2008 module exam

Question 1

where does fluid collection occur in a female in the (supine position?)

a. rectouterine pouch
b. vesicouterine pouch

Answer 1

a. rectouterine pouch

Question 2

branch of splenic

a. short gastric
b. gastroepiploic

Answer 2

a. short gastric

Question 3

Superficial epigastric artery is branch of which artery?

Answer 3

branch of femoral artery

Question 4

when liver develops it projects into:

Answer 4

ventral mesogastrium

Question 5

if an (instrument?) is passed through the pharynx, upper esophageal sphincter, body, and lower esophageal sphincter, what would be the readings?

Answer 5

0→50→0→30

Question 6

what would occur if external rectal sphincter relaxes:

a. contraction of rectum
b. rectocolonic reflex
c. further relaxation of internal anal sphincter

Answer 6

?

Question 7

which organism would adhere to small intestinal epithelium and destroy them?

a. shigella b.enterohemorrhagic E.coli c.enteroinasive E.coli
d. enteropathogenic E.coli

Answer 7

(according to what was written literally in Dr. Wafaa notes: enteropathogenic- according to Dr. Noura, it is enteroinvasive- according to Dr. Iqbal, “this question has been taken care of!”)

Question 8

in which part of GI does reverse peristalisis occur?

Answer 8

colon

Question 9

Inferior mesenteric artery occlusion is often asymptomatic b.coz it can be supplied by branches of:

a. middle colic
b. right colic

Answer 9

a.middle colic

Question 10

what supplies ascending colon?

Answer 10

Right colic artery

Question 11

someone ate 275gram of carbohydrate out of 2000Kcal, what is the percentage of carbohydrates of the total calorie intake?

a. 30%
b. 35%
c. 50%
d. 55%

Answer 11

d.55%

1 gram of carbohydrates gives us 4 Kcal\ 1 g of fats = 9 Kcal\ 1 g of protein = 4 Kcal

Question 12

6 yr old girl with diarrhea and failure to thrive:

Answer 12

Giardia lamblia

Question 13

what attaches the bladder to the umbilicus?

Answer 13

median umbilical Ligament

Question 14

what …….left umbilical vein?

Answer 14

Round ligament

Question 15

what ( covers??) the remnants of umbilical vessels?

Answer 15

medial umbilical ligament

Question 16

73 year-old male with one week history of jaundice, weight loss ,no abdominal pain. On US the gallbladder is distended with no stones. What is the cause of the jaundice?

Answer 16

pancreatic cancer

Question 17

25 year-old man had a test for employment that showed high levels of AST ALP (in the range of 100s):

Answer 17

Chronic hepatitis

Question 18

a smoker with a tumour in the salivary gland that showed papillary projections into a cyst with oncocytes Warthin’s

Answer 18

-

Question 19

a tumour that shows perinueral invasion:

Answer 19

Adenoid cyst carcinoma

Question 20

Female with diarrhea and weight loss for the last 12 months. The results shows high levels of transglutaminase antibody. What would help in the management:

Answer 20

Gluten-free diet

Question 21

Cytoprotective drug used in combination therapy for H.pylori

a. Bismuth
b. sucralfate

Answer 21

a. Bismuth

(sucralfate is a cytoprotective agent as well, but we think bismuth is more correct since it is a part of quadruple therapy for H. pylori)

Question 22

drug that leads to black tongue and stool:

Answer 22

bismuth

Question 23

severe chronic liver( disease\failure?) with fetor hepaticus, flapping tremors and then lapsed into coma. What would increase in blood test:

Answer 23

ammonia

Question 24

A dog was prevented from eating for a day, and an electrical record was done for its bowel. The recording showed an intense peristaltic movement that occurs every 90 minutes. What is this type of movement?

Answer 24

MMC

Question 25

In a study to assess the effect of a drug to prevent H. pylori infection. In the section of methods, they mentioned that the doctors who assess the outcome where unaware of the exposure status. Why is this done?

Answer 25

Prevent bias in ....

Question 26

what is the purpose of the blinding in RCT?

Answer 26

Prevent bias in ascertaining outcome

Question 27

the purpose of “intention to treat”:

Answer 27

keep randomization intact

Question 28

last lymph node to filter stomach before reaching cysterna chyli:

Answer 28

Celiac lymph nodes

Question 29

the prevelance of hep. A increases in septomper to October what is the possible cause: a. returning of families b. the served dishes in the restaurants are contaminated with hep A

Answer 29

a.returning of families

Question 30

a patient returned from Egypt, he has RUQ pain and fever. Negative for HBV & HCV. Stool showed calcilike virus

Answer 30

Hep. E

Question 31

multiple ulcers in stomach and duodenum: a. lymphoma b. sarcoma c. adeno... d. neuroendocrine tumor

Answer 31

D. neuroendocrine tumor (we think- remember gastrinoma and ZE syndrome)

Question 32

Pregnant lady with positive HBs, what would happen to the baby? a. acute hepatitis b. hepatic failure c. fulminant hepatitis d. chronic hepatitis

