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Gastrointestinal Block > GIS Important Questions > Flashcards

GIS Important Questions Flashcards

1
Q

[PP]
Which branch of the abdominal aorta supplies the spleen? (1 mark)

A

Coeliac trunk

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2
Q

[PP]
Which organ is bordered superiorly by the spleen and supplied by the splenic artery? (1 mark)

A

Pancreas

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3
Q

[PP]
Which peritoneal ligament transmits the splenic artery? (1 mark)

A

Splenorenal / Lienorenal ligament

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4
Q

[PP]
A 33-year-old man involved in a car accident arrived at the hospital with a distended abdomen and pain in his left shoulder. Further examination revealed a haemoperitoneum and a laceration of the diaphragmatic surface of the spleen. Where would the blood accumulate in the greater sac if the patient remained seated? (1 mark)

A

Left paracolic gutter OR Rectovesical pouch

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5
Q

[PP]
A 33-year-old man involved in a car accident arrived at the hospital with a distended abdomen and pain in his left shoulder. Further examination revealed a haemoperitoneum and a laceration of the diaphragmatic surface of the spleen. Which nerve transmitted the nociceptive signals for the referred shoulder pain? (1 mark)

A

Phrenic nerve

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6
Q

[PP]
Name the MOST COMMON histological subtype of primary pancreatic cancer. (1 mark)

A

Adenocarcinoma

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7
Q

[PP]
Name the cell type from which pancreatic adenocarcinoma is derived from. (1 mark)

A

Ductal epithelium

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8
Q

[PP]
Name the anatomical part in which pancreatic cancer MOST COMMONLY occurs. (1 mark)

A

Head of pancreas

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9
Q

[PP]
Name two symptoms associated with pancreatic cancer. (2 marks)

A
  1. Pain
  2. Obstructive jaundice
  3. Weight loss, malaise, anorexia
  4. Symptoms of gastric outlet obstruction
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10
Q

[PP]
Name two IMPORTANT aetiological factors leading to hepatocellular carcinoma. (2 marks)

A
  1. Chronic HBV infection (80%)
  2. Chronic HCV infection
  3. Chronic alcoholism (via cirrhosis)
  4. Cirrhosis (irrespective of causes)
  5. Non-alcoholic steatohepatitis (NASH)
  6. Metabolic disease
  7. Aflatoxin
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11
Q

[PP]
Name one histological feature of hepatocellular carcinoma. (1 mark)

A
  1. Trabecular pattern: cords of tumour cells separated by sinusoids lined by endothelial cells (simulating normal liver architecture)
  2. Bile pigment production: focal production by carcinoma cells (evidence of hepatocytic differentiation)
  3. Clear cell change (uncommon)
  4. Tumour cells: central nuclei with eosinophilic cytoplasm (simulating hepatocytes)
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12
Q

[PP]
What is the MOST COMMON mode of spread of hepatocellular carcinoma? (1 mark)

A

Venous invasion

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13
Q

[PP]
Name one blood tumour marker specific for hepatocellular carcinoma. (1 mark)

A

Serum alpha-fetoprotein

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14
Q

[PP]
What is the purpose of faecal microbiota transplantation (FMT)? (1 mark)

A

Restore normal gut microbiota

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15
Q

[PP]
Which disease has FMT been used as an experimental therapy? (1 mark)

A

Recurrent C. difficile infection

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16
Q

[PP]
Which modulator is the MOST COMMON therapy for bacterial infections? (1 mark)

A

Antibiotics

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17
Q

[PP]
Inulin (a dietary fibre ingredient) is classified as which modulator? (1 mark)

A

Prebiotics

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18
Q

[PP]
Which health condition has been shown to be improved in animal experiments via FMT from animals to humans? (1 mark)

A

Malnutrition / Kwashiorkor / Obesity

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19
Q

[PP]
Disability-adjusted life year (DALY) is a summary measure of population disease burden.
DALY can be calculated as the sum of which two parameters? (2 marks)

A
  1. Years of Life Lost due to Premature Mortality (YLL)
  2. Years of Life Lost due to Disability (YLD)
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20
Q

[PP]
How has the following changed over the last two decades? (3 marks)
1. contribution of communicable diseases to global DALY
2. contribution of NCDs to global DALY
3. contribution of NCDs to DALY in low-income countries

A
  1. decreasing
  2. increasing
  3. increasing
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21
Q

[PP]
Name the blood supply to the liver. (2 marks)

A
  1. Hepatic portal vein
  2. Hepatic artery
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22
Q

