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Gastro-intestinal (including liver, biliary, pancreas and spleen)

1. A 65 year old male presents with chest pain. A barium swallow demonstrates strong, repetitive, non-propulsive contractions with intermittent normal peristaltic waves. Several small diverticulae are noted in the mid-oesophagus. The most likely diagnosis is:
Diffuse oesophageal spasm
Crohns disease
2. An 80 year old man presents with intermittent dysphagia and an occasional feeling of a foreign body in the mouth. A barium swallow reveals a large, heterogenous filling defect in the oesophageal lumen which doesn’t cause any significant delay in the transit of barium. What is the most likely diagnosis?
Glycogenic acanthosis
Oesophageal adenocarcinoma
Fibrovascular polyp
3. A 36 year old lady undergoes MRI for characterisation of a lesion in segment 2 of the liver. Majority of the lesion is isointense to the liver on T1 imaging and high signal on T2 imaging. The lesion has a central scar which is hypointense on T1 imaging and high signal on T2 imaging. Post gadolinium, most of the lesion enhances in the arterial phase except for the central scar which enhances in the porto-venous phase. A sulphur colloid study is normal. What is this lesion most likely to be?
Colorectal cancer metastasis
Hepatic adenoma
Focal nodular hyperplasia
Gastrinoma metastases
4. A 47 year old male patient undergoes a CT-KUB. The liver is noted to have a high attenuation value (HU 110). On a subsequent MRI, the liver and spleen are noted to have diffuse low signal on T1 and T2 weighted imaging. What is the most appropriate biochemical test?
Serum ferritin
Caeruloplasmin levels
Philadelphia chromosome
Blood culture
Alpha 1 antitrypsin
5. A 60 year old labourer is pyrexial and undergoes abdominal USS. A 10 cm hypoechoic, well defined cyst is seen in the left lobe of the liver. It contains a smaller cyst within it and a small amount of calcification within the cyst wall. What is the most likely organism?
Echinococcus Granulosus
Schistosomiasis Mansoni
Mycobacterium Tuberculosis
Ascariasis Lumbroides
E Coli

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