[MCQ] Acute and Chronic Pancreatitis- Part 5

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Acute and Chronic Pancreatitis- Part 5

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Question 1

Walls of pseudocysts consist of ?

A	Necrotic tissue
B	Granulation tissue
C	Fibrous tissue
D	All of the above

Question 1 Explanation:

Pseudocysts of pancreas do not have an epithelial lining. Their walls consist of necrotic tissue, granulation tissue, and fibrous tissue.

Question 2

The lining of a pancreatic pseudocyst is ?

A	Squamous epithelium
B	Cuboidal epithelium
C	Granulation tissue
D	Any of the above

Question 2 Explanation:

Lining of a pancreatic pseudocyst is granulation tissue from pancreatic duct leakage.

Question 3

After acute pancreatitis, pseudocysts of pancreas develop over a period of ?

A	1 - 2 weeks
B	2 - 3 weeks
C	3 - 4 weeks
D	4 - 6 weeks

Question 3 Explanation:

Pseudocysts of pancreas are collections of tissue, fluid, debris, pancreatic enzymes & blood that develop over 4-6 weeks after acute pancreatitis

Question 4

Which of the following about pseudocysts of pancreas is false ?

A	Preceded by pancreatitis in 90% of cases
B	Mostly located in body or tail of pancreas
C	Abdominal pain is the usual presenting complaint
D	Serum amylase level is mostly normal

Question 4 Explanation:

Serum amylase level is elevated in 75% of pseudocysts of pancreas at some point during their illness and may fluctuate markedly.

Question 5

Significant number of pancreatic pseudocysts resolve spontaneously how many weeks after their formation ?

A	> 1 week
B	> 2 weeks
C	> 4 weeks
D	> 6 weeks

Question 5 Explanation:

Significant number of pancreatic pseudocysts resolve spontaneously >6 weeks after their formation

Question 6

Complication of a pancreatic pseudocyst is ?

A	Rupture
B	Hemorrhage
C	Abscess
D	All of the above

Question 6 Explanation:

Complications of pancreatic pseudocyst are pain, pressure on other viscera, rupture, hemorrhage & abscess.

Question 7

Which artery most frequently forms ‘Pseudoaneurysm’ in acute pancreatitis ?

A	Splenic artery
B	Inferior pancreatic duodenal artery
C	Superior pancreatic duodenal artery
D	Hepatic artery

Question 7 Explanation:

Splenic artery is most often involved, but gastroduodenal, inferior pancreatico-duodenal and superior pancreatico-duodenal arteries can be affected.

Question 8

Which of the following statements is false for Purtscher’s retinopathy ?

A	Due to occlusion of anterior retinal artery
B	Sudden and severe loss of vision
C	Cotton wool spots & hemorrhages in optical fundus
D	It is a complication of acute pancreatitis

Question 8 Explanation:

Purtscher’s retinopathy in acute pancreatitis is due to occlusion of posterior retinal artery with aggregated granulocytes. Optical fundus shows cotton-wool spots & hemorrhages confined to an area limited by optic disk & macula.

Question 9

The fluid in true pancreatic ascites usually has an amylase concentration of ?

A	>5000 U/L
B	>10000 U/L
C	>15000 U/L
D	>20000 U/L

Question 10

Differential diagnosis of pancreatic ascites is ?

A	Tuberculous peritonitis
B	Constrictive pericarditis
C	Budd-Chiari syndrome
D	All of the above

Question 10 Explanation:

Differential diagnosis of pancreatic ascites includes intraperitoneal carcinomatosis, tuberculous peritonitis, constrictive pericarditis, and Budd-Chiari syndrome.

Question 11

When main pancreatic duct is disrupted posteriorly, internal fistula may develop between pancreatic duct and ?

A	Peritoneum
B	Pleural space
C	Retroperitoneum
D	Any of the above

Question 11 Explanation:

If the pancreatic duct disruption is posterior, an internal fistula may develop between the pancreatic duct and the pleural space, producing a pleural effusion (pancreaticopleural fistula) that is usually left-sided and often massive.

Question 12

Cardinal complications of chronic pancreatitis is ?

A	Abdominal pain
B	Steatorrhea
C	Diabetes mellitus
D	All of the above

Question 12 Explanation:

Complications of chronic pancreatitis are abdominal pain, steatorrhea, weight loss & diabetes mellitus

Question 13

Which of the following is best related to chronic pancreatitis ?

A	Fluctuating symptomatology
B	Risk of malignancy
C	Irreversible damage to pancreas
D	All of the above

Question 13 Explanation:

Chronic pancreatitis is characterized by irreversible damage to pancreas.

