Bank 1 Flashcards by Margaret Grant

Pre Hepatic Jaundice Causes? Choose as many as you think

a) haemolysis
b) alcohol
c) hepatitis
d) primary biliary cholangitis
e) primary sclerosing cholangitis
f) cholelithiasis
g) cholangiocarcinoma
h) chronic pancreatitis
i) pancreatic carcinoma

a) haemolysis

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Hepatic Jaundice Causes? Choose as many as you think

a) haemolysis
b) alcohol
c) hepatitis
d) primary biliary cholangitis
e) primary sclerosing cholangitis
f) cholelithiasis
g) cholangiocarcinoma
h) chronic pancreatitis
i) pancreatic carcinoma

b) alcoholism, c) hepatitis, d) primary biliary cholangitis, e) primary sclerosing cholangitis

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Post Hepatic Jaundice Causes? Choose as many as you think

a) haemolysis
b) alcohol
c) hepatitis
d) primary biliary cholangitis
e) primary sclerosing cholangitis
f) cholelithiasis
g) cholangiocarcinoma
h) chronic pancreatitis
i) pancreatic carcinoma

f) cholelithiasis, g) cholangiocarcinoma, h) chronic pancreatitis, i) pancreatic carcinoma

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Jaundice in dark skin. What will the colour of Urine be?

a) Dark brown or brownish-red
b) dark yellow
c) light yellow
d) White

a) Dark brown or brownish-red

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which of the following body parts does NOT change colour due to jaundice?

a) skin
b) bodily fluids
c) tongue
d) sclera of eyes
e) all of above can change

e) all of above can change

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Spider nevi commonly occur due to lots of what in the body?

a) oestrogen
b) blood
c) plasma
d) fluids

Oestrogen

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Which of the following may require a PEG (Percutaneous endoscopic gastrostomy) tube insertion?

Select one or more:

a. Abdominal Malignancy
b. oesophageal cancer
c. Prolonged period on ICU
d. Motor neurone disease

All of them

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Which electrolyte abnormalities can occur in refeeding syndrome?

Select one or more:

a. Hypokalemia
b. Hypomagnesemia
c. Hypocalcaemia
d. hypernatremia
e. Hypophosphatemia
f. Hyperkalemia
g. Hypercalcaemia
h. Hyponatremia

A) Hypokalaemia, B) Hypomagnesmia and E) Hypophosphatemia

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Which of the following are indications for TPN (total parenteral nutrition)?

Select one or more:

a. Malabsorption secondary to pancreatic insufficiency
b. Prolonged ileus post surgery
c. Malnutrition secondary to oesophageal stricture
d. Morning sickness
e. Severe anorexia

B) Prolonged ileus post surgery, E) Severe anorexia , A) Malabsorption secondary to pancreatic insufficiency , C) Malnutrition secondary to oesophageal stricture

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Which biochemical abnormalities may you expect to see in severe cases of anorexia nervosa?

Select one or more:

a. Hyponatremia
b. Hypercalcaemia
c. Respiratory acidosis
d. Hypokalemia
e. Metabolic Alkalosis

Metabolic Alkalosis , Hypokalemia , Hyponatremia

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Which anti-emetic should be avoided in bowel obstruction?

Select one:

a. Cyclizine
b. Metoclopramide
c. Ondansetron

Metoclopramide

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Which vitamin deficiency may you expect to see post gastrectomy?

Select one:

a. Vitamin K
b. Vitamin A
c. Vitamin B12
d. Vitamin C
e. Vitamin D

Vitamin B12

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What detail in a history should make you suspicious of raised intracranial pressure as a cause of vomiting?

Select one:

a. Multiple of the patients contacts have also developed vomiting
b. Nausea is not relieved by vomiting
c. Patient is pregnant
d. Associated diarrhoea
e. Vomiting and nausea occur early in the morning

e. Vomiting and nausea occur early in the morning

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What would you expect to see upon endoscopy in ulcerative colitis?

Select one or more:

a. continuous uniform involvement
b. Skip lesions
c. Loss of vascular marking
d. Crypt abscesses
e. Stricturing

Loss of vascular marking , Crypt abscesses , continuous uniform involvement

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Which of the following are causes of lower GI bleeding?

Select one or more:

a. Duodenal ulcer
b. Diverticular disease
c. Inflammatory bowel disease
d. Ischaemic colitis
e. Haemorrhoids

Diverticular disease, Haemorrhoids , Ischaemic colitis , Inflammatory bowel disease

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Which of the following conditions have an association with coeliac disease?

