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Flashcards in 2017 module exam Deck (94)
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1
Q

A colorectal cancer patient biopsy showed the following molecular features: -ve cimp,
chromosomal and microstatellite instability, APC & p53 mutations, what is of this effect on
the patient’s survival ?
A. Superior survival post relapse
B. No effect on survival
C. Worse survival post relapse
D. Worse relapse free & overall survival

A

A. Superior survival post relapse

2
Q
An infant may continue passing meconium during micturition due to which congenital
anamoly?
A. Urorectal fistula
B. Rectovaginal fistula
C. Rectoperineoal fistula
D. Vitelline fistula
A

A. Urorectal fistula

3
Q
The duodenal biopsy of a 9 y/o underweight girl with severe diarrhoea and bulky foul smelling stool showed flagellated microorganism on the mucosal surface. There was no evidence of mucosal ulceration or inflammation. What diagnosis best explain these findings?
A. amoebiasis
B. giardiasis
C. Spirochetes
D. cryptosporidiosis
E. microsporidiosis
A

B. giardiasis

4
Q

What is the best practice to minimise the incidence of hepatitis A virus in developing
countries?
A. provide clean water and food intake
B. sanitation and vaccinate children younger than one year old
C. sanitation and vaccinate children older than one year old
D. vaccinate the whole population in the area

A

C. sanitation and vaccinate children older than one year old

5
Q

What is the primary function of bile salts?

A

A. emulsification of lipids

6
Q

Why is a renal transplant patient on cyclosporine advised not to drink grapefruit juice?
A. It inhibits cyclosporine metabolism
B. The dose of cyclosporine needs to be increased

A

A. It inhibits cyclosporine metabolism

7
Q
Which lymph nodes mainly receive superficial lymphatics from the posterior aspect of the
liver?
A. Celiac
B. Hepatic
C. Phrenic
D. Pyloric
E. Right gastric
A

C. Phrenic

8
Q

What is the function of collagen table?

A

A. Regulates water absorption by venules

9
Q
Which type of food is associated with botulinum toxin?
A. raw tuna
B. canned food
C. raw egg
D. chicken
A

B. canned food

10
Q

A 30 Y/O man presented to the hospital after a road traffic accident with a fracture in the left base of the scalp and damage to his left vagus nerve. What is expected to be found in this patient?
A. deviation of uvula to the right
B. deviation of the tongue to the left on protrusion
C. loss of general sensation on left of the tongue
D. loss of general sensation on left soft palate

A

A. deviation of uvula to the right

11
Q
Which adenovirus serotypes are responsible for Gastroenteritis ?
A. serotypes 40 and 41
B. serotypes 50 and 51
C. serotypes 20 and 21
D. serotypes 17 and 18
A

A. serotypes 40 and 41

12
Q
Which of these diseases caused by an inherited genetic mutation?
A. Wilson’s disease
B.Acute hepatitis
C. NASH
D. Cirrhosis
E. Hepatocellular carcinoma
A

A. Wilson’s disease

13
Q
Which of the following is a characteristic of amiodarone-induced hepatic toxicity?
A. Steatohepatitis
B. Cholecystitis
C. Hepatocellular carcinoma
D. Metabolic acidosis
A

A. Steatohepatitis

14
Q

What best describes the slow waves of the intestinal smooth muscle cells?
A. Tonic contractions
B. Action potentials
C. Originate from interstitial cells of cajal
D. Same frequency in all the gut

A

C. Originate from interstitial cells of cajal

15
Q
A 19 Y/O male who had consumed contaminated milk presented with mesenteric adenitis ( enlarged mesenteric lymph nodes ) and appendicitis like pain. What is the causative organism ?
A. Yersenia Entercolitica
B. E. coli
C. Vibrio cholera
D. Salmonella typhi
A

A. Yersenia Entercolitica

16
Q

Why is concurrent administration of antacids and some other drugs not recommended?
A. Antacids can alter the absorption of other drugs
B. Antacids can increase bicarbonate secretion
C. Antacids can inhibit CYP 450 enzymes
D. the combination can lead to increase in gastric acid secretion

A

A. Antacids can alter the absorption of other drugs

17
Q
Which complication is more likely to be associated with ulcerative colitis than Crohn’s
disease?
A. perforation
B. fistula
C. toxic megacolon
D. Strictures
A