Question 14

There is a strong association of which of the following and chronic pancreatitis ?

A	Smoking
B	Intravenous drug use
C	Prolonged fasting
D	Obesity

Question 15

Which of the following plays a key role in the development of chronic pancreatitis ?

A	Islet cells of Langerhans
B	Pancreatic stellate cells (PSC)
C	Acinar epithelial cells
D	All of the above

Question 15 Explanation:

Pancreatic stellate cells (PSC) play a role in maintaining normal pancreatic architecture that can shift toward fibrogenesis in the case of chronic pancreatitis.

Question 16

Which of the following hypothesis describes events in the pathogenesis of chronic pancreatitis ?

A	Sentinel acute pancreatitis event
B	Sentinel chronic pancreatitis event
C	Sequential acute pancreatitis event
D	Sequential chronic pancreatitis event

Question 17

Which of the following induces pancreatic stellate cells (PSC) activity with subsequent new collagen synthesis ?

A	Proinflammatory cytokines
B	Oxidants
C	Growth factors
D	All of the above

Question 17 Explanation:

Proinflammatory cytokines, tumor necrosis factor (TNF-), interleukin 1 (IL-1), and interleukin 6 (IL- 6) as well as oxidant complexes & growth factors are able to induce PSC activity with subsequent new collagen synthesis.

Question 18

Which of the following plays a role in the self-activating autocrine pathways lead to progression in chronic pancreatitis ?

A	Tumor necrosis factor (TNF-)
B	Interleukin 1 (IL-1)
C	Interleukin 6 (IL-6)
D	Transforming growth factor (TGF-)

Question 18 Explanation:

PSCs also possess transforming growth factor (TGF-)–mediated self-activating autocrine pathways that may explain disease progression in chronic pancreatitis even after removal of noxious stimuli.

Question 19

Which of the following is the most frequent cause of clinically apparent chronic pancreatitis in children ?

A	Cystic fibrosis
B	Hereditary pancreatitis
C	Isolated autoimmune chronic pancreatitis
D	Pancreas divisum

Question 19 Explanation:

In United States, alcoholism is the most common cause of clinically apparent chronic pancreatitis in adults, while cystic fibrosis is the most frequent cause in children.

Question 20

In hereditary chronic pancreatitis, defect in gene encoding for which of the following is found ?

A	Pepsin
B	Chymotrypsin
C	Trypsinogen
D	All of the above

Question 21

Which of the following mutation increases the risk of chronic pancreatitis ?

A	N32S SPINK1
B	N33S SPINK1
C	N34S SPINK1
D	N35S SPINK1

Question 21 Explanation:

Presence of an N34S SPINK1 mutation increased the risk of chronic pancreatitis by twentyfold. A combination of two CFTR mutations and an N34S SPINK1 mutation increased the risk of chronic pancreatitis 900-fold.

Question 22

Autoimmune Pancreatitis (AIP) is which form of pancreatitis ?

A	Acute
B	Chronic
C	Recurrent
D	All of the above

Question 23

Autoimmune Pancreatitis (AIP) is also called ?

A	Sclerosing pancreatitis
B	Tumefactive pancreatitis
C	Nonalcoholic destructive pancreatitis
D	All of the above

Question 23 Explanation:

AIP is also referred to as sclerosing pancreatitis, tumefactive pancreatitis and nonalcoholic destructive pancreatitis

Question 24

Autoimmune pancreatitis is frequently associated with ?

A	Rheumatoid arthritis
B	Sjögren’s syndrome
C	Inflammatory bowel disease
D	All of the above

Question 24 Explanation:

AIP is associated with primary sclerosing cholangitis, primary biliary sclerosis, rheumatoid arthritis, Sjögren’s syndrome, ulcerative colitis, mediastinal adenopathy, autoimmune thyroiditis, tubulointerstitial nephritis, and retroperitoneal fibrosis.

Question 25

Majority of patients with AIP present with ?

A	Obstructive jaundice
B	Acute pancreatitis
C	Recurrent pancreatitis
D	Malabsorption syndrome

Question 25 Explanation:

In the United States, 50–75% of patients with AIP present with obstructive jaundice.

