Gastroenterology Flashcards
1
Q
Motility disorders of the esophagus include:
A. Mallory Weiss syndrome
B. nutcracker esophagus
C. squamous cell carcinoma of the esophagus
D. reflux esophagitis
E. hiatus hernia
A
B. nutcracker esophagus
2
Q
Choose the correct answer that belongs to the set of characteristics of achalasia:
A. propulsive esophageal peristalsis is normal
B. the cause may be the collapse of inhibitory neurons in the wall of the esophagus
C. chest pain is a rare symptom
D. calcium channel antagonists are a successful and permanent drug
E. patients are well fed
A
B. the cause may be the collapse of inhibitory neurons in the wall of the esophagus
3
Q
Which of the following applies to physiological gastroesophageal reflux:
A. occurs before eating food
B. occurs between meals
C. appears after a meal (appears after a meal and between meals during periods of
spontaneous sphincter relaxation. Is this the most correct answer?)
D. formation is linked to the act of swallowing
E. is present in 90% of people
A
C. appears after a meal (appears after a meal and between meals during periods of
spontaneous sphincter relaxation. Is this the most correct answer?)
4
Q
The following does NOT apply to pathological gastroesophageal reflux:
A. it is caused by inappropriate relaxation of the lower esophageal sphincter
B. the cleaning action of the esophagus is weakened
C. a hiatus hernia may be present
D. all patients with pathological gastroesophageal reflux have reflux
esophagitis
E. it is more common in obese people
A
D. all patients with pathological gastroesophageal reflux have reflux
esophagitis
5
Q
Everyday reflux problems are listed by:
a) 40% of people
b) 10% of people
c) 5% of people
d) 100% of people
e) 95% of people
A
c) 5% of people
6
Q
As a rule, what does NOT belong to the symptoms of esophageal disease?
a) chest pain
b) pain under the rib cage
c) dysphagia
d) odynophagia
e) pyrosis
A
b) pain under the rib cage
7
Q
Choose the combination of correct statements regarding reflux esophagitis:
A. Reflux esophagitis occurs in 50% of patients with reflux
B. reflux esophagitis causes reflux of stomach acid
C. reflux esophagitis causes reflux of duodenal contents
D.reflux esophagitis is caused by an infection withHelicobacter pylori
E. reflux esophagitis causes hypergastrinemia
a) statements A, B, E are correct
b) statements B, C, D are correct
c) statements B, Č, E are correct
d) statements A, B, C are correct
e) all statements are correct
A
d) statements A, B, C are correct
8
Q
Which of the following is true of reflux esophagitis:
a) the diagnosis is established by endoscopy
b) the diagnosis is established by X-ray examination of the esophagus
c) the diagnosis is made with laboratory tests
d) we always make the diagnosis based on the anamnesis
e) the diagnosis is established by clinical examination
A
a) the diagnosis is established by endoscopy
9
Q
How do we identify motility disorders of the esophagus?
a. with chest CT
b. with contrast X-ray examination of the esophagus
c. with esophagoscopy
d. with esophageal pH-metry
e. with capsule endoscopy
A
b. with contrast X-ray examination of the esophagus
10
Q
A symptom or disease that is not related to GERD is:
a) asthma
b) chronic cough
c) diarrhea
d) tooth enamel erosion
e) chronic laryngitis
A
c) diarrhea
11
Q
For the treatment of esophageal reflux disease, a personal physician may prescribe the following to the patient
for two weeks as a therapeutic test:
a) H2 receptor antagonist 800 mg/day
b) proton pump inhibitor in a therapeutic dose twice a day
c) paracetamol 500 mg daily
d) acetylsalicylic acid 100 mg
e) Hygienic - dietary regime in GERD
A
b) proton pump inhibitor in a therapeutic dose twice a day
12
Q
Choose the correct doses of drugs for the treatment of esophageal reflux disease:
a) lansoprazole 120mg/day
b) pantoprazole 2x40mg/day for 14 days
c) omeprazole 30 mg/day
d) omeprazole 2x60 mg/day
e) pantoprazole 80 mg/day for 14 days
A
b) pantoprazole 2x40mg/day for 14 days
13
Q
What is NOT considered an alarm sign in gastroesophageal reflux disease?
a) dysphagia
b) odynophagia
c) positive stool hematest
d) persistent vomiting
e)night cough
A
e)night cough
14
Q
Dysphagia occurs when eating dry food in a patient with gastroesophageal reflux disease. What
would be the most appropriate action?
a) The patient is prescribed a prokinetic drug and ordered to undergo a follow-up
outpatient examination
b) We prescribe a proton pump blocker to the patient and tell him to come
back in 2 weeks if the problem persists
c) The patient is immediately referred for gastroscopy
d) The patient is admitted to the hospital and a chest CT is performed immediately
e) We advise the patient to avoid dry food
A
c) The patient is immediately referred for gastroscopy
15
Q
The question is really about H2 receptor blockers, which
they are only effective for a short time due to tachyphylaxis (receptors get used to them after a few days)
a. due to a carcinogenic effect (no research has confirmed this)
b. because they cause steatorrhea
c. because with permanent treatment, they only have a temporary effect, which is not reversible even if
we increase the dose
d. because they are too expensive for chronic treatment
e. because they are very effective and can mask the alarm signs
A
a. due to a carcinogenic effect (no research has confirmed this)
16
Q
A characteristic complication of long-term reflux esophagitis is:
a) esophageal atresia
b) esophageal achalasia
c) squamous esophageal cancer
d) adenocarcinoma of the esophagus
e) lymphoma of the esophagus
A
d) adenocarcinoma of the esophagus
17
Q
. Choose the correct statement for Barrett’s esophagus :
A. is associated with the formation of squamous esophageal cancer
B. is associated with chronic laryngitis
C. is associated with the formation of adenocarcinoma
D. it is associated with chronic infectionwith Helicobacter pylori
E. it is hyperplasia of the squamous epithelium in the distal esophagus
A
C. is associated with the formation of adenocarcinoma
18
Q
Choose the correct statements for Barrett’s esophagus :
a) occurs in patients with duodenoesophageal reflux
b) histologically, it is a metaplasia of the glandular epithelium of the gastric mucosa v
esophagus
c) occurs in the first year of severe reflux disease
d) occurs in smokers
e) Barrett’s esophagus is treated exclusively with drugs
A
b) histologically, it is a metaplasia of the glandular epithelium of the gastric mucosa v
esophagus
19
Q
Which of the following is true of non-reflux esophagitis?
A. it is caused by anaerobic bacteria
B. it is caused by viruses of the human herpes virus group
C. it is caused by dermatophytes
D. it is caused by the rota virus
E. it is caused by actinomycetes
A
B. it is caused by viruses of the human herpes virus group
20
Q
Reflux esophagitis is associated with:
A. axial hiatus hernia
B. paraesophageal hernia
C. esophageal atresia
D. agenesis of the esophagus
E. esophageal diverticula
A
A. axial hiatus hernia
21
Q
What is characteristic of achalasia?
a) absence of esophageal peristalsis
b) esophageal stricture
c) esophageal diverticulum, which obstructs peristalsis
d) spasm of the lower esophageal sphincter
e) ulcer on the lower esophageal sphincter
A
d) spasm of the lower esophageal sphincter
22
Q
Which of the following is a typical etiological factor for non-reflux esophagitis?
a) AIDS
b) immunosuppressive treatment
c) Herpes simplex virus
d) eating hot food
e) sicca syndrome, e.g. in the context of Sjogren’s syndrome
A
a) AIDS
b) immunosuppressive treatment
c) Herpes simplex virus
23
Q
Zencker’s diverticulum is indicated by all the listed symptoms except:
A. pressure on the neck
B. bad breath
C. regurgitation of several days old food
D. hemohesia
E. dysphagia
A
D. hemohesia
24
Q
Which of the following is NOT true of esophageal cancer :
A. the most common form in Caucasians is adenocarcinoma
B. is associated with smoking and alcohol
C. can cause hoarseness
D. radical surgical treatment is possible in 70% of patients
E. progressive dysphagia may be present
A
D. radical surgical treatment is possible in 70% of patients
25
To estimate the prevalence of esophageal cancer, we use:
A. endoscopy (endoscopic US and CT are complementary)
B. ultrasound examination of the abdomen
C. clinical examination
D. computed tomography - CT
E. x-ray examination of the esophagus with contrast
D. computed tomography - CT
26
A 19-year-old young man, who has been completely healthy so far and has no vices, accompanied by friends, comes
to the emergency clinic because of chest pain and shortness of breath. The pain is burning, localized behind the
sternum, spreading from the spoon upwards in the chest, intensity 5/10, constant, it appeared half an hour before
arriving at the emergency room - after he had drunk 2 dcl of red wine at his friends' house. The pain is worse if he bends
over. Since the onset of the pain, he has not taken any medicine or drunk anything.
On arrival, he is unharmed, oriented, agitated, and does not appear to be drunk. Palpation of the epigastrium is somewhat
painful, otherwise the results of the physical examination are within normal limits.
Based on the anamnesis, taking into account all the listed risk factors, the most likely working
diagnosis is:
A. acute myocardial infarction
B. alcoholic hepatitis
C. achalasia
D. esophageal reflux disease
E. pulmonary embolism
D. esophageal reflux disease
27
A 19-year-old young man, who has been completely healthy up to now and has no vices, accompanied by friends,
comes to the emergency clinic because of burning pain in the chest and shortness of breath. The pain is burning,
localized behind the sternum, spreading from the spoon upwards in the chest, intensity 5/10, constant, it appeared half
an hour before arriving at the emergency room - after he had drunk 2 dcl of red wine at his friends' house. The pain is
worse if he bends down. Since the onset of the pain, he has not taken any medicine or drunk anything.
On arrival, he is unharmed, oriented, agitated, and does not appear to be drunk. Palpation of the epigastrium is somewhat
painful, otherwise the results of the physical examination are within normal limits.
The emergency team recorded an EKG, took blood for basic tests, because the young man still
complains of chest pain, the doctor on duty decides to treat him immediately.
