All formatives Flashcards
A 45 year old man undergoes gastrectomy for treatment of a benign ulcer, which of the following hormones is likely to be most deficient as a result:
- Cholecystokinin
- Gastrin
- Motilin
- Secretin
- Vasoactive intestinal polypeptide
b. gastrin
A 20 year old man consulted his general practitioner complaining of bloating of his stomach after eating. A barium meal showed normal gastric mucosal appearance but delayed gastric emptying. The excess production of which of the following hormones may be responsible:
- Cholecystokinin
- Gastrin
- Motilin
- Secretin
- Somatostatin
a. CCK
A digestive tract enzyme may be initially released in the inactive form. What is the best term to describe this compound:
- Enterokinase
- Enzyme
- Polypeptide
- Protease
- Zymogen
- zymogen
A 19 year old man ate a large bar of white chocolate. Which of the following digestive processes is most important to promote digestion of the food:
- Conjugation
- Emulsification
- Enterohepatic circulation
- Glycolysis
- Phosphorylation
b. emulsification
A 23 year old male with a history of alcohol misuse presented with acute upper-abdominal pain and vomiting. He was found to have a raised serum amylase. What is the most likely diagnosis:
- Acute appendicitis
- Acute pancreatitis
- Cholangitis
- Dissecting aortic aneurysm
- Peptic ulcer
B - acute pancreatitis
A 47 year old man was referred for investigation of impaired defecation. Which of the following mechanisms best describes the normal defecation mechanism:
- Stretch receptors in the rectal wall activate both sympathetic and parasympathetic centers in the spinal cord
- Stretch receptors in the rectal wall activate parasympathetic centers in the spinal cord
- Stretch receptors in the rectal wall activate sympathetic centers in the spinal cord
- The external anal sphincter contracts
- The internal anal sphincter is consciously relaxed
- Stretch receptors in the rectal wall activate parasympathetic centers in the spinal cord
A 50 year old man presented to the emergency department complaining of a 3 month history of epigastric pain and a 2 day history of a very high volume of vomiting. What is the most likely anatomic site of bowel obstruction to cause this symptom:
- Distal ileum
- Gastro-oesophageal junction
- Mid-oesophagus
- Sigmoid colon
- Third part of the duodenum
- third part of the duodenum
A 45 year old woman has surgical removal of her distal ileum to treat inflammatory bowel disease. Which of the following vitamins is she at risk of becoming deficient in:
- Vitamin B1
- Vitamin B5
- Vitamin B6
- Vitamin B12
- Vitamin C
D. vitamin B12
A 24 year old has an inherited defect and is unable to produce intrinsic factor. The absorption of which of the following substances is most likely to be impaired:
- Bile salts
- Free amino acids
- Glucose
- Vitamin B12
- Water
4 - vitamin B12
A 55 year old man presents with a 6 year history of progressive painless jaundice and weight loss. On inspection, he is jaundiced. Abdominal palpation is normal. What is the most likely diagnosis:
- Crohn’s disease
- Diverticular disease
- Duodenal ulcer
- Pancreatic cancer
- Renal carcinoma
- pancreatic cancer
A 30 year old man presents with jaundice. He has been complaining of intermittent right hypochondrial pain and nausea for several months, but the pain has worsened, his urine is darker than usual and his stools pale. Which imaging is most appropriate in the first instance:
- Abdominal radiograph
- Abdominal ultrasound
- Computed tomography
- Isotope liver scintigraphy
- Positron emission tomography
- abdominal ultrasound
A 45 year old man is stabbed in the lower chest. The knife cuts most of the vagus nerve fibres around the oesophagus. He makes a good recovery. Which of the following is most likely to occur as a result of the nerve injury:
- Delayed gastric emptying
- Increased gastrin secretion
- Increased intestinal peristalsis
- Increased pancreatic enzyme production
- Reduced bile production
- delayed gastric emptying
A 40 year old man has a total colectomy to treat a colonic carcinoma. The operation is curative. Which of the following is most likely to occur as a result of this operation:
- Constipation
- Excessive water retention
- Hyponatremia
- Reduced absorption of vitamin A
- Reduced glucose absorption
- hyponatraemia