C. toxic megacolon

18
Q
Which toxin that c.diffecile produce which is critical for antibiotic associated diarrhea?
A. Toxin type A
B. Toxin type B
C. c.diffecile toxin
D. hemolysin
A

B. Toxin type B

19
Q
Which organ/structure is in the posterior wall of the epiploic foramen (foramen of winslow)?
A. 1st part of duodenum
B. hepatic portal vein
C. hepatic segment V
D. IVC
E. left crus of the diaphragm
A

D. IVC

20
Q

What best describes the secondary peristalsis?
A. Starts at the site where food is stuck in the esophagus after a wave of primary peristalsis
B. initiated after swallowing

A

A. Starts at the site where food is stuck in the esophagus after a wave of primary peristalsis

21
Q
Which artery is most likely affected by erosion due to posterior perforation of the stomach ?
A. splenic artery
B. gastroduadenal
C. hepatic artery
D. left gastroepiplotic
A

A. splenic artery

22
Q
In terms of biotransformation, a phase II reaction described as:
A. Conjugation reaction
B. Anaerobic reaction
C. Hydrolysis reaction
D. Oxidative phosphorylation
A

A. Conjugation reaction

23
Q
What is the most common cause of chronic sialadenitis?
A. Radiation
B. Medication
C. Stone obstruction
D. Recurrent infection
A

C. Stone obstruction

24
Q

A cancer in the left body of the stomach is most likely going to spread to which of the
following lymph nodes initially?
A. Lesser ommental lymph nodes
B. Greater ommental lymph nodes
C. Plyoric lymph nodes
D. Lymph nodes of the Upper border of pancreas

A

B. Greater ommental lymph nodes

25
Q
Which of the following vessels lies posterior to the head of the pancreas?
A. Common hepatic artery
B. Inferior vena cava
C. Splenic artery
D. Superior mesenteric artery
A

B. Inferior vena cava

26
Q
What form of vitamin b12 is used in food fortifications?
A. Cyanocobalamin
B. Hydroxylcobalamin
C. Methylcobalamin
D. Intrinsic factor
A

A. Cyanocobalamin

27
Q
Where does the majority of water absorption in the GI tract occur?
A. ascending colon
B. small intestine
C. cecum
D. transverse colon
A

B. small intestine

28
Q

What is the histological picture of acetaminophen hepatotoxicity?
A. periportal destruction
B. pericentral destruction
C. panlobular destruction

A

B. pericentral destruction

29
Q
What is the mechanism by which bile acid is secreted to bile canaliculi?
A. Primary active transport
B. Secondary active transport
C. Tertiary active transport
D. Facilitated diffusion
A

A. Primary active transport

30
Q

A male with dysphagia has undergone lateral barium swallow radiograph and it shows
narrowing of the lumen of the esophagus at T4 level, dilation of which structure is responsible for this finding?
A. mesenteric lymph nodes
B. left pulmonary artery
C. arch of aorta
D. right bronchus

A

C. arch of aorta

31
Q

What is most common feature in sjogren’s syndrome?
A. lymphoid infiltrate with germinal centres
B. necrosis
C. thickened gland
D. granulation

A

A. lymphoid infiltrate with germinal centres

32
Q
What hormone generates MMC ( migrating myoelectric complex )?
A. Motilin
B. gastrin
C. secretin
D. CCK
A

A. Motilin

33
Q

An instrument was inserted into the intestine of a dog to measure the electrical activity of
the GI tract. Intense bursts of electrical activity were recorded, which took place every 90
minutes while fasting. What do these waves represent?

A

MMC

34
Q
A healthy person made a BaSO4 GI motility test and showed reverse peristalsis in one
section, which part of the GI is this?
A. Colon
B. Stomach
C. Esophagus
D. Small intestine
A

A. Colon

35
Q

A 35 year old women with bilateral ovarian tumor microscopy revealed signet ring cell
tumor. Gastric biopsy revealed similar tumor. What is the possible route of transmission?
A. direct spread
B. blood
C. transperitoneal
D. lymphatic
E. perineural

A

C. transperitoneal

36
Q

What is the mechanism of halothane drug induced hepatotoxicity?
A. idiosyncratic toxicity
B. intrinsic toxicity

A

A. idiosyncratic toxicity

37
Q

What mediates hepatic damage in autoimmune hepatitis?
A. Cytotoxic T cells
B. Antibody-mediated cellular toxicity
C. Cytokines

