Abdominal Pain (Acute/Chronic) MCQ Quiz | Gastrointestinal System

Welcome to this comprehensive quiz on Acute and Chronic Abdominal Pain, designed for MBBS students. This quiz will test your understanding of differential diagnoses, pathophysiology, clinical signs, and management strategies for various conditions presenting with abdominal pain. Covering key topics within the gastrointestinal system, these 25 multiple-choice questions are structured to challenge your clinical reasoning and knowledge base. Carefully evaluate each scenario and select the most appropriate answer. After submitting, you’ll receive your score and a detailed review of all questions. You can also download a PDF copy of all questions and their correct answers for your revision. Good luck!

1. A 22-year-old male presents with periumbilical pain that has migrated to the right iliac fossa over 12 hours. On examination, tenderness is maximal at a point two-thirds of the distance from the umbilicus to the anterior superior iliac spine. This point is known as:

Murphy’s point McBurney’s point Rovsing’s point Psoas point

2. What are the two most common causes of acute pancreatitis in adults?

Hypertriglyceridemia and trauma Gallstones and alcohol abuse Viral infections and autoimmune disease Medications and idiopathic causes

3. A patient describes a chronic, dull, gnawing epigastric pain that is relieved by eating. This presentation is most characteristic of:

Acute cholecystitis Gastric ulcer Duodenal ulcer Irritable bowel syndrome

4. Which of the following is considered a “red flag” symptom in a patient presenting with abdominal pain, warranting urgent investigation?

Pain relieved by defecation Bloating and flatulence Unintentional weight loss Intermittent constipation

5. Pain from an inflamed gallbladder (acute cholecystitis) is often referred to which anatomical location due to phrenic nerve irritation?

Left shoulder Right shoulder or scapula The groin The lower back

6. A 65-year-old male with a history of atrial fibrillation presents with sudden, severe, diffuse abdominal pain that is disproportionate to the findings on physical examination. Which diagnosis is most likely?

Perforated peptic ulcer Acute mesenteric ischemia Ruptured abdominal aortic aneurysm Diverticulitis

7. Visceral abdominal pain is typically described as:

Sharp, well-localized, and constant Dull, crampy, and poorly localized Burning and associated with skin changes Radiating down the leg

8. A 45-year-old female presents with severe right upper quadrant (RUQ) pain, fever, and jaundice. This triad (Charcot’s triad) is characteristic of:

Acute cholecystitis Acute viral hepatitis Acute ascending cholangitis Sphincter of Oddi dysfunction

9. In a patient with suspected small bowel obstruction, what is the most appropriate initial imaging modality?

Abdominal ultrasound CT scan of the abdomen with contrast MRI of the abdomen Barium enema

10. A 70-year-old male presents with tearing, severe central abdominal pain radiating to the back, accompanied by hypotension. What is the most critical diagnosis to consider?

Myocardial infarction Acute pancreatitis Perforated viscus Ruptured abdominal aortic aneurysm (AAA)

11. The Rome IV criteria are used to diagnose which of the following conditions?

Inflammatory bowel disease Irritable bowel syndrome (IBS) Celiac disease Chronic pancreatitis

12. A patient with left lower quadrant (LLQ) pain, fever, and leukocytosis most likely has:

Appendicitis Ectopic pregnancy Acute diverticulitis Ulcerative colitis flare

13. In a patient with a perforated viscus, what finding is classically seen on an erect chest X-ray?

Pleural effusion Cardiomegaly Free air under the diaphragm (pneumoperitoneum) Atelectasis

14. Carnett’s sign is used to distinguish visceral pain from pain originating from the:

Abdominal wall Retroperitoneum Thorax Pelvis

15. The “string sign” on a barium follow-through study is a classic finding in which condition?

Ulcerative colitis Crohn’s disease Intussusception Pyloric stenosis

16. Kehr’s sign, which is pain in the left shoulder, is a classic sign of:

Acute pancreatitis Myocardial infarction Splenic rupture Renal colic

17. A 30-year-old female presents with chronic lower abdominal pain, bloating, and alternating diarrhea and constipation. Symptoms are relieved with defecation. There are no red flag symptoms. The most likely diagnosis is:

Celiac disease Inflammatory bowel disease Irritable bowel syndrome (IBS) Colorectal cancer

18. Colicky abdominal pain is most characteristic of obstruction of a:

Solid organ Hollow viscus Large blood vessel Nerve root

19. Which laboratory test is most specific for acute pancreatitis?

Serum amylase Serum lipase Alanine transaminase (ALT) C-reactive protein (CRP)

20. Rovsing’s sign, where palpation of the left lower quadrant causes pain in the right lower quadrant, is associated with:

Diverticulitis Appendicitis Pelvic inflammatory disease Renal colic

21. In chronic pancreatitis, what is the most common clinical manifestation?

Jaundice Acute recurrent pain attacks Steatorrhea Chronic epigastric abdominal pain

22. A patient complains of “postprandial abdominal angina.” This symptom is highly suggestive of:

Gastroparesis Chronic mesenteric ischemia Sphincter of Oddi dysfunction Peptic ulcer disease

23. Murphy’s sign, characterized by inspiratory arrest during palpation of the right upper quadrant, is indicative of:

Acute cholecystitis Acute appendicitis Hepatic abscess Perforated duodenal ulcer

24. What is the mechanism of pain in renal colic?

Peritoneal inflammation Ischemia of the renal parenchyma Acute distension of the ureter and renal capsule Direct irritation of the psoas muscle

25. A patient with known peptic ulcer disease presents with sudden, severe, generalized abdominal pain and a rigid, board-like abdomen. This is most concerning for:

Gastric outlet obstruction Hemorrhage Perforation Malignant transformation

Abdominal Pain (Acute/Chronic) MCQ Quiz | Gastrointestinal System

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