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GI module - 4th year > 2008 module exam > Flashcards

2008 module exam Flashcards

1
Q

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

a. rectouterine pouch
b. vesicouterine pouch

A

a. rectouterine pouch

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2
Q

branch of splenic

a. short gastric
b. gastroepiploic

A

a. short gastric

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3
Q

Superficial epigastric artery is branch of which artery?

A

branch of femoral artery

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4
Q

when liver develops it projects into:

A

ventral mesogastrium

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5
Q

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

A

0→50→0→30

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6
Q

what would occur if external rectal sphincter relaxes:

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

A

?

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7
Q

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

A

(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!”)

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8
Q

in which part of GI does reverse peristalisis occur?

A

colon

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9
Q

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

a. middle colic
b. right colic

A

a.middle colic

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10
Q

what supplies ascending colon?

A

Right colic artery

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11
Q

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%

A

d.55%

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

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12
Q

6 yr old girl with diarrhea and failure to thrive:

A

Giardia lamblia

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13
Q

what attaches the bladder to the umbilicus?

A

median umbilical Ligament

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14
Q

what …….left umbilical vein?

A

Round ligament

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15
Q

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

A

medial umbilical ligament

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16
Q

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?

A

pancreatic cancer

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17
Q

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

A

Chronic hepatitis

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18
Q

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

A

-

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19
Q

a tumour that shows perinueral invasion:

A

Adenoid cyst carcinoma

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20
Q

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:

A

Gluten-free diet

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21
Q

Cytoprotective drug used in combination therapy for H.pylori

a. Bismuth
b. sucralfate

A

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)

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22
Q

drug that leads to black tongue and stool:

A

bismuth

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23
Q

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

A

ammonia

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24
Q

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?

A

MMC

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25
Q

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?

A

Prevent bias in ….

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26
Q

what is the purpose of the blinding in RCT?

A

Prevent bias in ascertaining outcome

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27
Q

the purpose of “intention to treat”:

A

keep randomization intact

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28
Q

last lymph node to filter stomach before reaching cysterna chyli:

A

Celiac lymph nodes

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29
Q

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

a.returning of families

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30
Q

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

A

Hep. E

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31
Q

multiple ulcers in stomach and duodenum:

a. lymphoma
b. sarcoma
c. adeno…
d. neuroendocrine tumor

A

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

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32
Q

Pregnant lady with positive HBs, what would happen to the baby?

a. acute hepatitis
b. hepatic failure
c. fulminant hepatitis
d. chronic hepatitis

A

d. chronic hepatitis

* *we think-(90% of children will develop a chronic infection)**

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33
Q

. liver cyst what used for diagnosis:

a. Serology for specific (antigens ??)
b. serology for antibody

A

b. serology for antibody

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34
Q

the least reliable test for eradication of H pylori:

A

Serology for Ab

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35
Q

.what is considered as a complication for portal hypertension:

a. ascites
b. shrunken liver

A

a. ascites

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36
Q

which one is a brush border enzyme:

A

Lactase

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37
Q

which one activates the pancreatic enzymes?

a. trypsin
b. carboxypeptidase
c. chemotrypsin

A

a. trypsin

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38
Q

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?

A

lactase deficiency

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39
Q

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

A

Anorexia

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40
Q

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

a) Crohn’s disease

Emedicine: crohn‘s can present as a mass due to extensive fibrosis

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41
Q

what is the origin of the internal ring?

a. external oblique
b. internal oblique
c. transversalis fascia

A

c. transversalis fascia

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42
Q

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

a. fibrosis and inflammation

I think this one since there is no clue suggesting malignancy

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43
Q

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

A

Cholecystitis

44
Q

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?

A

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

45
Q

what carries preganglionic parasympathetic to hind gut:

A

s2-s4

46
Q

what carries preganglionic parasympathetic to hind gut:

A

pelvic splanchnic

47
Q

function of cells that have smooth endoplasmic reticulum:

A

absorption of fatty acids

48
Q

.the presence of which structure necessitate active transport of electrolytes:

a. tight junction
b. gap junction

A

a. tight junction

49
Q

what is the characteristic feature of sublingual:

a. musinouc acinus
b. serous acinus

A

a.musinouc acinus

50
Q

mutation in which gene causes conversion of adenoma to cancer?

A

P53

51
Q

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

a. mucosal ulceration and intervening regeneration

* *it’s the same as pseudopolyp**

52
Q

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

A

Transverse colon

53
Q

what lies behind the omental foramen?