A

A. Cytotoxic T cells

38
Q
32 year old woman with increased liver enzymes, anti SMA, antimitochondrial antibodies.
Liver biopsy will show?
A. Mallory hyaline bodies
B. Epitheloid granuloma
C. Microabscesses
D. Plasma cell and lymphocytes
E. Steatohepatitis
A

D. Plasma cell and lymphocytes

39
Q
What is true regarding pancreatic secretions?
A. Hypotonic
B. CKK stimulates pancreatic secretions
C. Gastrin stimulates HCO3 secretion
D. Cl concentration is more than plasma
A

B. CKK stimulates pancreatic secretions

40
Q

44 yr old housewife and a mother of 5 presented with constant RUQ colicky pain associated with nausea & vomiting for 2 hours. On the following day, she developed a yellowish discolouration of the sclera & tea colored urine (Table: high bilirubin 86, High aspartate aminotranferase 130, High alkaline phosphate)

A. Oral contraceptives
B. Cholestatic jaundice
C. Acute hepatitis

A

-

41
Q

Which of the following demonstrated the role of gut microbiota in the development in
kwashiorkor?

A

A. the use of RUTF and antibiotics improved the outcomes for kwashiorkor patients compared to
RUTF alone

42
Q
By which mechanism in the intestinal lumen is the glucose absorbed across the brush
border?
A. Facilitated diffusion
B. Primary active transport
C. Secondary active transport
D. Endocytosis
E. Exchange with hydrogen
A

C. Secondary active transport

43
Q
A 30 year old women presented with jaundice and RUQ pain for one week and on testing
she showed high levels of ALT, she has traveled to Thailand for plastic surgery 3 months ago.
Upon testing she had:
Hcv abs -
Hbs antigen +
Hbs antibodies -
Hbe antigen +
Hbe antibody -
Hbc igm antibodies +
A. Chronic hbv infection high infectivity
B. Acute hbv infection
C. Vaccination
D. Recovery from previous hbv infection
A

B. Acute hbv infection

44
Q

What occurs when exocrine secretion of the Pancreas increases?
A. The secretion becomes hypertonic with more HCO3 than in plasma
B. The secretion becomes hypertonic with less HCO3 than in plasma
C. The secretion becomes isotonic with more Cl than in plasma
D. The secretion becomes isotonic with less Cl than in plasma

A

A. The secretion becomes hypertonic with more HCO3 than in plasma

45
Q

What defines the portal lobule?

A

A. A triangular area connecting three central veins in three adjacent classic liver lobules

46
Q

Which of the following receptors is required for the pathogenesis of SARS 2 COVID ?

A

A. Ace 2 modification

47
Q
Where does the posterior layer of the rectus sheath ends inferiorly?
A. pectineal line
B. midaxillary line
C. arcuate line
D. subcostal line
E. semilunar line
A

C. arcuate line

48
Q

A CT scan showed a subphrenic abscess in a 50 y/o man due to a ruptured appendix.
Through which peritoneal part did the fluid reach the site of the abscess.
A. Epiploic formaina
B. Hepatophrenic recess
C. Lesser sac
D. Paracolic gutter
E. Paradudanal recess

A

D. Paracolic gutter

49
Q
Which of the following genes is responsible for HNPCC?
A. APC
B. MLH1
C. MSH1
D. MHH1
A

B. MLH1

50
Q
  1. A man w/ chronic renal failure is presenting with a peptic ulcer and increased gastrin. What is the reason behind the high acid secretion?
A

A. H.pylori

51
Q
Which of the following enzymes is responsible for converting tyrpsinogen to typsin?
A. Enterokinase
B. Carboxypeptidase
C. Kemotrypsin
D. Trypsin inhibitor
A

A. Enterokinase

52
Q
An otherwise healthy man comes in with a positive fecal occult stool test. No family history, no medications, no previous history of disease. What’s the next step?
A. Colonoscopy
B. Second fecal occult
C. Sigmoid colonoscopy
D. Digital rectal exam
A

A. Colonoscopy

53
Q

Which of the following is a diagnostic method of giardiasis?
A. Stool microscopy
B. Anti-body titer
C. Blood culture

