2009 module exam Flashcards

1
Q

Fundus of gallbladder is seen in which plane?

A

Transpyloric

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2
Q

Where is urachus seen?

A

Median umbilical fold

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3
Q

What is responsible for formation of superficial inguinal ring?

A

External oblique

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4
Q

Preganglionic secretomotor comes from which nerve for parotid gland?

A

Glossopharyngeal

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5
Q

Postganglionic fibers for submandibular gland is carried out by ?

A

Lingual nerve

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6
Q

Characteristic of sublingual gland ?

A

Mucus acinus

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7
Q

White patch cannot be scrapped off and show displasia ?

A

leukoplakia

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8
Q

Oral lesion with lip swelling and cobalstone appearance ?

A

Crohns Disease

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9
Q

Keratoconjunktivitis and xerostomia due to exocrine destruction by lymphocytes?

A

Sjogren syndrome

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10
Q

Which artery diiferntiate between direct and indirect hernia ?

A

Inferior epigastric artery

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11
Q

Question about hernia –> go to the scrotum and there were right groin swelling with difficulty urinating

A

Indirect

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12
Q

Which least affect the esophagus ?

A

left ventricle

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13
Q

What is posterior to omental foramen ?

A

IVC

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14
Q

Which ganglia responsible for innervation of gut and goes to celiac trunk ?

A

T5-T9

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15
Q

If you coniously swallow every 1-2 seconds in water , what will happen ?

A

esophagus will not contract untill the last swallow

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16
Q

Which neorotransmitter is most responsible for relaxation of lower esophgeal sphincter ?

A

NO

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17
Q

What is responsible for receptive relaxation in stomach ?

A

VIP

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18
Q

What is responsible for relaxation of pyloric sphincter ?

A

VIP

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19
Q

What is related to low PH in deudenum to inhibit gastric emptying ?

A

Secretin

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20
Q

Which enzyme deactivated in high PH ?

A

Pepsin

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21
Q

Picture of esophagus in obese female and fine mucosal nodularity ?

A

Reflux esophgitis

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22
Q

What ligamint attaches liver to diaphragm ?

A

coronary lig.

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23
Q

if we want to follow segment VI of liver , which vein will we follow ?

A

Rt hepatic vein

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24
Q

Which is characteristic of portal lobule ?

A

Bile flows from central vein to portal triad

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25
Q

What is responsible for contraction of gallbladder?

A

CCK

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26
Q

What is characteristic of HepD ?

A

Defective RNA virus

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27
Q

Which virus has co-infection with HBV ?

A

HDV

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28
Q

Pregnant woman went to Bangladsih and developed fever & juandice of 40 days duration and then developed fulminant Heptitis ?

A

Hep E virus

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29
Q

Young female developed fulminant hepatic necrosis. Glascow score 3/5. Most common cause is ?

A

Aceteminophen overdose

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30
Q

Patient with drug use and ground glass hepatocytes ?

A

HBV

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31
Q

Obese female with high glucose levels and high (AST & ALT) , most likly due to ?

A

NASH

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32
Q

Middle aged woman with portal infiltration of lymphocytes and plasma cells and responds to steroids ?

A

Autoimmune Hepatitis

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33
Q

Which is conginital liver problem ?

A

Wilsons disease

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34
Q

Which disease causes iron deposition and accumelation ?

A

Hemachromatosis

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35
Q

Macro & micro nodules with fibrosis lining them ?

A

Cirrhosis

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36
Q

Most common primary hepatic tumor with vascular repture ?

A

Hemangioma

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37
Q

Patient wth 10 years history of HBV deve;oped 10 cm mass

A

Hepatocellular carcinoma

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38
Q

Which gives us hydroxyl radical ?

A

H2O2 + Fe+2

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39
Q

Which of the following is oxidant ?

A

Fe-4S

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40
Q

Which is secondary retroperitoneal ?

A

Duedenum

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41
Q

What happens due to failure of reteurn of the physiological herniation of the midgut loop ?

A

Omphalocele

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42
Q

Persistant cloacal membrane ?

A

Imperforate anus

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43
Q

Patient with mucus/bloody diarhhea, abcesses in liver , and recently he was in india with flask shaoed ulcer ?

A

Entameba histolitica

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44
Q

Patient with parasite abscess. how to diagnose him ?

  • Culture for abscess
  • Serology Ag
  • Serology Ab
  • Microscopy for abscess
A

?

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45
Q

Patient with AST and ALT levels of 1300 . He was in syria for a month. What would be seen in the investigation ?

A

HAV _ IgM

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46
Q

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?

A

HEV

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47
Q

DNA virus causes hepatocellular carcininoma ?

A

HBV

48
Q

What gives high Guanylase cyclase ?

A

Heme oxygenase –> CO –> high cGMP

49
Q

What causes premature juandice in babies ?

A

Decrease activity of bilirubin glucurcyl trasferase

50
Q

Which disease diagnosed by procollagen type 2 ?

A

Hepatic fibrosis

51
Q

disease diagnosed by monitoring bilirubin levels while fasting ?

A

Gilbert Syndrome

52
Q

In which organ retropulsion occur ?

A

Stomach

53
Q

Which has discontinous epithelium ?

A

Hepatic sinosoids

54
Q

Problem in hepatoduedenal lig. would likely affect ?

A

Bile duct

55
Q

Contraction of what will cause filling of gallbladder ?

A

common bile duct

56
Q

Feature amylase in pancreas ?