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See all quizzes of Acute and Chronic Pancreatitis at here:

1. Walls of pseudocysts consist of ?
A. Necrotic tissue
B. Granulation tissue
C. Fibrous tissue
D. All of the above

2. The lining of a pancreatic pseudocyst is ?
A. Squamous epithelium
B. Cuboidal epithelium
C. Granulation tissue
D. Any of the above

3. After acute pancreatitis, pseudocysts of pancreas develop over
a period of ?
A. 1 – 2 weeks
B. 2 – 3 weeks
C. 3 – 4 weeks
D. 4 – 6 weeks

4. Which of the following about pseudocysts of pancreas is false ?
A. Preceded by pancreatitis in 90% of cases
B. Mostly located in body or tail of pancreas
C. Abdominal pain is the usual presenting complaint
D. Serum amylase level is mostly normal

5.Significant number of pancreatic pseudocysts resolve
spontaneously how many weeks after their formation ?
A. > 1 week
B. > 2 weeks
C. > 4 weeks
D. > 6 weeks

6. Complication of a pancreatic pseudocyst is ?
A. Rupture
B. Hemorrhage
C. Abscess
D. All of the above

7. Which artery most frequently forms ‘Pseudoaneurysm’ in acute
pancreatitis ?
A. Splenic artery
B. Inferior pancreatic duodenal artery
C. Superior pancreatic duodenal artery
D. Hepatic artery

8. Which of the following statements is false for Purtscher’s
retinopathy ?
A. Due to occlusion of anterior retinal artery
B. Sudden and severe loss of vision
C. Cotton wool spots & hemorrhages in optical fundus
D. It is a complication of acute pancreatitis

9.The fluid in true pancreatic ascites usually has an amylase
concentration of ?
A. >5000 U/L
B. >10000 U/L
C. >15000 U/L
D. >20000 U/L
10. Differential diagnosis of pancreatic ascites is ?
Harrison’s 18th Ed. 2643
A. Tuberculous peritonitis
B. Constrictive pericarditis
C. Budd-Chiari syndrome
D. All of the above

11. When main pancreatic duct is disrupted posteriorly, internal
fistula may develop between pancreatic duct and ?
A. Peritoneum
B. Pleural space
C. Retroperitoneum
D. Any of the above

12. Cardinal complications of chronic pancreatitis is ?
A. Abdominal pain
B. Steatorrhea
C. Diabetes mellitus
D. All of the above

13. Which of the following is best related to chronic pancreatitis ?
A. Fluctuating symptomatology
B. Risk of malignancy
C. Irreversible damage to pancreas
D. All of the above

14. There is a strong association of which of the following and
chronic pancreatitis ?
A. Smoking
B. Intravenous drug use
C. Prolonged fasting
D. Obesity

15. Which of the following plays a key role in the development of
chronic pancreatitis ?
A. Islet cells of Langerhans
B. Pancreatic stellate cells (PSC)
C. Acinar epithelial cells
D. All of the above

16. Which of the following hypothesis describes events in the
pathogenesis of chronic pancreatitis ?
A. Sentinel acute pancreatitis event
B. Sentinel chronic pancreatitis event
C. Sequential acute pancreatitis event
D. Sequential chronic pancreatitis event

17. Which of the following induces pancreatic stellate cells (PSC)
activity with subsequent new collagen synthesis ?
A. Proinflammatory cytokines
B. Oxidants
C. Growth factors
D. All of the above

18.Which of the following plays a role in the self-activating
autocrine pathways lead to progression in chronic
pancreatitis ?
A. Tumor necrosis factor (TNF-)
B. Interleukin 1 (IL-1)
C. Interleukin 6 (IL-6)
D. Transforming growth factor (TGF-)

19.Which of the following is the most frequent cause of clinically
apparent chronic pancreatitis in children ?
A. Cystic fibrosis
B. Hereditary pancreatitis
C. Isolated autoimmune chronic pancreatitis
D. Pancreas divisum

20. In hereditary chronic pancreatitis, defect in gene encoding for
which of the following is found ?
A. Pepsin
B. Chymotrypsin
C. Trypsinogen
D. All of the above

21. Which of the following mutation increases the risk of chronic
pancreatitis ?
A. N32S SPINK1
B. N33S SPINK1
C. N34S SPINK1
D. N35S SPINK1

22. Autoimmune Pancreatitis (AIP) is which form of pancreatitis ?
A. Acute
B. Chronic
C. Recurrent
D. All of the above
23. Autoimmune Pancreatitis (AIP) is also called ?
A. Sclerosing pancreatitis
B. Tumefactive pancreatitis
C. Nonalcoholic destructive pancreatitis
D. All of the above
.
24. Autoimmune pancreatitis is frequently associated with ?
A. Rheumatoid arthritis
B. Sjögren’s syndrome
C. Inflammatory bowel disease
D. All of the above

25. Majority of patients with AIP present with ?
A. Obstructive jaundice
B. Acute pancreatitis
C. Recurrent pancreatitis
D. Malabsorption syndrome

Acute and Chronic Pancreatitis

[MCQ] Acute and Chronic Pancreatitis- Part 5

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Acute and Chronic Pancreatitis- Part 5

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