According to the working diagnosis, he will decide to:
A. heparin 5,000 units iv.
B. calcium antagonist, e.g. verapamil 40mg po.
C. Nitroglycerin under the tongue, Aspirin direct, oxygen and morphine as an analgesic
D. a proton pump inhibitor in a therapeutic dose iv. or after
E. iv infusion of 0.9% NaCl solution with the addition of 100 mg Thiamine
D. a proton pump inhibitor in a therapeutic dose iv. or after
28
A 19-year-old young man, who has been completely healthy so far and has no vices, accompanied by friends,
comes to the emergency clinic because of chest pain and shortness of breath. The pain is burning, localized behind the
sternum, spreads from the spoon upwards into the chest, has a strength of 5/10, is constant, appeared half
7
hours before arriving at the emergency room - after he drank 2 dcl of red wine at his friends' house. The pain is worse
if he bends over. Since the onset of the pain, he has not taken any medicine or drunk anything.
On arrival, he is unharmed, oriented, agitated, and does not appear to be drunk. Palpation of the epigastrium is somewhat
painful, otherwise the results of the physical examination are within normal limits.
Twenty minutes after the iv injection of the proton pump inhibitor, he dies. EKG and laboratory tests
are normal. The doctor reassures the young man and explains to him why the pain occurred and how
the treatment will proceed in the future. What is the next appropriate procedure in such a patient?
A. proton pump inhibitor in a therapeutic dose for 14 days
B. initiation of treatment with vitamin K antagonists
C. Aspirin 100 mg for life
D. gastroscopy
E. initiation of calcium antagonist therapy
A. proton pump inhibitor in a therapeutic dose for 14 days
29
The characteristics of the parietal cells of the stomach are all of the above except:
a) they secrete gastric acid and intrinsic factor
b) secrete pepsinogen
c) are predominantly in the fundus and body of the stomach
d) they are stimulated by gastrin
e) they are stimulated by histamine
b) secrete pepsinogen
30
Mucous cells of the stomach secrete:
a) mucus and pepsinogen
b) mucus
c) pepsinogen
d) mucus and HCl
e) mucus and bicarbonate
e) mucus and bicarbonate
31
Acute gastritis can be thought of with the following symptoms:
A. Vomiting
B. pain in the spoon
C. bleeding
D. all three of the above
E. with none of the above
D. all three of the above
32
In which condition would you expect gastric hypersecretion?
a. atrophic gastritis
b. after vagotomy
c. in chronic renal failure
d. in Zollinger-Ellison syndrome
e. treatment with esomeprazole
d. in Zollinger-Ellison syndrome
33
How does severe gastric hypersecretion affect digestion? Choose the WRONG answer.
a. causes malabsorption
b. causes
c. causes diarrhea
d. causes duodenal and jejunum ulcers
e. causes incomplete protein digestion
e. causes incomplete protein digestion
34
Which statement refers to infection withH. pyloriit isINCORRECT? :
A. leads to the formation of gastric ulcer
B. infection is associated with the appearance of MALT lymphoma
C. we prove it with the Schiller test
D. the infection can be asymptomatic throughout life
E. can lead to duodenal ulcers
C. we prove it with the Schiller test
35
Choose the correct combination that contains all the correct statements about autoimmune
gastritis:
a.causes megaloblastic anemia
b. antimitochondrial antibodies are characteristic
c.causes atrophy of the corpus mucosa
d. we treat it with vitamin B-12
a.causes megaloblastic anemia
c.causes atrophy of the corpus mucosa
36
The most common causes of peptic ulcer of the stomach and duodenum are:
a) Treatment with nonsteroidal antirheumatic drugs
b) Zollinger-Ellison syndrome
c) Crohn's disease
d) Treatment with calcium channel blockers
e) Treatment with vitamin K antagonists
a) Treatment with nonsteroidal antirheumatic drugs
37
Choose the correct statement regarding peptic ulcer:
A. the pain is characteristically colicky
B. Bleeding is common (1 out of 10 duodenal ulcers bleeds)
C.often progresses to adenocarcinoma
D. the pain often radiates to the right iliac area, so it can be replaced
for acute appendicitis
E. pain is always present
B. Bleeding is common (1 out of 10 duodenal ulcers bleeds)
38
Medicines of choice for the treatment of peptic ulcer in case of infection withH. pyloriare:
A. antibiotics
B. proton pump inhibitors
C. both (antibiotics and proton pump inhibitors)
D. H receptor blockers2
E.antacids
C. both (antibiotics and proton pump inhibitors)
39
Treatment of duodenal ulcer disease in case of infection withH. pyloriconsists of:
A. one-week antibiotic treatment
B. two-week antibiotic treatment
C. three-week treatment with proton pump inhibitors
D. one week of antibiotics and proton pump inhibitors (from the book: recommended
eradication treatment lasts one week in Europe, and in the USA 2)
E. antibiotics for one week and proton pump inhibitors for three weeks
E. antibiotics for one week and proton pump inhibitors for three weeks
40
The drug of choice for the treatment of peptic ulcer is/are:
A. bismuth subsalicylate
B.proton pump inhibitors(right)
C. H2 receptor blockers
D. antacids
E. mesalazine
B.proton pump inhibitors(right)
41
Choose the right combination! Success of eradication treatmentHelicobacter pylori
controlled by:
a. mucosal biopsy
b. serological tests (basically it is with urea breath test and fecal test, nowhere
it doesn't say that a 1x biopsy is done, WHO WOULD KNOW)
c. urea breath test
d. polymerase chain reaction – it will always be wrong in this context!!!
a. mucosal biopsy
c. urea breath test
42
Common complications of ulcer disease include all except:
A. pyloric stenosis
B. bleeding
C. perforations
D. ileus
E.penetrations
D. ileus
43
Symptoms of pyloric stenosis are all of the above except:
A. pain after feeding
B. vomiting food
C. vomiting of hematinized contents
D.vomiting of bile (100% because bile is secreted in the duodenum,
this one stays in the stomach)
E. poor appetite
D.vomiting of bile (100% because bile is secreted in the duodenum,
this one stays in the stomach)
44
Zollinger-Ellison syndrome causes excessive secretion of :
A. gastrin
B. somatostatin
C.VIP's
D. Glucagon
E. cholecystokinin
A. gastrin
45
In the case of a patient suspected of having a perforation of a hollow abdominal organ
due to free air under the diaphragm, further treatment requires:
A. perform an emergency endoscopy of the upper gastrointestinal tract
B. do an abdominal ultrasound
C. make a computed tomography of the abdomen
D. refer the patient to a surgeon as an emergency
E. perform magnetic resonance angiography of the abdomen
D. refer the patient to a surgeon as an emergency
46
How is gastroparesis defined?
a.Symptomatic disturbance in gastric emptying, which is not the result of a mechanical obstruction
b. Any symptomatic disturbance in gastric emptying
c. Symptomatic or asymptomatic gastric emptying disorder resulting from achlorhydria
d. Symptomatic or asymptomatic gastric emptying disorder secondary to stroke
e. Symptomatic or asymptomatic gastric emptying disorder resulting from vagotomy
a.Symptomatic disturbance in gastric emptying, which is not the result of a mechanical obstruction
47
Blind gyrus syndrome indicates:
A. malabsorption of di- and polysaccharides
B. malabsorption of fats and iron
C. malabsorption of saccharides and iron
D. malabsorption of fat and vitamin B-12
E. malabsorption of thiamine
D. malabsorption of fat and vitamin B-12
48
Gastric bradygastria is:
a. reduced frequency of the formation of peristaltic waves in the stomach
b. slow pulse in stomach ulcer
c. shortened stomach after partial resection
d. formation of shorter peristaltic waves in the stomach
e. nothing, it's a joke
a. reduced frequency of the formation of peristaltic waves in the stomach
49
Choose a combination of correct answers! A peptic ulcer on the jejunum can be caused by:
a. Zollinger-Ellison syndrome
b. glucagonoma
c. after gastric resection according to Billroth II
d. after choledochojejunoanastomosis
a. Zollinger-Ellison syndrome
c. after gastric resection according to Billroth II
50
Which of the following is NOT true of gastric disease resulting from NSAIDs?
a. the disease is characterized primarily by stomach ulcers
b. it is caused by aspirin and other nonsteroidal anti-inflammatory drugs that inhibit
cyclooxygenase
c. COX-2 selective cyclooxygenase inhibitors cannot cause gastric ulcers
d. treatment includes discontinuation of the causative drug and treatment with a proton
pump inhibitor
e. patients who are at high risk of gastric ulcer when taking NSAIDs should be protected
while taking these drugs with a proton pump inhibitor
c. COX-2 selective cyclooxygenase inhibitors cannot cause gastric ulcers
51
What is NOT true of stress gastric disease?
