2010 module exam Flashcards
1
Q
A patient presented with dysphagia of liquid & solid, he noticed regurgitation and remnant of undigested food. what would the monometery show?
A
LES pressure is high
Characteristic of achlasia
2
Q
In which case common hepatic duct can be injured when removing cystic duct?
A
Adhesion of cystic duct to the hepatic duct.
3
Q
Why ranitidine decrease the efficacy of sucralfate?
A
Decrease acidity.
4
Q
Which of the following is part of the innate immunity?
A
Mucus
5
Q
If we remove part of the bowel and cut all autonomic innervation, which of the following will lead to increase perstalsis?
- Acetylcholine.
- Blockage of ENS
A
- Acetylcholine.
6
Q
Alcoholic patient with psychosis?
A
GGT elevated.
7
Q
In which part of the following you will find inferior recess of the lesser sac?
- Transverse colon
- Lesser omentum
- Leinorenal ligament
A
- Transverse colon (not sure)
8
Q
Which form anterior wall of the lesser sac?
A
Stomach.
9
Q
A patient was administered 100gm of glucose, his blood glucose went up by 20%. Then he was administered 200gm of lactose and his blood glucose didnt change. What does this suggest?
A
lack of lactase in enterocytes brush border.
10
Q
An elderly patient 60 yrs old, presented w/ diarrhea after ingesting antibiotic amoxicillin, what is most likely the causative agent?
A
C.difficile.
11
Q
Into which part the the liver develops?
A
Ventral mesogastrium.
12
Q
Which of the following will constrict duodenum during development?
A
Annular pancreas.
13
Q
The doctor wanted to resect segment III, what did he follow to do the surgery?
A
Left hepatic vein.
14
Q
What is a predominant characteristic about submandibular?
- Serous.
- Mucous.
- Centroacinar
A
- Serous.
15
Q
During parotid gland resection, what may get injured?
A
Facial nerve.
16
Q
What’s the mechanism of action of senna?
A
Stimulate contraction of colon.
17
Q
Patient w/esophageal webs & microcytic anemia & dysphagia, what is the diagnosis?
A
Plummer-vinson syndrome.
18
Q
Plays a role in acquired humoral immunity?
- IgA
- M cells
A
?
19
Q
Cells that secrete lysozymes?
A
Paneth cells.
20
Q
Tri & di oligopeptides move through?
A
Tertiary active transport
21
Q
Glucose moves by?
A
Secondary active transport.
22
Q
Glucose and galactose need what for transportation?
A
Na
23
Q
How bile is transported to the canaliculi?
A
Primary active transport.
24
Q
Deep inguinal ring opening of what?
- Transversalis fascia.
- Internal oblique aponerosis.
A
- Transversalis fascia.
25
A baby presented w/rash on his mouth histology showed hyphae and spores?
Candida.
26
A Young female came to the gasteroentologist to check her jaundice, she presented one month ago to the health camp w/flu like symptoms and fever. All liver enzymes, Hb, & WBC were normal, bilirubin was high
Now she is asymptomatic and she is health, what is the diagnosis?
Gilberts syndrome.
27
A female presented with family history of endometrial cancer and she underwent colonectomy. She's worried if her son gets the diease. what would you tell her?
You have mutation in missmatch repair mechanism.
28
A Young male went to a clinic for checkups the dr took his weight and it was 60 and normally for his age and growth should be 80.. He told the dr that he is fat and he want pills, the dr was worried.
What the diagnosis?
Anorexia nervousa.
29
What drug is an Inducer of abortion?
Misoprestol.
30
Cytoprotective drug used for the treatment of h.pylori?
- Bismuth chelate
- Sucralfate
?
31
Produce black tongue and stool?
Bismuth chelate.
32
Patient w/ high fasting blood glucose?
Glucagonoma
33
The inferior end of the posterior part of the rectus sheath?
- Arcuate line.
- Pictinate line.
- Arcuate line.
34
How to locate the base of the appendix anatomicaly?
- ilial orifice.
- Tenia coli.
- Haustra coli
- ilial orifice.
35
The reffered pain of appendicitis?
T10
36
Root of Greater splanchnic nerve?
T5-T9
37
Cells sitting on the basement membrane and are for presenting antigens and immunity?
M-cell (microfolds).
38
Carries the postganglionic fibers to the sublingual and submandibular?
Lingual nerve.
