CRUX OF SURGERY

Latest — 26 Feb 2026

Peptic Ulcer Disease

A patient on NSAIDs develops haematemesis. What is the mechanism by which aspirin contributes to the formation of gastric ulcers? * ((Inhibit prostaglandin synthesis::☑️ Aspirin inhibits COX-1, reducing PGE₂, which decreases mucus, bicarbonate secretion and mucosal blood flow)) * ((Inhibit somatostatin::Would increase acid secretion rather than impair mucosal protection)) * ((Inhibit gastrin:

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Spleen

Which of the following statements about the spleen is true? * ((Haemopoiesis in normal individual::In adults, haemopoiesis ceases after birth; extramedullary haemopoiesis occurs only in pathological states)) * ((Contains macrophages::☑️ The red pulp contains cords and sinusoids rich in macrophages responsible for filtration and removal of aged red cells)) * ((Primary lymphoid

Liver

A retired PVC factory machinist develops a large, irregular liver tumor on CT. Which lesion is most likely? * ((Liposarcoma::Primary hepatic liposarcoma is rare; not associated with PVC exposure)) * ((Angiosarcoma::☑️ Vinyl chloride exposure is a classic risk factor for hepatic angiosarcoma)) * ((Hamartoma::Benign lesion, typically incidental and not linked to

Biliary System

👩‍⚕️ It's easiest to learn by working through the MCQs. Get to grips with the anatomy, physiology, and management of the different pathologies. A 30-year-old woman has RUQ pain after eating fatty meals. Bilirubin is normal. Diagnosis? * ((Biliary colic::☑️ Intermittent post-prandial RUQ pain with normal bilirubin suggests transient cystic

Pancreas

👩‍⚕️ Work your way through this list of MCQs. Hover over each option for the answers and explanations. Which enzyme is responsible for autodigestion in acute pancreatitis? * ((Lipase::Causes fat necrosis but is activated downstream)) * ((Elastase::Causes vascular damage and haemorrhage but not the initiating enzyme)) * ((Trypsin::☑️ Premature activation of trypsinogen

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