a. caused by hypoperfusion of the stomach in critically ill patients
b.arises due to increased secretion of HCl in the stomach
c. manifested by bleeding from the stomach
d. it is mostly gastric erosions, ulcers are less common
e. bleeding from erosions is stopped endoscopically
b.arises due to increased secretion of HCl in the stomach
52
The most common polyps in the stomach are histologically:
A. adenomas (non-invasive intraepithelial neoplasia)
B. hyperplastic polyps
C. adenocarcinomas
D. squamous cell carcinomas
E. fundic gland polyps
E. fundic gland polyps
53
The most reasonable examination for polyps in the stomach is:
A. X-ray examination of the stomach and polypectomy
B. gastroscopy and polypectomy
C. X-ray examination of the stomach only
D. determination of the level of oncofetal antigens in the serum
E. computed tomography of the abdomen
B. gastroscopy and polypectomy
54
Gastric carcinoma does NOT occur often in the following circumstances: :
A. in pernicious anemia
B. in atrophy of the gastric mucosa
C. in intestinal metaplasia
D. after Helicobacter pylori infection
E. with regular consumption of strongly spiced food
E. with regular consumption of strongly spiced food
55
The following applies to early gastric carcinoma:
A. endoscopy is the investigation of choice
B. endoscopic biopsy is 100% reliable
C. often arises from a stomach ulcer
D. never radiates to the lymph nodes
E. staging with additional tests upon discovery is not necessary
A. endoscopy is the investigation of choice
56
Radiation to the lymph nodes can be present in:
a. early stomach cancer
b. adenoma
c.scirrhous gastric cancer(non-ulcerating gastric cancer, same as adenocarcinoma,
EUZ for diagnostics)
d. advanced stomach cancer
a. early stomach cancer
c.scirrhous gastric cancer(non-ulcerating gastric cancer, same as adenocarcinoma,
EUZ for diagnostics)
d. advanced stomach cancer
57
The preoperative treatment of a patient with stomach cancer includes everything except:
A. upper gastrointestinal endoscopy
B. histological examination of the tissue sample
C. serology atHelicobacter pylori
D. ultrasound examination of the abdomen
E. endoscopic ultrasound of the stomach
C. serology atHelicobacter pylori
58
Which of the following is the most reliable sign that a gastric ulcer is benign? :
A. When the gastric ulcer heals
B. If the gastric mucosa and lymph nodes near the stomach during endoscopic ultrasound
they show no signs of malignant infiltration
C. If bleeding from the ulcer does not recur within 14 days
D. If the lymph nodes near the stomach and the celiac trunk do not show according to the CT criteria
signs of malignant infiltration
E. Pathohistology of ulcer causes is negative for malignancy
E. Pathohistology of ulcer causes is negative for malignancy
59
Choose the combination of correct statements! Precancerous changes of the gastric mucosa
include:
a. atrophic gastritis
b. endocrine cell hyperplasia
c. intestinal metaplasia
d. adenoma polyp
a. atrophic gastritis
c. intestinal metaplasia
d. adenoma polyp
60
Everything applies to a stress ulcer, except:
A. it is caused by neurosurgical interventions
B. leading symptom is bleeding
C. patients have characteristic pain (they do not, the ulcer does not have characteristic pain,
often these are also unconscious patients)
D. bleeding is stopped endoscopically
E. we prevent it with proton pump inhibitors
C. patients have characteristic pain (they do not, the ulcer does not have characteristic pain,
often these are also unconscious patients)
61
Early stomach cancer indicates:
A. grows limited to the mucosa and submucosa, with lesions in regional areas
with or without lymph nodes
B. grows limited to the mucosa
C. absence of lymph node metastases
D. histologically exclusively intestinal type according to Lauren
E. histologically exclusively mixed cell type according to Lauren
A. grows limited to the mucosa and submucosa, with lesions in regional areas
with or without lymph nodes
62
The most common localization of cancer on the stomach is: at least not in this form
A.the lower third of the stomach(antrum, moving up today)
B. fundus of the stomach
C. pyloric duct
D. lesser curvature of the stomach (from surgery: most often it is limited to the lesser curvature
middle third of the stomach)
E. body of the stomach
A.the lower third of the stomach(antrum, moving up today)
63
Choose the combination of correct statements! The following symptoms are characteristic of developed gastric carcinoma:
a.anemia
b. vomiting
c. weight loss
d. dysphagia
e. constipation
a.anemia
c. weight loss
d. dysphagia
64
Low-grade non-Hodgkin's MALT lymphoma is:
A. in 90% associated with infection withHelicobacter pylori
B. 50% associated with EBV infection
C. we treat it with surgery
D. we treat it with diet
E. treatment is started with chemotherapy
A. in 90% associated with infection withHelicobacter pylori
65
Which of the following is NOT true of melena? :
A. melena is most often a sign of bleeding from the upper gastrointestinal tract
B. melena is the result of digestion of blood in the lumen of the gastrointestinal tract
C. may occur simultaneously with hematemesis
D. is more common than hematemesis
E. occurs even with insignificant bleeding in the gastrointestinal tract
E. occurs even with insignificant bleeding in the gastrointestinal tract
66
Hematemesis is:
A. vomiting of fresh, coagulated or old black blood
B. Vomiting of yellow fluid
C. a sure sign of gastric carcinoma
D. rare in esophageal bleeding
E. common in bleeding from the jejunum
A. vomiting of fresh, coagulated or old black blood
67
Hematochezia occurs in all conditions except:
A. hemorrhoids
B. intestinal tumors
C. Crohn's disease
D. duodenal peptic ulcers
E. pseudomembranous colitis
D. duodenal peptic ulcers
68
The most common source of bleeding from the lower gastrointestinal tract is
A. hemorrhoids and intestinal tumors
B. colonic polyps and hemorrhoids
C. diverticula
D. angiodysplasia of the colon
E. chronic inflammatory bowel disease
C. diverticula
69
The initial method of choice for localization of bleeding in the gastrointestinal tract is:
A. angiography
B. endoscopy
C. computed tomography
D. scintigraphy with labeled erythrocytes
E. endoscopic ultrasound
B. endoscopy
70
Choose the correct answers related to the treatment of gastrointestinal bleeding:
a. most often it is stopped endoscopically
b. we use photocoagulation to stop the bleeding
c. fibrin glue is used to stop the bleeding
d. in most cases, bleeding from the upper gastrointestinal tract can only be stopped by surgery
intervention, surgery
a. most often it is stopped endoscopically
b. we use photocoagulation to stop the bleeding
c. fibrin glue is used to stop the bleeding
71
Contraindications for emergency endoscopy in case of bleeding from the upper gastrointestinal tract are:
A. poor general condition of the patient
B. acute myocardial infarction
C. injury by ingestion of lye or acid more than 12 hours ago
D. acute alcohol intoxication
E. severe bleeding
E. severe bleeding
72
Typical signs of shock due to severe bleeding are all except:
A. pallor
B. bradycardia
C. low blood pressure
D. disturbance of consciousness
E. dizziness
B. bradycardia
73
In which of the described patients would you NOT decide to transfuse concentrated
erythrocytes? :
a. previously healthy patient, bleeding has stopped, hemoglobin value 90
g/l
b. previously healthy patient, still bleeding heavily, hemoglobin value 90 g/l
c. severe cardiac patient, bleeding stopped, hemoglobin value 100 g/l
d. severe cardiac patient, bleeding not stopped, hemoglobin value 100 g/l
e. shocked patient, still bleeding, previously healthy, hemoglobin value 120 g/l
a. previously healthy patient, bleeding has stopped, hemoglobin value 90
g/l
74
The family doctor is called to the clinic in the morning by the relatives of a gentleman with known liver
cirrhosis. He was recently hospitalized in the gastroenterology department due to worsening of the disease with
ascites and swelling of the legs, at which time the degree of liver function impairment was assessed as Child
Pugh class C. He drank yesterday, he felt bad in the morning. He vomited fresh blood twice in the morning, and
shortly afterwards his relatives found him lying on the toilet floor. They noticed completely black, smelly, liquid
feces in the toilet bowl. He soon regained consciousness, but he is still "bad" during the phone call.
Which working diagnosis is most likely?
A. Bleeding from a duodenal ulcer
B. Bleeding from Mallory Weiss poke
C. Bleeding from esophageal varices
D. Bleeding from the papilla of Vateri
E. Bleeding from angiodysplasias of the small intestine
C. Bleeding from esophageal varices
75
The family doctor is called to the clinic in the morning by the relatives of a gentleman with a known liver problem
cirrhosis. Due to aggravation of the disease with ascites and swelling of the legs, he was recently
hospitalized in the gastroenterology department, at that time the degree of liver function impairment
rated Child Pugh class C. Yesterday he drank, this morning he felt bad. In the morning e
twice vomited fresh blood, shortly afterwards his relatives found him lying on the toilet floor. V
completely black, smelly, liquid faeces were observed in the toilet bowl. He soon regained consciousness, however
is still "bad" during a phone call.
The family doctor informed the emergency team about the patient's condition and the most likely diagnosis.
Upon their arrival, the patient was pale, cold, blood pressure was 80/50 mmHg, saturation was measured
on the finger 88%, signs of recent gastrointestinal bleeding were present. He's an emergency doctor
prescribed infusions of colloidal solution, oxygen by mask with 60% of oxygen in inhaled air
and transferred him to internal medicine first aid.
Which examination is necessary for the patient in such a case?
A. urgent CT angiography
B. emergency rectoscopy
C. emergency endoscopic ultrasound
D. emergency angiography with superselective embolization of the bleeding vessel
E. emergency esophagogastroduodenoscopy
E. emergency esophagogastroduodenoscopy
76
The family doctor is called to the clinic in the morning by the relatives of a gentleman with a known liver disease
cirrhosis. Due to aggravation of the disease with ascites and swelling of the legs, he was recently
hospitalized in the gastroenterology department, at that time the degree of liver function impairment
rated Child Pugh class C. Yesterday he drank, this morning he felt bad. In the morning e
twice vomited fresh blood, shortly afterwards his relatives found him lying on the toilet floor. V
completely black, smelly, liquid faeces were observed in the toilet bowl. He soon regained consciousness, however
is still "bad" during a phone call.
The doctor at the internal medicine first aid found anemia with a hemoglobin of 67g/L, and ordered blood
for transfusion and referred the patient to the appropriate emergency examination, where they diagnosed and treated
gastrointestinal bleeding.
What can you do in a patient with profuse gastrointestinal bleeding and known cirrhosis of the liver Child Pugh C
expected in the next few hours?
