2009 module exam Flashcards
Fundus of gallbladder is seen in which plane?
Transpyloric
Where is urachus seen?
Median umbilical fold
What is responsible for formation of superficial inguinal ring?
External oblique
Preganglionic secretomotor comes from which nerve for parotid gland?
Glossopharyngeal
Postganglionic fibers for submandibular gland is carried out by ?
Lingual nerve
Characteristic of sublingual gland ?
Mucus acinus
White patch cannot be scrapped off and show displasia ?
leukoplakia
Oral lesion with lip swelling and cobalstone appearance ?
Crohns Disease
Keratoconjunktivitis and xerostomia due to exocrine destruction by lymphocytes?
Sjogren syndrome
Which artery diiferntiate between direct and indirect hernia ?
Inferior epigastric artery
Question about hernia –> go to the scrotum and there were right groin swelling with difficulty urinating
Indirect
Which least affect the esophagus ?
left ventricle
What is posterior to omental foramen ?
IVC
Which ganglia responsible for innervation of gut and goes to celiac trunk ?
T5-T9
If you coniously swallow every 1-2 seconds in water , what will happen ?
esophagus will not contract untill the last swallow
Which neorotransmitter is most responsible for relaxation of lower esophgeal sphincter ?
NO
What is responsible for receptive relaxation in stomach ?
VIP
What is responsible for relaxation of pyloric sphincter ?
VIP
What is related to low PH in deudenum to inhibit gastric emptying ?
Secretin
Which enzyme deactivated in high PH ?
Pepsin
Picture of esophagus in obese female and fine mucosal nodularity ?
Reflux esophgitis
What ligamint attaches liver to diaphragm ?
coronary lig.
if we want to follow segment VI of liver , which vein will we follow ?
Rt hepatic vein
Which is characteristic of portal lobule ?
Bile flows from central vein to portal triad
What is responsible for contraction of gallbladder?
CCK
What is characteristic of HepD ?
Defective RNA virus
Which virus has co-infection with HBV ?
HDV
Pregnant woman went to Bangladsih and developed fever & juandice of 40 days duration and then developed fulminant Heptitis ?
Hep E virus
Young female developed fulminant hepatic necrosis. Glascow score 3/5. Most common cause is ?
Aceteminophen overdose
Patient with drug use and ground glass hepatocytes ?
HBV
Obese female with high glucose levels and high (AST & ALT) , most likly due to ?
NASH
Middle aged woman with portal infiltration of lymphocytes and plasma cells and responds to steroids ?
Autoimmune Hepatitis
Which is conginital liver problem ?
Wilsons disease
Which disease causes iron deposition and accumelation ?
Hemachromatosis
Macro & micro nodules with fibrosis lining them ?
Cirrhosis
Most common primary hepatic tumor with vascular repture ?
Hemangioma
Patient wth 10 years history of HBV deve;oped 10 cm mass
Hepatocellular carcinoma
Which gives us hydroxyl radical ?
H2O2 + Fe+2
Which of the following is oxidant ?
Fe-4S
Which is secondary retroperitoneal ?
Duedenum
What happens due to failure of reteurn of the physiological herniation of the midgut loop ?
Omphalocele
Persistant cloacal membrane ?
Imperforate anus
Patient with mucus/bloody diarhhea, abcesses in liver , and recently he was in india with flask shaoed ulcer ?
Entameba histolitica
Patient with parasite abscess. how to diagnose him ?
- Culture for abscess
- Serology Ag
- Serology Ab
- Microscopy for abscess
?
Patient with AST and ALT levels of 1300 . He was in syria for a month. What would be seen in the investigation ?
HAV _ IgM
Patient travelled to area endimic eith HAV and came back with elevated liver enzymes and juandice. No HAV/HBV were seen. What would be the cause?
HEV
DNA virus causes hepatocellular carcininoma ?
HBV
What gives high Guanylase cyclase ?
Heme oxygenase –> CO –> high cGMP
What causes premature juandice in babies ?
Decrease activity of bilirubin glucurcyl trasferase
Which disease diagnosed by procollagen type 2 ?
Hepatic fibrosis
disease diagnosed by monitoring bilirubin levels while fasting ?
Gilbert Syndrome
In which organ retropulsion occur ?
Stomach
Which has discontinous epithelium ?
Hepatic sinosoids
Problem in hepatoduedenal lig. would likely affect ?
Bile duct
Contraction of what will cause filling of gallbladder ?
common bile duct
Feature amylase in pancreas ?
Contraacinar cells
Zymogen granules in apices ?