A

Hepatoduodenal ligament

54
Q

Which strucuture is secondary retropertoneal :

a. pancreas
b. spleen
c. suprarenal gland
d. rectum
e. UB

A

a. pancreas

55
Q

what is peroxynitrite:

A

oxidant

56
Q

Antioxidant with multiple cysteine:

a. metallothionein
b. glutathione reductase

A

a. metallothionein

57
Q

what is used for synthesis of ketone bodies after 4 weeks of starvation?

a. trigelycerides
b. proteins

A

a. trigelycerides

58
Q

Feature of esophagus:

A

stratified squamous epithelium non-keratinized

59
Q

function of M cells:

A

expoure of ( transporting??) Ag to lymphocytes

60
Q

which cell secretes lysozymes?

A

Panth cells

61
Q

Paracrine hormone produced from ECM :

A

histamine

62
Q

Infective dose of shigella:

a. 10-100
b. 100-1000

A

a. 10-100

63
Q

what is produced from the duodenum in response to low PH?

a. secretin
b. cholecystkinin
c. somatostatin

A

a.secretin

64
Q

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

A

Enteric fever

65
Q

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

A

The fluid pushes the enzymes that are already there

66
Q

what is the feature in an empty stomach:

A

rugae

67
Q

what should be done to a worker with Salmonella?

A

3 constitutive negative stool tests

68
Q

Axis for rotation of gut in the embryo:

a. superior mesenteric artery
b. inferior mesenteric artery
c. abdominal aorta
d. inferior rectal artery

A

a.superior mesenteric artery

69
Q

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

A

Left gastric veins

70
Q

major oxidant in liver :

A

cytochrome P450

71
Q

which one is an antioxidant for…Produced in mitochondria?

a. superoxide dismutase
b. xanthine oxidase
c. heme oxygenase
d. NADPH oxidase

A

a. superoxide dismutase

72
Q

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

A

?

73
Q

infection of anal sinus:

A

cryptitis

74
Q

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

A

reduce the dose of diazepam

75
Q

why vegetarians are advised to take (complementary vegetables together?)

a. prevent catabolism of amino acids
b. help in digestion of proteins

A

a.prevent catabolism of amino acids

76
Q

Which organism is a probiotic:

A

lactibasillus

77
Q

how to diagnose C.difficile:

A

Detect toxins (Ag?) in stools

78
Q

the difference between primary secrtion and oral saliva:

a. hypertonic
b. high K

A

b. high K

79
Q

vit K activate prothrombin by which mechanism?

A

Carboxylation

80
Q

oral vaccine:

A

Cholera 01

81
Q

type of toxin in enterohemorrhagic E.coli

A

Verotoxin 1&2

82
Q

what nerve plexus is in sub mucosa?

A

Missiner

83
Q

what prevents bile from leaking:

A

tight junctions

84
Q

complication of hydatid cyst:

a. anaphylactic shock
b. chronic hepatitis
c. chronic jaundice

A

a. anaphylactic shock

85
Q

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

A

primary biliary cirrhisosis

86
Q

What is prodrug:

A

converted to active metabolite

87
Q

what causes traveller’s diarrhea ?

A

Enterotoxogenic E.coli

88
Q

RNA virus that causes glomeriolonephritis

A

Hepatitis C

89
Q

DNA virus that causes liver cancer

A

Hep. B

90
Q

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

A

Viral RNA

91
Q

what does the intercalated duct secrete ?

a. Na and Hco3
b. Cl and K

A

a.Na and Hco3

92
Q

autoimmune disease against exocrine glands:

A

Sjogren’s

93
Q

.which structure has the lowest intensity of haustration?

A

Lower rectum

94
Q

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

A

favors increase transit time

95
Q

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

a) Primary Active transport

96
Q

what would increase in case of active parietal cell:

a. intrinsic factor
b. gastrin

A

a.intrinsic factor

97
Q

clinical Q!!!!!

a. 24 hr esophageal PH
b. upper endoscopy

A

b. upper endoscopy

98
Q

duct of pancreas develops from:

A

endoderm

99
Q

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

A

innervation by T6- T9

100
Q

immunopathogenesis of celiac

A

Th1 response (to\ against :P) gluten

101
Q

immunological basis of pernicious anemia

A

Ab to IF

102
Q

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

A

acute pancreatitis

103
Q

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

a) NASH

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

104
Q

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**

A

rota virus

105
Q

the microorganism associated with antibiotic associated diarrhea

A

C. difficile

106
Q

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

A

family history

GI module - 4th year (17 decks)

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