[PP]
Describe the liver appearance of cirrhotic liver on computed tomography. (1 mark)

A
  1. Irregular surface / outline
  2. Small liver
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23
Q

[PP]
Name two of the portosystemic collateral pathways developed with portal hypertension. (2 marks)

A
  1. Recanalized umbilical vein
  2. Gastroesophageal collaterals
  3. Gastroepiploic collaterals
  4. Splenorenal collateral
  5. Pancreatico-duodenal collaterals
  6. Haemorrhoidal collaterals
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24
Q

[PP]
Define “diverticulum”. (1 mark)

A

Outpouching of intestinal wall

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25
Q

[PP]
Name two potential complications of diverticular disease. (2 marks)

A
  1. Diverticulitis
  2. Diverticular abscess
  3. Acute peritonitis
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26
Q

[PP]
Give one possible cause for diverticulum. (1 mark)

A

Low fibre diet, chronic constipation, hard stool

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27
Q

[PP]
Barrett’s oesophagus is a pathological condition typically in which part?

A

Lower oesophagus

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28
Q

[PP]
Name the histological hallmark for the diagnosis of Barrett’s oesophagus. (2 marks)

A

Intestinal metaplasia

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29
Q

[PP]
Name the major risk factor of Barrett’s oesophagus. (1 mark)

A

Prolonged reflux oesophagitis

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30
Q

[PP]
Name the major complication of Barrett’s oesophagus. (2 marks)

A

Adenocarcinoma

(Lower 1/3 of oesophagus)

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31
Q

[PP]
Explain what is faecal microbiota transplantation. (2 marks)

A

Therapy by infusing a solution of healthy donor faeces through a nasoduodenal tube / enema / nasogastric tube / capsule form to the patient’s gastrointestinal tract

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32
Q

[PP]
Suggest a possible reason why antibiotic treatment failed. (2 marks)

A

Most probably antibiotic resistance developed in the pathogenic Clostridium difficile strain
Previous antibiotic treatment disrupted the normal microbiota, allowing the outgrowth of Clostridium difficile

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33
Q

[PP]
Suggest one hypothesis why faecal microbiota transplantation is effective in recurrent Clostridium difficile infection. (1 mark)

A

Restore normal gut microbiota in the patient => rebalance the immunity and suppress growth of C. difficile

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34
Q

[PP - Formative]
A 45-year old man has moderately raised liver enzymes (transaminases) and is suspected of hepatitis. He mentions that he has previous episodes of such. Which of the following is the most likely cause of hepatitis in this man?
A: Epstein Barr virus
B: Hepatitis C virus
C: Hepatitis D virus
D: Human immunodeficiency virus

A

B

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35
Q

[PP - Formative]
A 35-year old man is diagnosed with having hepatitis C viral (HCV) infection. His HCV RNA level in the blood is high and his liver enzymes are raised. His disease is different from hepatitis B viral (HBV) infection in which of the following:
A: He is more prone to develop hepatocellular carcinoma than those with HBV infection
B: His HCV infection can be eradicated with anti-viral drug while HBV
infection cannot
C: His HCV infection could have been prevented with anti-HCV vaccine
D: His disease is less likely to develop cirrhosis than HBV infection

A

B

X A: HBV has a higher oncogenic potential (DNA virus)
B: Curative anti-viral drug for HCV but not HBV, only suppressive anti-viral for HBV
X C: Vaccine for HBV but not HCV

Note:
1. Maternal transmission for HBV but not HCV
2. Both: hepatitis, carrier state, end-stage liver disease, HCC

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36
Q

[PP]
A 45-year-old man has moderately raised liver enzymes (transaminases) and is suspected of having hepatitis. Which of the following is the MOST LIKELY cause of hepatitis in this man?
A. Alcoholism
B. Biliary stones
C. Clonorchiasis
D. Pancreatitis

A

A

Chronic alcoholism directly damages the liver hepatocytes and causes hepatitis, while the other diseases may cause damage to the bile ducts and not directly on the hepatocytes.

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37
Q

[PP]
A 32-year-old woman is admitted with fulminant hepatitis. She is in the third trimester of pregnancy. She returned from Pakistan 4 weeks ago. What is the MOST LIKELY viral cause of her hepatitis?

A

Hepatitis E

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38
Q

[PP]
In adults, there are several vestigial remnants of anatomical structures which are found in the foetus. The round ligament of liver is a remnant of which embryological structure?

