CP SEM 2 - Final Ex Part 1 Flashcards
1.True about C-peptides
A. It is a worse indicator of B-cell function than peripheral insulin
B. Used to differentiate between gestational and non-gestational diabetes
C. It is usually in extremely low amounts in diabetes insipidus
D. None of the Above
D. None of the Above
Rationale: C-peptide is actually a better indicator of B-cell function than peripheral insulin because it reflects endogenous insulin production without being affected by exogenous insulin administration. It is not used to differentiate between gestational and non-gestational diabetes; instead, it is used to distinguish between type 1 and type 2 diabetes. It is not relevant to diabetes insipidus, which affects the posterior pituitary’s production of antidiuretic hormone rather than insulin or C-peptide levels.
2.Lactic acidosis is diagnosed by the presence of the following except:
A. High blood lactate levels (>45 mg/dl or >5.0 mmol/L)
B. An elevated anion gap
C. A low blood ph (<7.35)
D. None of the above
D. None of the above
Rationale: All of the options listed are actually correct indicators of lactic acidosis: high blood lactate levels indicate excess lactate production, an elevated anion gap is a result of excess acids in the blood, including lactate, and a low blood pH reflects the acidotic state.
3.It is non – reducing sugar composed of glucose and fructose connected by a glycosidic band.
A. Maltose
B. Sucrose
C. Lactose
D. None of the above
B. Sucrose
Rationale: Sucrose is a non-reducing sugar composed of glucose and fructose connected by a glycosidic bond, specifically an α-1,β-2 bond. This type of bond prevents it from participating in reducing reactions, unlike maltose and lactose, which are reducing sugars.
4.The following are functions of Insulin except:
A. Promotes glycolysis
B. Promotes lipolysis
C. Stimulates the synthesis of amino acids from pyruvate
D. Increases glucose entry into the cell
B. Promotes lipolysis
Rationale: Insulin is a hormone that promotes the storage of glucose and fat. It inhibits lipolysis (the breakdown of fats), which is the opposite of promoting it. The other options listed are functions of insulin: promoting glycolysis, stimulating amino acid synthesis from pyruvate, and increasing glucose entry into cells.
5.The diagnosis of diabetes requires the following criteria except:
A. Fasting plasma glucose of 126 mg/dl (7.0 mmol/L) or greater on at least two occasions
B. Casual plasma glucose level of 200 mg/dl (11.1 mmol/L) or greater
C. Glycosalated hemoglobin (hba1c) of 6.5% or greater on at least two occasions
D. Fasting plasma glucose is less than 100 mg/dl (5.6 mmol/L)
D. Fasting plasma glucose is less than 100 mg/dl (5.6 mmol/L)
Rationale: A fasting plasma glucose less than 100 mg/dl is considered normal and does not meet the diagnostic criteria for diabetes. The other options listed are part of the criteria for diagnosing diabetes.
6.True of glucagon except:
A. Synthesized in the pancreatic alpha cells and the L cells of the distal small bowel
B. Fasting plasma glucagon concentrations are normally 25-50 pg/ml
C. Released during stress and fasting states
D. Promotes glycogenesis
D. Promotes glycogenesis
Rationale: Glucagon primarily promotes glycogenolysis (the breakdown of glycogen into glucose) and gluconeogenesis (the production of new glucose), especially during stress and fasting states. It does not promote glycogenesis, which is the synthesis of glycogen, typically promoted by insulin.
7.It is the most common methodology used to analyze glucose:
A. Glucose Dehydrogenase System
B. Glucose Oxidase System
C. Hexokinase System
D. None of the above
B. Glucose Oxidase System
Rationale: The glucose oxidase system is one of the most common methodologies used in glucose meters for personal and clinical use due to its specificity and stability. The hexokinase system, while highly accurate, is more commonly used in laboratory settings.
8.For Type 1 Diabetes, it is a single screening marker for detecting multiple antibody markers for beta cell destruction and more common in children.
