Standards of answers

1 – c; 2 – d; 3 – a; 4 – c; 5 – a; 6 – b; 7 – c; 8 – d; 9 – b; 10 – b; 11 – c; 12 – c; 13 – d; 14 – c; 15 – c; 16 – d; 17 – d; 18 – a; 19 – b; 20 – a.

Chapter 3. Acute pancreatitis

Tests (one answer is correct)

1. Acute pancreatitis is:

1. inflammation of pancreas;

2. inflammation of gallbladder and pancreas;

3. autodigestion of tissues by pancreatic enzymes, and econdary infection and multiorgan system failure may be associated with autodigestion process;

4. purulent inflammation of pancreas.

2. Risk factors for cholecystitis include:

1. gallstones;

2. pregnancy;

3. fatty foods;

4. all answers are correct.

3. Mark incorrect answer about classification of acute pancreatitis:

1. oedematous pancreatitis and pancreonecrosis;

2. fatty and haemorrhagic pancreonecrosis;

3. catarrhal, phlegmonous, gangrenous;

4. incomplicated and complicated.

4. Сharacteristic of pain in acute pancreatitis:

1. intensive pain in the upper abdomen, has constant character;

2. colic pain;

3. moderate pain in the upper abdomen, may radiate to the right shoulder or scapula;

4. “knife-like” pain.

5. Describe Mayo-Robson’s sign:

1. regional tension of anterior abdominal wall in epigastria region, along the projection of pancreas;

2. palpation pain in the left costovertebral angle;

3. abdominal distension in upper region;

4. absence of pulsation of abdominal aorta in epigastria region.

6. Describe Gobye’s sign:

1. regional tension of anterior abdominal wall in epigastria region, along the projection of pancreas;

2. palpation pain in the left costovertebral angle;

3. abdominal distension in upper region;

4. absence of pulsation of abdominal aorta in epigastria region.

7. Describe Voskresensky’s sign:

1. regional tension of anterior abdominal wall in epigastria region, along the projection of pancreas;

2. palpation pain in the left costovertebral angle;

3. abdominal distension in upper region;

4. absence of pulsation of abdominal aorta in epigastria region.

8. Describe Korte’s sign:

1. regional tension of anterior abdominal wall in epigastria region, along the projection of pancreas;

2. palpation pain in the left costal-vertebral angle;

3. abdominal distension in upper region;

4. absence of pulsation of abdominal aorta in epigastria region.

9. Describe Cullen’s sign:

1. bluish discolouration around the umbilicus;

2. reddish-brown discolouration along the flanks resulting from retroperitoneal blood dissecting;

3. violet sports on the body and face;

4. cyanosis of skin of abdominal wall.

10. Describe Mondor’s sign:

1. bluish discolouration around the umbilicus;

2. reddish-brown discolouration along the flanks resulting from retroperitoneal blood dissecting along tissue plaines;

3. violet sports on the body and face;

4. cyanosis of skin of abdominal wall.

11. Describe Grey-Turner’s sign:

1. bluish discolouration around the umbilicus;

2. reddish-brown discolouration along the flanks resulting from retroperitoneal blood dissecting;

3. violet sports on the body and face;

4. cyanosis of skin of abdominal wall.

12. Describe Holsted’s sign:

1. bluish discolouration around the umbilicus;

2. reddish-brown discolouration along the flanks resulting from retroperitoneal blood dissecting;

3. violet sports on the body and face;

4. cyanosis of skin of abdominal wall.

13. The main method in diagnostic procedure is:

1. X-ray examination;

2. Ultrasonic;

3. laboratory studies;

4. anamnestic and clinical examination.

14. Specifical ultrasonographic findings of acute pancreatitis include:

1. changing in size and structure of pancreas;

2. free liquid in abdominal cavity;

3. gallstones;

4. all answers are correct.

15. Treatment policy of acute pancreatitis is:

1. only conservative;

2. only surgical;

3. initial treatment is conservative + surgery for some indications;

4. individual.

16. Indications for surgical treatment are:

1. peritonitis;

2. retention of abdominal pain and muscles resistance;

3. increasing of body temperature and leukocytosis;

4. formation of mass.

17. Optimal term for operation in patients with gallstones pancreatitis:

1. 2 hours;

2. 12 hours;

3. 24–48 hours;

4. 72 hours.

18. If acute gallstones pancreatitis resolves, optimal policy is:

1. following conservative management may be the mainstay of treatment;

2. laparoscopic cholecystectomy can be carried out 2 weeks later;

3. laparoscopic cholecystectomy can be carried out 4–6 weeks later;

4. open cholecystectomy can be carried out 4–6 weeks later.

19. Indication for peritoneal lavage is:

1. formation of mass;

2. retroperitoneal phlegmone;

3. increasing of body’s temperature and leukocytosis;

4. peritonitis.

20. Treatment of the pancreatic mass:

1. surgical;

2. conservative;

3. surgical in young patients, conservative in elderly;

4. laparoscopy drainage.