case 2 from prev qs Flashcards
Higher doses of this antidiarrheal agent can lead to central nervous system effects, and prolonged use can lead to opioid dependence is.
a. Methylnaltrexone
b. Loperamide
c. Diphenoxylate
d. Tegaserod
C. Diphenoxylate
Diphenoxylate is a prescription opioid agonist that has no analgesic properties in standard doses; however, higher doses have central nervous system effects, and prolonged use can lead to opioid dependence.
The acceptable treatment options for maintaining remission in a patient with Crohn’s ileocolitis include all the following EXCEPT.
a. Budesonide
b. Mesalamine
c. 6-mercaptopurine
d. Ciprofloxacin
A. Budesonide
Corticosteroids are not useful for maintaining disease remission. Other medications such as aminosalicylates or immunosuppressive agents should be used for this purpose.
Which of these types of gallstones appear transparent in radiography and forms within the gallbladder and later migrate to the bile duct is/are.
a. Cholesterol
b. Pigment
c. Brown
d. Any of the options
A. Cholesterol
Stones that contain only sufficient calcium will
appear radiopaque on plain abdominal film.
Which of the following statements about parietal pain is correct?
A. More precise localized over involved structure
B. More severe with other symptoms such as sweating, nausea and vomiting
C. More difficult to determine its localization
D. More variations in quality
A. More precise localized over involved structure
Which of the following is the first line agent for mild to moderate active UC treatment
A. Corticosteroids
B. Sulfasalazine
C. Antibiotics
D. Methotrexate
B
Which of the following statements about H. pylori infection is/are correct?
A. Its catalyzed urea hydrolysis to produce buffering ammonia
B. The H. pylori gastritis increases hydrochloric acid production
C. The protective of GERD in cases of H.pylori duodenal ulcer
D. Any of the options
D
Which of the following is most likely to occur with pre-existing systemic illness in children?
A. Calculous cholecystitis
B. Acalculous cholecystitis
C. Cholestasis
D. Cholelithiasis
B. acalculous cholecystitis
Acute acalculous cholecystitis is uncommon in children and is usually caused by infection. Acalculous cholecystitis may also be seen with a variety of other systemic disease processes (e.g., sarcoidosis, cardiovascular disease, tuberculosis, syphilis, actinomycosis)
Increased peristaltic waves appreciated during inspection of the abdomen in which of the following GIT pathology.
a. Ascites
b. Hernia
c. Renal artery stenosis
d. Intestinal obstruction
A. Ascites
A positive fluid wave, shifting dullness, and peripheral edema makes the presence of ascites to three to six times more likely
A 20 year old female complains of melena. She has a history of chronic intake of NSAID use. She complains of abdominal pain, epigastric pain in location, burning in quality which sometimes awakes her at night. What is your most likely diagnosis?
a. Mallory Weiss tear
b. Hemorrhoids
c. Bleeding peptic ulcer disease
d. Bleeding diverticulosis
C. Bleeding peptic ulcer disease
Epigastric pain described as a burning or gnawing discomfort can be present in both DU and GU. Pain that awakes the patient from sleep (between midnight and 3 a.m.) Up to 87% of patients with NSAID-induced mucosal disease can present with a complication (bleeding, perforation, andobstruction) without antecedent symptoms.
All of the ff statements about inflammatory Bowel Disease are correct EXCEPT.
a. Different manifestations of the same disease process
b. May begin as early as first year
c. Crohn’s disease is believed to be more common in female
d. None of the options
D.
IBD may begin as early as the 1st yr of life.
Men are slightly more likely to acquire ulcerative colitis than are women; the reverse is true for Crohn disease
IBD (CD & UC) results from a combination of abnormalities in immune regulation, host-microbe interactions, and epithelial barrier functions in genetically susceptible individual
Which of the following GI disorders has a high pitched rushing bowel sound accompanied with cramping?
a. Alcoholic hepatitis
b. Adynamic ileus
c. Early intestinal obstruction
d. Intestinal Obstruction
C. Early intestinal obstruction
High-pitched rushing bowel sounds with cramping
Intestinal obstruction
High-pitched, tinkling bowel sounds (early)
Absent bowel sounds (late)
The most effective regimens for H pylori eradication are combinations of two antibiotics and a proton pump inhibitor. Which one of the following antibacterial agents is LEAST used with the combination
a. Metronidazole
b. Amoxicillin
c. Clindamycin
d. Clarithromycin
C. Clindamycin
Combination therapy for 14 days provides the greatest efficacy, The agents used with the greatest frequency include amoxicillin, metronidazole, tetracycline, clarithromycin, and bismuth compounds.
All of the following are included in the Pediatric ulcerative Colitis Activity Index. Which one is the EXCEPTION?
a. Rectal sparing
b. Number of stools per 24 hours
c. Nocturnal stools
d. None of the options
D
Which of the following abdominal areas is affected whenever pain arises from organs proximal to the ligament of Treitz?
a. Midline lower abdomen
b. Periumbilical
c. Epigastrium
d. Hypogastrium
C. EPIGASTRIUM
Ligament of Treitz - used interchangeably with duodenojejunal flexure. It is located posterior to the duodenum and the pancreas.
The most potent inhibitor of gastric acid secretion available today is:
a. Dicyclolmine
b. Misoprostol
c. Ranitidine
d. Lansoprazole
D
Lansoprazole is a PPI used to treat stomach and intestinal ulcers. Proton pump inhibitors (PPIs) inhibit the final step of acid secretion, and are currently the most potent acid inhibitors.