A. Antibodies to glutamic acid decarboxylase (GAD65)
B. Insulin autoantibodies (IAA)
C. Autoantibodies to pancreatic alpha cells (APA1)
D. Autoantibodies to zinc transporter 8 (znt8)
A. Antibodies to glutamic acid decarboxylase (GAD65)
Rationale: Antibodies to GAD65 are a common screening marker for Type 1 Diabetes as they are frequently present in the autoimmune attack on pancreatic beta cells. The other antibodies listed also can be involved, but GAD65 is more common and widely tested in children and adults.
9.True of Diabetes Mellitus Type 2 except:
A. C-peptide are normal to high in Type 2 DM
B. In general, it is recommended that adults ages 45 be screened for diabetes every 3 years, but Screening should be performed earlier and more frequently if the individual is at high risk.
C. The preferred test is a fasting plasma glucose and hba1c level.
D. Home blood glucose monitoring devices, are preferred compared to lab based plasma glucose determination
D. Home blood glucose monitoring devices, are preferred compared to lab based plasma glucose determination
Rationale: Lab-based plasma glucose and HbA1c tests are actually the preferred methods for diagnosing and managing diabetes mellitus type 2, as they are more accurate and standardized. Home monitoring is useful for daily management but not as a primary diagnostic tool.
10.Which of the following is characteristic of type 1 diabetes mellitus?
A. Requires an oral glucose tolerance test for diagnosis
B. Is the most common form of diabetes mellitus
C. Usually occurs after age 40
D. Requires insulin replacement to prevent ketosis
D. Requires insulin replacement to prevent ketosis
Rationale: Type 1 diabetes mellitus results from the autoimmune destruction of insulin-producing beta cells in the pancreas, necessitating insulin replacement to manage blood glucose levels and prevent ketosis, a serious condition resulting from the body burning fat for fuel in the absence of sufficient insulin.
11.Which statement regarding gestational diabetes mellitus (GDM) is correct?
A. Is diagnosed using the same oral glucose tolerance criteria as in nonpregnancy
B. Converts to diabetes mellitus after pregnancy in 60%–75% of cases
C. Presents no increased health risk to the fetus
D. Is defined as glucose intolerance originating during pregnancy
D. Is defined as glucose intolerance originating during pregnancy
Rationale: Gestational diabetes mellitus (GDM) is defined specifically as glucose intolerance that begins or is first recognized during pregnancy. This differentiates it from diabetes mellitus types 1 and 2, which may pre-exist or develop independently of pregnancy.
12.Which statement regarding glycosylated Hgb is true?
A. It has as a sugar attached to the C-terminal end of the β chain
B. Is a highly reversible aminoglycan
C. Reflects the extent of glucose regulation in the 8- to 12-week interval prior to sampling
D. Will be abnormal within 4 days following an episode of hyperglycemia
C. Reflects the extent of glucose regulation in the 8- to 12-week interval prior to sampling
Rationale: Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the lifespan of red blood cells, typically 8-12 weeks, making it a valuable indicator of long-term glucose regulation. The other options contain incorrect information about the biochemical nature and behavior of HbA1c.
13.Insulin is produced by
A. Alpha cells
B. Beta cells
C. Delta cells
D. PP or F cells
B. Beta cells
Rationale: Insulin is produced by the beta cells of the islets of Langerhans in the pancreas. These cells are primarily responsible for the regulation of glucose levels in the blood.
14.glucagon is produced by
A. Alpha cells
B. Beta cells
C. Delta cells
D. PP or F cells
A. Alpha cells
Rationale: Glucagon, which works to increase blood glucose levels, is produced by the alpha cells of the pancreatic islets. It acts as a counter-regulatory hormone to insulin.
15.somatostatin is produced by
A. Alpha cells
B. Beta cells
C. Delta cells
D. PP or F cells
C. Delta cells
Rationale: Somatostatin, which inhibits the secretion of many hormones including growth hormone, insulin, and glucagon, is produced by the delta cells of the pancreatic islets.
