Hepatobiliary and pancreatic surgery: periampullary carcinoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: periampullary carcinoma

Sample item

A patient has intermittent jaundice, silver-coloured stools, and a polypoid mass at the ampulla on duodenoscopy with biopsy-proven adenocarcinoma. Why is the outlook generally better than for pancreatic head cancer?

AIt is always benignBIt is unresponsive to surgeryCIt causes early obstruction and presents at a smaller stage, with higher resectability and survivalDIt never spreads to nodes

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. It causes early obstruction and presents at a smaller stage, with higher resectability and survival

Periampullary tumours (ampulla, distal CBD, duodenum) obstruct the bile duct early, leading to earlier diagnosis. Whipple resection yields 5-year survival of about 30 to 50 percent for ampullary cancer, versus under 20 percent for pancreatic cancer.

Option by option

A. It is always benign
These are malignant tumours.
B. It is unresponsive to surgery
Surgery is the main treatment.
C. It causes early obstruction and presents at a smaller stage, with higher resectability and survival (correct)
Correct. Early symptoms mean earlier, more resectable disease.
D. It never spreads to nodes
Nodal spread occurs.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, It causes early obstruction and presents at a smaller stage, with higher resectability and survival. Periampullary tumours (ampulla, distal CBD, duodenum) obstruct the bile duct early, leading to earlier diagnosis.

Why is "It is always benign" not the answer?

These are malignant tumours.

Why is "It is unresponsive to surgery" not the answer?

Surgery is the main treatment.

Why is "It never spreads to nodes" not the answer?

Nodal spread occurs.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: periampullary carcinoma in General Surgery. Whipple resection yields 5-year survival of about 30 to 50 percent for ampullary cancer, versus under 20 percent for pancreatic cancer.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: periampullary carcinoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.