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CLIN PATH > GIT ASSESSMENT 5th > Flashcards

GIT ASSESSMENT 5th Flashcards

1
Q

In a patient taking Lamivudine 150 mg orally bid for the past 4 weeks, which of these HBV-DNA viral loads is the best sign that he is recuperating?

  • 1x10 to the power of 6 copies/mL
  • none of the above
  • 1x10 to the power of 8 copies/mL
  • 3x10 to the power of 4 copies/mL
  • 2x10 to the power of 7 copies/mL
A

NONE

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2
Q

Differentiate the different Viral Hepatitides: HCV

  • none of the above
  • intravenous drug use (60%); 85% develop chronic hepatitis
  • enterically transmitted, endemic in India
  • shed in the stool for 2 to 3 weeks before and1 week after the onset of jaundice.
  • transmitted vertically; causes both acute & chronic hepatitis
  • superinfection of a chronic carrier of HBV
A

intravenous drug use (60%); 85% develop chronic hepatitis

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3
Q

If the peripheral smear of Mr. A is suspicious for an intravascular hemolysis. Which of these results would confirm that suspicion?

• all Bilirubin Increased; Increased Alkaline & Acid Phosphatase; increased both Transaminases;
target cells seen on Peripheral smear
• only indirect & Total Bilirubin are Increased; normal Alkaline & Acid Phosphatase & both Transaminases;
schistocytes seen on Peripheral smear
• None of the above
• only direct & Total Bilirubin are Increased; normal Alkaline Phosphatase; only SGPT is increased; Tear drop
cells seen on Peripheral smear
• only indirect & Total Bilirubin are Increased; normal Alkaline & Acid Phosphatase; only SGOT is increased;
schistocytes seen on Peripheral smear

A

all Bilirubin Increased; Increased Alkaline & Acid Phosphatase; increased both Transaminases;
target cells seen on Peripheral smear

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4
Q

Chronic hepatitis B Infection Four stages: Immune Reactivation

A

positive HBeAb; high HBV DNA; Liver damage

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5
Q

This transaminase is more specific in detecting liver diseases in non-alcoholic asymptomatic patients.

A

ALT

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6
Q

This inherited autosomal disorder of bilirubin metabolism is characterized by a decreased hepatic excretion of bilirubin with hepatic pigmentation:

A

Dubin-Johnson Syndrome

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7
Q

State the transmission of the different Hepatitis Viruses: HDV

A

Blood inoculation

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8
Q

This inherited autosomal disorder of bilirubin metabolism is characterized by a defect of the enzyme Uridine Diphosphate Glucuronyltransferase:

A

Criggler-Najjar Syndrome

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9
Q

Mr. Bo came in complaining of yellowish discoloration of skin. The following are his lab results: Alkaline
phosphatase increased; SGPT increased; Total & Direct Bilirubin increased; Urine =dark yellow but clear; 0-1 red cells/hpf; 0-1 pus cells/hpf. What do you expect in his urine chemical tests?

A

Normal glucose, normal protein, negative nitrite, negative leukocytes, negative bilirubin, positive
urobilinogen

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10
Q

Causes of Physiological jaundice EXCEPT:

  • All of the above
  • inadequate amounts of hepatic enzymes
  • high levels of free bilirubin
  • rapid fall in blood hemoglobin concentrations
  • excessively high rate of red cell destruction
A

inadequate amounts of hepatic enzymes

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11
Q

State the transmission of the different Hepatitis Viruses: HEV

A

contaminated water and foods

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12
Q

It is needed as a cofactor of the transaminases, acting as a carrier of the amino group from one acid to another.

A

Vit B6

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13
Q

The laboratory test to assess the integrity of the liver cells:

A

liver Enzyme Tests

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14
Q

Chronic hepatitis B Infection Four stages: Immune Active

A

liver damage; fluctuating ALT, variable levels of HBV DNA.

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15
Q

This transaminase is very high in alcoholic or toxic liver disease & cardiovascular disease.

A

AST

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16
Q

Differentiate the different Viral Hepatitides: HAV

  • intravenous drug use (60%); 85% develop chronic hepatitis
  • superinfection of a chronic carrier of HBV
  • enterically transmitted, endemic in India
  • shed in the stool for 2 to 3 weeks before and1 week after the onset of jaundice.
  • none of the above
  • transmitted vertically; causes both acute & chronic hepatitis
A

shed in the stool for 2 to 3 weeks before and1 week after the onset of jaundice

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17
Q

The components of bile in decreasing order of concentration are as follows:

A

bile acids, lecithin, cholesterol, bilirubin, urobilinogen, & electrolytes

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18
Q

patient infected with HBsAg had his Hep B DNA viral load tested 2 months ago, which revealed 2,000,000,000 copies/mL. This could be a case of:

A

Chronic Hep B Infection & Immune Tolerant Stage

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19
Q

Differentiate the different Viral Hepatitides: HEV

  • enterically transmitted, endemic in India
  • none of the above
  • superinfection of a chronic carrier of HBV
  • shed in the stool for 2 to 3 weeks before and1 week after the onset of jaundice.
  • transmitted vertically; causes both acute & chronic hepatitis
  • intravenous drug use (60%); 85% develop chronic hepatitis
A

enterically transmitted, endemic in India

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20
Q

State the transmission of the different Hepatitis Viruses: HAV
• blood inoculation
• contaminated water and foods
• none of the above

A

contaminated water and foods

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21
Q

The level of this enzyme is a sensitive measure of overexposure to organophosphorus poisoning.

