2016 final Flashcards

1
Q

investigations of a patient applying for a job showed the following:

Weight:
93

Hight:
160

Blood pressure:
High

Fasting glucose:
High

AST, ALT:
High but below 1000

His liver span = 15 cm, and he denied drinking alcohol. What is the diagnosis

A

Nonalcoholic fatty liver disease

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2
Q

A case of a middle aged male with steatorrhea, how would this case be managed?

A

Supplementation with pancreatic enzymes

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3
Q

case of someone with dysphagia, choose the appropriate esophageal manometry pattern

A

2ndstrap from the left

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4
Q

Which of the following occur in starvation?

A) increased ketogenesis, reduced proteolysis, reduced gluconeogenesis
B) increased lipolysis, increased ketogenesis, increased glycogenolysis
C) increased lipogenesis, increased glycolysis, reduced gluconeogenesis

A

A) increased ketogenesis, reduced proteolysis, reduced gluconeogenesis

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5
Q

viral hepatitis that can be treated with acyclovir?

A) Measles
B) Varicella zoster
C) Mumps

A

B) Varicella zoster

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6
Q

52 year old patient with history of heart burn presents with progressive dysphagia to solids but not liquids over 1 year

A) Diffuse esophageal spasm
B) Esophageal (Schatzki) ring
C) Peptic stricture

A

C) Peptic stricture

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7
Q

mechanism of treating jaundice with blue light:

A) Breaks bilirubin
B) Converts bilirubin to biliverdin
C) Breaks tetrapyrrole heme
D) Increase binding of bilirubin to ligandin

A

A) Breaks bilirubin

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8
Q

what is the percentage of patients with enteric fever that become carriers

A) 5
B) 10
C) 20
D) 40

A

none of the percentages were correct..

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9
Q

48 years old African American male with history of hemorrhoids due to weight lifting presents to the primary care physician with rectal bleeding, which test is best for screening in this case

A) Colonoscopy
B) Fixable sigmoidoscopy
C) Digital rectal exam
D) Occult blood test

A

A) Colonoscopy

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10
Q

How are arboviruses transmitted

  1. Droplet
  2. Airborne
  3. Fecal oral
  4. Bite from infected mosquito
A
  1. Bite from infected mosquito
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11
Q

triangular diverticulum in the pharynx caused by which muscle

A) Cricopharyngeus
B) Middle constrictor

A

A) Cricopharyngeus

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12
Q

Case of acute pancreatitis, what makes you admit the patient to the ICU

A) LDH level
B) Creatinine
C) Hypocapnia
D) Amylase level

A

C) Hypocapnia

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13
Q

Food handler in the hospital with S.typhi, what is the recommendation in this case

A) Treat him with antibiotics
B) Stop working until 3 consecutive stool specimens are negative

A

B) Stop working until 3 consecutive stool specimens are negative

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14
Q

3 years old with pyrexia of unknown origin

A

S. typhi

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15
Q

Prevention of infection by HCV

A) Vaccination
B) Prevent contact with infected blood or fluids
C) Immediate administration of immunoglobulins

A

B) Prevent contact with infected blood or fluids

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16
Q

A patient infected with HBV, he is a drug abuser and had superinfection with HDV. Which of the following is used for treatment

A) Interferon
B) Protease inhibitor

A

B) Protease inhibitor

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17
Q

patient with classical signs of acute pancreatitis. Which of the following indicates worse prognosis. (there was a table showing the vital signs and it showed low O2 saturation with high amylase)

A) Low O2 saturation
B) Pancreatic edema on CT
C) Amylase level

A

A) Low O2 saturation

*the idea was the same in another question but the choices differ make sure to review the “red flag” sings.

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18
Q

a men developed limb weakness and numbness. He had gullian-barre syndrome after an infection that caused diarrhea. What is the pathogen

A

A) Campylobacter jejuni

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19
Q

what is the committed step in bile synthesis

A) Hydroxylation of 7 alpha-carbon
B) Shortening of the hydrophobic chain on position 3

A

A) Hydroxylation of 7 alpha-carbon

20
Q

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

A) 3 years
B) 5 years
C) 1 year
D) 10 years

A

B) 5 years

21
Q

surgery to remove a sialolith from the submandibular gland duct through the oral cavity. Though which layers should the surgeon cut to reach the duct?

