Q.1 Which of the following is the most common cause of acute pancreatitis?
Alcohol abuse
Gallstones
Hyperlipidemia
Viral infections
Explanation - Gallstones obstruct the pancreatic duct, leading to inflammation, making them the most common cause of acute pancreatitis.
Correct answer is: Gallstones
Q.2 Which laboratory test is most specific for diagnosing acute pancreatitis?
Amylase
Lipase
ALT
AST
Explanation - Lipase is more specific and remains elevated longer than amylase in acute pancreatitis.
Correct answer is: Lipase
Q.3 A patient with cirrhosis develops confusion and altered mental status. What is the most likely cause?
Hypoglycemia
Hepatic encephalopathy
Sepsis
Electrolyte imbalance
Explanation - Accumulation of ammonia and other toxins in liver dysfunction leads to hepatic encephalopathy, causing confusion.
Correct answer is: Hepatic encephalopathy
Q.4 What is the first-line treatment for bleeding esophageal varices?
Propranolol
Octreotide
Lactulose
Furosemide
Explanation - Octreotide reduces portal pressure and is used as first-line therapy for acute variceal bleeding.
Correct answer is: Octreotide
Q.5 In patients with acute liver failure, what electrolyte disturbance is most commonly seen?
Hypokalemia
Hyperkalemia
Hyponatremia
Hypercalcemia
Explanation - Acute liver failure often leads to dilutional hyponatremia due to impaired water handling and portal hypertension.
Correct answer is: Hyponatremia
Q.6 Which scoring system is used to assess the severity of liver disease?
APACHE II
SOFA
Child-Pugh
Glasgow Coma Scale
Explanation - The Child-Pugh score estimates the severity and prognosis of chronic liver disease, especially cirrhosis.
Correct answer is: Child-Pugh
Q.7 Which complication is most associated with portal hypertension?
Acute kidney injury
Esophageal varices
Pancreatitis
Cholelithiasis
Explanation - Portal hypertension leads to the development of esophageal and gastric varices, which may bleed.
Correct answer is: Esophageal varices
Q.8 In severe acute pancreatitis, which intervention is most important in the initial management?
Immediate antibiotics
Aggressive IV fluid resuscitation
Nasogastric tube insertion
Pancreatic enzyme replacement
Explanation - Early and aggressive IV fluid resuscitation is critical to maintain perfusion and prevent organ failure in severe pancreatitis.
Correct answer is: Aggressive IV fluid resuscitation
Q.9 What is the primary mechanism of lactulose in managing hepatic encephalopathy?
Promotes diuresis
Traps ammonia in the colon
Reduces portal pressure
Increases bile secretion
Explanation - Lactulose acidifies the colon, converting ammonia to ammonium, which is trapped and excreted.
Correct answer is: Traps ammonia in the colon
Q.10 Which imaging study is best for detecting gallstones?
CT scan
MRI
Ultrasound
X-ray
Explanation - Ultrasound is the most sensitive, specific, and non-invasive method for detecting gallstones.
Correct answer is: Ultrasound
Q.11 What condition is commonly associated with ascites in cirrhosis?
Hypoalbuminemia
Hypercalcemia
Hypertension
Polycythemia
Explanation - Decreased albumin production in cirrhosis reduces plasma oncotic pressure, leading to ascites.
Correct answer is: Hypoalbuminemia
Q.12 Which clinical sign is most specific for peritonitis?
Abdominal tenderness
Rebound tenderness
Nausea
Abdominal distension
Explanation - Rebound tenderness indicates peritoneal irritation, making it a specific sign of peritonitis.
Correct answer is: Rebound tenderness
Q.13 What is the most common cause of upper GI bleeding in cirrhotic patients?
Peptic ulcer disease
Esophageal varices
Mallory-Weiss tear
Gastritis
Explanation - Variceal bleeding due to portal hypertension is the leading cause of upper GI bleed in cirrhotics.
Correct answer is: Esophageal varices
Q.14 Which drug is used for long-term prophylaxis to prevent variceal bleeding?
Propranolol
Lactulose
Rifaximin
Furosemide
Explanation - Non-selective beta blockers like propranolol reduce portal pressure, preventing variceal rebleeding.
Correct answer is: Propranolol
Q.15 In acute GI bleed, which fluid resuscitation is preferred initially?
Normal saline
Dextrose 5%
Ringer’s lactate
Albumin
Explanation - Isotonic crystalloids like normal saline are preferred for initial fluid resuscitation in acute GI bleeding.
Correct answer is: Normal saline
Q.16 Which diagnostic test confirms spontaneous bacterial peritonitis (SBP)?
Ultrasound
Ascitic fluid analysis
CT abdomen
MRI
Explanation - A neutrophil count >250/mm³ in ascitic fluid confirms SBP.
Correct answer is: Ascitic fluid analysis
Q.17 Which complication is most feared in acute severe ulcerative colitis?
Toxic megacolon
Bowel obstruction
Intestinal perforation
Fistula formation
Explanation - Toxic megacolon is a life-threatening complication of severe ulcerative colitis requiring urgent management.
Correct answer is: Toxic megacolon
Q.18 What is the most common cause of acute upper GI bleeding overall?
Esophageal varices
Peptic ulcer disease
Gastritis
Mallory-Weiss tear
Explanation - Peptic ulcer disease remains the most common cause of upper GI bleeding in general population.
Correct answer is: Peptic ulcer disease
Q.19 Which diagnostic marker is most reliable for acute viral hepatitis?
ALT
AST
Alkaline phosphatase
Bilirubin
Explanation - ALT is more specific for hepatocellular injury compared to AST or alkaline phosphatase.
Correct answer is: ALT
Q.20 Which electrolyte abnormality worsens hepatic encephalopathy?
Hypokalemia
Hyperkalemia
Hypercalcemia
Hyponatremia
Explanation - Hypokalemia promotes renal ammoniagenesis, worsening hepatic encephalopathy.
Correct answer is: Hypokalemia
Q.21 In liver cirrhosis, which complication indicates poor prognosis?
Jaundice
Ascites
Hepatic encephalopathy
Spider angiomas
Explanation - The development of hepatic encephalopathy is associated with poor prognosis in cirrhotic patients.
Correct answer is: Hepatic encephalopathy
Q.22 Which test is used to confirm H. pylori infection non-invasively?
Urea breath test
Endoscopy
Serology
Stool microscopy
Explanation - The urea breath test is a reliable, non-invasive method for detecting active H. pylori infection.
Correct answer is: Urea breath test
Q.23 What is the drug of choice for spontaneous bacterial peritonitis (SBP)?
Cefotaxime
Ciprofloxacin
Amoxicillin
Vancomycin
Explanation - Third-generation cephalosporins like cefotaxime are first-line therapy for SBP.
Correct answer is: Cefotaxime
Q.24 Which vitamin deficiency is common in chronic liver disease?
Vitamin A
Vitamin D
Vitamin K
Vitamin C
Explanation - Chronic liver disease impairs fat-soluble vitamin absorption, leading to vitamin K deficiency and coagulopathy.
Correct answer is: Vitamin K
Q.25 Which condition is a contraindication for liver transplantation?
Hepatocellular carcinoma within Milan criteria
Uncontrolled sepsis
Acute liver failure
Decompensated cirrhosis
Explanation - Active uncontrolled sepsis is a contraindication for liver transplantation due to poor outcomes.
Correct answer is: Uncontrolled sepsis