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GIT > Gallbladder Diseases > Flashcards

Gallbladder Diseases Flashcards

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1
Q

All are differential diagnosis for RUQ pain EXCEPT:

A. Acute cholangitis
B. Acute pancreatitis
C. Chronic pancreatitis
D. Hepatitis
E. Nephrolithiasis
A

E. Nephrolithiasis

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2
Q

It is the most common and most characteristic symptom of liver disease.

A. Nausea
B. Poor appetite
C. Fatigue
D. Lethargy
E. Diarrhea
A

C. Fatigue

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3
Q

Liver pain is due to stretching or irritation of which of the following?

A. Quadrate lobe
B. Caudate lobe
C. Glisson's capsule
D. Falciform ligament
E. Porta hepatitis
A

C. Glisson’s capsule

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4
Q

Which of the following is the most reliable marker of severity of liver disease?

A. Fatigue
B. Jaundice
C. Weight loss
D. Poor appetite
E. Pruritus
A

B. Jaundice

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5
Q

Jaundice without dark urine usually indicates which of the following?

A. Direct hyperbilirubinemia
B. Indirect hyperbilirubinemia
C. Cystic duct obstruction by gallstones
D. Hemolytic anemia
E. Two of the options
F. All of the options
A

E. Two of the options

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6
Q

This is the most reliable physical finding in examining the liver.

A. Palpable
B. Tenderness
C. Color
D. Enlargement
E. All of the options
A

B. Tenderness

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7
Q

Which of the following enzymes is considered the most specific indicator of liver injury?

A. AST
B. ALT
C. ALP
D. Serum amylase
E. Two of the options
F. All of the options
A

B. ALT

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8
Q

All of the following clotting factors are synthesized in the liver EXCEPT

A. Factor III
B. Factor V
C. Factor VIII
D. Factor IX
E. Factor X
A

C. Factor VIII

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9
Q

First line imaging technique if the initial blood tests suggest cholestasis

A. Ultrasound
B. CT
C. MRI
D. MRCP
E. ERCP
A

A. Ultrasound

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10
Q

Considered as single best acute measure of hepatic synthetic function

A. gamma-glutamyl transpeptidase
B. serum globulins
C. coagulation factors
D. serum bilirubin
E. alkaline phosphatase
A

C. coagulation factors

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11
Q

Scleral icterus manifests if the serum bilirubin is at least which of the following levels?

A. 2.0 mg/dL
B. 3.0 mg/dL
C. 2.0 g/dL
D. 3.0 g/dL
E. 5.0 g/dL
A

B. 3.0 mg/dL

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12
Q

This provides the estimate levels of serum unconjugated bilirubin

A. Direct fraction
B. Indirect fraction
C. Total fraction
D. Partial fraction
E. None of the above
A

B. Indirect fraction

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13
Q

Patients with Gilbert syndrome has which of the following?

A. Almost 100% unconjugated bilirubin in serum
B. 70% unconjugated bilirubin in serum
C. 85% conjugated bilirubin in serum
D.  55% conjugated bilirubin in serum
E. Any of the options
A

A. Almost 100% unconjugated bilirubin in serum

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14
Q

Suppose the laboratory results shown a proportion of ALP > ALT/AST, which of the following does this indicate?

A. Direct hyperbilirubinemia
B. Indirect hyperbilirubinemia
C. Cholestatic condition
D. Hepatocellular condition

A

C. Cholestatic condition

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15
Q

This is the most common cause of extrahepatic cholestasis.

A. Cholelithiasis
B. Cholecystitis
C. Choledocholithiasis
D. Cholangitis
E. Primary sclerosing cholangitis
A

C. Choledocholithiasis

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16
Q

This is characterized by the destruction and fibrosis of larger bile ducts.

A. Cholelithiasis
B. Cholecystitis
C. Choledocholithiasis
D. Cholangitis
E. Primary sclerosing cholangitis
A

E. Primary sclerosing cholangitis

17
Q

This is the “gold standard” for identifying choledocholithiasis.

A. US
B. CT
C. MRI
D. MRCP
E. ERCP
A

E. ERCP

18
Q

Which of the following clinical manifestations is present on patient with severe cholangitis?