16.In microscopic examination for sperm analysis, progressive motility (normal Range 32% or above) is expressed as the percentage of sperm that move, in Addition forward movement is graded. Sperm that move rapidly in a straight line With little yaw and lateral movement is graded as :
A. Grade 4
B. Grade 3
C. Grade 2
D. Grade 1
A. Grade 4
Rationale: In sperm motility grading, sperm that move rapidly in a straight line with minimal lateral movement are graded as Grade 4, indicating the highest quality of motility observed in sperm analysis.
17.Which set of results is most likely in an adult male with primary testicular Failure?
A. Increased LH, FSH, and decreased testosterone
B. Decreased LH, FSH, and testosterone
C. Decreased testosterone, androstenedione, and FSH
D. Increased androstenedione, decreased testosterone, and normal FSH
A. Increased LH, FSH, and decreased testosterone
Rationale: In primary testicular failure, the testes are unable to produce normal amounts of testosterone due to intrinsic damage or dysfunction, leading to increased secretion of LH and FSH as the body tries to stimulate testosterone production.
18.True of PROM except:
A. It may be followed by chorioamnionitis, fetal pulmonary hypoplasia, placental abruption, and Neonatal Respiratory distress
C. Amniotic fluid is alkaline, with pH of 7.0 to 7.5.
D. The vaginal pool aspirate can be tested with nitrazine paper to estimate pH visually.
E. A positive test is indicated by a yellow green color , and a negative one by a blue color
C. Amniotic fluid is alkaline, with pH of 7.0 to 7.5.
Rationale: Amniotic fluid is actually slightly acidic to neutral, typically with a pH closer to 7.0 or slightly below, rather than alkaline. The other statements are correct regarding PROM (premature rupture of membranes) and its associated risks and diagnostic tests.
19.The following are true on sample collection for sperm analysis except:
A. The patient should be instructed to collect semen after 2 to 5 days of sexual abstinence
B. The bladder should be evacuated before ejaculation occurs.
C. The semen specimen should be delivered to the laboratory within 1 hour of collection and kept Warm during transportation.
D. Longer periods of abstinence usually result in a higher semen volume and improved sperm Motility.
D. Longer periods of abstinence usually result in a higher semen volume and improved sperm motility.
Rationale: Longer periods of abstinence can indeed increase semen volume, but they often result in decreased sperm motility, not improved. Sperm may become less viable the longer they remain stored in the reproductive tract.
20.A female with severe excessive pubic and facial hair growth (hirsutism) should Be tested for which of the following hormones?
A. Estrogen and progesterone
B. Chorionic gonadotropin
C. Growth hormone
D. Testosterone
D. Testosterone
Rationale: Excessive hair growth (hirsutism) in women is often linked to elevated levels of androgens, such as testosterone. Testing for elevated testosterone levels can help identify conditions like polycystic ovary syndrome (PCOS) or other endocrine disorders contributing to hirsutism.
21.Macroscopic examination for semen analysis should be performed after Liquefaction, which usually occurs in :
A. Less than 20 minutes at room temperature
B. Around 3 hours at room temperature
C. Exactly 12 hours at room temperature
D. None of the above
A. Less than 20 minutes at room temperature
Rationale: Liquefaction of semen typically occurs within 20 to 30 minutes of ejaculation at room temperature. This allows for more accurate assessment of viscosity and other characteristics necessary for a thorough semen analysis.
22.The following statements are true about neural tube defects except:
A. Failure of the neural tube to close by the 27th day after conception.
B. Sporadic in 90% of cases and represent isolated defects with a multi- factorial origin, involving Both genetic and nongenetic factors.
C. Folic acid supplementation before conception reduces the recurrence of fetal NTDs
D. In NTDs, AFP is decreased
D. In NTDs, AFP is decreased
Rationale: In neural tube defects (NTDs), the level of alpha-fetoprotein (AFP) is actually increased in the amniotic fluid and maternal serum, not decreased. This marker is used for prenatal screening to identify potential NTDs.
23.This is considered as the more potent androgen .
A. Testosterone
B. Dihydrotestosterone(DHT)
C. Androstenedione
D. Dehydroepiandrosterone (DHEA)
B. Dihydrotestosterone (DHT)
Rationale: Dihydrotestosterone (DHT) is a more potent androgen than testosterone. It is produced from testosterone by the action of the enzyme 5-alpha reductase, particularly in target tissues such as the skin, hair follicles, and prostate.