Select one or more:

a. IgA Nephritis
b. Autoimmune thyroiditis
c. Dermatitis Herpetiformis
d. Haemochromatosis
e. Seborrheic keratitis
f. Insulin dependent diabetes mellitus
g. Primary biliary cholangitis
h. Cystic fibrosis

Dermatitis Herpetiformis, Insulin dependent diabetes mellitus , Autoimmune thyroiditis , Primary biliary cholangitis

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Which of the following can be complications of coeliac disease?

Select one or more:

a. Hepatocellular carcinoma
b. Cholangiocarcinoma
c. Oesophageal carcinoma
d. Small bowel lymphoma
e. Small bowel adenocarcinoma

Small bowel lymphoma, Oesophageal carcinoma, Small bowel adenocarcinoma

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What is the treatment for dermatitis herpetiformis?

Select one or more:

a. Acyclovir
b. Antibiotics
c. Hydrocortisone
d. Dapsone
e. Gluten free diet

Gluten free diet , Dapsone

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Which stool test can be used to help diagnose inflammatory bowel disease?

Select one:

a. Stool culture
b. Faecal calprotectin
c. faecal immunochemical test
d. Faecal occult blood
e. C. DIff antigen

Faecal calprotectin

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Which of the following are functional causes of vomiting?

Select one or more:

a. Small bowel obstruction
b. Acute cholecystitis
c. Migraine
d. Pregnancy
e. Alcohol

Pregnancy, Migraine, Alcohol

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Which of the following would be termed “functional GI disorders”?

Select one or more:

a. irritable bowel syndrome
b. colonic adenocarcinoma
c. Biliary dyskinesia
d. non-ulcer dyspepsia
e. Oesophageal spasm

Oesophageal spasm , non-ulcer dyspepsia, Biliary dyskinesia , irritable bowel syndrome

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Which of the following can cause malabsorption?

Select one or more:

a. Coeliac disease
b. Post radio-therapy
c. Cystic fibrosis
d. Previous gastrectomy
e. Chronic pancreatitis

All

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Which of the following are organic causes of constipation?

Select one or more:

a. Depression
b. Diverticular disease
c. Colonic tumour
d. Anal fissure

In contrast to functional disorders, organic disorders are those in which there is an observable pathology.

The correct answers are: Anal fissure, Colonic tumour , Diverticular disease

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Metaplasia is the process in which one type of differentiated cell is transformed into another type of differentiated cell. Barrett’s oesophagus is a type of metaplasia in which stratified squamous cells change to which type of epithelium?

Select one:

a. Pseudostratified columnar
b. Stratified cuboidal
c. Simple cuboidal
d. Simple Columnar
e. Simple squamous

Simple Columnar

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Which of the following drugs commonly cause constipation as a side-effect? Select one: a. NSAIDs b. Opioids c. PPIs d. Magnesium e. Anti-biotics

Opoids

Cystic fibrosis is one of several conditions that can cause fat malabsorption as a result of pancreatic dysfunction. Which vitamin deficiencies are patients with fat malabsorption at risk of? Select one or more: a. Vitamin D b. Vtiamin B12 c. Vitamin E d. Vitamin K e. Folic Acid f. Vitamin A

Vitamin K

In which condition is villous atrophy a characteristic finding upon intestinal biopsy? Select one: a. Irritable bowel syndrome b. Coeliac disease c. Ulcerative Colitis d. Type 1 Diabetes e. Pernicious anaemia

b. Coeliac disease

NSAIDs and Aspirin interfere with the body’s production of gastroprotective prostaglandins. What clinical condition typically occurs in patients on long term or high doses of these drugs? Select one: a. Gastroenteritis b. Gastric cancer c. Crohn's disease d. Peptic ulcer disease e. Pancreatitis