39
What is present behind the hepatoduodenal ligament?
Portal vein.
40
A Male travelled to mexico present after 6 weeks with right hypochondrium pain, diagnosed with ameabic liver abscess what is the lab diagnosis?
- Serology Ab.
- Aspiration of abscess.
- Serology Ab.
41
What feature of the liver makes it a metabolic organ?
Blood distribution from portal veins to central vein.
42
What is the primary muscle for anal continence?
- Puborectalis
- Iliococcegoes
- Nternal anal sphincter
- Pubococcegoes
- Puborectalis
43
What us a character of HCV?
It causes chronicity in most ppl.
44
A patient with oral blisters, histology showed multinucleated giant cells and internuclear inclusions?
Herpes
45
Owl eye
CMV
46
A 70 year old man presented with unilateral cervical lymphadenopathy for 2 months, biopsy revealed keratinized pearl cell?
Squamous cell ca from upper esophagus
47
A 35 year old lady presented with severe vomiting after 2 hrs of eating fried rice from chinese resturant?
bacillus cereus.
48
48 yr old male came with rectal bleeding with history of hemorrhoids normal vital signs, WBC normal, hematocrit normal.
What is the best way to diagnose colerectal caner in this patient?
- Colonoscopy
- Degital rectal
- Occult blood test
- Sigmoidoscopy
- Colonoscopy
49
What is the main controller of rate of bile synthesis and secretion on the hepatocytes?
- Concentration of bile acid in portal vein.
- Concentration of bile in gallbladder.
- ph of doudenum.
- secretin.
- glycone and taurin in hepatocyte.
- Concentration of bile acid in portal vein.
50
Which immune effector is likely to be seen around damaged duct cells in primary billiary cirrhosis?
- T helper cells
- T suppressor cells
- B cells
- NK cells
- Neutrophils
- T helper cells
51
A patient Clinically present with diarrea weight loss anemia. histologically: small intistine has villus atrophy?
Celiac disease.
52
13 year old with pyrexia of unknown origin presented with poly O and poly H antigens. What is the causative agent?
Salmonella typhi
53
What is the mechanism of megaloblastic anemia due to b12 deficiency?
trapping of folate
54
Which drug causes microsteatosis?
Valporic acid
55
Esophagus with a characteristic of trachialization?
eosinophylic esophygitis
56
Gastric tumor c-KIT (CD117)?
GIST
57
What's the difference btw primary salivary secretion & oral secrtion?
Oral saliva with greater K+
58
Female with dark urine?
Alkaline phosphate + bilirubin increased
59
Female with signs of hepatocellular damage?
ALT & AST increased
60
EBM: RCT was conducted to know about the efficay of treatment X . They mentioned in the study that "The doctors were not aware about which group the patient is in, taking the medication or not" . What is the importance of this in a RCT study?
To avoid bais in the outcome ( elfkra elle bain "..." they mean blinding to avoid information bais)
61
EBM: RCT was conducted for treatment of disease X . 200 participants were randomized to be in the surgery group and 200 in the medication group. The 200 in the surgery group , 177 of them went to the surgey where 23 didnt. The 200 in medication group 145 of them took the medication and the rest didnt. The follow up was 93% in surgey group and 95% in medication. What is the main concern in this study?
Cross over
62
indian farmer with rose spot rash, fever, leukopenia, & hepatosplenomegaly. What drug is used to treat him?
Ceftriaxone
63
Regarding the previous Qs, what is the best method to prevent it?
proper water disposal control
64
What separates the greater sac into superior & inferior part?
Transverse mesocolon
65
The answer was NoA of glutathione (but not sure what was the qs)
-
66
How does superoxide generate hydroxyl radical?
- by releasing iron (iron reacts with h2o2 to produce OH radical)
- 2 react with each other (this will only form h2o2)
- by releasing iron (iron reacts with h2o2 to produce OH radical)
67
In hemolytic anemia, what enzyme is elevated?
Urobilinogen is urine
68
What effects terminal ileum in crohn's patient and cause obstruction?
Stenosis
69
Persistant cloacal membrane?
Imperforate anus
70
What carries pain sensation from parotid gland?
AuriculoTemporal
71
Bands of fibrous tissue with nodularity in the liver?
Cirrhosis
72
What ion is maintained at 25 mM in colon by transporters?
K+
73
Which ion binds with unconjugated bilirubin and forms stones?