24.This hormone induces Sertoli cells to synthesize and secrete androgen-binding Protein into the lumen of the seminiferous tubule, and this maintains the high Testosterone concentration required for normal spermatogenesis
A. FSH
B. LH
C. Inhibin
D. None of the above
A. FSH
Rationale: Follicle-stimulating hormone (FSH) induces Sertoli cells to synthesize and secrete androgen-binding protein, which maintains the high concentration of testosterone necessary for normal spermatogenesis within the seminiferous tubules.
25.This hormone induces Leydig cells to synthesize testosterone.
A. FSH
B. LH
C. Inhibin
D. None of the above
B. LH
Rationale: Luteinizing hormone (LH) stimulates Leydig cells in the testes to produce testosterone, which is crucial for the development and maintenance of male secondary sexual characteristics and reproductive function.
26.What is the most common cause of secondary amenorrhea?
A. A trophoblastic tumor
B. Turner Syndrome
C. Pregnancy
D. None of the above
C. Pregnancy
Rationale: Pregnancy is the most common cause of secondary amenorrhea, which is defined as the cessation of menstrual periods in women who have previously menstruated normally.
27.During an evaluation of a woman with amenorrhea, you have the following lab Results: hCG below 5mIU/mL, Prolactin High, T4 and TSH normal. What is an Appropriate next step?
A. Do another pregnancy test
B. Do imaging of the brain and surrounding structures
C. Treat for thyroid disease
D. None of the above
B. Do imaging of the brain and surrounding structures
Rationale: Given the high levels of prolactin and normal thyroid function, it is appropriate to investigate potential causes for hyperprolactinemia, such as a prolactinoma or other pituitary disorders. Imaging of the brain, specifically the pituitary region, would be a suitable next step.
28.During an evaluation of a woman with amenorrhea, you have the following lab Results: hCG below 5mIU/mL, Prolactin normal, T4 and TSH high. What is an Appropriate next step?
A. Do another pregnancy test
B. Do imaging of the brain and surrounding structures
C. Treat for thyroid disease
D. None of the above
C. Treat for thyroid disease
Rationale: With elevated T4 and TSH levels indicating a possible thyroid dysfunction (likely primary hypothyroidism with a compensatory rise in TSH), the appropriate next step is to address and treat the thyroid condition, which could be contributing to amenorrhea.
29.During an evaluation of a woman with amenorrhea, you have the following lab Results: hCG below 5mIU/mL, Prolactin, T4 and TSH normal, no withdrawal Bleeding observed. What is an appropriate next step?
A. Do imaging of the genital tract
B. Treat for thyroid disease
C. Evaluate for adrenal hyperplasia
D. None of the above
A. Do imaging of the genital tract
Rationale: With normal prolactin, thyroid function, and absence of withdrawal bleeding after progesterone challenge, imaging of the genital tract (such as ultrasound) is warranted to investigate possible anatomical or structural causes of amenorrhea.
30.During an evaluation of a woman with amenorrhea, you have the following lab Results: hCG below 5mIU/mL, Prolactin, T4 and TSH normal, no withdrawal Bleeding observed but with high FSH and LH. What is the probable cause of These findings?
A. The patient has a primary ovarian failure
B. The patient has a hydatidiform mole
C. The patient has an adrenal tumor
D. None of the above
A. The patient has primary ovarian failure
Rationale: High levels of FSH and LH with normal prolactin, T4, and TSH suggest primary ovarian insufficiency (failure), where the ovaries do not produce normal amounts of estrogen or release eggs regularly, leading to elevated gonadotropins as the feedback mechanism tries to stimulate ovarian function.
31.During an evaluation of a woman with amenorrhea, you have the following lab Results: hCG below 5mIU/mL, Prolactin, T4 and TSH normal, withdrawal bleeding is Present with high testosterone. What can be a probable cause of these findings?