A

A. Stool microscopy

54
Q

In a 60 year old man a direct herniation was found on ultrasound. Which relation to the
herniation loop helped the radiologist arrive at the diagnosis?
A. The location of the loop medial to deep inguinal ring
B. The location of the loop posterior to the inguinal ligament
C. The location of the loop medial to the inferior epigastric artery
D. The location of the loop medial to the conjoint tendon

A

C. The location of the loop medial to the inferior epigastric artery

55
Q
Based on the data in Kuwait hospitals, which age group is the most vulnerable to Hepatitis A infection?
A. <2
B. 3-6
C. 7-12
D. 13-18
E. >18
A

C. 7-12

56
Q

A 24 year old man came for HCV and HBV screening: HCV-RNA: - HCV- Ab: - HBsAg: +
HBeAg: - HBsAb: - HBeAb: + Total Anti-core Ab: +
A. Passive immunization of HBV
B. Acute HBV infection
C. Chronic HBV with low infectivity
D. Recovery

A

C. Chronic HBV with low infectivity

57
Q

A 52 years old woman who has undergone a colonoscopy. The colonoscopist removed a
pedunculated 8 mm polyp from the ascending colon . Histopathology revealed tubular adenoma that is completely excised. What is the appropriate surveillance interval for this woman?
A. 1 years
B. 3 years
C. 5 years
D. 10 years

A

B. 3 years

58
Q

Which of the following structures makes an impression on the liver over lobes 2 and 3?
A. Diaphragm
B. Body of the stomach

A

B. Body of the stomach

59
Q

Which of the following characterises hyperplastic polyps?
A. Luminal serrations
B. Dysplasia

A

A. Luminal serrations

60
Q

Which of the following represent drug nutrient interaction in cron’s disease?

A

A. Sulfamethoxazole and iron absorption

61
Q

What is the most common cause of vitamin b12 malabsorption?

A

Intrinsic factor deficiency

62
Q

Which of the following best describes the portal acinus?
A. The direction of the bile flow is from the central vein to the portal triad structure
B. Zone 3 receives richly oxygenated blood compared to zone 1
C. The direction of the blood flow is from the central vein to the portal triad structure

A

A. The direction of the bile flow is from the central vein to the portal triad structure

63
Q
What is the mechanism by which bile salts are absorbed from the small intestine?
A. Primary active transport
B. Secondary active transport
C. Tertiary active transport
D. Facilitated diffusion
E. Simple diffusion
A

B. Secondary active transport

64
Q

What is the genetic mutation in juvenile polyposis syndrome?

A

SMAD4/BMPR1A

65
Q

What is the most common location from which gastric cancer arises?

A

A. Lesser curvature of the stomach

66
Q

A patient comes with inability to rotate his trunk towards the right (to the right hip). Which muscles are affected?

A. Left external oblique and right internal oblique
B. Right external oblique and Left internal oblique
C. Right external oblique and right internal oblique
D. Left external oblique and right transversus abdominus
E. Right transversus abdominus and right internal oblique

A

A. Left external oblique and right internal oblique

67
Q
  1. An injury to the right facial nerve during a parotid gland tumour excision can result in which of the following?
    A. Protrusion of the mandible
    B. Inability to move the jaw from side to side
    C. Squinting of the right eye
A

C. Squinting of the right eye

68
Q

Which of the following organisms can cause explosive vomiting?
A. Norovirus
B. Adenovirus
C. Rotavirus

A

A. Norovirus

69
Q
What is the type of antibody used in the diagnosis of celiac disease?
A. IGM
B. IGG
C. IGA
D. IGD
A

C. IGA

70
Q

A 10 Y/O male presented to the hospital with signs of hepatolenticular degeneration and
neurological manifestations. With further examination he was found to have brown rings in his cornea ( Kayser-fleischer ring). What is the likely diagnosis?
A. Hepatocellular carcinoma
B. Alpha 1 anti-trypsin deficiency
C. Hereditary hemochromatosis
D. Wilson’s disease

A

D. Wilson’s disease

71
Q

What governs the rate of synthesis and secretion of biles acids and salts?
A. The availability of amino acids
B. The concentration of bile acids and salts in the portal vein

A

B. The concentration of bile acids and salts in the portal vein

72
Q
Which of the following drugs is a 5ht3 receptor antagonist?
A. Ondansetron
B. Metoclopramide
C. Hyoscine
D. Cyclizine
A

