Pathology of Biliary & Pancreatic Disorders - Quiz
Great wars & Great creationsstart first in human mind…!-- Thoughts are seeds with potential.
54y man with chornic intermittend right upper quadrant painnow presents with severe abdominal pain. Raised Bilirubin(direct), ALP, Amylase. Image abdominal CT. Diagnosis ?.1 2 3 4 57% 7%14%0%71%1. Acute Cholecystitis.2. Chronic Pancreatitis.3. Acute pancreatitis.4. Acute Hepatitis.5. Pancreatic carcinoma.1. Explain the clinical features? – acute, sudden over chronic.2. Explain the laboratory data? – Bil, ALP, Amylase (pancreatitis).3. What are possible risk factors? – smoking, alcoholism, diabetes, cholelithiasis.4. What is the pathogenesis? – activation of enzymes, inflammation, fat necrosis.
38y F, Obese, abdominal colicky pain, Gallbladder:? Type of stones1 2 3 4 575%19%0%0%6%A. Pure cholesterolB. Mixed cholesterol.C. PigmentD. CalciumE. Triple phosphate.
38y F, Obese, abdominal colicky pain, Gallbladder:? Type of stones1 2 3 4 50%71%0%0%29%A. Pure cholesterolB. Mixed cholesterol.C. PigmentD. CalciumE. Triple phosphate.
A 45y mildly obese woman, 1-week history of upperabdominal pain, fever, shaking chills, and vomiting. P/Esevere right upper quadrant tenderness. Lab: serumbilirubin of 1.0 mg/dL, AST of 25 U/L, ALT of 35 U/L, ALP220 U/L (high), WBC of 14,000/µL, and amylase of 95 U/L(normal).Most likely diagnosis?1 2 3 4 587%0%13%0%0%1. Acute Cholecystitis2. Acute Pancreatitis3. Carcinoma pancreas4. Carcinoma Gall bladder5. Primary biliary cirrhosis.
69y M, Massive GI bleeding, jaundice.Section of liver ? Pathogenesis1 2 3 4 525%19%0%6%50%1. Cholangiocarcinoma2. Hepatocellular carcinoma3. Metastatic carcinoma4. Liver abscesses5. Tuberculosis.
38y F, Obese, intermittent abdominal colicky painsince 2y, Gallbladder: ? DiagnosisA. B. C. D. E.14%43%0%0%43%A. AdenocarcinomaB. CholelithiasisC. CholecystitisD. CholesterosisE. Primary Biliary Cirrhosis.
A 21 year old man, abdominal pain, rigidity since 3 days.Serum Lipase raised but calcium normal. Image showsappearance of his pancreas. He had 4 similar attacks since8 years. ? Most likely Etiology.1 2 3 4 538%8% 8%38%8%1. Explain the clinical features? – acute, sudden recurrent.2. Explain the laboratory data? – Lipase, Calcium.3. What are possible risk factors? – Genetic AD Trypsin mutation (PRSS1),4. What is the pathogenesis? – uncontrolled activation of enzyme trypsin,1. Chronic Acoholism.2. Chronic Cholecystitis.3. Type 1 Diabetes.4. Genetic disorder.5. Unknown.