A. A trophoblastic tumor
B. PCOS
C. Thyroid disease
D. None of the above
B. PCOS
Rationale: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism (high testosterone), irregular or absent menstrual periods, and often, polycystic ovaries. The presence of withdrawal bleeding indicates that the endometrium is responsive, which is consistent with PCOS.
32.During an evaluation of a man with infertility, you have the following lab Results: azoospermia, reduced testosterone, increased FSH and LH. What can be a Probable cause of these findings?
A. Thyroid disease
B. Primary testicular failure
C. Hypothalamic-pituitary necrosis
D. None of the above
B. Primary testicular failure
Rationale: Primary testicular failure is indicated by azoospermia (absence of sperm), reduced testosterone, and increased FSH and LH levels. This suggests that the testes are not responding to hormonal stimulation from the pituitary gland, which is compensating by increasing these hormones.
33.During an evaluation of a man with infertility, you have the following lab Results: oligospermia, reduced testosterone, normal FSH and LH, increased Prolactin. What can be a probable cause of these findings?
A. Thyroid disease
B. Primary testicular failure
C. A hypothalamic-pituitary problem
D. None of the above
C. A hypothalamic-pituitary problem
Rationale: Increased prolactin with reduced testosterone and normal FSH and LH levels suggest a possible issue with the hypothalamic-pituitary axis, potentially a prolactinoma or other disorder that elevates prolactin levels, which can inhibit gonadal function and reduce sperm production (oligospermia).
34.During an evaluation of a man with infertility, you have the following lab Results: azoospermia, reduced testosterone, increased FSH and LH. What is an Appropriate next step?
A. Chromosomal analysis
B. Orchiectomy
C. Vasectomy
D. None of the above
A. Chromosomal analysis
Rationale: With azoospermia and hormonal evidence of primary testicular failure (increased FSH and LH, reduced testosterone), a chromosomal analysis is an appropriate next step to determine if there is a genetic cause, such as Klinefelter syndrome.
35.During an evaluation of a man with infertility, you have the following lab Results: oligospermia, normal testosterone, FSH and LH, seminal fructose present, And normal spermatogenesis on biopsy. What is an appropriate next step?
A. Surgery
B. Antithyroid drugs
C. Administration of pituitary antagonists
D. None of the above
D. None of the above
Rationale: Given the findings of oligospermia, normal hormone levels, presence of seminal fructose, and normal spermatogenesis on biopsy, the infertility issue might be related to a post-testicular factor such as a blockage or other physical issue not addressed by surgery, antithyroid drugs, or pituitary antagonists.
36.A patient with seminiferous tubule failure would exhibit:
A. Polyspermia
B. Normal testosterone
C. Increased beta HCG
D. None of the above
D. None of the above
Rationale: Seminiferous tubule failure typically results in reduced sperm production leading to azoospermia or severe oligospermia, not polyspermia. It also generally results in altered hormone levels, particularly increased FSH due to the lack of feedback inhibition from inhibin, which is produced by Sertoli cells in the seminiferous tubules.
37.A surge of LH happens during:
A. Ovulation
B. Recruitment of oocytes
C. Selection of oocytes
D. None of the above
A. Ovulation
Rationale: A surge in LH (luteinizing hormone) triggers ovulation—the release of an egg from the ovary. This is a key event in the menstrual cycle.
38.The WHO 2010 standard method for counting sperms is:
A. Via a hematocytometer chamber
B. Via flow cytometric analysis
C. Via electron microscopy
D. None of the above
A. Via a hematocytometer chamber
Rationale: The WHO 2010 standard method for sperm counting is by using a hemocytometer chamber, which allows for accurate counting of sperm cells under a microscope.
39.During pregnancy, hCG levels start to plateau and decline during:
A. Sexual intercourse
B. The end of the first trimester
C. The end of the second trimester
D. Parturition
B. The end of the first trimester
Rationale: Human chorionic gonadotropin (hCG) levels typically rise rapidly in early pregnancy, peaking around the 10th week, then plateau and start to decline towards the end of the first trimester as the placenta takes over more of the hormone production functions.