A

Umbilical vein (carry oxygenated blood from placenta to foetus)

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39
Q

[PP]
The peritoneum lines the abdominal cavity. Which of the following organs is retroperitoneal?

A. ileum
B. liver
C. pancreas
D. transverse colon

A

C

Secondarily retroperitoneal

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40
Q

[PP]
A 56-year-old man with acute severe abdominal pain suffered from ischaemic necrosis of the rectosigmoid junction. Where is the artery supplying the affected region of the colon?

A. Inside the mesentery
B. Inside the transverse mesocolon
C. Posterior to the left inframesocolic compartment
D. Posterior to the right paramesenteric compartment

A

C

Rectosigmoid junction is supplied by branches of IMA (sigmoid a. & sup. rectal a.)

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41
Q

[PP]
Which structure forms from the common bile duct and pancreatic duct at the level of the duodenum?

A

Ampulla of Vater

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42
Q

[PP]
Name the folds in different parts of the GI tract.

A

Stomach: rugae (longitudinal)
Small intestine: plicae circulares (circular folds, transverse)
Large intestine: semilunar folds, haustra (transverse)

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43
Q

[PP]
A patient arrived at the Accident and Emergency Department complaining about severe right upper quadrant pain. Laceration of the liver was diagnosed. Which structure was clamped to stop the internal bleeding during the Pringle manoeuvre?

A

Hepatoduodenal ligament

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44
Q

[PP]
During early foregut development, the stomach, liver, and spleen are held in place by a mesentery that is connected to both the dorsal and ventral body walls. Which structure is formed from the mesentery located between the liver and the ventral wall of the embryo?

A

Falciform ligament

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45
Q

[PP]
Which vascular structure is used to divide the right from left hepatic lobe?

A

Middle hepatic vein

46
Q

[PP]
Which structure is formed by the right and left hepatic duct?

A

Common hepatic duct

47
Q

[PP]
The pancreas first appears at approximately 5 weeks of gestation. Which germ layer gives rise to the pancreas? (1 mark)

A

Endoderm

48
Q

[PP]
Which part of the gut tube gives rise to the pancreas? (1 mark)

A

Duodenum / Foregut

49
Q

[PP]
Which two parts of the pancreas are derived from the ventral pancreatic bud? (2 marks)

A
  1. Caudal head
  2. Uncinate process
50
Q

[PP]
Name a developmental defect caused by failure of fusion of the dorsal and ventral pancreatic ducts. (1 mark)

A

Pancreatic divisum

51
Q

[PP]
Name five consecutive layers of the anterolateral abdominal wall between skin and abdominal cavity. (5 marks)

A
  1. Superficial fascia: Camper’s fascia & Scarpa’s fascia
  2. Muscles: external oblique, internal oblique, transversus abdominis
  3. Transversalis fascia
  4. Extraperitoneal fat: might be missing
  5. Peritoneum
52
Q

[PP]
Name the procedure for removal of the gallbladder.

A

Laparoscopic cholecystectomy

53
Q

[PP]
Which type of neuronal fibres are contained in superior mesenteric plexus?

A. Postganglionic parasympathetic
B. Preganglionic parasympathetic
C. Preganglionic sympathetic
D. Somatic motor

A

B

54
Q

[PP]
The embryonic midgut undergoes rotation and physiological umbilical herniation during development. Which two regions of the intestine originate from the cranial limb of the midgut? (2 marks)

A
  1. Jejunum
  2. Ileum
55
Q

[PP]
What causes physiological umbilical herniation? (2 marks)

A

The growth of midgut is faster than the abdominal cavity.

56
Q

[PP]
Name one congenital disorder that results from failure of the herniated gut to return to the abdominal cavity. (1 mark)

A

Omphalocele

57
Q

[PP]
A 63-year-old man was diagnosed with a pancreatic head cancer and presented with jaundice and abdominal pain. Explain the anatomical basis of his jaundice. (1 mark)

A

Compression of biliary tract

58
Q

[PP]
List the structures that convey the pain impulse from the head of the pancreas to the spinal cord. (4 marks)

A
  1. celiac ganglion and plexus
  2. splanchnic nerves
  3. sympathetic chain and rami communicantes
  4. dorsal root ganglion
59
Q

[Self-assessment]
A 28-year-old woman is admitted to the obstetric service for caesarean section delivery of a fetus that is in the breech position. The patient elects to have a transverse, suprapubic (Pfannenstiel or “bikini”) incision. Which nerve is most likely injured during this procedure?

A

Iliohypogastric nerve

60
Q

[PP]
Which aetiology accounts for high incidence of HCC in Europe?