Ca+
74
A diabetic patient with grey white pseudomembrane?
Candidal esophygitis
75
Cancer in fundus of stomach with epitheloid cells and lymphocytes around it, what is the causative agent?
EBV - induced cancer
76
Which of the following cells have chemoreceptors?
Enteroendocrine
77
Which of the following is paracrine secretion?
Histamin
78
Barium swallow x-ray showed stenosis (mechanical dysphagia) so what is the next step (A picture of baruim swallow test)..
endoscopy
79
Female travelled to endemic area of HAV, had symptoms of hepatitis later but when she was screened there was no signs of HAV, what is the most likely causative agent?
HEV
80
Patient with a problem in copper transport?
Wilson's disease
81
The intercalated duct cells are responsible for?
HCO3 secretion
82
Substrate in 7 alpha hydroxylase?
Cholesterol
83
Common cause of viral gastroenteritis in children and have extending fibers?
Adenovirus
84
What causes inhibition of acid secretion?
Low ph in antrum
85
Multiparous women with RUQ pain?
Gall stones
86
Contraction of ascending colon is lower than the descending which is lower than sigmoid, why?
Increase transeit time
87
Which of the following is the first step in colorectal cancer initiation?
APC mutation
88
Parasympathetic innervation to the hindgut?
Pelvic splanchnic
89
Foveolar hyperplasia with flattened mucus? patho 5 slide2
- Fundic gland polyp ?
- inflammatory polyp ?
?
90
Patient who vomits blood and found fresh blood in the stomach, which vessel is most likely to be injured?
Left gastric artery (or vien)
91
A patient taking OCP what do you advice her not to take with it?
John warts herbs
92
Patient with autolysed visera, omental fat necrosis & bleeding?
Hemorrhagic pancreatitis
93
Which of the following is a DNA virus?
HBV
94
Which of the following would NOT be used to check H. Pylori eradication?
serology IgG
95
Which area is difficult to pass the endoscope through?
Pharyngo-esophageal junction
96
A 45 yr old male with a reducible mass which was not descending to the scrotum?
Direct inguinal hernia
97
Tumor in the middle third of esophagus, where does it most likely metastasize?
Paratracheal
98
A girl who's losing weight & her stool color is abnormal. What do we do for diagnosis?
- D- xylose ?
- Biopsy?
?
99
Where do the hepatic canaliculi are located?
Intercellular space
100
A question about warthin tumor?
Oncocytes
101
Flapping tremor with liver disease, what would be elevated?
Ammonia
102
A lady who had an accident had an injury to her head followed by acute gastritis, what would be the cause?
- Cushing's
- Curling
- Cushing's
103
Which drug causes hepatotoxicity due to genetic variation on acetyltransferase?
Isoniazid
104
patient ingested shellfish, which organism is associated with it?
v.Parahemolyticus
105
Which of the following is a characteristic for vibrio cholera?
Affects Human only
106
Which part of the GIT have reverse peristalsis?
- Colon
- Esophagus
- Colon
107
Where does the greater spanchnic nerve end?
Celiac node
108
Left umbilical vein is the remenant of what?
Round ligament
109
What will constrict lower esophagial sphincter?
Vagus ach
110
During intestinal phase. which of the following will be correct?
Fluid secretions increase and push with it enzymes that already
present in the duct
111
Patient presented with oral ulcers, diarrhea and microscopy showed non- caseating gramuloma?
Crohn's disease
112
Immunocompromised patient presented with dysphagia and herpetic ulcers in the lower esophagus. what would be the characteristic feature?
intranuclear inclusions
113
A patient presented with a single well demarcated tumor in the liver. After resection the doctor ensures her that she doesn't need any further treatment?
Hepatic adenoma
114
How can diet induce cancer?
Nitroso (LT)
115
What hormone induces pain after eating fatty food in the case of cholethiasis?
CCK
116
A 70 year old patient on isoniazid treatment, presented with elevated liver enzymes. What most likely would be the cause?
accumulation of active metabolites in liver
117
After removal of intestinal lymph nodes during surgery. Absorption of what will be affected?
Lipids
118
What catalysis a reaction that lead to a signaling molecule which increases (cGmp)?
- Heme oxygenase (this is the catalyzing enzyme)
- CO (this is the signaling molecule)
?
119
What is the main characteristic of enterocytes?
Have microvilli
