Gg

Question 1

A patient presented with HBsAg (-ve), Hb core IgM (-), and HBsAB (+ve)

Answer 1

Recently vaccinated

Question 2

A lady and her husband recently came back from travel and they developed signs of
liver disease, during their trip they had consumed oysters

Answer 2

HAV

Question 3

A lady presented with ALT and AST increased (over 1000). Her husband recently
came back from India 3 weeks ago. Which would be useful for diagnosis?

Answer 3

HAV IGM

Question 4

Mirco question about celiac disease

Answer 4

TH1 cells stimulated by gluten to release cytokines (something like that)

Question 5

A 19 years old male who underwent a colonoscopy and was found to have multiple
polyps in his colon. He also has a family history of colon disease. Which mutation
does he have?

Answer 5

APC

Question 6

Lactase deficiency, what is expected?

Answer 6

No glucose change, high H2

Question 7

A young girl with malnutrition (several things are low) and positive tissue
transglutaminase ab (IgA). What is the best next step to confirm the diagnosis?

Answer 7

small bowel biopsy

Question 8

How is unconjugated bile taken up into hepatocytes?

Answer 8

Bound to albumin and binds to ligandin

Question 9

Role of bacteria in bile salts processing?

Answer 9

Converts bile salts to bile acid

Question 10

Micelles are essential in absorption of what?

Answer 10

Vit d

Question 11

A lady who is 162 cm, 62 Kg, has an increased total bilirubin, decreased direct bilirubin and yet she was healthy with no symptoms. What could she have?

Answer 11

Gilbert syndrome

Question 12

. A lady applying to a job was found to have an abnormal parameter in her blood tests

Answer 12

(chronic case of hepatitis)

Question 13

A patient with chronic pancreatitis, complained of a large amount of fatty foul smelling
stool. what is the cause of her symptoms?

Answer 13

low lipase

Question 14

What separates the lesser sac from the left paracolic gutter?

Answer 14

Gastrosplenic ligament

Question 15

Fluid around the right kidney, where does it go while standing? (not sure if it is renal
or gi)

Answer 15

Right Iliac fossa

Question 16

Which disease is an example of autoimmune pancreatitis type 1 ?

Answer 16

IgG4-related disease

Question 17

What occurs in prolonged starvation?

Answer 17

decrease gluconeogenesis

Question 18

Colon cancer in the proximal colon that can be treated by immunotherapy. What
describes the cms?

Answer 18

MSI & BRAF

Question 19

Patient with NASH who was doing well and presented a bit of fatigue. on cbc, he had
high bilirubin, prolonged INR, low albumin, low platelets, low hb. What indicates that
there is an increase in pressure in the portal vein?

Answer 19

Low platelet

Question 20

What is the difference between a descending colon and ileum under a microscope?

Answer 20

No Lymphatics in lamina propria in colon, …

Question 21

Which drug causes black tongue?

Answer 21

Bismuth

Question 22

What drug is best to use for a patient’s calcium stones?

Answer 22

Hydrochlorothiazide

Question 23

Metoclopramide MOA

Answer 23

dopamine D2 antagonist but also acts as an agonist on serotonin 5-HT4 receptors and causes weak inhibition of 5-HT3 receptors.

Question 24

really long case… past african with rectal bleeding. What is best used to diagnose
colon cancer? (african american presenting with bleeding, he thinks that its
hemorrhoids because he does weight lifting, what would you do to screen him for
colon cancer)

Answer 24

colonoscopy

Question 25

which is not essential for protein digestion, meaning that protein digestion won’t be affected after gastrectomy?

Answer 25

pepsin

Question 26

GI biochem: What type of error/mutation happens in microsatellite instability ?

Answer 26

Replication

Question 27

Mass in liver with central scar, with bile duct proliferation, with vessels between septa (not sure how it was written) multiple gallstones & thickened gallbladder membrane. a mass in the liver was noted to be well circumfered and there was a central scar.

Answer 27

focal nodular hyperplasia

Question 28

A mass is salivary gland has Polyhedral cells with granular eosinophilic cytoplasm and mitochondria hyperplasia (not the exact wording but it was something like that)

Answer 28

Oncocytoma

Question 29

Dome shaped swelling in the floor of the mouth lateral from the midline causing an Obstruction to the salivary gland

Answer 29

ranula

Question 30

What is the most common cause of peptic ulcer disease?

Answer 30

NSAIDS

Question 31

What form of b12 is oral and why?

Answer 31

Cyanocobalamin, stable

Question 32

Pt with night sweats, fever, weight loss, he didn’t travel recently, he presented with abdominal pain and there was round ulcer in the ileum over hyperplastic peyer patches. he presented with abdominal pain & diarrhea. There was a perforation found.

Answer 32

Typhoid ileitis

Question 33

Radiology shows a mass in the quadrate lobe of liver, during excision of the mass, what vessel should be clamped to avoid bleeding?

Answer 33

Left hepatic artery

Question 34

. A woman reports fecal incontinence. Examination shows weakening of the external anal sphincter. What nerve innervates the external anal sphincter?

Answer 34

Pudendal

Question 35

A colonoscopy was done to a female who had an 8mm pedunculated polyp in the ascending colon. The polyp was excised, it was adenomatous and showed tubular structure. When should be the next surveillance colonoscopy?

Answer 35

5 years

Question 36

How to prevent food going into the larynx during swallowing in the pharyngeal phase?

Answer 36

constrict laryngeal opening

Question 37

a case of mild fatigue and fecal oral transmission w/ AST ( and I think abdominal discomfort)

Answer 37

HEV

Question 38

A 39-year-old man with raised liver enzymes. Biopsy showed ground glass cytoplasm, active inflammation, and damaged hepatocytes. What is the diagnosis?

Answer 38

HBV

Question 39

A patient with appendicitis, where would his pain be located?

Answer 39

T10

Question 40

After a radiograph revealed a sialolith (stone) in a patient's right submandibular duct, the surgeon exposed the duct via an intraoral approach. In this approach, what tissues or structures must be cut through?

Answer 40

Mucous membrane only

Question 41

During tonsillectomy procedure, which nerve is likely to be injured?

Answer 41

Glossopharyngeal

Question 42

A case of liver cirrhosis. Which indicates decompensation?

Answer 42

Low ferritin

Question 43

Which artery crosses the ischioanal fossa?

Answer 43

Inferior rectal artery

Question 44

Repeated middle ear infections have destroyed the tympanic plexus in the middle ear cavity. The loss of preganglionic parasympathetic fibers that pass through the plexus diminish production of:

Answer 44

Saliva by the parotid gland

Question 45

patient with long term retrosternal pain presented with weight loss (they specified how much) over the last 3 months and difficulty swallowing solids

Answer 45

adenocarcinoma of esophagus

Question 46

Receptive relaxation of the stomach after vagotomy? (not sure if im mixing two questions up)

Answer 46

VIP

Question 47

From which roots does the greater splanchnic arise

Answer 47

T5 - T9

Question 48

Which of the following is a function of a parasympathetic muscarinic receptor?

Answer 48

relax GI sphincter

Question 49

single unit vs multi unit

Answer 49

Single unit is connected by gap junctions

Question 50

what characterizes slow waves

Answer 50

generated by enteric nervous system

Question 51

Why does hepatitis A cases in Kuwait increase in September to october?

Answer 51

Return of expats from vacation