A. Development or worsening of hepatic encephalopathy(due to protein digestion
rich own blood, which appeared in the gastrointestinal tract due to bleeding - high N content)
B. Development of ileus
C. Perforation of the hollow digestive organ
D. Development of iatrogenic pancreatitis
E. Sepsis (not far from the truth, but all patients in such cases get AB
protection (amoxicillin, so sepsis is unlikely)
A. Development or worsening of hepatic encephalopathy(due to protein digestion
rich own blood, which appeared in the gastrointestinal tract due to bleeding - high N content)
77
The efficiency of sodium absorption in the small intestine is:
A. 30%
B. 60%
C. 90%
D. 99%
E. 10%
D. 99%
78
Nutrients pass through the small intestine by the following mechanisms
a. by simple diffusion
b. endocytosis
c. apoptosis
d. active transport
a. by simple diffusion
b. endocytosis
d. active transport
79
Iron is resorbed in :
A. proximal jejunum
B. distal jejunum
C. to the ileum
D. colon
E. stomach
A. proximal jejunum
80
Choose a combination of correct answers! Maldigestion is caused by:
a. chronic pancreatitis
b. cystic fibrosis
c. lactase deficiency
d. cholecystectomy
a. chronic pancreatitis
b. cystic fibrosis
c. lactase deficiency
81
The oral iron absorption test is used in diagnostics:
A. malabsorption
B. hemochromatosis
C. steatorrhea
D. sideroblastic anemia
E. chronic pancreatitis
A. malabsorption
82
Choose the correct statements regarding prothrombin time:
a. a prolonged prothrombin time may be a sign of liver disease
b. prolonged prothrombin time is common in steatorrhea
c. a prolonged prothrombin time indicates a dietary vitamin B-12 deficiency
d. the length of the prothrombin time is part of the classification of liver cirrhosis according to Child -
to Pough
a. a prolonged prothrombin time may be a sign of liver disease
b. prolonged prothrombin time is common in steatorrhea
d. the length of the prothrombin time is part of the classification of liver cirrhosis according to Child -
to Pough
83
In what proportion of people older than 50 can we expect lactase deficiency:
A. 5% of the population
B. 25% of the population
C. 50% of the population
D. 75% of the population (the book says 40-100% hahaha)
E. 100% of the population
D. 75% of the population (the book says 40-100% hahaha)
84
The most common cause of malabsorptive syndrome is:
A. Whipple's disease
B. celiac disease
C. scleroderma
D. intestinal lymphoma
E. colorectal carcinoma
B. celiac disease
85
Bacterial colonization of the small intestine prevents:
a. normal peristalsis
b. bactericidal action of gastric juice
c.the presence of an ileocecal valve(this valve allows the passage of bacteria only
down but not up)
d. stasis of intestinal contents
a. normal peristalsis
b. bactericidal action of gastric juice
c.the presence of an ileocecal valve(this valve allows the passage of bacteria only
down but not up)
86
Fully expressed short bowel syndrome is the result of all of the above EXCEPT :
A. loss of absorptive surface
B. loss of microvilli in the small intestine
C. rapid passages of food
D. bacterial colonization of the small intestine
E. malabsorption of nutrients and fluid from the chyme
B. loss of microvilli in the small intestine
87
Short bowel syndrome develops when the length of the small intestine is:
A. shorter than 500 cm
B. shorter than 300 cm
C. shorter than 100 cm
D. shorter than 200 cm
E. longer than 400 cm
C. shorter than 100 cm
88
Choose the combination of correct statements! Which of the following is true of celiac disease?
a. is gluten intolerance
b. it occurs in genetically susceptible people
c. shows a characteristically altered colonic mucosa
d. it always begins in childhood
e. it always gets confused with lymphoma
a. is gluten intolerance
b. it occurs in genetically susceptible people
89
How does atypical celiac disease differ from typical? :
A. after an extraordinary disability
B. after an asymptomatic course
C. after the absence of antibody against tissue transglutaminase 2
D. after the colon is affected
E. after normal intestinal histology
A. after an extraordinary disability
90
Celiac disease is characterized by:
A. obesity
B. eating disorders
C. poor nutrition and weight loss
D. body mass index above 30 kg/m2
E. erythrocytosis
C. poor nutrition and weight loss
91
Choose the correct statements regarding celiac disease:
a. often presents with sideropenic anemia due to gastrointestinal bleeding (no,
due to malabsorption of Fe and B12)
b. recurrent aphthous stomatitis is characteristic
c.a shuffling gait is a sign of myopathy
d. hyposplenism is common
b. recurrent aphthous stomatitis is characteristic
c.a shuffling gait is a sign of myopathy
d. hyposplenism is common
92
. Which of the listed clinical pictures does NOT belong to the different forms of celiac disease?
A. typical symptomatic celiac disease
B. atypical celiac disease with non-threatening symptoms
C. tropical sprue
D.refractory sprue
E.ulcerative jejunoileitis (belongs to ulcers of the small intestine and is clinically
similar to celiac disease
C. tropical sprue
93
A gluten-free diet is the first therapy of choice for patients with:
A. typical symptomatic celiac disease
B. Whipple's disease
C. tropical sprue
D. refractory sprue
E. Crohn's disease
A. typical symptomatic celiac disease
94
Celiac disease is ruled out by:
A. Absence of diarrhea
B. Absence of anemia
C. Obesity
D. Absence of information about celiac disease in the family
E. None of the above
E. None of the above
95
Whipple's disease - all apply EXCEPT :
A. multiorgan involvement is characteristic
B. it is caused by actinomycetes
C. the diagnosis is confirmed histologically
D. a 14-day treatment is required
E. if the patient is not treated, the disease is fatal
D. a 14-day treatment is required
96
In eosinophilic gastroenteritis, there is always:
A. peripheral eosinophilia
B. peripheral leukocytosis
C. increased presence of eosinophils in the mucosa of the gastrointestinal tract
D. increased CRP value
E. fever
C. increased presence of eosinophils in the mucosa of the gastrointestinal tract
97
The drug of choice for eosinophilic gastroenteritis is:
A. Loperamide
B. antibiotic
C.corticosteroid
D. antihistamine
E. aminosalicylic acid
C.corticosteroid
98
The following applies to tumors of the small intestine:
A. they are most often localized in Meckel's diverticulum
B. the most common are liposarcomas
C. are much rarer than colon tumors
D. are common in young people
E. patients with carcinoid have defects of the mitral and aortic valves
C. are much rarer than colon tumors
99
In the diagnosis of tumors of the small intestine, we use all of the above except:
A. contrast enteroclysis
B. colonoscopy with ileoscopy
C. angiography
D. scintigraphy with marked leukocytes
E. enteroscopy
D. scintigraphy with marked leukocytes
100
Acute mesenteric ischemia - which of the following is true? Choose the most appropriate
combination of answers:
a. it is most often the result of embolism or thrombosis of the upper mesenteric
arteries
b. formation is associated with arrhythmias
c. it is characterized by massive bleeding in the gastrointestinal tract
d. the diagnostic method is a native x-ray of the abdomen
e. characterized by severe abdominal pain
a. it is most often the result of embolism or thrombosis of the upper mesenteric
arteries
b. formation is associated with arrhythmias
e. characterized by severe abdominal pain
101
Crohn's disease always affects:
A. rectum
B. terminal ileum
C. stomach
D. duodenum
E. None of the above
E. None of the above
102
An inflammatory reaction that spreads to all layers of the GIT wall is characteristic of:
a) ulcerative colitis
b) Crohn's disease
c) celiac disease
d) superficial colitis
e)gastritis associated with infection withH. pylori
b) Crohn's disease
103
All apply to Crohn's disease EXCEPT:
A. can involve the entire gastrointestinal tract
B. inflammation extends to the submucosa
C. segments of the healthy and affected digestive tract typically alternate
D. in the late phase has a characteristic pseudopolyposis appearance
E. fistulas develop in about a third of patients
B. inflammation extends to the submucosa
104
Deep fissures and fistulas are characteristic of:
a) ulcerative colitis
b) Crohn's disease
c) Lymphoma of the ileum
d) tuberculous enteritis
b) Crohn's disease
d) tuberculous enteritis
105
Choose the combination of correct statements! The clinical characteristics of ulcerative colitis are:
a) bloody mucous stool
b) constipation
c) false calls to the mud
d) abdominal pain
a) bloody mucous stool
c) false calls to the mud
d) abdominal pain
106
Extraintestinal symptoms of Crohn's disease do NOT include:
A. arthritis
B. ankylosing spondylitis
C. iritis
D. dermatitis herpetiformis
E. erythema nodosum
D. dermatitis herpetiformis
107
Characteristic blood count in Crohn's disease does NOT include:
A. leukopenia
B. thrombocytosis
C. elevated C-reactive protein
D. increased sedimentation of erythrocytes
E. anemia
A. leukopenia
108
Choose the combination of correct statements! Anemia in Crohn's disease can be caused by:
a) bleeding
b) malabsorption of B-12 and folates
c) iron malabsorption
d) hemolysis
a) bleeding
b) malabsorption of B-12 and folates
c) iron malabsorption
109
The prevalence and localization of Crohn's disease is assessed by:
A. radioisotope examination with marked erythrocytes
B. radioisotope examination with labeled leukocytes
C. only by gastroscopy
D. only with colonoscopy
E. only by rectoscopy
B. radioisotope examination with labeled leukocytes
110
Choose all the correct statements regarding Crohn's disease:
a) mostly affects young people
b) using a radioisotope examination with marked leukocytes, we visualize the bleeding site
c) terminal ileum and colon are most often affected
d) often occurs in certain families
a) mostly affects young people
c) terminal ileum and colon are most often affected
d) often occurs in certain families
111
Pseudomembranous colitis is associated with the causative factor:
a) taking antibiotics
b) consumption of diuretics
c) taking beta receptor blockers
d) consumption of laxatives
e) intravenous injection of drugs
a) taking antibiotics
112
The following applies to pseudomembranous colitis:
A. it is an infection with a histolytic amoeba
B. we prove it by determining Clostridium difficile toxin A
C. it is a fungal infection
D. it is a viral infection of the colon
E. is a type of ulcerative colitis
B. we prove it by determining Clostridium difficile toxin A
113
Choose the correct statements regarding toxic megacolon:
a) is a complication of ulcerative colitis
b) is a complication of Crohn's disease
c) patients are highly febrile
d) colectomy is often required for resolution
e) it can be recognized on a transparent X-ray image of the abdomen
a) is a complication of ulcerative colitis
c) patients are highly febrile
d) colectomy is often required for resolution
e) it can be recognized on a transparent X-ray image of the abdomen
114
To treat chronic inflammatory bowel disease, we use all EXCEPT:
A. sulfasalazine
B.trimethoprim - sulfamethoxazole
C. 5-aminosalicylic acid
D. corticosteroid
E. infliximab
B.trimethoprim - sulfamethoxazole
115
With treatment, we achieve successful remission in chronic inflammatory bowel disease in:
A. 30% of cases
B. 10% of cases
C. 50% of cases
D. 55% of cases
E. 90% of cases
E. 90% of cases
116
Signs of diverticulitis are all EXCEPT:
a) abdominal pain
b) leukocytosis
c) painful resistance in the left atrial quadrant of the abdomen
d) hematochezia
e) elevated indicators of inflammation
d) hematochezia
117
In case of acute suspicion of acute diverticulitis, the first examination to be carried out is:
1. flexible sigmoidoscopy
2. irrigography
3. full colonoscopy
4. ultrasound of the abdomen with examination of the intestines
5. stool examination for parasites
4. ultrasound of the abdomen with examination of the intestines
118
The most common colon polyps are:
A. inflammatory polyps
B. adenomas
C. hamartomas
D. dysplastic polyps
E. malignant
B. adenomas
119
The following applies to adenomas of the colon:
a. they can arise as part of familial adenomatous polyps
b. we treat them with endoscopic removal
c. most colorectal cancers originate from adenomas
d. patients require surgery
a. they can arise as part of familial adenomatous polyps
b. we treat them with endoscopic removal
c. most colorectal cancers originate from adenomas
120
Characteristics of familial adenomatous polyposis are:
a. autosomal dominant inheritance
b. is a precancer with 100% mortality from colorectal carcinoma
c. requires screening of relatives
d. has low penetrance
e. pedunculated polyps are common
a. autosomal dominant inheritance
b. is a precancer with 100% mortality from colorectal carcinoma
c. requires screening of relatives
121
Which of the following is NOT true of familial adenomatous polyposis - FAP :
A. APC gene mutation
B. DCC gene mutation
C. carriers of the gene are detected by a blood test
D. is treated with preventive colectomy
E. Intestinal cancer develops early in carriers of the gene
B. DCC gene mutation
122
Constipation is the result of a disorder:
a. disturbances in the motility of the colon
b. disturbed rectal emptying
c. consumption of laxatives
d. improper diet
e. consumption of prokinetics
a. disturbances in the motility of the colon
b. disturbed rectal emptying
123
All of the above applies to dyspepsia, except:
A. it is often a functional disorder
B. we must pay attention to the so-called warning signs
C. most patients are infected withHelicobacter pylori
D. is a disorder of gastric emptying
E. pain in the upper half of the abdomen is often present
C. most patients are infected withHelicobacter pylori
124
The Rome criteria (Roma III) for the diagnosis of irritable bowel syndrome include all EXCEPT:
A. persistent or recurring abdominal pain or discomfort for at least 3 months in the
past 6 months
B. relief after passing stool
C. altered frequency of bowel movements
D. discharge of mucus mixed with blood
E. altered hardness of the stool
D. discharge of mucus mixed with blood
125
Irritable colon syndrome applies to:
a. that it is the most common functional disease of the gastrointestinal tract
b. the pathophysiological mechanism of the disease is known
c. mostly men are affected
d. the symptoms improve in most cases already with dietary measures (we advise against coffee, alcohol, etc.)