40.The following statements about diabetes are true:
A. After testing for FBS, no further confirmatory test is needed
B. Wildly varying random glucose levels throughout the day is a worrisome issue
C. DKA is not an emergency and most cases are managed at home
D. Hypoglycemic symptoms with a plasma glucose level of ≤ 50 mg/dl (2.8 mmol/L) in an Individual who is not receiving medications for diabetes is not a concern.
B. Wildly varying random glucose levels throughout the day is a worrisome issue
Rationale: Wild fluctuations in random blood glucose levels can indicate poor glycemic control, which is a concern in diabetes management. The other options are incorrect: FBS alone may not be sufficient for diabetes diagnosis without confirmatory tests, DKA is a medical emergency requiring immediate care, and hypoglycemic symptoms with very low glucose are definitely a concern.
41.Which of the following is a non-organ specific autoimmune disease?
A. Pemphigus Vulgaris
B. Pernicious Anemia
C. Scleroderma
D. Hashimotos Thyroiditis
C. Scleroderma
Rationale: Scleroderma, also known as systemic sclerosis, is a non-organ specific autoimmune disease as it affects multiple systems including the skin, blood vessels, and internal organs such as the lungs and gastrointestinal tract. The other options are more organ-specific: Pemphigus vulgaris primarily affects the skin, Pernicious anemia targets the stomach’s ability to produce intrinsic factor, and Hashimoto’s thyroiditis specifically affects the thyroid.
42.Which of the following laboratory test will NOT evaluate autoimmunity
A. Carcinoembryonic antigen
B. Indirect immunofluorescence
C. Enzyme-linked immunosorbent assay
D. Western blot
A. Carcinoembryonic antigen
Rationale: Carcinoembryonic antigen (CEA) is used primarily as a tumor marker, not for evaluating autoimmunity. The other tests listed (indirect immunofluorescence, enzyme-linked immunosorbent assay, Western blot) are commonly used to detect autoantibodies and evaluate autoimmune conditions.
43.Histologic hallmark of the pemphigus group and responsible for the clinical Presentation of flaccid blisters and erosions
A. Intraepidermal acantholysis
B. Subepidermal blister formation
C. Hyperkeratosis
D. Parakeratosis
A. Intraepidermal acantholysis
Rationale: Intraepidermal acantholysis is the histologic hallmark of pemphigus, characterized by the loss of cell-cell adhesion within the epidermis, leading to the formation of flaccid blisters and erosions. This is a distinguishing feature from other blistering diseases which might involve subepidermal blistering or other skin changes.
44.This is the most common variant of pemphigus
A. Pemphigus vulgaris
B. Pemphigus foliaceus
C. Paraneoplastic pemphigus
D. IgA pemphigus
A. Pemphigus vulgaris
Rationale: Pemphigus vulgaris is the most common variant of pemphigus, characterized by painful mucosal ulceration and flaccid cutaneous blisters. It is more prevalent than the other types listed.
45.Which of the following finding is associated with Autoimmune disease
A. Presence of humoral or cell mediated immunity
B. Ability to transfer the disease with antibodies
C. Disease recurrence with organ transplantation in the absence of immunosuppression
D. All of the above
D. All of the above
Rationale: All the options listed are associated with autoimmune diseases. Autoimmune disorders often involve both humoral (B-cells, antibodies) and cell-mediated immunity (T-cells), the ability to transfer disease with antibodies (e.g., neonatal lupus with anti-Ro/SSA antibodies), and disease recurrence in transplanted organs due to immune memory.
46.Which of the following is associated with antibodies against the dermal-Epidermal junction (BMZ)
A. Bullous pemphigoid
B. Pemphigus foliaceus
C. Paraneoplastic pemphigus
D. IgA pemphigus
A. Bullous pemphigoid
Rationale: Bullous pemphigoid is characterized by antibodies against the basement membrane zone (BMZ), leading to subepidermal blisters. It is distinguished by linear deposition of C3 and IgG along the BMZ on direct immunofluorescence.