Acinar cells
Intercelated duct cells are responsible for ?
HCO3- secretion
Which enzyme activates other enzymes ?
Trypsim
Bile acids are secreted from ?
Hepatocellular paranchymal cells
Substrate in 7 alpha hydroxylase ?
Cholestrol
Defiency of which will lead to gallstones ?
Biles acids/salts
A 28 patient with normal liver test but AST + ALT were 110 . What is he suffering from ?
Chronic viral hepatitis
A 78 old man with high ALK of 550 but other enzymes are normal, he had large dilated bile duct and distended gallbladder. US showed no stones in gallbladder
- Pancreatic cancer
- common bile duct stones
?
A 35 female with multiple gallstones and distended bile duct. What is most likely elevated enzyme ?
Alkalaine phosphotase
Patient came with foul smell diarrhea and abdominal pain. X-ray shown. What is the best management
Pancreatic enzymes
Alpha carboxylation bu vit K leads to ?
Increase negative charges
After not eating for couple of hours, a burst intense electrical activity occured in GI every 90 minutes ?
Migrating Myeelectric Complex
Absorpyion of di-tri peptides in small intestine is by ?
Teriory active transport
Absorption of water in GIT mainly occur in ?
Small intestine
Function of M cells ?
Antigen transport
Hypofunction of parietal cells leads to decreased ?
Interensic Factor
Patient with high t TG. What is best method to treat ?
Gluten free diet
Diarrhea due to wheel like structure ?
Rota virus
2nd most common cause of Viral gastrointeritis and have extending fibers?
Adenovirus
What is the infective dose of S.typhi
1000000
Bacteria that produce enterotoxin ?
Vibro cholera
Starved people are advised not to ingest high diet protein due to ?
low activity of urea cycle
Patient with RLQ pain and mass and clubbing with diarrhea. X ray picture ?
Crohns disease
Xray of patient
UC and toxic megacolon
how fibers affect IBD ?
increase butyrate
PICO question for study on 11 year old boy who want to know drug effect on him (EBM) ?
Children - drug - improvement - no treat
What causes black tongue and stool?
bismith chelate
How do antiacids affect sacalfate efficacy ?
altering PH in stomach
What induces abortion ?
Misoprestol
What is mechanism of action of omeparazol?
inhibits H/K ATPase
If diazpam and cimitedin given together , what must be done ?
reduce diazpam dose
What is H1 anatagonist ?
Cycizine
What is 5-HT3 receptor antagonist ?
Ondansteron
what is the mechanism of action of ……. ?
increase peristalsis by stimulating enteric nerves
fast and slow acetators affect which drug ?
Isonazide
Acetominophen causes hepatocellular necrosis by ? -
depletion of glutathione
Occlosion of IMA is asymptomatic due to ?
Middle colic artery
What should be done with a worker with salmonella ?
3 constitutive negative stool tests
which structure have lower intensity of contraction ?
lower rectum
Most important risk factor for colon cancer in less than 40 old people ?
Family history
What will cause inhibition of acid secretion ?
Low PH in antrum
Appenicitis pain is through which root ?
T10
Uptake of xenobiotics to liver is done by ?
Organic anion transporting polypeptides (OATP)
FEcal occult blood positive. What is the next investigation ?
colonscopy
45 old woman with RUQ pain , juandice and fever and slight tenderness in UQ , high ALT and AST , high high ALP and bilirubin
Gallstones
female came with history of gallstones and acute onset of fever , RUQ pain , juandice , serum amylase was 1500
Acute pancreatitis
Which polyps will most likely cause malignancy ?
Villous adenoma
loss of which muscle will cause fetal incontinance ?
puborectalis
prolapse of rectal mucosa with dilated veins ?
Internal hemaroids
part of anal canal which below pictunate line is developed from ?
ectoderm
contraction in ascending colon is lower the descending colon , while contraction of sigmoid is less than descending colon , why ?
increase transiet time between ascending and descending colon
patient with colon cancer but without family history . what gene affected ?
P53
How do we diagnose C.difficile ?
Tissue culture of toxin
What disease causes increased unconjugated bilirubin ?
sickle cell anemia
Patient came with abdominal pain and constipation . Xray showed apple core apperance ?
colon cancer
which is closest to zone 3 ?
central vein
Supply submucosal glands of esophagus ?
misseners plexus
its inhibition causes contraction of external anal sphincter ?
Auerbach
What causes conjucation of bile acid ?
Glycine
patient with signs of anemia. whan given Vit b12 he becomes better ?
Vit B12 deficincy
child with enteric fever . how to treat him
Ceftrixone