e. it is often accompanied by symptoms and signs of an inflammatory process
A. a, d
B. d, e
C. a, c
D. a, b
E. b, c
A. a, d
126
In case of suspicion of an acute surgical abdomen, the following investigations are reasonable
a. determination of the number of leukocytes in the peripheral blood
b. native x-ray of the abdomen
c. endoscopic ultrasound of the upper gastrointestinal tract
d. ultrasound examination of the abdomen
a. determination of the number of leukocytes in the peripheral blood
b. native x-ray of the abdomen
d. ultrasound examination of the abdomen
127
For neuroendocrine tumors of the gastrointestinal tract, all EXCEPT:
A. Diarrhea is often present
B. patients always lose weight(insulinoma can be treated + keyword is always - because
neuroendocrine tumors progress slowly, there are often no symptoms for a long time)
C. octreoscen is positive in 80-90% of cases
D. can be benign or malignant
E. may be asymptomatic or cause symptoms due to hormone secretion
B. patients always lose weight(insulinoma can be treated + keyword is always - because
neuroendocrine tumors progress slowly, there are often no symptoms for a long time)
128
The following applies to carcinoid syndrome:
a. it is the result of the action of serotonin, histamine, kallikrein and other substances
b. symptoms usually appear before the tumor spreads to the liver
c. it is most often manifested by flushes of redness in the face and upper body
d. it is proven by determining catecholamines in urine
e. in carcinoid syndrome, we expect a solitary tumor without seeds
f. the prognosis is good
a. it is the result of the action of serotonin, histamine, kallikrein and other substances
c. it is most often manifested by flushes of redness in the face and upper body
129
Choose the correct statements regarding acute pancreatitis:
a. it is most often the result of pancreatic division
b. drugs are never the cause of its formation
c. the disease takes place in 80% of cases in a severe form
d. accompanied by abdominal pain
e. it is proven by an increase in pancreatic enzymes in the blood
d. accompanied by abdominal pain
e. it is proven by an increase in pancreatic enzymes in the blood
130
The most important initial event of acute pancreatitis is the activation of:
a) lipases
b) amylase
c) transcription factors
d) trypsinogen
e) chymotrypsin
d) trypsinogen
131
Free fluid in the abdomen can be a complication:
A. acute cholecystitis
B. acute pancreatitis
C. acute appendicitis
D. peritonitis
E. all of the above
E. all of the above
132
The following applies to the clinical picture of acute pancreatitis:
a. often occurs after drinking alcohol
b. elevated temperature speaks against pancreatitis
c. may occur simultaneously with jaundice
d. the severe form occurs with complex complications or multiple organ failure
e. most patients have known hypertriglyceridemia
f. vomiting is not a common sign, after vomiting the pain subsides for patients
a. often occurs after drinking alcohol
c. may occur simultaneously with jaundice
d. the severe form occurs with complex complications or multiple organ failure
133
Acute pancreatic pseudocyst is:
a. salivary fluid surrounded by epithelium
b. develops more often in biliary than in alcoholic pancreatitis
c. occurs four or more weeks after the onset of illness
d. all patients have symptoms at the expense of predocyst
e. the pseudocyst is usually sterile
c. occurs four or more weeks after the onset of illness
e. the pseudocyst is usually sterile
134
Circle the correct answers that apply to acute pancreatitis :
a. it is confirmed by finding an increase in amylase and lipase in the blood
b. an increase in lipase in the urine is characteristic
c. the level of amylase normalizes in 2-3 days, and the level of lipase after 1 week
d. amylase and lipase activity in the serum is a measure of the intensity of inflammation
e. An isolated increase in amylase always means pancreatitis
a. it is confirmed by finding an increase in amylase and lipase in the blood
c. the level of amylase normalizes in 2-3 days, and the level of lipase after 1 week
135
Acute pancreatitis can be accompanied by metabolic changes:
a. hyperglycemia
b. hypoglycemia
c. hyperammonemia
d. hypertriglyceridemia
e. hypocalcemia
a. hyperglycemia
d. hypertriglyceridemia
e. hypocalcemia
136
X-ray findings of the sentinel gyrus are:
1. often a sign of acute pancreatitis
2. indicates localized ileus of the jejunum
3. accompanied by acute appendicitis
4. is a sign of perforation
5. always associated with vomiting
1. often a sign of acute pancreatitis
2. indicates localized ileus of the jejunum
137
Acute biliary pancreatitis indicates:
a. increased indirect bilirubin
b. increased alkaline phosphatase
c. gallstones visible on ultrasound
d. AST is more than twice as elevated as ALT
e. endoscopic papillotomy is required
b. increased alkaline phosphatase
c. gallstones visible on ultrasound
e. endoscopic papillotomy is required
138
Ranson's indicators are used to classify the level/intensity:
A. sepsis
B. acute pancreatitis
C. diabetic ketoacidosis
D. hypovolemic shock
E. multiorgan failure
B. acute pancreatitis
139
Ranson's indicators include:
a. age
b. hematocrit value
c. number of leukocytes
d. amylase value
e. CK value
a. age
b. hematocrit value
c. number of leukocytes
140
In acute pancreatitis, the use of all the listed analgesics is allowed, except:
A. paracetamol
B. tramadol
C. morphine
D. pentazotocin
E. piritramide
C. morphine
141
We do not prescribe opiates when obstruction of the common bile duct is suspected:
A. because they cause a disturbance of consciousness
B. because they can lead to respiratory arrest
C. because they increase the tone of the sphincter of Oddi
D. because they increase the tone of the pylorus
E. because they can induce vomiting
C. because they increase the tone of the sphincter of Oddi
142
The most common cause of chronic pancreatitis is .
1. hereditary pancreatitis
2. idiopathic pancreatitis
3. alcoholic – toxic pancreatitis
4. autoimmune pancreatitis
5. Pancreatitis due to pancreatic division
3. alcoholic – toxic pancreatitis
143
In severe pancreatitis with retroperitoneal necrosis, a sign may be present
A. Murphy's sign
B. Blumberg's sign
C. Cullen's sign
D. Castello's sign
E. Traube's sign
C. Cullen's sign
144
Acute pancreatitis was diagnosed in a 45-year-old previously healthy patient at the internist's first
aid, which, according to his story, developed after a dietary violation. In the laboratory results, ALT is
elevated five times, AST twice, gamma-glutamyl transferase and alkaline phosphatase are elevated, direct
hyperbilirubinemia is present. The patient denies excessive consumption of alcoholic beverages.
What is the most likely etiology of pancreatitis?
A. iatrogenic pancreatitis
B. idiopathic pancreatitis
C. alcoholic pancreatitis
D. Pancreatitis due to steroids
E. biliary pancreatitis
E. biliary pancreatitis
145
Acute pancreatitis was diagnosed in a 45-year-old previously healthy patient at the internist's first
aid, which, according to his story, developed after a dietary violation. In the laboratory results, ALT is
elevated five times, AST twice, gamma-glutamyl transferase and alkaline phosphatase are elevated, direct
hyperbilirubinemia is present. The patient denies excessive consumption of alcoholic beverages.
Which examination will be used to confirm the etiology of pancreatitis in the described patient?