A

Chronic alcoholism

61
Q

[PP]
A patient presents with haemoperitoneum and is found to have HCC. Which feature of the tumour does the surgeon find during operation?

A

Tumour is highly vascular

62
Q

[PP]
Inflammatory bowel disease can be further subclassified with reference to clinical and pathological features. By histology full-thickness inflammation and which of the following are classically seen in Crohn’s disease?
A. Eosinophilic abscess
B. Foreign body giant cell reaction
C. Granulomas
D. Vasculitis

A

C

63
Q

[PP]
Idiopathic inflammatory bowel disease with continuous involvement of bowel segment and toxic megacolon as a potential complication. Which pathological entity?

A

Ulcerative colitis

64
Q

[PP]
Idiopathic inflammatory bowel disease with transmural inflammation and granulomas. Which pathological entity?

A

Crohn’s disease

65
Q

[PP]
Outpouching of mucosa and submucosa through defects in bowel wall. Which pathological entity?

A

Diverticulum

66
Q

[PP]
Cessation of peristalsis resulting in intestinal obstruction. Which pathological entity?

A

Paralytic ileus

67
Q

[PP]
Intestinal wall twists around itself. Which pathological entity?

A

Volvulus

68
Q

[PP]
Intestinal wall gets caught in the peristaltic wave and gets carried along. Which pathological entity?

A

Intussusception

69
Q

[PP]
Acute pancreatitis refers to inflammation of the pancreas. What is the COMMONEST etiology for acute pancreatitis in Hong Kong?

A. Alcoholism
B. Biliary stones
C. Cystic fibrosis
D. Drug-induced

A

B

70
Q

[PP]
A 50-year-old male has an isolated increase in plasma alanine transaminase (ALT) concentration. Which of the following is a cause of the biochemical abnormality?
A. Carcinoma of pancreas
B. Carcinoma of the common bile duct
C. Cirrhosis
D. Fatty liver

A

D

71
Q

[Old PP]
Which of the following infections is transmitted by sharing of needles among intravenous drug abusers in Hong Kong?
A. Hepatitis A
B. Hepatitis C
C. Hepatitis E
D. Herpes simplex type 2
E. Influenza

A

B

HCV: Contact with blood and body fluids (needles, sex, medical equipment)

72
Q

[Old PP]
What is the nature of the viral genome of HBV?

A

Double-stranded DNA

73
Q

[Old PP]
Most common cause(s) of post-transfusion hepatitis

A

HBV, HCV

74
Q

[Old PP]
Which hepatotropic viruses are transmitted by fecal-oral route?

A

HAV, HEV

75
Q

[Old PP]
Which hepatitic viruses can give rise to chronic liver disease?

A

HBV, HCV, HDV

76
Q

[PP]
A proportion of patients with chronic viral hepatitis will progress to cirrhosis. Name four complications / clinical manifestations of cirrhosis / portal hypertension (severe blockage of blood return from hepatic portal vein.)

A
  1. Esophageal (and other) varices
  2. Ascites, caput medusae
  3. Splenomegaly
  4. Hepatic encephalopathy
  5. Haemorrhoids
77
Q

[Old PP]
Which hepatitic viruses cause infection by parental transmission?

A

HBV, HCV, HDV

78
Q

[Old PP]
Apart from HK, which parts of the world also have a high prevalence of HBV infection?

A

Sub-Saharan Africa, Southeast Asia, China

79
Q

[Old PP]
Incidence of which viral hepatitis is higher in Japan than Southeast Asia and Hong Kong?

A

Hepatitis C (also prevalent in Epygt and Pakistan)

80
Q

[Old PP]
HDV is a defective virus and it requires presence of another hepatitis virus to be infective. What is this virus?

A

HBV

81
Q

[PP]
Name the peritoneal formation that connects the transverse colon to the posterior abdominal wall.

A

Transverse mesocolon

82
Q

[PP]
Name the double-layered fold of peritoneum that connects the jejunum and ileum to the posterior abdominal wall.

A

Mesentery

83
Q

[PP]
Name the first peritoneal formation usually encountered in a midline laparotomy.

A

Greater omentum

84
Q

[PP]
Name a peritoneal formation derived from the ventral mesentery.

A

Falciform ligament

85
Q

[PP]
Name the peritoneal formation that extends from the lesser curvature of the stomach and the first part of duodenum to the inferior surface of liver.

A

Lesser omentum

86
Q

[PP]
Which two veins form the hepatic portal v.?