A) Mucosa
B) Mucosa, submucosa, mylohyoid muscle
C) Mucosa, submucosa, hyoglossus muscle

A

A) Mucosa

22
Q

which of the following presents the antigen in autoimmune liver disease

A) MHC class 2
B) MHC class 1
C) T cell receptor
A

A) MHC class 2

23
Q

what is the reason behind the referred pain of the gall bladder to the shoulder

A) Phrenic nerve
B) T9
C) T10
D) Vagus nerve

A

A) Phrenic nerve

24
Q

which of the following will provide collateral circulation if the inferior mesenteric artery was blocked

A) Middle colic
B) Ileocolic
C) Superior rectal
D) Middle rectal

A

A) Middle colic

25
Q

a case who had intestinal material oozing from the umbilicus. What is the defect

A) Uracus fistula
B) Vitelline fistula
C) Meckels diverticulum

A

B) Vitelline fistula

26
Q

which of the following represent the anterior border of the lesser sac

A) Stomach
B) Transverse colon

A

A) Stomach

27
Q

anal fistula lateral to the wall of the anal canal will open in which of the following

A) Pelvic cavity
B) Ischioanal fossa
C) Urogenital sinus

A

B) Ischioanal fossa

28
Q

Caput medusae are caused by backflow of blood through which of the following

A) Paraumbilical veins
B) Splenic vein

A

A) Paraumbilical veins

29
Q

Which structure is affected in ileitis that will result in vit B12 deficiency

A) Deoxyadenosyl cobalamin
B) Methylcobalamin
C) Haptocorrin
D) Intrinsic factor

A

D) Intrinsic factor

30
Q

lymphatic flow from the right gastroepiploic nodes will first drain into which group of lymph nodes

A) Along the left gastric artery
B) Along the splenic artery
C) Deep to the pylorus

A

C) Deep to the pylorus

31
Q

what are probiotics

A) Live microorganisms when administered in adequate amounts will help to improve the overall health
B) Non digestible food products that stimulate the growth of beneficial microorganisms
C) Killed microorganisms that have benefits

A

A) Live microorganisms when administered in adequate amounts will help to improve the overall health

32
Q

A 30-year-old woman with abdominal pain, jaundice, fever for one week. She had cosmetic surgey 3 weeks before, in Thailand. She was tested for HBV and the results showed: HBsAg+, HBeAg+, HBc IgM+, total HBcAB-, HBsAb-, what does she have?

A) Chronic hepatitis with high infectivity
B) Acute hepatitis B
C) Recovered from previous infection
D) Vaccinated

A

B) Acute hepatitis B

33
Q

what is the basis of tissue damage in Cron’s disease

A

Cell mediated immune reaction against bacterial flora

34
Q

asymptomatic women came for regular checkup. A table was given which showed normal ALT and AST, high total bilirubin, and normal direct bilirubin. What is the diagnosis

A

Gilbert syndrome

35
Q

young male recently arrived from Mexico presented with watery diarrhea. He had no blood or mucus in the stool. What is the offending organism

A) ETEC
B) EHEC
C) EPEC
D) EIEC

A

A) ETEC

36
Q

a patient had diarrhea after an antibiotic course treatment. What is most likely the antibiotic

A) Metronidazole
B) Clindamycin
C) Penicillin

A

A) Metronidazole

37
Q

the internal oblique muscle contribute to the formation to which structure

A) Inguinal ligament
B) Conjoint tendon
C) Deep inguinal ring
D) Lacunar ligament

A

B) Conjoint tendon

38
Q

20 year old male presented with groin pain and an indirect hernia. which nerve caused the pain

A) Ilioinguinal
B) Iliohypogastric

A

A) Ilioinguinal

39
Q

woman presented with rectal incontinence after a procedure to give childbirth. Which muscle is mostly affected

A) Puborectalis
B) Bulbocavernosus

A

A) Puborectalis

40
Q

A lady visited the clinic for regular checkup. Her height was 162cm and weight 95 kg. Her profile showed (we had a table with the results and the normal ranges) : high ALT (72), AST(75), ALP, and globulins. Normal GGT and CBC. Blood glucose high (9.5). What does she have?

A) Autoimmune chronic active hepatitis
B) Non-alcoholic steatohepatitis

A

B) Non-alcoholic steatohepatitis

41
Q

A neonate was born with a membrane covered sac protruding from the anterior abdominal wall. What is the diagnosis

A

Omphalocele

42
Q

a woman presented with a salivary gland mass that showed myxoid cartilaginous stroma with epithelial cells. What is the diagnosis

A

Pleomorphic adenoma

43
Q

which of the following has a clear benefit from H.pylori antibiotic treatment (don’t remember the exact question but the idea is the same)

A

MALT lymphoma

44
Q

60 year old patient with changes in bowel movements and rectal bleeding. Barium enema showed apple core appearance of the colon. What is the diagnosis

A) Colon cancer
B) Ulcerative colitis
C) Toxic megacolon

A

A) Colon cancer

45
Q

40 year old woman presented with biliary colic and jaundice. ERCP showed gallstones obstructing the bile duct. Which set of laboratory data would be found in such patient.

A

Increased bilirubin – decreased urine urobilinogen – decreased fecal stercobilinogen

46
Q

a question about imaging of hydrocele

A

Ultra sound