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MBBS VI Medicine > Gastroenterology and hepatology MCQ > Flashcards

Gastroenterology and hepatology MCQ Flashcards

1
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C

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2
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C

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3
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E (non invasive test for checkup)

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4
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C

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5
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C (protective levels of antibody to HAV could be present for at least 25y in adults and at least 14-20y in children)

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6
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B

D is not likely as asymptomatic

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7
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A

Ans: C

A – ascitic protein classically <10
B – usu G- or streptococci, or may be -ve
D – pH <7.3 suspicious; pH <7.15 a/w poor prognosis
E – diagnostic paracentesis always needed!

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8
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A

C

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9
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E

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10
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Ans: C

A (esophageal web in Plummer Vinson syndrome)

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11
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Ans: C

Pathophysiology incl:
* Altered gastric motility and compliance
* Visceral hypersensitivity
* Helicobacter pylori infection, altered gut microbiome
* Psychosocial dysfunction

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12
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A

Ans: A

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13
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Ans: C. HEV infection

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14
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Ans: D

E (mitral stenosis resulting in enlargement of left atrium which can cause compression of the recurrent laryngeal nerve (dysphagia/hoarsness in voice) –> Ortner syndrome)

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15
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A

Ans: C

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16
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Ans: B (day 3 CT scan used to detect necrosis: may need further management)

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17
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A

C.

A: reversed de Ritis ratio 2:1 typical
D: histological features incl lipogranuloma, neutrophil infiltration, Mallorys hyaline, pericellular fibrosis
E: Maddrey score based on PT, bilirubin

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18
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Ans: A

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19
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C
Obstructive jaundice: cholestatic component leading to vit K deficiency
Painless jaundice more likely to be malignant cause (but HCC CBD obstruction usually uncommon)

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20
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Ans: A

B, C, D – in Glasgow criteria
E – part of SIRS

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21
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Ans: C

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22
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Ans: C

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23
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Ans: A

Inflammatory exudation – IBD, GI malignancy, CD colitis, multiple ulcer
Mucosal condition – celiac disease, Whipple disease, Menetrier disease, lupus enteritis
Lymphatic obstruction – primary lymphangiectasis, constrictive pericarditis, Rt HF, portal HT

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24
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Ans: A

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25
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Ans: C (will actually exacerbate HE)

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26
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Ans: A

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27
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Ans: E (for HE prophylaxis)

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28
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Ans: E (PSA)

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29
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Ans: B (increased absorption of ammonia into the mesenteric blood supply due to slow transit constipation –> such absorption most likely overwhelemd hepatic excretion)

C: hypoK

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30
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A

Ans: B

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31
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Ans: A

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32
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Ans: B

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33
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Ans: B

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34
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Ans: E

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35
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A

Ans: A

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36
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Ans: D

  • 5y: low-risk adenoma (1-2 polyps, tubular, <1cm, ≤moderate dysplasia), low-risk sessile (SSP <1cm + no dysplasia)
  • 3y: high-risk adenoma (≥3 polyps, villous element, ≥1cm, severe dysplasia), high-risk sessile (SSP ≥1cm or dysplastic or TSA)
  • <3y: >10 adenoma
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37
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A

Ans: C

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38
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Ans: B (HSV associated with shallow ulcers)

A: candida (whitish patches)
C: CMV (deep longitudinal ulcers)

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39
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A

Ans: C

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40
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A

C. (TAF first line, TDF only reserved for pregnancy)

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41
Q
A

Ans: D (PT included in Kings criteria)

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42
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A

Ans: B (should add PPI too)

43
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A

Ans: E (hyperplastic polyp risk not increased)

44
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46
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47
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Ans: B

RF: immune tolerance phase, no treatment, amle sex, HCV/HDV coinfection, alcoholism

48
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51
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A

Ans: A

Causes of AST>ALT are acute cholangiohepatitis and alcoholic hepatitis. For alcoholic hepatitis, ALT AST typically <500. For acute cholangiohepatitis it can be of any level.

52
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Ans: A (sustained virologic response defined by undetectable HCV RNA 12w after completion i.e. means that is cleared already)

53
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54
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Ans: B

Cholestasis: OCP, steroids, chlorpromazine
Mixed cholestatic hepatitis; Augmentin, erythromycin, ACEI, NSAID Hepatitis: Panadol, isoniazid, rifampicin, allopurinol Steatosis: tetracycline, valproate, amiodarone, tamoxifen, TPN, glucocorticoid, metoprolol

55
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A

Ans: B (PBC)

56
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57
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Ans: A

Most commonly * fluoroquinolone * clindamycin * broad-spectrum penicillin/cephalosporin

58
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60
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61
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62
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Ans: B

MRA is 1st line (e.g. spironolactone)

63
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70
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Ans: E (most common cause of renal impairment in cirrhosis is not hepatorenal syndrome, but hypovolemia due to excessive diuretics. In case of renal function worsening, stop or reduce diuretics first)

71
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77
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Ans: B (non invasive test)

78
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81
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82
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Ans: B

Alternatives are ceftriaxone, cefazolin, ceftazidime
All similar efficacy

83
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84
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Ans: A (HBV DNA high)

85
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86
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87
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Ans: metronidazole

88
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89
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90
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91
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92
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93
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94
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Ans: E (sky high ALT and AST usu suggest ischemic or toxic liver injury. The reversed de Ritis ratio here may suggest more to ischemic cause (as AST being released from other ischemic organs)

95
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97
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Ans: B (reduces ammonia production by eliminating ammonia producing colonic bacteria)

98
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100
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101
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A

Ans: C (increasing clarithromycin resistance)

102
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104
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Ans: B

assess response to intravenous corticosteroid by third day; consider rescue therapy incl infliximab or cyclosporine if fail to show significant improvement within 3–5d

MBBS VI Medicine (101 decks)

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