A. gastroscopy
B. blood ethanol
C. pancreatic biopsy
D. abdominal ultrasound
E. X-ray of the abdomen "on empty"
D. abdominal ultrasound
146
The clinical picture of chronic pancreatitis includes:
a. overweight
b. chronic or recurring abdominal pain
c. steatorrhea
d. Diabetes
e. it is more common in women
b. chronic or recurring abdominal pain
c. steatorrhea
d. Diabetes
e. it is more common in women
147
In the treatment of chronic pancreatitis, we use all EXCEPT:
A. abstinence from alcohol
B. oral vitamin replacement
C. endoscopic removal of stones from the pancreatic duct
D. H2 receptor antagonists
E. enzyme preparations containing amylase
B. oral vitamin replacement
148
All of the above apply to pancreatic cancer EXCEPT :
A. is more common in men than in women
B. one-year survival is 20%
C. the most common type is acinar cell carcinoma
D. smoking is a risk factor
E. if it arises in the head of the pancreas, it usually causes obstructive jaundice
C. the most common type is acinar cell carcinoma
149
What is the first ultrasound (imaging?) diagnostic imaging examination when a pancreatic
tumor is suspected? :
A. ultrasound examination of the abdomen
B. computed tomography
C. endoultrasound
D. x-ray examination of the abdomen natively
E. endoscopic retrograde cholangiopancreatography (ERCP)
A. ultrasound examination of the abdomen
150
Which tumor marker is suitable for the diagnosis of pancreatic tumor v
early stages of the disease? :
a) alpha-fetoprotein
b) About 19-9
c) CEA
d) ANCA
e) There is no suitable tumor marker for the diagnosis of the early stage of the disease
e) There is no suitable tumor marker for the diagnosis of the early stage of the disease
151
Which of the tumor markers would you choose to confirm advanced pancreatic
carcinoma (Interna 4, 630):
A. About 19-9
B. About 15-3
C. Alpha-fetoprotein
D. PSA
E. TPA
A. About 19-9
152
In acute pancreatitis (AP), the following applies:
A. Hyperamylasemia is pathognomonic
B. Both enzymes - amylase and lipase - are always equally elevated
C. The most common cause is autoimmune
D. Most often, the cause of AP remains unexplained - idiopathic pancreatitis
E. The most common causes of acute pancreatitis are gallstones and alcohol
E. The most common causes of acute pancreatitis are gallstones and alcohol
153
Increased urobilinogenuria is a sign (Interna 4, 635):
A. hemolytic jaundice
B. intrahepatic cholestasis
C. extrahepatic cholestasis
D. steatorrhea
E. chronic pancreatitis
A. hemolytic jaundice
154
Prolonged prothrombin time is corrected after intravenous vitamin K supplementation in:
A. hemolytic jaundice
B. prison jaundice
C. parenchymal jaundice
D. acute liver failure
E. liver cirrhosis
B. prison jaundice
155
Indirect hyperbilirubinemia is:
a. may be a congenital metabolic disorder
b. indicates hemolysis
c. it is dangerous in adulthood
d. cause of bilirubinuria
e. histological examination of the liver shows hepatitis
a. may be a congenital metabolic disorder
b. indicates hemolysis
e. histological examination of the liver shows hepatitis
156
. The following applies to alkaline phosphatase in the blood:
a. it is formed exclusively in the liver
b. it is formed in the bones, intestines and liver
c. it is excreted mainly through the kidneys
d. it is excreted with bile
e. an elevated value is an indicator of impaired bilirubin conjugation
f. an elevated value is an indicator of biliary obstruction
b. it is formed in the bones, intestines and liver
d. it is excreted with bile
f. an elevated value is an indicator of biliary obstruction
157
The following applies to AST and ALT aminotransferases:
a. ALT is a more specific indicator of liver damage than AST
b. ALT and AST are equally specific indicators of liver damage
c. ALT is elevated only in hepatitis
d. the magnitude of the increase in AST and ALT is not proportional to the severity of the liver lesion
e. in circulatory shock, aminotransferase values are reduced
a. ALT is a more specific indicator of liver damage than AST
158
Choose the correct answers related to hepatitis A:
a. is transmitted via the fecal-oral route
b. it is confirmed by evidence of HAV antigen in the serum
c. often becomes chronic with chronic carriers
d. we use active immunization to prevent infection
e. AST is more elevated than ALT
a. is transmitted via the fecal-oral route
d. we use active immunization to prevent infection
159
. Choose the correct answers regarding hepatitis B
a. often has a fulminant course
b. 90% progress to cirrhosis
c. usually transmitted intrauterinely
d. it may be accompanied by polyarteritis nodosa
e. the first sign of infection is the presence of HBs antigen
d. it may be accompanied by polyarteritis nodosa
e. the first sign of infection is the presence of HBs antigen
160
HBc antigen in hepatitis B is demonstrated:
1. in the blood
2. in serum
3. in plasma
4. in hepatocytes
5. in leukocytes
4. in hepatocytes
161
When in contact with a patient with HBV infection, protection with immunoglobulins is required for:
A. needle stick / mucosal contact in unvaccinated adults
B. sexual contact with a chronic carrier of HBV, unvaccinated
C. family members of a chronic HBV carrier
D. sexual contact with a chronic carrier of HBV, vaccinated
E. in adults with a high titer of anti-HBs antibodies
A. needle stick / mucosal contact in unvaccinated adults
B. sexual contact with a chronic carrier of HBV, unvaccinated
C. family members of a chronic HBV carrier
162
Choose the correct answers regarding acute hepatitis C:
A. Hepatitis C infection often takes the form of acute icteric hepatitis
B. the fulminant course is in 20%
C. is often (in 70-80% of cases) asymptomatic
D. passes into a chronic form in 70-80%
E. is a common cause of HCC
C. is often (in 70-80% of cases) asymptomatic
D. passes into a chronic form in 70-80%
E. is a common cause of HCC
163
Choose the correct answers related to autoimmune hepatitis:
a. is a disease of young women
b. it is often accompanied by arthralgias
c. splenomegaly is never present
d. it is successfully treated with Interferon
a. is a disease of young women
b. it is often accompanied by arthralgias
164
Which disease is characterized by AMA antibodies
A. autoimmune hepatitis
B. primary biliary cirrhosis
C. primary sclerosing cholangitis
D. alcoholic hepatitis
E. chronic C hepatitis
B. primary biliary cirrhosis
165
What is true about chronic hepatitis B?:
a. develops in 80% of those infected with the hepatitis B virus
b. patients have characteristic clinical symptoms
c. it is proven by determining anti-HBs antibodies in the serum
d. the presence of HBs antigen in the serum indicates infectivity
e. a late complication may be hepatocellular carcinoma
d. the presence of HBs antigen in the serum indicates infectivity
e. a late complication may be hepatocellular carcinoma
166
The second (immunoreactive) phase of chronic hepatitis B is manifested by: :
a. characteristic symptoms
b. permanent increase of ALT and AST
c. positive HBsAg
d. low concentration of HBV DNA in the blood
e. negative HBsAg
c. positive HBsAg
d. low concentration of HBV DNA in the blood
167
Choose which of the following characterizes healthy HBs antigen carriers:
A. presence of anti-HBs
B. presence of HBe antigen
C. low or undetectable HBV DNA
D. elevated aminotransferases
E. absence of HBs-Ag in the blood
C. low or undetectable HBV DNA
168
Chronic hepatitis B is treated with:
a. interferon alfa-2
b. interferon beta
c. with lamivudine
d. with adefovir
e. with cyclosporine
a. interferon alfa-2
c. with lamivudine
d. with adefovir
169
Choose the correct answers that refer to the successful treatment of chronic hepatitis
B:
a. it is characterized by the disappearance of HBsAg
b. characterized by a decrease in HBV DNA
c. is successful in 60% of patients
d. normalization of elevated ALT
a. it is characterized by the disappearance of HBsAg
b. characterized by a decrease in HBV DNA
d. normalization of elevated ALT
170
Choose the correct statement related to hepatitis C:
A. 70% of patients are acutely icteric
B. often progresses to cirrhosis
C. needs the presence of HBs antigen
D. we confirm it by determining HCV DNA
E. active prophylaxis with vaccination is possible
B. often progresses to cirrhosis
171
Chronic hepatitis C is treated with:
a. corticosteroids
b. interferon alfa-2
c. ribavirin
d. lamivudine
e. the best response is in patients with genotype 1 B
b. interferon alfa-2
c. ribavirin
172
Alcoholic liver cirrhosis develops ( 659):
a. in 10% of alcoholics
b. the type of alcoholic beverage is important
c. occasional abstinence worsens liver disease
d. in men, the activity of ADH in the gastric mucosa is lower than in women
e. the cause lies in genetic factors
a. in 10% of alcoholics
e. the cause lies in genetic factors
173
Alcoholic liver disease is characterized by:
a. spider nevi
b. enlarged liver
c. AST : ALT ratio: < 2
d. hypertriglyceridemia
e. increase in uric acid
a. spider nevi
b. enlarged liver
d. hypertriglyceridemia
e. increase in uric acid
174
The characteristics of hyperkinetic circulation in liver cirrhosis are:
a. decreased peripheral resistance
b. arterial hypertension
c. increased cardiac output
d. decreased central blood volume
a. decreased peripheral resistance
c. increased cardiac output
175
An increase in IgM is characteristic of :
A. alcoholic liver cirrhosis
B. primary biliary liver cirrhosis
C. bile duct atresia
D. alcoholic hepatitis
E. worsening of liver cirrhosis of any etiology
B. primary biliary liver cirrhosis
176
The Child-Turcott-Pugh classification for assessing the degree of liver disease includes:
a. assessment of encephalopathy
b. bilirubin level
c. assessment of ascites
d. gamma globulin concentration
e. prothrombin time
a. assessment of encephalopathy
b. bilirubin level
c. assessment of ascites
e. prothrombin time
177
Signs of portal hypertension are ( 667):
a. prolonged prothrombin time
b. enlarged spleen
c. hemorrhoids
d. jaundice
e. ascites
b. enlarged spleen
c. hemorrhoids
e. ascites
178
Which pressure difference between the portal vein and the inferior vena cava is
considered preclinical portal hypertension? :
A. 2-5 mm Hg
B. 5-9 mm Hg
C. 10-12 mm Hg
D. 15-20 mm Hg
E. 20-25 mm Hg
B. 5-9 mm Hg
179
The pressure difference between the portal vein and the inferior vein that causes the clinical picture of portal
hypertension is:
A. above >7 mm Hg
B. above >10 mm Hg
C. above >12 mm Hg
D. above >20 mm Hg
E. above >30mmHg
B. above >10 mm Hg
180
Which of the listed drugs are used for the preventive treatment of portal
hypertension? :
a. propranolol
b. nifedipine
c. atenolol
d. Nadolol
e. sotalol
a. propranolol
d. Nadolol
181
Bleeding in portal hypertension is treated:
a. with dobutamine
b. with octapressin
c. with vasopressin
d. endoscopically
e. with dopamine
b. with octapressin
c. with vasopressin
d. endoscopically
182
A functioning TIPS (transjugular portosystemic shunt) can worsen:
1. hepatic encephalopathy
2. ascites
3. hypotension
4. state of nutrition
5. survival of patients with liver cirrhosis
1. hepatic encephalopathy
183
Hepatic encephalopathy in liver cirrhosis is:
a. the result of a decrease in the function of liver parenchymal liver cells
b. portal hypertension
c. anemia
d. hyperuricemia
a. the result of a decrease in the function of liver parenchymal liver cells
b. portal hypertension
184
Hepatic encephalopathy is triggered by:
a. gastrointestinal bleeding
b. dehydration
c. benzodiazepines, narcotics, alcohol
d. paracentesis of a very large volume of ascites
e. excessive dietary protein intake
All
185
The characteristics of ascites in cirrhosis are:
a. specific gravity is lower than 1016
b. protein concentration is lower than 25 g/L
c. the number of leukocytes is higher than 250 cm3
d. a difference in the concentration of albumin in serum and albumin in ascites that is higher
than 11 g/L is characteristic of ascites in portal hypertension
a. specific gravity is lower than 1016
b. protein concentration is lower than 25 g/L
d. a difference in the concentration of albumin in serum and albumin in ascites that is higher
than 11 g/L is characteristic of ascites in portal hypertension
186
Choose the correct measures related to the treatment of ascites in liver cirrhosis:
a. limit salt to 1-2 g/day
b. spironolactone
c. furosemide
d. body weight is reduced by 3 kg/day
e. paracentesis without albumin replacement
a. limit salt to 1-2 g/day
b. spironolactone
c. furosemide
187
Which of the following is true of hepatorenal syndrome?