Answer 32

d. chronic hepatitis | * *we think-(90% of children will develop a chronic infection)**

Question 33

. liver cyst what used for diagnosis: a. Serology for specific (antigens ??) b. serology for antibody

Answer 33

b. serology for antibody

Question 34

the least reliable test for eradication of H pylori:

Answer 34

Serology for Ab

Question 35

.what is considered as a complication for portal hypertension: a. ascites b. shrunken liver

Answer 35

a. ascites

Question 36

which one is a brush border enzyme:

Answer 36

Lactase

Question 37

which one activates the pancreatic enzymes? a. trypsin b. carboxypeptidase c. chemotrypsin

Answer 37

a. trypsin

Question 38

a patient was given glucose orally. After a while, his glucose levels increased in his blood, and when he was given lactose, the levels didn’t increase. What could be the reason?

Answer 38

lactase deficiency

Question 39

Someone whose weight is below normal, and she thinks she is obese and she has amenorrhea?

Answer 39

Anorexia

Question 40

20 year old male with 6 months history of diarrhea and RLQ pain . On examination: clubbing and RLQ tender mass a) Crohn’s disease b) cecum carcinoma c) cecum diverticulitis

Answer 40

a) Crohn’s disease **Emedicine: crohn‘s can present as a mass due to extensive fibrosis**

Question 41

what is the origin of the internal ring? a. external oblique b. internal oblique c. transversalis fascia

Answer 41

c. transversalis fascia

Question 42

40 year-old female with gallstones and recurrent pain for 10 yr, what would you see in the gallbladder histologically: a. fibrosis and inflammation b. malignant cells

Answer 42

a. fibrosis and inflammation | I think this one since there is no clue suggesting malignancy

Question 43

a 46 year-old female with history of recurrent RUQ pain and jaundice. 2 days ago, she developed fever, rigors

Answer 43

Cholecystitis

Question 44

A patient presented with dysphagia. He stated that he couldn’t swallow solid food and liquids. He also noticed that he would regurgitate foods that he ate several days before as they are (hint: =mega- esophagus). Which of the following manometer readings is his?

Answer 44

( the answer included achalasia manometry: lower esophageal sphincter pressure is high and the esophagus pressure is low)

Question 45

what carries preganglionic parasympathetic to hind gut:

Answer 45

s2-s4

Question 46

what carries preganglionic parasympathetic to hind gut:

Answer 46

pelvic splanchnic

Question 47

function of cells that have smooth endoplasmic reticulum:

Answer 47

absorption of fatty acids

Question 48

.the presence of which structure necessitate active transport of electrolytes: a. tight junction b. gap junction

Answer 48

a. tight junction

Question 49

what is the characteristic feature of sublingual: a. musinouc acinus b. serous acinus

Answer 49

a.musinouc acinus

Question 50

mutation in which gene causes conversion of adenoma to cancer?

Answer 50

P53

Question 51

Ulcertative colitis with polyps, what is seen histologically: (we asked Dr. Maamon about this Q.. he said he meant pseudopolyps, not true cancerous polyps) a. mucosal ulceration and intervening regeneration b. adenoma c. local inflammation d. Cobble stone

Answer 51

a. mucosal ulceration and intervening regeneration | * *it’s the same as pseudopolyp**

Question 52

what’s attached to the stomach by the greater omentum:

Answer 52

Transverse colon

Question 53

what lies behind the omental foramen?

Answer 53

Hepatoduodenal ligament

Question 54

Which strucuture is secondary retropertoneal : a. pancreas b. spleen c. suprarenal gland d. rectum e. UB

Answer 54

a. pancreas

Question 55

what is peroxynitrite:

Answer 55

oxidant

Question 56

Antioxidant with multiple cysteine: a. metallothionein b. glutathione reductase

Answer 56

a. metallothionein

Question 57

what is used for synthesis of ketone bodies after 4 weeks of starvation? a. trigelycerides b. proteins

Answer 57

a. trigelycerides

Question 58

Feature of esophagus:

Answer 58

stratified squamous epithelium non-keratinized

Question 59

function of M cells:

Answer 59

expoure of ( transporting??) Ag to lymphocytes

Question 60

which cell secretes lysozymes?

Answer 60

Panth cells

Question 61

Paracrine hormone produced from ECM :

Answer 61

histamine

Question 62

Infective dose of shigella: a. 10-100 b. 100-1000

Answer 62

a. 10-100

Question 63

what is produced from the duodenum in response to low PH? a. secretin b. cholecystkinin c. somatostatin

Answer 63

a.secretin

Question 64

A pateint returned from India; after 10 days he presented with fever of unknown origin and ....??

Answer 64

Enteric fever

Question 65

in the intestinal phase of pancreatic secretion, the ducts secrete large amounts of fluid, but the secretion to intestine contains enzymes.why?

Answer 65

The fluid pushes the enzymes that are already there

Question 66

what is the feature in an empty stomach:

Answer 66

rugae

Question 67

what should be done to a worker with Salmonella?