A

Sup. mesenteric v. & Splenic v.

Some blood from inf. mesenteric v. and pancreatic v. drains into splenic v.

87
Q

[PP]
Explain what the ‘portal system’ means. (1 mark)

A

Blood passing through 2 intermittent capillary beds between an artery and a vein.

Heart -> artery -> 1st capillary network in abdominal viscera -> hepatic portal v. -> 2nd capillary network in liver -> hepatic v. -> inf. vena cava -> heart

88
Q

[PP]
The superior mesenteric, inferior mesenteric and internal iliac arteries are the major blood supplying arteries to different parts of the colon. What is the watershed area that is the MOST SUSCEPTIBLE to ischemic injury?

A

Splenic flexure

89
Q

[PP]
Typhoid fever can be diagnosed by different laboratory tests. Which of the following tests is MOST SPECIFIC for the diagnosis of typhoid fever?
A. A positive blood culture
B. A positive Weil-Felix test in a single blood sample
C. A positive Widal’s test in a single blood sample
D. Acid-fast stain of stool showed acid-fast bacilli
E. Gram smear of stool showed Gram negative bacilli

A

A

Positive culture = always most SPECIFIC in bacteriology

B & D: X for typhoid fever

C: not very specific, need paired sera for a four-fold rise

E: stool contains a huge variety of Gram -ve bacilli

BASU
1st week: blood culture
2nd week: Agglutination (Widal’s test, commercial antigen detection tests)
3rd week: stool culture, rectal swab
4th week: Urine culture (low +ve rate)

Bone marrow culture: high +ve rate but invasive

90
Q

[PP]
A 25-year-old lady presented with high fever and abdominal pain for 1 week. She had had mild diarrhoea which spontaneously subsided. A faint rash is noted over her abdomen. She had recently returned to Hong Kong after visiting relatives in India. What is the MOST LIKELY causative agent?

A

Salmonella typhi
=> typhoid fever

Prodrome: constipation, diarrhoea
Untreated: up to 4 weeks
Abdominal pain, headache, relative bradycardia

-> Rose spots (at the end of first week) (<1/3 of patients), splenomegaly, hepatomegaly, leukopenia

Complications: intestinal hemorrhage, intestinal perforation, toxaemia

Less severe: paratyphoid fever (Salmonella paratyphi A, B, C)

91
Q

[PP]
A 78-year-old woman was hospitalised for community-acquired pneumonia and treated with intravenous meropenem. After 10 days of treatment, she developed diarrhoea. Antibiotic-associated diarrhoea was suspected. Which of the following is the MOST LIKELY cause of her antibiotic-associated diarrhoea?

A

Clostridioides (Clostridium) difficile

92
Q

[PP]
An 80-year-old man was hospitalised for intra-abdominal abscesses and ventilator-associated pneumonia. He developed bloody diarrhoea after 3 consecutive weeks of intravenous meropenem. What is the most likely causative agent?

A

C. difficile

93
Q

[Old PP]
Which of the following requires anaerobic culture from stool?
A. Bacillus cereus
B. Clostridium difficile
C. Salmonella typhimurium
D. Vibrio parahaemolyticus

A

B

94
Q

[Old PP]
Which of the following bacteria has to be grown in anaerobic culture?
A. Bacillus cereus
B. Clostridium difficile
C. Campylobacter jejuni
D. Salmonella typhimurium
E. Vibrio cholerae

A

B

95
Q

[Self-assessment]
Regarding antibiotic-associated diarrhoea,
A. Intravenous vancomycin is an effective treatment for C. difficile colitis.
B. Toxic megacolon is a potentially life-threatening complication of Clostridioides (Clostridium) difficile.
C. C. difficile is a non-spore forming, anaerobic Gram-positive bacillus.

A

B

First-line treatment:
- Oral vancomycin
- Oral fidaxomicin (X HK)

96
Q

[PP]
A 38-year-old man presented with acute fever, abdominal pain, and bloody diarrhoea. Stool culture yielded a curved Gram-negative bacillus under microaerophilic conditions. What is the most likely causative agent?