47.Which of the following variant of pemphigus will not show IgG deposition and
C3 in Direct immunofluorescence
A. Pemphigus vulgaris
B. IgA pemphigus
C. Pemphigus foliaceus
D. Paraneoplastic pemphigus
B. IgA pemphigus
Rationale: IgA pemphigus will not show IgG deposition as it involves IgA autoantibodies, unlike other forms of pemphigus which typically involve IgG antibodies. Direct immunofluorescence in IgA pemphigus shows IgA deposition.
48.Which of the following immunologic feature will differentiate Bullous Pemphigoid from Dermatitis Herpetiformis
A. Granular IgA deposition in the dermal papilla
B. Circulating anti-BMZ autoantibodies
C. Serum IgA autoantibodies directed against endomysium can be detected
D. Serum IgA autoantibodies tTG and eTG can be detected
B. Circulating anti-BMZ autoantibodies
Rationale: Bullous pemphigoid can be differentiated from dermatitis herpetiformis by the presence of circulating anti-BMZ autoantibodies, indicative of an autoimmune response against structural components in the dermal-epidermal junction. Dermatitis herpetiformis involves granular IgA deposition, particularly in relation to gluten sensitivity.
49.This blister disorder is associated with Celiac disease
A. Bullous pemphigoid
B. Pemphigoid gestationis
C. Mucous membrane pemphigoid
D. Dermatitis Herpetiformis
D. Dermatitis Herpetiformis
Rationale: Dermatitis herpetiformis is closely associated with celiac disease and is characterized by intense itching and blistering skin lesions. It is linked to gluten sensitivity, and the skin symptoms typically improve with a gluten-free diet.
50.Which of the following is least associated with Autoimmune Gastritis
A. Known consequence is vitamin B12 deficiency
B. Leads to mucosal atrophy and achlorhydria
C. Presents with very high serum gastrin concentrations
D. Precedes with gastric hypertrophy
D. Precedes with gastric hypertrophy
Rationale: Autoimmune gastritis typically leads to gastric atrophy (thinning of the stomach lining), not hypertrophy (thickening). It is characterized by mucosal atrophy, achlorhydria (absence of hydrochloric acid in gastric secretions), high serum gastrin levels due to loss of negative feedback inhibition, and is a known cause of vitamin B12 deficiency due to the resultant lack of intrinsic factor.
51.Characteristic histologic finding of Celiac Disease include:
A. Increased intraepithelial CD8 T lymphocytes (>25/100 enterocytes)
B. Villous hyperplasia
C. Hypoplastic crypts
D. All of the above
A. Increased intraepithelial CD8 T lymphocytes (>25/100 enterocytes)
Rationale: Characteristic histologic findings of celiac disease include increased intraepithelial lymphocytes (usually CD8+ T cells), villous atrophy (not hyperplasia), and crypt hyperplasia (not hypoplasia). The correct features are thus increased lymphocytes and crypt hyperplasia, along with villous atrophy.
52.Confirmatory test for Celiac Disease
A. Traditional antigliadin antibody tests
B. IgA endomysial autoantibodies (anti-EMA)
C. IgG antideamidated gliadin peptide (DGP)
D. IgA antitissue transglutaminase autoantibodies (anti-tTG)
D. IgA antitissue transglutaminase autoantibodies (anti-tTG)
Rationale: The IgA anti-tissue transglutaminase autoantibody (anti-tTG) test is considered the primary serologic test for the diagnosis of celiac disease, due to its high sensitivity and specificity. IgA endomysial antibodies (anti-EMA) are also highly specific but are used less frequently due to higher costs and the need for operator-dependent interpretation.
53.Which of the following is mostly associated with Ulcerative colitis
A. Characterized by discontinuous transmural ulcerations
B. Found throughout the digestive tract
C. P-ANCA is present in 40% to 80% of patients
D. highly associated with anti–Saccharomyces cerevisiae mannan antibodies (ASCA)
C. P-ANCA is present in 40% to 80% of patients
Rationale: P-ANCA (perinuclear anti-neutrophil cytoplasmic antibodies) are often associated with ulcerative colitis and can be detected in a significant number of patients. This form of colitis is characterized by continuous, superficial inflammation limited to the colon, not by transmural ulcerations or presence throughout the digestive tract.