A 70 year old woman presents with jaundice. She has been complaining of right abdominal pain and altered bowel habit for several months. On examination she has a hard craggy mass in her right iliac fossa and hepatomegaly. An abdominal ultrasound is performed. Which of the following is the most likely finding in the liver at ultrasound:
- Cholecystitis
- Gallstones impacted in the common bile duct
- Liver abscess
- Macronodular cirrhosis
- Multiple liver metastases
- multiple liver metastases
A 70 year old man presented with abdominal pain, vomiting and abdominal distension. He reported absolute constipation. An abdominal radiograph shows multiple dilated loops of bowel. Which of the following bowel findings on abdominal x-ray would be in keeping with small bowel obstruction:
- Central distribution of loops of bowel
- Haustral mucosal folds
- Peripheral distribution of loops of bowel
.4. Relatively few loops - Wide angle of curvature of loops of bowel
- Central distribution of loops of bowel
A 70 year old man presented with abdominal pain, vomiting and abdominal distension. He reported absolute constipation. An abdominal radiograph shows multiple dilated loops of bowel. Which of the following bowel findings on abdominal x-ray would be in keeping with small bowel obstruction:
- Central distribution of loops of bowel
- Haustral mucosal folds
- Peripheral distribution of loops of bowel
.4. Relatively few loops - Wide angle of curvature of loops of bowel
- Central distribution of loops of bowel
A 45 year old smoker presents with massive haematemesis and melaena. Endoscopy reveals an actively bleeding posterior ulcer in the first part of the duodenum. Which artery is most likely to be bleeding:
- Aorta
- Common hepatic
- Gastroduodenal
- Right gastric
- Splenic
- Gastroduodenal
A 20 year old female medical student suffers from severe secretory diarrhoea while backpacking in India. She remembers that oral rehydration therapy (ORT) is an effective way to counter the dehydration caused by intestinal fluid loss. Which of the following ingredients would be required to make up a suitable ORT solution:
- Potassium chloride + fructose
- Potassium chloride + glucose
- Sodium chloride + fructose
- Sodium chloride + glucose
- Sodium chloride + monoglyceride
- Sodium chloride + glucose
A patient underwent a cholecystectomy for treatment of chronic cholecystitis. During the operation, the surgeon noticed arterial blood loss from the gallbladder neck. Which artery is most likely to have been injured:
- Coeliac trunk
- Cystic artery
- Inferior pancreaticoduodenal artery
- Splenic artery
- Superior mesenteric artery
- Cystic artery
A 50 year old patient has chronic peptic ulcer disease that has not responded to drug therapy and undergoes surgical removal of the gastric antrum to reduce gastric acid production. How does the surgical procedure reduce acid production:
- Decreases gastrin production
- Decreases pepsin synthesis
- Increases bile production
- Increases cholecystokinin production
- Increases gastric emptying
- Decreases gastrin production
A 25 year old woman presents with a 6-week history of diarrhoea and oral aphthous ulcers. Her stool contains blood and mucous. What is the most likely diagnosis:
- Crohn’s disease
- Diverticulitis
- Infective diarrhoea
- Irritable bowel syndrome
- Ulcerative colitis
- Crohn’s disease
A 25 year old man presents with fever, bloody diarrhoea and cramping for several weeks that does not resolve with antibiotic therapy. Proctosigmoidoscopy reveals red, raw mucous and pseudopolyps. What is the most likely cause:
- Campylobacter infection
- Crohn’s disease
- Irritable bowel disease
- Ulcerative colitis
- Viral gastroenteritis
- Ulcerative colitis
A 20 year old man presents with a 12-history of collicky periumbillical pain, which shifts to the right iliac fossa, fever and a loss of appetite. What is the most likely diagnosis:
- Acute appendicitis
- Acute pancreatitis
- Acute viral hepatitis
- Diverticular disease
- Perforated peptic ulcer
- Acute appendicitis
A 45 year old man was admitted to hospital after ingesting 25 g of paracetamol 3 days earlier. He had no past medical history of note, took no regular medication and rarely consumed alcohol. Which of the following signs would be consistent with his presentation:
- Finger clubbing
- Gynaecomastia
- Jaundice
- Palmar erythema
- Spider naevi
- Jaundice