A. Ondansetron

73
Q
A surgeon wanted to remove a retro pharyngeal tumour. What is the outermost layer of the pharynx the surgeon is going to incise before gaining access to the tumour?
A.Mucosa
B.Sub-mucosa
C. Buccopharyngeal fascia
D. pharyngobasilar fascia
E. Prevertebral fascia
A

C. Buccopharyngeal fascia

74
Q
Which of the following drugs can cause galactorrhea and gynecomastia?
A. Dicyclomine
B. Misoprostol
C. Cimetidine
D. Omeprazole
A

C. Cimetidine

75
Q
74. Which of the following markers is the most sensitive for GISTs?
A. Dog1
B. S100
C. Desmin
D. DCL2
A

A. Dog1

76
Q

Where is the site of mutation in Dubin-Johnson syndrome?
A. MRP2
B. OATP
C. GUT1A1

A

A. MRP2

77
Q

A 25 Y/O woman with 2 children presented to the clinic complaining of gingiva swelling in
her third pregnancy. What is the most likely lesion?
A. Pyogenic granuloma
B. Aphthous ulcer
C. Irritation fibroma
D. Ameloblastoma

A

A. Pyogenic granuloma

78
Q

A fetus was born with a congenital anomaly due to the failure of the anal membrane to
rupture. What is the fetal manifestation?
A. Recto-perineal fistula
B. Uro-rectal fistula
C. Meckel’s diverticulum
D. Imperforate anus

A

D. Imperforate anus

79
Q
Which of the following is used in the assessment of hepatic anion transport?
A. AST
B. ALT
C. Plasma albumin
D. PT
E. Plasma bilirubin
A

E. Plasma bilirubin

80
Q
Which artery is most likely affected by erosion due to anterior perforation of the
duodenum ?
A. splenic artery
B. Hepatic artery
C. Gastroduodenal artery
A

C. Gastroduodenal artery

81
Q
What is the gold standard for the diagnosis for c.difficile?
A. Latex agglutination from stool
B. Real time PCR assay
C. ELISA
D. Stool culture
A

A. Latex agglutination from stool

82
Q
Abnormal expression of which is involved in autoimmune hepatitis?
A. HLA class 2
B. HLA class 1
A

A. HLA class 2

83
Q
Decreased stomach Ph stimulates the secretion of which of the following?
A. Gastrin
B. Secretin
C. Somatostatin
D. Histamine
A

C. Somatostatin

84
Q
Fracture of the sacrum affects which of the following nerves?
A. Greater thoracic
B. Lesser thoracic
C. Least thoracic
D. Pelvic splanchic
A

D. Pelvic splanchic

85
Q
What is used for the treatment of HDV?
A. Adefovir
B. INF
C. Tenofovir
D. Lamivudine
A

B. INF

86
Q
What serological test is used for the diagnosis of hepatocellular carcinoma?
A. Alpha fetoprotein
B. D-dimmer
C. AST
D. TGT
A

A. Alpha fetoprotein

87
Q
What structure is affected by the spread of nasopharyngeal carcinoma to the sinus of
Morgagni?
A. Auditory tube
B. Internal laryngeal nerve
C. Glossopharyngeal nerve
D. Stylopharyngeus
A

A. Auditory tube

88
Q

Match cause of malnutrition with consequence
A. severe starvation-> wasting
B. anorexia -> stunting
C. bulimia->malabsorption

A

A. severe starvation-> wasting

89
Q
What stain is used to confirm diagnosis of Barretts esophagus?
A. PAS
B. Alcin blue
C. Acid Shiff stain
D. Silver stain
A

B. Alcin blue

90
Q

What makes the colon susceptible to diverticulum?

A

A. Perpendicular perforation of the colonic wall by its arteries

91
Q

What is the best major to control the enteric fever?

A

A. Good hygiene

92
Q

What is used as a treatment for chronic carriers of salmonella typhi and paratyphi

A

A. Gall bladder removal

93
Q

What is the difference between the primary salivary secretion and oral saliva?
A. The primary secretion is hypotonic and saliva is hypertonic
B. The primary secretion contains more Na+
C. Saliva has less HCO3
D. Both have the same composition of electrolytes

A

B. The primary secretion contains more Na+

94
Q

Which of the following differentiates the pancreas from the parotid gland histologically?

A

Centroacinar cells are found in the pancreas but there is no striated ducts