d. Peptic ulcer disease

``` How would you expect transferrin and ferritin levels to be effected by iron deficiency? Select one: a. Low transferrin, low ferritin b. High transferrin, low ferritin c. Low transferrin, high Ferritin d. High transferrin, high ferritin e. High transferrin, normal ferritin ```

b. High transferrin, low ferritin

Pernicious anaemia is a condition in which there is autoimmune destruction of intrinsic factor, gastric parietal cells, or both. What Vitamin Deficiency would you expect as a result? Select one: a. Vitamin B12 b. Vitamin K c. Folic Acid d. Vitamin D e. Vitamin A

a. Vitamin B12

How would you expect chronic pancreatitis to affect glucose levels? Select one: a. Hyperglycaemia b. Glucose levels not affected c. Hypoglycaemia

Hyperglycaemia

CREON and pancreatin are the brand names of two commonly used pancreatic enzyme supplements. For which conditions might you see one of these prescribed? Select one or more: a. Type 2 diabetes b. Coeliac disease c. Type 1 diabetes d. Cystic Fibrosis e. Pancreatic cancer f. Chronic Pancreatitis

d. Cystic Fibrosis f. Chronic Pancreatitis e. Pancreatic cancer

Acute mesenteric ischaemia refers to the condition in which there is a sudden decrease in blood supply to the bowel, resulting in bowel ischaemia and eventual necrosis. Two significant causes of acute mesenteric ischaemia are emboli or atheroscleroitc occlusion of arteries to the gut. If both the small intestine and the ascending colon became ischaemic, which artery would you expect to be occluded? Select one: a. Inferior mesenteric b. Superior Mesenteric c. Gastroduodenal d. Celiac trunk e. Middle colic artery

b. Superior Mesenteric

How can choledocolithiasis (gall stones in the bile duct) present? Select one or more: a. Painful obstructive jaundice b. Acute pancreatitis c. Ascending cholangitis d. Painless obstructive jaundice

c. Ascending cholangitis b. Acute pancreatitis a. Painful obstructive jaundice

How is crohn's disease definitively diagnosed? Select one: a. occult fecal blood test b. Endoscopy c. Raised Alpha feto protein d. Anti-mitochondrial antibodies e. From history and examination findings

b. Endoscopy

Which of the following is a post-hepatic cause of jaundice? Select one: a. Hepatocellular carcinoma b. Hereditary heamochromatosis c. autoimmune haemolytic anaemia d. Primary billiary cirrhosis e. Cholangiocarcinoma

e. Cholangiocarcinoma

What can be a side effect of use of proton pump inhibitors such as omeprazole? Select one: a. Increased risk of C. Diff infection b. increased risk of gastro oesophageal reflux disease c. increased risk of duodenal ulcers d. increased risk of diabetes e. increased risk of gastric ulcers

a. Increased risk of C. Diff infection

Which of the following is a pre-hepatic cause of jaundice? Select one: a. Gall stones b. Viral Hepatitis c. Autoimmune haemolytic anaemia d. Hepatocellular carcinoma e. Autoimmune Hepatitis

c. Autoimmune haemolytic anaemia

Which auto antibodies are characteristic for primary biliary cholangitis? Select one: a. anti gliadin antibodies b. islet autoantibodies c. anti smooth muscle antibodies d. antimitochondrial antibodies e. antinuclear antibodies

d. antimitochondrial antibodies

Which of the following are signs of chronic liver disease? Select one or more: a. gynaecomastia b. spider naevi c. ascites d. loss of axillary hair e. palmar erythema

All

What concentration of neutrophils in an ascitic tap would indicate starting antibiotics for spontaneous bacterial peritonitis? Select one: a. < 100 cells per mm3 b. < 200 cells per mm3 c. > 1000 cells per mm3 d. > 250 cells per mm3 e. > 500 cells per mm3

d)> 250 cells per mm3

Which of the following should be used to manage all cases of hepatic encephelopathy? Select one or more: a. Pabrinex b. Lactulose c. Reversal of precipitating factors d. IV antibiotics e. Supportive care

b. Lactulose c. Reversal of precipitating factors e. Supportive care

Lipase is effective in breaking down triacylglycerols because of its high lipid solubility Select one: True False

False

Proteins are broken down into amino acids which are absorbed coupled to Ca2+ transport. Select one: True False

False

In the small intestine: the frequency of the basic electrical rhythm increases in the direction of the anus. Select one: True False

False

Vagal stimulation results in stimulation of a profuse watery salivary secretion. Select one: True False

False

Stomach distension leads to inhibition of gastrin secretion Select one: True False

False

The intensity of segmentation contractions is increased following increased parasympathetic activity Select one: True False

True

The secretions from Brunner’s Glands aid in the neutralisation of gastric acid. Select one: True False

True

In the stomach pepsinogens are secreted by the parietal cells in response to lowering pH Select one: True False

False

Fatty acid absorption is enhance by the formation of micelles. Select one: True False

True

Concerning the Duodenum: Cholecystokinin stimulates the secretion of bicarbonate from Brunner's glands Select one: True False

