1. MCQS
• The risk factors for pancreatic cancer includes all except:
•
1. Diabetes mellitus
2. Hereditary predisposition
3. Chronic pancreatitis
4. Smoking
5. Acute pancreatitis
2. • . The differential diagnosis of a mass lesion in pancreas
includes all except:
•
1. Lymphoma
2. Neuroendocrine tumour
3. Focal chronic pancreatitis
4. Autoimmune pancreatitis
5. None of the above
3. • 3. A 65 year old gentleman presented with dull aching upper abdominal pain radiating
through to the back and worsened by eating. He had also noticed yellow discoloration
of his skin and had lost weight. In his past medical history, he was diagnosed with
diabetes mellitus 6 months earlier. A CT scan revealed a localised mass lesion in the
head of pancreas with biliary duct dilatation. All the following are true except:
•
1. CT guided biopsy is needed to confirm the diagnosis
2. There is little evidence of benefit from routine biliary stenting of jaundiced patients before
resection.
3. A diagnosis of pancreatic cancer should be considered in unexplained diabetes (no family
history, obesity or steroids) in patients over 50 years of age.
4. Gastroduodenal artery encasement is not a contraindication for curative surgery
5. Whipple’s operation is the standard operation for cancer of pancreatic head
4. • 5) Which is the most common site of pancreatic cancer?
a) Head
b) Body
c) Tail
d) Body and tail
5. •
6) Which feature is least common in carcinoma head of the pancreas?
a) Abdominal pain
b) Weight loss
c) Malabsorption
d) Jaundice
e) Palpable nontender gallbladde
6. • 7) What is the most common sign of carcinoma pancreas?
a) Pain
b) Jaundice
c) Pale stool
d) Palpable GB
7. • 8) Pain is least severe problem in lesions arising in the -------------
-----
a) Body
b) Tail
c) Head
d) None
8. • 8) Pain is least severe problem in lesions arising in the -------------
-----
a) Body
b) Tail
c) Head
d) None
9. • 8) Pain is least severe problem in lesions arising in the -------------
-----
a) Body
b) Tail
c) Head
d) None
10. • 10) Trousseau's sign in pancreatic cancer
a) Hypocalcemia
b) Hyponatremia
c) Hypernatremia
d) Migratory venous thrombophlebitis
11. • 9) Massive hepatic metastasis are typical of pancreatic
carcinoma arising from ------------------
a) Head of pancreas
b) Body and tail of pancreas
c) Both
9) Massive hepatic metastasis are typical
of pancreatic carcinoma arising from --------
----------
a) Head of pancreas
b) Body and tail of pancreas
c) Both
12. • 11) Which indicate(s) the presence of distant metastases?
a) "Sister Mary Joseph node"
b) "Blummer's shelf"
c) "Virchow's node"
d) All
13. • 12) How can most cases of curable pancreatic carcinoma be detected very early?
a) Spiral CT
b) MRI
c) Cytology of duodenal contents
d) ERCP with endoscopic ultrasonography
e) None of the above
•
14. • 13) First investigation in suspected pancreatic cancer
a) CT
b) ERCP
c) Endoscopic US
d) MRI
e) CA - 19
•
15. • 14) How can you get a definite diagnosis in 100% of cases?
a) CT
b) MRI
c) ERCP
d) Laparotomy
16. • 15) Specific for early pancreatic cancer
a) CEA
b) CA - 19 antigen
c) Alpha-fetoprotein
d) All of the above
17. • 16) Which is false?
a) CEA may be raised in any obstructive jaundice
b) USS can reliably differentiate intrahepatic cholestasis from extrahepatic biliary
obstruction
c) Pancreas can be well imaged by USS in all cases
d) Large liver metastases are typical of tumors from the body and tail
e) All of the above
•
18. • 17) Which is very effective in most patients with pancreatic cancer?
a) 5-fluorouracil
b) Gemcitabine
c) Surgery
d) Radiation
e) None
•
19. • 18) How is jaundice due to bile duct obstruction in pancreatic
cancer relieved?
a) Stenting
b) Cholestyramine
c) Radiation
d) Steroids
20. 19 ) Malignancies associated with type 2 diabetes include which of
the following?
• a. Breast cancer
• b. Colon cancer
• c. Pancreatic cancer
• d. All of the above
