal quinsy
D	Retroperitoneal burn

Question 19 Explanation:

Exudation of blood & plasma proteins into retroperitoneal space due to activated proteolytic enzymes in acute pancreatitis is termed as retroperitoneal burn.

Question 20

Pleural effusion in acute pancreatitis is most frequently ?

A	Left-sided
B	Right-sided
C	Bilateral
D	Any of the above

Question 20 Explanation:

Pleural effusion in acute pancreatitis is most frequently left-sided.

Question 21

Erythematous skin nodules in acute pancreatitis is due to ?

A	Vasculitis
B	Subcutaneous fat necrosis
C	Thromboembolism
D	All of the above

Question 21 Explanation:

Erythematous skin nodules in acute pancreatitis is due to subcutaneous fat necrosis.

Question 22

Fat necrosis associated with pancreatic disease is seen in ?

A	Pancreatic carcinoma
B	Acute pancreatitis
C	Chronic pancreatitis
D	All of the above

Question 22 Explanation:

Fat necrosis associated with pancreatic disease is secondary to circulating lipases and is seen in pancreatic carcinoma and acute & chronic pancreatitis.

Question 23

Cullen’s sign of severe necrotizing pancreatitis is due to ?

A	Pancreatic pseudocyst
B	DIC
C	Intestinal ischemia
D	Hemoperitoneum

Question 23 Explanation:

Cullen’s sign in severe necrotizing pancreatitis refers to a faint blue discoloration around umbilicus as the result of hemoperitoneum.

Question 24

Turner’s sign of severe necrotizing pancreatitis is due to ?

A	Tissue catabolism of hemoglobin
B	Pyoperitoneum
C	Intestinal ischemia
D	DIC

Question 24 Explanation:

Turner’s sign of severe necrotizing pancreatitis refers to a blue-red-purple or green-brown discoloration of flanks and reflects tissue catabolism of hemoglobin.

Question 25

Pearson syndrome is characterized by ?

A	Diabetes mellitus from pancreatic insufficiency
B	Pancytopenia
C	Lactic acidosis
D	All of the above

Question 25 Explanation:

Pearson syndrome is characterized by diabetes mellitus from pancreatic insufficiency with pancytopenia & lactic acidosis, caused by sporadic deletion of several mtDNA genes.

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See all quizzes of Acute and Chronic Pancreatitis at here:

1. CFTR and SPINK1 genetic mutations causing acute pancreatitis
are frequent in ?
A. Thalassemia patients
B. HIV-positive patients
C. COPD patients
D. Leukemia patients

2.CCK-releasing factor (CCK-RF) is present in ?
A. Stomach
B. Duodenum
C. Jejunum
D. All of the above

3.Which of the following is the most common cause of acute
pancreatitis ?
A. Gallstones
B. Alcohol
C. Drugs
D. ERCP

4. Risk factors for post-ERCP pancreatitis include ?
A. Sphincter of Oddi dysfunction
B. Age < 60 years
C. > 2 contrast injections into pancreatic duct
D. All of the above

5. What level of hypertriglyceridemia causes acute pancreatitis ?
A. > 250 mg / dL
B. > 500 mg / dL
C. > 750 mg / dL
D. > 1000 mg / dL

6. Which of the following statements is false ?
A. Hypertriglyceridemia can precede & cause pancreatitis
B. >80% patients of acute pancreatitis do not have
hypertriglyceridemia
C. Patients with pancreatitis & hypertriglyceridemia have
preexisting abnormalities in lipoprotein metabolism
D. Fasting Tg levels of < 500 mg/dL pose no risk of pancreatitis
Fasting Tg levels of < 300 mg/dL pose no risk of pancreatitis.
7. Drugs that can elevate serum triglycerides include all except ?
A. Progesterone
B. Vitamin A
C. Thiazide diuretics
D. Beta-blockers

8. Deficiency of which of the following have an increased
incidence of pancreatitis ?
A. ApoA-I
B. ApoB-100
C. ApoC-I
D. ApoC-II

9.Deficiency of which of the following poses an increased
incidence of pancreatitis ?
A. Apolipoprotein CII
B. Apolipoprotein A-I
C. Apolipoprotein A-II
D. All of the above

10.What percentage of acute pancreatitis are drug-related ?
A. 2 to 5%
B. 6 to 12%
C. 15 to 20%
D. About 25%

11. Activation, chemoattraction & sequestration of neutrophils in
pancreas occur in which phase of pancreatitis ?
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4

12. Cathepsin B is best related to ?
A. Fat necrosis
B. Activation of elastase & phospholipase
C. Zymogen activation
D. Chemoattraction of neutrophils

13. In pancreatitis, cellular injury results in liberation of ?
A. Bradykinin peptides
B. Vasoactive substances
C. Histamine
D. All of the above
14. Which of the following is an accurate predictor of severity &
death when measured early in the course of acute pancreatitis
?
A. Bradykinin peptides
B. Vasoactive substances
C. Histamine
D. MCP-1 levels

15. Which of the following susceptibility gene is a determinant of
severity of inflammatory response in pancreatitis ?
A. PRSS1
B. CFTR
C. SPINK1
D. MCP-1

16. Which of the following is a risk factor for severe acute pancreatitis ?
A. MCP-1 2516 G allele
B. MCP-1 2517 G allele
C. MCP-1 2518 G allele
D. MCP-1 2519 G allele

17. Which of the following is false about abdominal pain of acute
pancreatitis ?
A. Colicky

B. Radiates to back
C. More intense in supine position
D. Located in periumbilical region

18. Abdominal pain due to pancreatitis may have which of the
following location ?
A. Right Upper Quadrant
B. Epigastric
C. Left Upper Quadrant
D. Any of the above
19. Exudation of blood & plasma proteins into retroperitoneal
space due to activated proteolytic enzymes in acute
pancreatitis is termed as ?
A. Retroperitoneal abscess
B. Retroperitoneal tan
C. Retroperitoneal quinsy
D. Retroperitoneal burn

20. Pleural effusion in acute pancreatitis is most frequently ?
A. Left-sided
B. Right-sided
C. Bilateral
D. Any of the above

21. Erythematous skin nodules in acute pancreatitis is due to ?
A. Vasculitis
B. Subcutaneous fat necrosis
C. Thromboembolism
D. All of the above

22. at necrosis associated with pancreatic disease is seen in ?
A. Pancreatic carcinoma
B. Acute pancreatitis
C. Chronic pancreatitis
D. All of the above

23.Cullen’s sign of severe necrotizing pancreatitis is due to ?
A. Pancreatic pseudocyst
B. DIC
C. Intestinal ischemia
D. Hemoperitoneum

24.Turner’s sign of severe necrotizing pancreatitis is due to ?
A. Tissue catabolism of hemoglobin
B. Pyoperitoneum
C. Intestinal ischemia
D. DIC

25.Pearson syndrome is characterized by ?
A. Diabetes mellitus from pancreatic insufficiency
B. Pancytopenia
C. Lactic acidosis
D. All of the above

Acute and Chronic Pancreatitis

[MCQ] Acute and Chronic Pancreatitis- Part 2

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Acute and Chronic Pancreatitis- Part 2

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