False

Trypsin is secreted by pancreatic acinar cells. Select one: True False

False

Cholecystokinin causes the sphincter of Oddi to relax. Select one: True False

True

Bile salts are reabsorbed in the proximal colon and returned to the liver via the hepatic portal vein. Select one: True False

False

Fructose is absorbed passively across the colonic eptihelium Select one: True False

False

Pepsin require an alkaline environment to catalyse the hydrolysis of peptide bonds Select one: True False

False

Colonic bacteria produce vitamin K Select one: True False

True

Pancreatic cellulase hydrolyses the B – 1,4 glycosidic bond in cellulose Select one: True False

False

In saliva, Lysozyme acts to cleave the polysaccharide component of bacterial cell walls Select one: True False

True

In the small intestine: Segmentation contractions are initiated by the arrival of food in the stomach. Select one: True False

True

Intrinsic factor/Vitamin B12 complex is absorbed in the proximal jejunum. Select one: True False

False

What is the function of the gall bladder? Select one: a. Stores and concentrates bile b. Secretes bile

a. Stores and concentrates bile

Which artery is the cystic artery most commonly a branch of? Select one: a. Left hepatic artery b. Coeliac trunk c. Right hepatic artery d. Common hepatic artery e. Right gastroepiploic artery

c. Right hepatic artery

A patient was diagnosed with bleeding ulcer of the lesser curvature of the stomach. Which artery is most likely involved? Select one: a. Left gastro-epiploic b. Gastroduodenal c. Right gastroepiploic d. Gastroduodenal e. Left gastric

e. Left gastric

Which of the following is a derivative of the dorsal mesogastrium? Select one: a. Hepatogastric ligament b. lesser omentum c. Hepatoduodenal ligament d. Falciform ligament e. Greater omentum

e. Greater omentum

A 60-year-old man with history of a chronic duodenal ulcer presents to the ER with signs of a severe internal hemorrhage. A perforation of the posterior wall of the first part of the duodenum and erosion of an artery behind it is suspected. Which artery is most likely iimplicated? Select one: a. Left gastroepiploic b. Common hepatic c. Right gastric d. Gastroduodenal e. Left gastric

d. Gastroduodenal

Which of the following is NOT in contact with the spleen? Select one: a. Colon b. Diaphragm c. Stomach d. Duodenum e. Pancreas

d. Duodenum

During surgery it is often necessary to distinguish macroscopically between the jejunum and ileum. Which of the following features is true of the jejunum? Select one: a. It occupies the lower right quadrant b. It has long vasa recta (straight arteries) c. It had more vascular arcades d. More pink e. It has a thinner wall

b. It has long vasa recta (straight arteries)

To which group of lymph nodes does lymph from the caecum drain? Select one: a. Coeliac group b. Inferior mesenteric group of pre-aortic c. Superior mesenteric group of pre-aortic d. Internal iliac group e. Deep inguinal group

c. Superior mesenteric group of pre-aortic

Which of the following organs might you find the left hypochondriac region? Select one: a. Gall bladder b. Liver c. Appendix d. Sigmoid colon e. Left ovary

b. Liver

The usual location for an appendectomy incision is the: Select one: a. Right upper quadrant b. Left lower quadrant c. Right lower quadrant d. Left upper quadrant

c. Right lower quadrant

The inferior border of the rectus sheath posteriorly is called the: Select one: a. Inguinal ligament b. Deep inguinal ring c. Transversalis fascia d. Linea alba e. Arcuate line

e. Arcuate line

An obstetrician decides to do a Caesarean section on a 25-year-old pregnant woman. A transverse suprapubic incision is chosen for that purpose. All of the following abdominal wall layers will be encountered during the incision EXCEPT the: Select one: a. Rectus abdominis b. Anterior rectus sheath c. Skin and superficial fascia d. Transversalis fascia and parietal peritoneum e. Posterior rectus sheath

e. Posterior rectus sheath

A 45 year old male develops an inguinal when lifting a heavy weight and needs to undergo surgery. During surgery a small knuckle of intra abdominal contents is found projecting from the anterior abdominal wall superior to the inguinal ligament and medial to the inferior epigastric artery Select one: a. Femoral hernia b. Indirect inguinal hernia c. Incisional hernia d. Direct inguinal hernia

Direct inguinal hernia

Which artery lies immediately medial to the deep inguinal ring? Select one: a. Superior epigastric b. Phrenic c. Inferior mesenteric d. Inferior epigartric

d. Inferior epigartric

Which of the following form the posterior wall of the inguinal canal? Select one: a. External oblique b. Internal oblique c. Transversalis fascia d. Inguinal ligament

c. Transversalis fascia

Which of the following organs is retroperitoneal? Select one: a. Transverse colon b. Ascending colon c. Liver d. Spleen e. Stomach

b. Ascending colon

Posteriorly the greater omentum is attached to the: Select one: a. Duodenum b. Spleen c. Liver d. Stomach e. Transverse colon

e. Transverse colon