2008 module exam Flashcards
where does fluid collection occur in a female in the (supine position?)
a. rectouterine pouch
b. vesicouterine pouch
a. rectouterine pouch
branch of splenic
a. short gastric
b. gastroepiploic
a. short gastric
Superficial epigastric artery is branch of which artery?
branch of femoral artery
when liver develops it projects into:
ventral mesogastrium
if an (instrument?) is passed through the pharynx, upper esophageal sphincter, body, and lower esophageal sphincter, what would be the readings?
0→50→0→30
what would occur if external rectal sphincter relaxes:
a. contraction of rectum
b. rectocolonic reflex
c. further relaxation of internal anal sphincter
?
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
(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!”)
in which part of GI does reverse peristalisis occur?
colon
Inferior mesenteric artery occlusion is often asymptomatic b.coz it can be supplied by branches of:
a. middle colic
b. right colic
a.middle colic
what supplies ascending colon?
Right colic artery
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%
d.55%
1 gram of carbohydrates gives us 4 Kcal\ 1 g of fats = 9 Kcal\ 1 g of protein = 4 Kcal
6 yr old girl with diarrhea and failure to thrive:
Giardia lamblia
what attaches the bladder to the umbilicus?
median umbilical Ligament
what …….left umbilical vein?
Round ligament
what ( covers??) the remnants of umbilical vessels?
medial umbilical ligament
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?
pancreatic cancer
25 year-old man had a test for employment that showed high levels of AST ALP (in the range of 100s):
Chronic hepatitis
a smoker with a tumour in the salivary gland that showed papillary projections into a cyst with oncocytes Warthin’s
-
a tumour that shows perinueral invasion:
Adenoid cyst carcinoma
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:
Gluten-free diet
Cytoprotective drug used in combination therapy for H.pylori
a. Bismuth
b. sucralfate
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)
drug that leads to black tongue and stool:
bismuth
severe chronic liver( disease\failure?) with fetor hepaticus, flapping tremors and then lapsed into coma. What would increase in blood test:
ammonia
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?
MMC
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?
Prevent bias in ….
what is the purpose of the blinding in RCT?
Prevent bias in ascertaining outcome
the purpose of “intention to treat”:
keep randomization intact
last lymph node to filter stomach before reaching cysterna chyli:
Celiac lymph nodes
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
a.returning of families
a patient returned from Egypt, he has RUQ pain and fever. Negative for HBV & HCV. Stool showed calcilike virus
Hep. E
multiple ulcers in stomach and duodenum:
a. lymphoma
b. sarcoma
c. adeno…
d. neuroendocrine tumor
D. neuroendocrine tumor (we think- remember gastrinoma and ZE syndrome)
Pregnant lady with positive HBs, what would happen to the baby?
a. acute hepatitis
b. hepatic failure
c. fulminant hepatitis
d. chronic hepatitis
d. chronic hepatitis
* *we think-(90% of children will develop a chronic infection)**
. liver cyst what used for diagnosis:
a. Serology for specific (antigens ??)
b. serology for antibody
b. serology for antibody
the least reliable test for eradication of H pylori:
Serology for Ab
.what is considered as a complication for portal hypertension:
a. ascites
b. shrunken liver
a. ascites
which one is a brush border enzyme:
Lactase
which one activates the pancreatic enzymes?
a. trypsin
b. carboxypeptidase
c. chemotrypsin
a. trypsin
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?
lactase deficiency
Someone whose weight is below normal, and she thinks she is obese and she has amenorrhea?
Anorexia
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
a) Crohn’s disease
Emedicine: crohn‘s can present as a mass due to extensive fibrosis
what is the origin of the internal ring?
a. external oblique
b. internal oblique
c. transversalis fascia
c. transversalis fascia
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
a. fibrosis and inflammation
I think this one since there is no clue suggesting malignancy
a 46 year-old female with history of recurrent RUQ pain and jaundice. 2 days ago, she developed fever, rigors
Cholecystitis
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?
( the answer included achalasia manometry: lower esophageal sphincter pressure is high and the esophagus pressure is low)
what carries preganglionic parasympathetic to hind gut:
s2-s4
what carries preganglionic parasympathetic to hind gut:
pelvic splanchnic
function of cells that have smooth endoplasmic reticulum:
absorption of fatty acids
.the presence of which structure necessitate active transport of electrolytes:
a. tight junction
b. gap junction
a. tight junction
what is the characteristic feature of sublingual:
a. musinouc acinus
b. serous acinus
a.musinouc acinus
mutation in which gene causes conversion of adenoma to cancer?
P53
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
a. mucosal ulceration and intervening regeneration
* *it’s the same as pseudopolyp**
what’s attached to the stomach by the greater omentum:
Transverse colon
what lies behind the omental foramen?