A

Campylobacter e.g. C. jejuni

97
Q

[PP]
Mrs Lee, a 38-year-old woman, presented with a 5-day history of cramping abdominal pain and bloody diarrhoea. She had opened her bowels over 13 times in the preceding 24 hours. There was fresh red blood mixed in with her stool. She felt feverish. She had returned from a family holiday with her husband and two children 3 days before the onset. Her laboratory report indicated the presence of Campylobacter jejuni in her stool. What is the MOST APPROPRIATE antibiotic to be given in the management of Campylobacter enteritis?
A. Azithromycin
B. Doxycycline
C. Metronidazole
D. Trimethroprim-sulfamethoxazole

A

A

Macrolides (e.g. erythromycin)

98
Q

[PP]
What is the MOST LIKELY explanation for the result of HBsAg negative, anti-HBs positive (>10 mIU/mL), and anti-HBc negative? (2 marks)

A

Prior HBV vaccination

99
Q

[PP]
If HBsAg is positive, which ANTIGEN test can help determine the phase of chronic hepatitis B infection? (2 marks)

A

HBeAg

100
Q

[PP]
If anti-HCV antibody is reactive, what is the follow-up test to determine whether there is current infection? (1 mark)

A

HCV RNA RT-PCR

101
Q

[PP]
A 40-year-old man with
HBsAg +ve
Anti-HBc +ve
Anti-HBc IgM +ve
Anti-HBs -ve
Anti-HAV IgG +ve
Anti-HAV IgM -ve

What is the MOST LIKELY serological diagnosis?

A

Recent / Acute hepatitis B infection

HBsAg ++
HBeAg +
HBV DNA +
Anti-HBc IgG + / -
Anti-HBc IgM +
Anti-HBe -
Anti-HBs -

102
Q

[PP]
A 60-year-old woman with:
HBsAg -
Anti-HBc +
Anti-HBc IgM -
Anti-HBs +
Anti-HAV IgG +
Anti-HAV IgM -

What is the most likely serological diagnosis?

A

Recovered from past hepatitis B infection

HBsAg -
HBeAg -
HBV DNA -
Anti-HBc +
Anti-HBc IgM -
Anti-HBe +/-
Anti-HBs +

103
Q

[PP]
A 28-year-old health care worker with:
HBsAg -
Anti-HBc -
Anti-HBs +
Anti-HAV IgG -
Anti-HAV IgM -

What is the most likely serological diagnosis?

A

Hepatitis B vaccinated

HBsAg -
HBeAg -
HBV DNA -
Anti-HBc -
Anti-HBc IgM -
Anti-HBe -
Anti-HBs +

104
Q

[PP]
A 35-year-old man with:
HBsAg +
Anti-HBc +
Anti-HBc IgM -
Anti-HAV IgG +
Anti-HAV IgM +

What is the most likely serological diagnosis?

A

Acute hepatitis A infection in a chronic hepatitis B carrier

HBsAg +
HBV DNA +
Anti-HBc +
Anti-HBc IgM -
Anti-HBs -

e-seroconverted (awakening of immune system, seroconversion may be marked by severe hepatitis, usually low level viral replication)
HBeAg -
Anti-HBe +

105
Q

[PP]
A 16-year-old male recently returned from Thailand with:
HBsAg -
Anti-HBc -
Anti-HBs +
Anti-HAV IgG +
Anti-HAV IgM +

What is the most likely serological diagnosis?

A

Acute hepatitis A infection in a person vaccinated against hepatitis B

106
Q

[Old PP]
What is the immunogen used in hepatitis B vaccine?

A

HBsAg

107
Q

[Old P]
Which serological marker can confirm a recent infection by HBV?

A

Anti-HBc IgM

108
Q

[PP, Formative]
What is the definition of chronic hepatitis B infection? (1 mark)

A

Carriage of HBsAg for >6 months

109
Q

[PP, Formative]
What is the significance of HBsAg? (2 marks)

A

Marker of hepatitis B infection

110
Q

[PP, Formative]
What is the significance of anti-HBc IgM? (2 marks)

A

Marker of acute hepatitis B infection

111
Q

[PP, Formative]
A 69-year-old woman is admitted with jaundice and loss of appetite. She reports frequent intake of pig liver congee. Which of the following is the MOST LIKELY cause of acute hepatitis in this scenario?

A

Hepatitis E

112
Q

[PP, Formative]
Helicobacter pylori infection is a major cause of gastric ulcer. Which of the following is a characteristic of Helicobacter pylori to cause infection in the stomach?
A. Ability to grow in anaerobic environment
B. Bipolar flagella
C. Survival in alkaline environment
D. Urease positive

A

Motility: unipolar flagella and spiral shape, urease (reduce mucus layer viscosity)
Survival within mucus gel & low O2 environment: microaerophilic (5% O2)
Survival in acidic environment: urease (urea -> ammonia)

Gastrointestinal Block (9 decks)

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