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Gallstones (PG)
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1. What are gallstones primarily composed of?
*
Calcium oxalate
Cholesterol or bilirubin
Magnesium sulfate
Uric acid
2. What is the most common symptom of gallstones?
*
Haematuria
Right upper quadrant pain after fatty meals
Constipation
Flank pain radiating to groin
3. Which imaging modality is the first-line for diagnosing gallstones?
*
CT scan
Abdominal ultrasound
MRI
X-ray abdomen
4. What is biliary colic?
*
Pain due to kidney stones
Cramping abdominal pain due to IBS
Intermittent RUQ pain from gallstone obstruction of cystic duct
Pain from pancreatic inflammation
5. Which of the following is NOT a known risk factor for gallstones?
*
Obesity
Rapid weight loss
Pregnancy
High-fibre diet
6. What is the definitive treatment for symptomatic gallstones?
*
NSAIDs
Low-fat diet
Cholecystectomy
Antibiotics
7. What complication can result from gallstone migration into the common bile duct?
*
Gastritis
Cholangitis
Colitis
Peptic ulcer disease
8. What is Murphy's sign?
*
Lower abdominal tenderness
Pain upon passive straight leg raise
Pain on inspiration with deep palpation of RUQ
Pain on dorsiflexion of the foot
9. Which blood test pattern may suggest gallstone-related obstruction?
*
Elevated ALT/AST only
Elevated bilirubin, ALP, and GGT
C. Low CRP and high WBC
Low Hb and high platelets
10. Which type of diet is recommended to help prevent gallstone formation?
*
High-fat, low-carb
Low-fat, high-fibre
Ketogenic
High-protein
11. What is acute cholecystitis?
*
Gallbladder inflammation
Liver infection
Pancreas inflammation from alcohol
Bowel obstruction from adhesions
12. Which of the following is a classic sign of acute cholecystitis?
*
Diffuse abdominal tenderness
Rebound tenderness in LLQ
Fever and RUQ pain
Bloody diarrhoea
13. What is the initial management of acute cholecystitis?
*
Urgent surgery in all cases
IV fluids, antibiotics, and pain relief
Endoscopy
Bowel rest only
14. How can silent (asymptomatic) gallstones be managed?
*
Cholecystectomy always
Dietary counselling and observation
Statins
Emergency referral
15. Which sex is more commonly affected by gallstones?
*
Male
Female
Equal
16. What is a porcelain gallbladder?
*
Gallbladder with gas
Calcified gallbladder wall seen on imaging
Enlarged gallbladder due to infection
Gallbladder with pus
17. Which enzyme is typically raised in gallstone pancreatitis?
*
Amylase
AST
ALT
CRP
18. What is a gallstone ileus?
*
Gallstones in colon
Gallstones blocking pancreatic duct
Bowel obstruction due to a large gallstone
Gallbladder abscess formation
19. Which of the following may mimic gallstone symptoms?
*
Peptic ulcer
Renal colic
Hepatitis
All of the above
20. When should a patient with suspected gallstones be referred for surgery?
*
Immediately if asymptomatic
If symptomatic or complications occur
Only in children
Only if bilirubin is low