A 46 year old man, 8 year history of intermittent abdominalpain now presents with steatorrhoea. Image showsabdominal CT. ? Most likely Diagnosis.1 2 3 4 50% 0%47%37%16%1. Explain the clinical features? – chronic steatorrhoea - pancreas.2. What are possible risk factors? – alcohol, diabetes, cholelithiasis,3. What is the pathogenesis? pancreatitis fat storage steatorrhoea fatty liver1. Fatty liver.2. Chronic Cholecystitis.3. Chronic pancreatitis4. Cholelithiasis & fatty liver.5. Both 1 & 3
Viral serology interpretation:A. B. C. D. E.0% 0% 0%0%0%HBsAg Negative,Anti HBc Ab NegativeAnti HBcAg IGM NegativeAnti HBs Ag PositiveA. Acute Viral HepatitisB. Immunised against Hep. BC. Past Hepatitis B infection.D. Hepatitis B carrier stageE. Chronic hepatits B
42y male smoker presented with recurrent cough& dyspnoea. Image shows cut section of hislung. What is the most likely diagnosis?1 2 3 4 50% 0% 0%0%0%1. Emphysematous bullae2. Panlobular emphysema3. Centrilobular emphysema4. Chronic Bronchitis + Emphysema.5. Smokers lung with Silicosis
46 year male on treatment for lymphoma presentswith pallor, shortness of breath and mild jaundice.Image shows his blood film appearance. What isthe most likely type of anemia?1 2 3 4 50% 0% 0%0%0%1. Anemia of chronic disorder2. Megaloblastic anemia3. Hemolytic anemia4. Aplastic anemia5. Iron deficiency Anemia
Histopathology Image is from lung biopsy of a 61 yearmale chronic smoker. What is the most likely type ofcarcinoma?1 2 3 4 50% 0% 0%0%0%1. Small cell carcinoma2. Adenocarcinoma3. Metastatic deposits4. Squamous carcinoma5. Lung abscesses
The gross image of lung specimen from a 59yearold male heavy smoker presented with high fever,shortness of breath. Likely type of pneumonia?1 2 3 4 50% 0% 0%0%0%1. Lobar pneumonia2. Interstitial pneumonia3. Broncho pneumonia4. Fungal pneumonia5. Carcinomatous pneumonia
Which of the following findings is most likely to beencountered in Mary?1 2 3 4 50% 0% 0%0%0%1. Alcoholic hepatitis2. Melena3. Pernicious anemia4. Steatorrhea5. Hypoglycemia
Mary presents again after 3 years. Physicalexamination shows jaundice. A CT scan of theabdomen shows a large fluid-filled cyst in the lessersac. What is the most likely diagnosis?1 2 3 4 50% 0% 0%0%0%1. Adenocarcinoma2. Carcinoid tumor3. True Pancreatic cyst4. Abscess in Pancreas5. Pancreatic Pseudocyst
65y man, Acromegaly, epigastric pain, melena,hypercalcemia, hyperlipidemia, hyperacidity.? Diagnosis1 2 3 4 50% 0% 0%0%0%1. Glucagonoma2. Insulinoma3. MEN I4. Pancreatic Carcinoid5. MEN II
52y F, severe multiple peptic ulcers in both duodenumand jejunum not responding to treatment. Pancreas shows1.2cm rounded tumor. ? Diagnosis.1 2 3 4 50% 0% 0%0%0%Peptic ulcers1. H.pylori & peptic ulcer2. Insulinoma3. MEN II syndrome4. Pancreatic Carcinoid5. Gastrinoma
A man with outward couragedares to die.A man with inward couragedares to live.Lao Tzu
Self Assessment is the key…!Retention of LearningTime Delay No review Review7 Days 33% 83%63 Days 14% 70%Whether new information is "stored" or "dumped"depends, then, on our Interest, Reciting, Writing &Reviewing the information.Source: http://www.web-us.com/memory/human_memory.htm
53Living becomes a glorious experienceonly when there is tolerance and love.Willingness to compromise with otherpeople’s ways of living andcooperation in common tasks, thesemake happy and successful societies.Divine Discourse, 17th February 1980 - Baba.Love is Selfless Service.
545 A’s & SNAP• Ask: 1. patients with diabetes, hypertension,hyperlidaemia, obesity or existing vascular disease• Assess: 2.Number of cigarettes or equivalent/day,Dependance 3.readiness to change/motivation• Advise: 4.provide written information, 5.motivationalinterviewing• Assist: 6.NRT ? Bupropion(Zyban) 7.Support• Arrange: 8.referral to QUIT 9.follow up with the GPSNAP Counseling: Smoking, Nutrition, Alcohol &Physical Activity.
Silence…55To the question "Who am I?" the only relevant answer is silence. Youneed to discard all answers in words, including "I am Nothing" or "Iam the Cosmic Self" or "I am the Self" - and just stick to the question"Who am I?". All other answers are just thoughts. Thoughts cannever be complete. Only Silence is complete.Thoughts are not the goal in themselves. Their goal is Silence. Whenyou ask the question "Who am I?" you get no answer, there issilence. That is the real answer. For your soul is solidified silence.This solidified silence is wisdom, is knowledge.The easy way to silence the thoughts is to arouse the feelings. For,through feelings only peace, joy and love dawn. And they are allyour very nature.- Sri Sri Ravishankar
Viral serology interpretation:1 2 3 4 50% 0% 0%0%0%HBsAg Negative,Anti HBsAg PositiveAnti HBcAg PositiveAnti HBcAg IGMNegativeA. Acute Viral Hepatitis BB. Immunised against Hep. BC. Past Hepatitis BD. Hepatitis B carrier stageE. Carrier state of Hepatitis B