a. it is progressive oliguric renal failure due to altered systemic hemodynamics in
severe liver damage
b. occurs only in acute severe liver failure
c. properly treated has an excellent prognosis
d. the most common cause is treatment with non-steroidal anti-inflammatory drugs
e. it is treated with a kidney transplant
a. it is progressive oliguric renal failure due to altered systemic hemodynamics in
severe liver damage
188
Spontaneous bacterial peritonitis
a. is a common complication of cirrhosis
b. the number of leukocytes in ascites is lower than 250 mm3
c. most leukocytes in ascites are lymphocytes
d. he is treated with cefotaxime 2 g every 8-12 hours iv.
a. is a common complication of cirrhosis
d. he is treated with cefotaxime 2 g every 8-12 hours iv.
189
Which of the following is not a cause of hemochromatosis?
A. genetic factors
B. transfusions
C. iron therapy
D. sickle cell anemia
E. alcohol consumption
D. sickle cell anemia
190
Among the listed diseases, circle those that are characteristic of hemochromatosis.
a. cirrhosis
b. diabetes
c. myocardiopathy
d. renal failure
a. cirrhosis
b. diabetes
c. myocardiopathy
191
Genetic (primary) hemochromatosis can be distinguished from secondary hemochromatosis by:
A. presence of iron in hepatocytes
B. the presence of iron in the spleen
C. the presence of iron in the bone marrow
D. the presence of iron in Kupfer cells
E. the presence of iron in the basal ganglia
A. presence of iron in hepatocytes
192
Hemochromatosis appears more often in men:
a. over 45 years old
b. over the age of 55
c. over 65 years old.
d. We treat it with venipunctures
e. Elevated iron and decreased ceruloplasmin are characteristic in the serum
b. over the age of 55
d. We treat it with venipunctures
193
The most common cause of death in untreated hemochromatosis is:
A. sepsis
B. left-sided heart failure
C. uncontrolled diabetes
D. hepatocellular carcinoma
E. hypothyroidism
D. hepatocellular carcinoma
194
Patients with genetic hemochromatosis have accumulated in their body
A. 3 to 5 g of iron
B. 10 to 15 g of iron
C. 20 to 30 g of iron
D. 25 to 50 g of iron
E. More than 100g of iron
C. 20 to 30 g of iron
195
Secondary hemochromatosis is prevented by:
a) deferoxamine is added during transfusions
b) to perform venipunctures
c) to treat with deferoxamine tablets
d) to give patients high doses of vitamin C
e) with oral iron
a) deferoxamine is added during transfusions
196
Choose the correct statements related to Wilson's disease:
a. it often presents first with neurological symptoms
b. serum ceruloplasmin is decreased
c. serum ferritin is elevated
d. the disease is curable in its early stages with lifelong treatment
e. a Keyser Fleischer ring is present
a. it often presents first with neurological symptoms
b. serum ceruloplasmin is decreased
d. the disease is curable in its early stages with lifelong treatment
e. a Keyser Fleischer ring is present
197
CREST syndrome is typically associated with:
1. primary biliary cirrhosis
2. autoimmune hepatitis
3. celiac disease
4. Crohn's disease
5. MALT lymphoma
1. primary biliary cirrhosis
198
The first signs of primary biliary cirrhosis are:
a. jaundice
b. itchy skin
c. increased alkaline phostatase
d. increased IgM
e. lowered cholesterol
b. itchy skin
c. increased alkaline phostatase
d. increased IgM
199
Primary biliary cirrhosis is confirmed in the laboratory by:
a. by evidence of anti-MPO antibodies
b. by evidence of Scl antibodies
c.by evidence of antibodies against pyruvate dehydrogenase of mitochondria
d. by evidence of anti-centromere antibodies
e. no lab test can help us, a liver biopsy is needed
c.by evidence of antibodies against pyruvate dehydrogenase of mitochondria
200
Hepatic steatosis is associated with all EXCEPT:
A. accumulation of triglycerides in hepatocytes
B. obesity
C. alcohol consumption
D. herpes virus infection
E. increased mobilization of fatty acids from adipose tissue
D. herpes virus infection
201
Clinical features of steatosis are
a. enlarged liver
b. enlarged liver and spleen
c. spider nevi
d. elevated ALT
e. diabetes
a. enlarged liver
d. elevated ALT
e. diabetes
202
Non-alcoholic steatohepatitis is:
A. alcoholic steatohepatitis in a patient who does not admit to alcohol consumption
B. accumulation of fat in liver cells in people who consume < 30g of alcohol per
week
C. steatosis of the liver in a patient receiving an excessive daily amount of glucose in
parenteral nutrition
D. steatohepatitis resulting from congenital hyperlipidemia
E. steatohepatitis resulting from insulin therapy
B. accumulation of fat in liver cells in people who consume < 30g of alcohol per
week
203
Choose the correct combination of answers. Pregnancy-specific liver disease is all
EXCEPT:
a. acute steatosis
b. HELLP syndrome
c. intrahepatic cholestasis
d. primary biliary cirrhosis
e. autoimmune hepatitis
d. primary biliary cirrhosis
e. autoimmune hepatitis
204
The most common benign liver tumors in adults are among the following:
A. lipomas
B. hemangiomas
C. focal nodular hyperplasia
D. hemangioendotheliomas
E. germinomas
B. hemangiomas
205
Choose the correct answer regarding hepatic hemangiomas:
A. is a common tumor of the liver
B. causes symptoms in most people
C. accompanied by elevated alpha-fetoprotein
D. diagnosis is made by liver biopsy
E. we treat it with surgery
A. is a common tumor of the liver
206
Choose a combination of correct answers. Which of the following liver tumors are associated with the
use of oral contraceptives:
a. adenoma
b. focal nodular hyperplasia
c. hemangioma
d. hepatocellular carcinoma
e. hemangioendothelioma
a. adenoma
b. focal nodular hyperplasia
207
Choose the correct answers that apply to hepatocellular carcinoma:
a. occurs in cirrhosis
b. is often associated with HBV and HCV infection
c. is associated with exposure to vinyl chloride
d. has characteristic symptoms
e. cytostatic treatment is successful
a. occurs in cirrhosis
b. is often associated with HBV and HCV infection
208
Liver metastases are characterized by:
a. liver enlargement
b. elevation of aminotransferases
c. elevation of alkaline phosphatase and LDH
d. most are detected by ultrasound
e. the diagnosis is established by biopsy
a. liver enlargement
c. elevation of alkaline phosphatase and LDH
d. most are detected by ultrasound
e. the diagnosis is established by biopsy
209
Budd-Chiari syndrome applies to:
a. it is caused by hepatic vein disease
b. patients have ascites
c. the liver is painful
d. treatment with anticoagulant therapy is effective
All of them
210
Choose the statements that apply to gallstones:
a. 10 to 20% of the population have them
b. they are common after the age of 60
c. the most common are pigment stones
d. the cause is increased secretion of cholesterol from hepatocytes
e. formation of boils aspirin
a. 10 to 20% of the population have them
b. they are common after the age of 60
d. the cause is increased secretion of cholesterol from hepatocytes
e. formation of boils aspirin
211
Choose the correct statements that apply to cholecystolithiasis
a. it is usually asymptomatic and is discovered by chance
b. may cause colic with obstructive jaundice
c. we find it out with an ultrasound
d. asymptomatic cholecystolithiasis is treated with surgery
e. characteristic is the Courvoiser sign
a. it is usually asymptomatic and is discovered by chance
b. may cause colic with obstructive jaundice
c. we find it out with an ultrasound
212
Choose the correct statements related to choledocholithiasis
a. may be a primary disease of the bile ducts
b. it is always accompanied by characteristic symptoms
c. it is always accompanied by an increase in amylase and lipase
d. we treat it with endoscopic papillotomy
a. may be a primary disease of the bile ducts
d. we treat it with endoscopic papillotomy
213
The most common form of cholecystitis is:
1. Acute acalculous cholecystitis
2.Acute calculous cholecystitis
3. Chronic acalculous cholecystitis
4. Viral cholecystitis
5. Gangrenous cholecystitis
2.Acute calculous cholecystitis
214
What applies to acute cholangitis
a. Charcot's triad is typical
b. sepsis originating from the bile duct
c. the most common source of infection is portal blood
d. endoscopic papillotomy is indicated
e. common causative agents of cytomegalovirus infection
a. Charcot's triad is typical
b. sepsis originating from the bile duct
d. endoscopic papillotomy is indicated
215
Primary sclerosing cholangitis is:
a. purulent inflammation of the bile ducts
b. 70% associated with ulcerative colitis
c. it is labeled by anti-mitochondrial antibodies
d. elevated alkaline phosphatase is characteristic
e. cholangiocarcinoma is a complication in 10-15% of patients
b. 70% associated with ulcerative colitis
d. elevated alkaline phosphatase is characteristic
e. cholangiocarcinoma is a complication in 10-15% of patients
216
Dyspepsia means:
a. upper abdominal pain
b. "heartburn"
c. a common term for discomfort in the upper abdomen
d. regurgitation of stomach contents into the esophagus
e. a general term for all symptoms resulting from inadequate secretion of pepsin
c. a common term for discomfort in the upper abdomen
217
to a 60-year-old patient , who comes to the doctor because of dyspepsia
a. we have to do a gastroscopy
b. first an antacid or H2 receptor blocker is prescribed for 14 days
c. eradication treatment for H. pylori is prescribed first
d. a gastroscopy is performed in case of anemia
e. first, we prescribe an ulcer diet for 14 days
a. we have to do a gastroscopy
218
