Gastrointestinal surgery: Forrest classification: 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 · Gastrointestinal surgery: Forrest classification

Sample item

A man with melaena has urgent endoscopy that shows a duodenal ulcer with a pulsatile spurt of blood from the ulcer base. Which Forrest class is this?

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

The answer and the reasoning

C. Forrest Ia

The Forrest classification grades bleeding peptic ulcers by endoscopic appearance: Ia spurting, Ib oozing, IIa non-bleeding visible vessel, IIb adherent clot, IIc flat pigmented spot and III clean base. High-risk stigmata (Ia, Ib and IIa) need endoscopic haemostasis followed by high-dose proton pump inhibitor therapy.

Option by option

  • A. Forrest Ib

    Forrest Ib is oozing blood without spurting.

  • B. Forrest III

    Forrest III is a clean-based ulcer with no stigmata of recent bleeding.

  • C. Forrest Ia (correct)

    Correct. Arterial spurting is Forrest Ia.

  • D. Forrest IIa

    Forrest IIa is a non-bleeding visible vessel.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Forrest Ia. The Forrest classification grades bleeding peptic ulcers by endoscopic appearance: Ia spurting, Ib oozing, IIa non-bleeding visible vessel, IIb adherent clot, IIc flat pigmented spot and III clean base.

Why is "Forrest Ib" not the answer?

Forrest Ib is oozing blood without spurting.

Why is "Forrest III" not the answer?

Forrest III is a clean-based ulcer with no stigmata of recent bleeding.

Why is "Forrest IIa" not the answer?

Forrest IIa is a non-bleeding visible vessel.

What concept does this question test?

It tests Gastrointestinal surgery: Forrest classification in General Surgery. High-risk stigmata (Ia, Ib and IIa) need endoscopic haemostasis followed by high-dose proton pump inhibitor therapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Gastrointestinal surgery: Forrest classification?

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.