Answer 67

3 constitutive negative stool tests

Question 68

Axis for rotation of gut in the embryo: a. superior mesenteric artery b. inferior mesenteric artery c. abdominal aorta d. inferior rectal artery

Answer 68

a.superior mesenteric artery

Question 69

which vein have reverse blood flow in a case of esophageal varices in a patient with portal hypertention?

Answer 69

Left gastric veins

Question 70

major oxidant in liver :

Answer 70

cytochrome P450

Question 71

which one is an antioxidant for...Produced in mitochondria? a. superoxide dismutase b. xanthine oxidase c. heme oxygenase d. NADPH oxidase

Answer 71

a. superoxide dismutase

Question 72

chronic constipation: (we asked Dr. Rao about this question.. he says it is not from him!) a. hemmoroids b. imperforate anus c. crypititis d. perianal abcess

Answer 72

?

Question 73

infection of anal sinus:

Answer 73

cryptitis

Question 74

.if a patient is taking cimitidine and diazepam, what should be done:

Answer 74

reduce the dose of diazepam

Question 75

why vegetarians are advised to take (complementary vegetables together?) a. prevent catabolism of amino acids b. help in digestion of proteins

Answer 75

a.prevent catabolism of amino acids

Question 76

Which organism is a probiotic:

Answer 76

lactibasillus

Question 77

how to diagnose C.difficile:

Answer 77

Detect toxins (Ag?) in stools

Question 78

the difference between primary secrtion and oral saliva: a. hypertonic b. high K

Answer 78

b. high K

Question 79

vit K activate prothrombin by which mechanism?

Answer 79

Carboxylation

Question 80

oral vaccine:

Answer 80

Cholera 01

Question 81

type of toxin in enterohemorrhagic E.coli

Answer 81

Verotoxin 1&2

Question 82

what nerve plexus is in sub mucosa?

Answer 82

Missiner

Question 83

what prevents bile from leaking:

Answer 83

tight junctions

Question 84

complication of hydatid cyst: a. anaphylactic shock b. chronic hepatitis c. chronic jaundice

Answer 84

a. anaphylactic shock

Question 85

disease that affects women more than men characterized by chronic destruction of bile duct within portal tract:

Answer 85

primary biliary cirrhisosis

Question 86

What is prodrug:

Answer 86

converted to active metabolite

Question 87

what causes traveller’s diarrhea ?

Answer 87

Enterotoxogenic E.coli

Question 88

RNA virus that causes glomeriolonephritis

Answer 88

Hepatitis C

Question 89

DNA virus that causes liver cancer

Answer 89

Hep. B

Question 90

a physician who was completely vaccinated, and he was found to have high ALT and AST levels. What diagnostic test you would use?

Answer 90

Viral RNA

Question 91

what does the intercalated duct secrete ? a. Na and Hco3 b. Cl and K

Answer 91

a.Na and Hco3

Question 92

autoimmune disease against exocrine glands:

Answer 92

Sjogren’s

Question 93

.which structure has the lowest intensity of haustration?

Answer 93

Lower rectum

Question 94

intensity of.....increased in proximal colon and..........??? ( we don’t remember the Q! sorry)

Answer 94

favors increase transit time

Question 95

bilirubin is moved from the hepatocytes to the canaliculi by which mechanism: a) Primary Active transport b) exchange with H c) exchange wih Na

Answer 95

a) Primary Active transport

Question 96

what would increase in case of active parietal cell: a. intrinsic factor b. gastrin

Answer 96

a.intrinsic factor

Question 97

clinical Q!!!!! a. 24 hr esophageal PH b. upper endoscopy

Answer 97

b. upper endoscopy

Question 98

duct of pancreas develops from:

Answer 98

endoderm

Question 99

patient with biliayr colic. The pain is radiating to back and shoulder. What is the anatomical basis of this?

Answer 99

innervation by T6- T9

Question 100

immunopathogenesis of celiac

Answer 100

Th1 response (to\ against :P) gluten

Question 101

immunological basis of pernicious anemia

Answer 101

Ab to IF

Question 102

a patient with history of biliary stone presented with acute severe epigastria pain. Amylase very high

Answer 102

acute pancreatitis

Question 103

46?? Year old patient on a routine medical checkup was found to have high ALT & AST. She is asymptomatic. Glucose: 9, blood count normal, doesn’t drink alcohol, obese a) NASH b) Wilson’’s c) hemochromatosis

Answer 103

a) NASH | I think this was the best one of the other choices- although it means there is hapatits but not increased WBC’s!

Question 104

which virus undergoes gene reassortment ?** Reassortment is the mixing of the genetic material of species into new combinations; in this case, it’s pigs and humans**

Answer 104

rota virus

Question 105

the microorganism associated with antibiotic associated diarrhea

Answer 105

C. difficile

Question 106

the most important risk factor for colonic cancer in 40 year old person

Answer 106

family history