Hepatoduodenal ligament
Which strucuture is secondary retropertoneal :
a. pancreas
b. spleen
c. suprarenal gland
d. rectum
e. UB
a. pancreas
what is peroxynitrite:
oxidant
Antioxidant with multiple cysteine:
a. metallothionein
b. glutathione reductase
a. metallothionein
what is used for synthesis of ketone bodies after 4 weeks of starvation?
a. trigelycerides
b. proteins
a. trigelycerides
Feature of esophagus:
stratified squamous epithelium non-keratinized
function of M cells:
expoure of ( transporting??) Ag to lymphocytes
which cell secretes lysozymes?
Panth cells
Paracrine hormone produced from ECM :
histamine
Infective dose of shigella:
a. 10-100
b. 100-1000
a. 10-100
what is produced from the duodenum in response to low PH?
a. secretin
b. cholecystkinin
c. somatostatin
a.secretin
A pateint returned from India; after 10 days he presented with fever of unknown origin and ….??
Enteric fever
in the intestinal phase of pancreatic secretion, the ducts secrete large amounts of fluid, but the secretion to intestine contains enzymes.why?
The fluid pushes the enzymes that are already there
what is the feature in an empty stomach:
rugae
what should be done to a worker with Salmonella?
3 constitutive negative stool tests
Axis for rotation of gut in the embryo:
a. superior mesenteric artery
b. inferior mesenteric artery
c. abdominal aorta
d. inferior rectal artery
a.superior mesenteric artery
which vein have reverse blood flow in a case of esophageal varices in a patient with portal hypertention?
Left gastric veins
major oxidant in liver :
cytochrome P450
which one is an antioxidant for…Produced in mitochondria?
a. superoxide dismutase
b. xanthine oxidase
c. heme oxygenase
d. NADPH oxidase
a. superoxide dismutase
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
?
infection of anal sinus:
cryptitis
.if a patient is taking cimitidine and diazepam, what should be done:
reduce the dose of diazepam
why vegetarians are advised to take (complementary vegetables together?)
a. prevent catabolism of amino acids
b. help in digestion of proteins
a.prevent catabolism of amino acids
Which organism is a probiotic:
lactibasillus
how to diagnose C.difficile:
Detect toxins (Ag?) in stools
the difference between primary secrtion and oral saliva:
a. hypertonic
b. high K
b. high K
vit K activate prothrombin by which mechanism?
Carboxylation
oral vaccine:
Cholera 01
type of toxin in enterohemorrhagic E.coli
Verotoxin 1&2
what nerve plexus is in sub mucosa?
Missiner
what prevents bile from leaking:
tight junctions
complication of hydatid cyst:
a. anaphylactic shock
b. chronic hepatitis
c. chronic jaundice
a. anaphylactic shock
disease that affects women more than men characterized by chronic destruction of bile duct within portal tract:
primary biliary cirrhisosis
What is prodrug:
converted to active metabolite
what causes traveller’s diarrhea ?
Enterotoxogenic E.coli
RNA virus that causes glomeriolonephritis
Hepatitis C
DNA virus that causes liver cancer
Hep. B
a physician who was completely vaccinated, and he was found to have high ALT and AST levels. What diagnostic test you would use?
Viral RNA
what does the intercalated duct secrete ?
a. Na and Hco3
b. Cl and K
a.Na and Hco3
autoimmune disease against exocrine glands:
Sjogren’s
.which structure has the lowest intensity of haustration?
Lower rectum
intensity of…..increased in proximal colon and……….??? ( we don’t remember the Q! sorry)
favors increase transit time
bilirubin is moved from the hepatocytes to the canaliculi by which mechanism:
a) Primary Active transport
b) exchange with H
c) exchange wih Na
a) Primary Active transport
what would increase in case of active parietal cell:
a. intrinsic factor
b. gastrin
a.intrinsic factor
clinical Q!!!!!
a. 24 hr esophageal PH
b. upper endoscopy
b. upper endoscopy
duct of pancreas develops from:
endoderm
patient with biliayr colic. The pain is radiating to back and shoulder. What is the anatomical basis of this?
innervation by T6- T9
immunopathogenesis of celiac
Th1 response (to\ against :P) gluten
immunological basis of pernicious anemia
Ab to IF
a patient with history of biliary stone presented with acute severe epigastria pain. Amylase very high
acute pancreatitis
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
a) NASH
I think this was the best one of the other choices- although it means there is hapatits but not increased WBC’s!
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**
rota virus
the microorganism associated with antibiotic associated diarrhea
C. difficile
the most important risk factor for colonic cancer in 40 year old person
family history