The smell of feces in vomited mass indicates:
a. ileus
b. organophosphate poisoning
c. gastrointestinal bleeding
d. disease of the biliary system
e. flatulence
a. ileus
219
Which is usually the first examination when a perforation of the alimentary canal is suspected:
a. ultrasound
b. plain radiograph of the abdomen
c. CT
d. lab. blood tests
e. rectal examination
b. plain radiograph of the abdomen
220
How much is a typical example:
a. visceral pain
b. parietal pain
c. transmitted pain
d. phantom pains
e. none of the above
a. visceral pain
221
Jaundice becomes visible with a concentration of bilirubin that:
a. exceeds the upper limit of normal
b. exceeds the upper limit of normal by 50%
c. exceeds the upper limit of normal by 100%
d. exceeds the upper limit of normal by 300%
e. it may also be in the normal range
d. exceeds the upper limit of normal by 300%
222
Bilirubin in urine is a sign of:
a. direct hyperbilirubinemia
b. indirect hyperbilirubinemia
c. prehepatic jaundice
d. kidney disease
e. Gilbert's disease
a. direct hyperbilirubinemia
223
Direct hyperbilirubinemia and an increase in alkaline phosphatase and gGT raise the suspicion of:
a. obstruction of the bile ducts by gallstones
b. hemolytic anemia
c. Gilbert syndrome
d. resorption of blood from a large hematoma
e. none of the above
a. obstruction of the bile ducts by gallstones
224
Indirect hyperbilirubinemia is found in:
a. Gilbert's syndrome
b. alcoholic liver disease
c. gallstones
d. primary biliary cirrhosis
e. bleeding in the gastrointestinal tract
a. Gilbert's syndrome
225
An enlarged and palpably painful liver is amonglistedcauses most likely sign:
a. carcinoma
b. acute cholecystitis
c. alcoholic liver cirrhosis
d. of acute left-sided heart failure
e. viral hepatitis
e. viral hepatitis
226
A strongly increased concentration of alkaline phosphatase is most indicative of:
a. acute hepatitis
b. obstruction of the bile duct
c. alcoholic liver cirrhosis
d. carbon monoxide poisoning
e. extravascular hemolysis
b. obstruction of the bile duct
227
When direct bilirubin increases, the first thing to do is:
a. Ultrasound of the liver and bile ducts
b. Abdominal CT
c. gastroscopy (and, if necessary, endoscopic ultrasound)
d. bone marrow puncture
e. lumbar puncture
a. Ultrasound of the liver and bile ducts
228
The normalization of the prolonged prothrombin time in a patient with hyperbilirubinemia after three
days of vitamin K administration speaks most in favor of the following of the listed diagnoses:
a. Gilbert syndrome
b. alcoholic hepatitis
c. viral hepatitis
d. carcinoma of the bile ducts
e. paracetamol poisoning
d. carcinoma of the bile ducts
229
Diarrhea in ulcerative colitis is
a. osmotic
b. secretarial
c. exudative
d. motility
e. none of the above
c. exudative
230
Osmotic diarrhea can be distinguished from secretory diarrhea with the help of:
a. starvation test
b. haematesta stool
c. rectal examination
d. gastroscopy
e. autopsies
a. starvation test
231
A 60-year-old chronic alcoholic comes to the doctor because of a 14-day swelling of the left
lower extremity distal to the knee. Among the listed causes, the most likely is:
a. heart failure (alcoholic cardiomyopathy)
b. hypoproteinemia due to inadequate nutrition
c. nephrotic syndrome
d. local inflammation
e. liver cirrhosis
d. local inflammation
232
What is not a symptom of GERD
a) regurgitation
b) heartburn
c) constipation
d) weakness
e) epigastric pain
c) constipation
233
H. Pylori
a) duodenal cancer
b) eradication does not cure GERD
c) evidence by the Rutgers NE test
d)mimics duodenal ulcer
b) eradication does not cure GERD
d)mimics duodenal ulcer
234
Ulcerative colitis:
a) terminal ileum and large intestine
b) small intestine
c) fistulas
d) general involvement of the gastrointestinal tract
e) inflammation limited to the mucosa
d) general involvement of the gastrointestinal tract
e) inflammation limited to the mucosa
235
For adematous polyps of the colon, the following applies:
a) the basic treatment is surgical
b) cause of inflammation, pain, bleeding
c) most cancers arise from them
d) treatment is endoscopic
e) they can occur in the family
c) most cancers arise from them
d) treatment is endoscopic
e) they can occur in the family
236
Choose the correct statements for Barrett's esophagus:
a) occurs in patients with duodenoesophageal reflux
b) histologically, it is a metaplasia of the glandular epithelium of the gastric mucosa in the esophagus
c) occurs in the first year of severe reflux disease
d) occurs in smokers
e) Barrett's esophagus is treated exclusively with drugs
b) histologically, it is a metaplasia of the glandular epithelium of the gastric mucosa in the esophagus
237
Which examination is used to determine motility disorders of the esophagus?
a) X-ray
b) MR
c) pH-metry
d) manometry
e) Ultrasound
d) manometry
238
The most common pattern for peptic ulcer formation is:
a)NSAIDs
b) stress
c) Zollinger-Ellison syndrome
d) Crohn's disease
a)NSAIDs
239
Acute pancreatitis is treated:
a. fluids are replaced
b. he must not eat fatty food for three days
c. analgesic
d. an antibiotic
e. fasting for a couple of days
a. fluids are replaced
c. analgesic
e. fasting for a couple of days
240
How do you treat infected necrotizing pancreatitis?
a. liquids
b. analgesics
c. antibiotics
d. you remove the stone if it is biliary pancreatitis
e. surgically
e. surgically
241
76-year-old, healthy, 3 hours on
the abdomen, which quickly escalated
to bloody stool, the tachycardia is
becoming more painful, the abdominal
papal X-ray does not show perforation.
a) CT
b) MR
c) CT angiography
d) Ultrasound
c) CT angiography
242
How do we treat bleeding from a duodenal ulcer? Circle the wrong answer:
a) methylprednisolone
b) surgical
c) endoscopically
a) methylprednisolone
243
Risk factors for colorectal cancer are:
a. frequent occurrence in the family
b. chronic inflammatory bowel diseases
c. constipation
a. frequent occurrence in the family
b. chronic inflammatory bowel diseases
244
Focal nodular hyperplasia (circle the wrong one)
a) most often in women between the ages of 20 and 50
b) lesion with central necrosis spreading in a stellate manner
c)not related to taking oral contraceptives
d) treated surgically with liver resection
c)not related to taking oral contraceptives
245
Treatment of necrotizing pancreatitis
a) broad-spectrum antibiotics
b)fluid replacement
c)analgesics
d) calcium channel inhibitors
b)fluid replacement
c)analgesics
246
What is not a warning sign?
a) weight loss
b)regurgitation
c) dysphagia
d) bleeding from the gastrointestinal tract
b)regurgitation
247
What about H. Pylori
a) GERD can be cured by eradication
b)causes stomach cancer
c) causes duodenal carcinoma
b)causes stomach cancer
248
Which of the following is not true of melena?
a) It can occur simultaneously with hematochezia
b)we prove it with hematest
c) can occur due to bleeding into the small intestine
d) indicates bleeding from the upper gastrointestinal tract
b)we prove it with hematest
249
Hematemesis is:
a) vomiting yellow liquid
b)common with bleeding from esophageal varices
c) rare in bleeding from the esophagus
d) vomiting of brown stomach contents
b)common with bleeding from esophageal varices
250
Hematochezia occurs in all conditions except:
a) hemorrhoids
b) intestinal tumors
c) Crohn's disease
d)duodenal peptic ulcers
e) pseudomembranous colitis
f) celiac disease
d)duodenal peptic ulcers
251
Risk factors for the development of colon cancer (circle the correct one, several
correct ones):
a)that someone in the family has had colorectal cancer
b)severe IBD for several years
c)survived colorectal cancer
d)adenomas
e) prolonged constipation
a)that someone in the family has had colorectal cancer
b)severe IBD for several years
c)survived colorectal cancer
d)adenomas
252
Acute Pancreatitis Condition Definition Scale (circle the correct one, multiple correct ones):
a)Ranson's indicators
b)Glasgow Scale
c)APACHE II
d)Child-Turcott-Pugh classification
a)Ranson's indicators
b)Glasgow Scale
c)APACHE II
253
The clinical picture of chronic pancreatitis includes:
a)overweight
b)chronic or recurring abdominal pain
c)steatorrhea
d)Diabetes
e)it is more common in women
b)chronic or recurring abdominal pain
c)steatorrhea
d)Diabetes
254
Incarcerated hernia:
a)it is not returnable
b)the stalk is inflamed
c)is reposable
a)it is not returnable
255
An elderly man (63 years old), tachycardic, hypertensive, severe sudden
abdominal pain, once passed slimy bloody thin stools. X-ray shows no
perforation. What do we do after that?
a) emergency gastroscopy
b) hemodynamic stabilization
c) CT angiography
c) CT angiography
256
Case report for acute biliary pancreatitis. Which diagnostic and therapeutic
method will you use?
a) angiography
b) ct
c) endoscopic ultrasound
d) transcutaneous ultrasound
e) X-ray
d) transcutaneous ultrasound
257
Damage to the mucous membrane of the
esophagus is caused by:
● aspirin
● NSAIDs
● folic Acid
● antacids
● aspirin
● NSAIDs
258
Esophageal perforation can manifest as:
● you may have subcutaneous emphysema of the neck
● may be a complication of gastroscopy
● may be a complication of Boerhaave syndrome
● it is common in summer due to cold drinks
● you may have subcutaneous emphysema of the neck
● may be a complication of gastroscopy
● may be a complication of Boerhaave syndrome
259
Risk factors for upper gastrointestinal bleeding after taking NSAIDs
● Advanced age(>65 years old)
● Proton pump inhibitors
● Previous ulcer
● Advanced age(>65 years old)
● Previous ulcer