A

Contraacinar cells

57
Q

Zymogen granules in apices ?

A

Acinar cells

58
Q

Intercelated duct cells are responsible for ?

A

HCO3- secretion

59
Q

Which enzyme activates other enzymes ?

A

Trypsim

60
Q

Bile acids are secreted from ?

A

Hepatocellular paranchymal cells

61
Q

Substrate in 7 alpha hydroxylase ?

A

Cholestrol

62
Q

Defiency of which will lead to gallstones ?

A

Biles acids/salts

63
Q

A 28 patient with normal liver test but AST + ALT were 110 . What is he suffering from ?

A

Chronic viral hepatitis

64
Q

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

?

65
Q

A 35 female with multiple gallstones and distended bile duct. What is most likely elevated enzyme ?

A

Alkalaine phosphotase

66
Q

Patient came with foul smell diarrhea and abdominal pain. X-ray shown. What is the best management

A

Pancreatic enzymes

67
Q

Alpha carboxylation bu vit K leads to ?

A

Increase negative charges

68
Q

After not eating for couple of hours, a burst intense electrical activity occured in GI every 90 minutes ?

A

Migrating Myeelectric Complex

69
Q

Absorpyion of di-tri peptides in small intestine is by ?

A

Teriory active transport

70
Q

Absorption of water in GIT mainly occur in ?

A

Small intestine

71
Q

Function of M cells ?

A

Antigen transport

72
Q

Hypofunction of parietal cells leads to decreased ?

A

Interensic Factor

73
Q

Patient with high t TG. What is best method to treat ?

A

Gluten free diet

74
Q

Diarrhea due to wheel like structure ?

A

Rota virus

75
Q

2nd most common cause of Viral gastrointeritis and have extending fibers?

A

Adenovirus

76
Q

What is the infective dose of S.typhi

A

1000000

77
Q

Bacteria that produce enterotoxin ?

A

Vibro cholera

78
Q

Starved people are advised not to ingest high diet protein due to ?

A

low activity of urea cycle

79
Q

Patient with RLQ pain and mass and clubbing with diarrhea. X ray picture ?

A

Crohns disease

80
Q

Xray of patient

A

UC and toxic megacolon

81
Q

how fibers affect IBD ?

A

increase butyrate

82
Q

PICO question for study on 11 year old boy who want to know drug effect on him (EBM) ?

A

Children - drug - improvement - no treat

83
Q

What causes black tongue and stool?

A

bismith chelate

84
Q

How do antiacids affect sacalfate efficacy ?

A

altering PH in stomach

85
Q

What induces abortion ?

A

Misoprestol

86
Q

What is mechanism of action of omeparazol?

A

inhibits H/K ATPase

87
Q

If diazpam and cimitedin given together , what must be done ?

A

reduce diazpam dose

88
Q

What is H1 anatagonist ?

A

Cycizine

89
Q

What is 5-HT3 receptor antagonist ?

A

Ondansteron

90
Q

what is the mechanism of action of ……. ?

A

increase peristalsis by stimulating enteric nerves

91
Q

fast and slow acetators affect which drug ?

A

Isonazide

92
Q

Acetominophen causes hepatocellular necrosis by ? -

A

depletion of glutathione

93
Q

Occlosion of IMA is asymptomatic due to ?

A

Middle colic artery

94
Q

What should be done with a worker with salmonella ?

A

3 constitutive negative stool tests

95
Q

which structure have lower intensity of contraction ?

A

lower rectum

96
Q

Most important risk factor for colon cancer in less than 40 old people ?

A

Family history

97
Q

What will cause inhibition of acid secretion ?

A

Low PH in antrum

98
Q

Appenicitis pain is through which root ?

A

T10

99
Q

Uptake of xenobiotics to liver is done by ?

A

Organic anion transporting polypeptides (OATP)

100
Q

FEcal occult blood positive. What is the next investigation ?

A

colonscopy

101
Q

45 old woman with RUQ pain , juandice and fever and slight tenderness in UQ , high ALT and AST , high high ALP and bilirubin

A

Gallstones

102
Q

female came with history of gallstones and acute onset of fever , RUQ pain , juandice , serum amylase was 1500

A

Acute pancreatitis

103
Q

Which polyps will most likely cause malignancy ?

A

Villous adenoma

104
Q

loss of which muscle will cause fetal incontinance ?

A

puborectalis

105
Q

prolapse of rectal mucosa with dilated veins ?

A

Internal hemaroids

106
Q

part of anal canal which below pictunate line is developed from ?

A

ectoderm

107
Q

contraction in ascending colon is lower the descending colon , while contraction of sigmoid is less than descending colon , why ?

A

increase transiet time between ascending and descending colon

108
Q

patient with colon cancer but without family history . what gene affected ?

A

P53

109
Q

How do we diagnose C.difficile ?

A

Tissue culture of toxin

110
Q

What disease causes increased unconjugated bilirubin ?

A

sickle cell anemia

111
Q

Patient came with abdominal pain and constipation . Xray showed apple core apperance ?

A

colon cancer

112
Q

which is closest to zone 3 ?

A

central vein

113
Q

Supply submucosal glands of esophagus ?

A

misseners plexus

114
Q

its inhibition causes contraction of external anal sphincter ?

A

Auerbach

115
Q

What causes conjucation of bile acid ?

A

Glycine

116
Q

patient with signs of anemia. whan given Vit b12 he becomes better ?

A

Vit B12 deficincy

117
Q

child with enteric fever . how to treat him

A

Ceftrixone