Page 2 of 2: MCQ "GIT"

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Question 4. Typical features of oesophageal achalasia include

recurrent pneumonia
True False

spasm of the lower oesophageal sphincter (LOS)
True False

heartburn and acid reflux
True False

predisposition to oesophageal carcinoma
True False

symptomatic response to pneumatic balloon dilatation
True False

recurrent pneumonia (True)

Explanation: Due to regurgitation and aspiration
spasm of the lower oesophageal sphincter (LOS) (False)

Explanation: Failure to relax the LOS with loss of ganglion cells in Auerbach's plexus on histology
heartburn and acid reflux (False)

Explanation: Acid reflux is prevented by the non-relaxing LOS
predisposition to oesophageal carcinoma (True)

Explanation: Even if the obstruction is treated
symptomatic response to pneumatic balloon dilatation (True)

Explanation: If this fails, Heller's myotomy may be indicated

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Question 5. Gastro-oesophageal reflux disease is associated with the following factors

decreased intra-abdominal pressure
True False

delayed gastric emptying
True False

prolonged oesophageal transit time
True False

increased lower oesophageal sphincter tone
True False

presence of a hiatus hernia
True False

decreased intra-abdominal pressure (False)

Explanation: Associated with increased intra-abdominal pressure (e.g. pregnancy)
delayed gastric emptying (True)
prolonged oesophageal transit time (True)

Explanation: Delayed oesophageal clearance is more common in the elderly
increased lower oesophageal sphincter tone (False)

Explanation: Associated with decreased lower oesophageal sphincter tone
presence of a hiatus hernia (True)

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