A. Charcot's triad
B. Reynold's pentad
C. Colicky pain w/ leukocytosis
D. Postprandial pain w/ fever and leukocytosis
E. Two of the options
F. All of the options
A

B. Reynold’s pentad

19
Q

A normal AST:ALT ratio is ______

A. equal to 1
B. equal to 1.5
C. less than 1
D. greater than 1
E. greater than 2
A

C. less than 1

20
Q

Which of the following is mostly present in patients with conditions that have bacterial/parasitic cause?

A. Cholesterol stone
B. Black stone
C. Brown stone
D. Pigmented stone
E. Any of the options
A

C. Brown stone

21
Q

A biliary colic that is present for more than 5 hours would be highly suggestive of which of the following?

A. Cholelithiasis
B. Acute cholecystitis
C. Chronic cholecystitis
D. Choledocholithiasis
E. Acute cholangitis
A

B. Acute cholecystitis

22
Q

Which of the following is 95% specific for detecting gallstones?

A. US
B. CT
C. MRI
D. MRCP
E. ERCP
A

A. US

23
Q

All of the following are TRUE about acalculous cholecystitis EXCEPT

A. Less common that calculous cholecystitis
B. Develops as a complication of a serious illness or infection of the gallbladder
C. Increased risk associated with prolonged fasting, serious trauma or burns
D. Gallstones are absent
E. Usually present in immunocompetent patients

A

E. Usually present in immunocompetent patients

24
Q

Which of the following complications of cholecystitis results from ischemia of the wall and patchy or complete tissue necrosis?

A. Empyema
B. Gangrene
C. Perforation
D. Gallstone ileus
E. Fistula
A

B. Gangrene

25
Q

Which of the following is the most common infectious cause of acute cholangitis?

A. Gram positive bacteria
B. Gram negative bacteria
C. Facultative anaerobic bacteria
D. Obligate anaerobic bacteria

A

B. Gram negative bacteria

26
Q

If US and CT is not diagnostic for evaluation of acute cholangitis, which of the following should you opt to use?

A. MRCP
B. ERCP
C. EUS
D. Try US/CT again

A

A. MRCP

27
Q

Which of the following is the least cause of periampullary carcinoma?

A. Duodenal cancer
B. Cholangiocarcinoma
C. Bile duct carcinoma
D. Pancreatic carcinoma
E. Two of the options
F. None of the options
A

A. Duodenal cancer

28
Q

Which of the following is considered as the strongest risk factor for pancreatic cancer?

A. Alcohol abuse
B. Smoking
C. Family history
D. Lifestyle and diet
E. Weight loss
A

B. Smoking

29
Q

Which of the following is the most frequently altered gene in pancreatic cancer?

A. KRAS
B. BRAF
C. EGFR
D. PIK3CA
E. CTNNB1
A

A. KRAS

30
Q

It is the single most useful endoscopic study since it permits identification of the tumor, biopsy, and decompression

A. US 
B. CT
C. MRI
D. MRCP
E. ERCP
A

E. ERCP

31
Q

First-line treatment of locally advanced (nonresectable stage II or III) or metastatic (stage IV) pancreatic adenocarcinoma

A. Capecitabine 
B. Gemcitabine
C. Cisplatin
D. Lenalidomide
E. Hydroxyurea
A

B. Gemcitabine

32
Q

All of the following are formed in the colon as bacterial metabolites EXCEPT:

A. Deoxycholate
B. Lithocholate
C. Ursodeoxycholic acid
D. Chenodeoxycholic acid
E. None of the options
A

D. Chenodeoxycholic acid

33
Q

Bile acids are absorbed in the gut in what process?

A. Active transport
B. Passive diffusion
C. Facultative diffusion
D. Protein-mediated transport
E. Any of the options
A

B. Passive diffusion

34
Q

Which of the following is the major hormone in controlling the evacuation of the gallbladder?

A. Secretin
B. Gastrin
C. Cholecystokinin
D. Leptin
E. Somatostatin
A

C. Cholecystokinin

35
Q

Which of the following is considered as the treatment of choice for most patients with acute cholecystitis?

A. Early cholecystectomy
B. Urgent cholecystectomy
C. Emergency cholecystectomy
D. Laparoscopic Cholecystectomy
E. Delayed surgical intervention
A

A. Early cholecystectomy

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