A

Pseudo-cholinesterase

22
Q

Chronic hepatitis B Infection Four stages: Immune tolerance

  • low HBV DNA; HB eAb positive; normal liver function tests resolution
  • None of the above
  • HBV DNA (1 billion IU/mL); normal serum aminotransferases; low risk of liver damage
  • positive HBeAb; high HBV DNA; Liver damage
  • liver damage; fluctuating ALT, variable levels of HBV DNA.
A

HBV DNA (1 billion IU/mL); normal serum aminotransferases; low risk of liver damage

23
Q

State the transmission of the different Hepatitis Viruses: HCV

A

blood inoculation

24
Q

Differentiate the different Viral Hepatitides: HDV

  • shed in the stool for 2 to 3 weeks before and1 week after the onset of jaundice.
  • intravenous drug use (60%); 85% develop chronic hepatitis
  • enterically transmitted, endemic in India
  • transmitted vertically; causes both acute & chronic hepatitis
  • none of the above
  • superinfection of a chronic carrier of HBV
A

superinfection of a chronic carrier of HBV

25
A 55 y.o. male, Mr. A, came in complaining of yellowish sclerae and skin. If, the cause of his condition is Cholelithiasis, which of these are his probable blood results? • only direct & Total Bilirubin are Increased; increased Alkaline Phosphatase; normal Acid Phosphatase; only SGPT is increased • All of the above • all Bilirubin Increased; Increased Alkaline & Acid Phosphatase; increased both Transaminases • only indirect & Total Bilirubin are Increased; normal Alkaline & Acid Phosphatase; only SGOT is increased • only indirect & Total Bilirubin are Increased; decreased Alkaline & Acid Phosphatase & both Transaminases
all Bilirubin Increased; Increased Alkaline & Acid Phosphatase; increased both Transaminases
26
The following could cause the blood sugar levels to be falsely low or falsely high during the 2 hours Postprandial Testing, EXCEPT: * All of the above * smoking * strenuous activity * exercising * drinking water
drinking water
27
Transport Medium of Choice for Stool samples: suspected Salmonella and Shigella
tetrathionate broth
28
GLUCOSE REFERENCE VALUES: Fasting Blood glucose, Serum or plasma
50-110 mg/dL
29
STOOL COLOR: Red * All of the above * May be caused by bleeding in the upper digestive tract. * Giardia infection or can indicate bowel hyperactivity * Obstruction to bile flow * Can indicate bleeding of the lower digestive tract or rectum.
Can indicate bleeding of the lower digestive tract or rectum
30
Hypoglycemia may be seen with: ``` Adrenal insufficiency Drinking excessive alcohol Severe liver disease Hypopituitarism Hypothyroidism Insulin overdose Insulinomas Starvation ```
All
31
These organisms can cause a bloody diarrhea: • Ancylostoma duodenale, Necator americanus, & Entamoeba histolytica • Salmonella, Shigella, and Campylobacter • All • Enterobius vermicularis & Giardia lamblia • Enterobius vermicularis & Giardia lamblia & Ancylostoma duodenale, Necator americanus, & Entamoeba histolytica
Salmonella, Shigella, and Campylobacter
32
Transport Medium of Choice for Stool samples: worm infestation
saline
33
STOOL COLOR: white * May be caused by bleeding in the upper digestive tract. * Obstruction to bile flow * Giardia infection or can indicate bowel hyperactivity. * Can indicate bleeding of the lower digestive tract or rectum. * All of the above
Giardia infection or can indicate bowel hyperactivity.
34
The following are the strict rules when requesting Stool Exam for your patients EXCEPT: * stool sample should be collected during chronic phase of diarrhea * a clean, wide neck container should be used * specimen must be sent to the lab within one hour * contamination with urine should be avoided * All of the above
stool sample should be collected during chronic phase of diarrhea
35
These conditions can lead to NON-INFECTIOUS type of Diarrhea EXCEPT: * Abetalipoproteinemia * all the above * Celiac Disease (Celiac Sprue) * Graft-Versus-Host Disease * Intussusception * Irritable Bowel Syndrome
Irritable Bowel Syndrome
36
The following are the instructions you should give your patient for stool examination, EXCEPT? * A clean, wide neck container should be used. * all the above * Specimen must be sent to the lab within 30min. * Stool sample should be collected in acute phase of diarrhea. * Contamination with urine should be avoided, * Stool sample may be collected from the sides of the toilet bowl
Stool sample should be collected in acute phase of diarrhea
37
GLUCOSE REFERENCE VALUES: Random Blood glucose, Serum or plasma
45-130 mg/dL
38
STOOL COLOR: Black * All of the above * May be caused by bleeding in the upper digestive tract. * Giardia infection or can indicate bowel hyperactivity. * Can indicate bleeding of the lower digestive tract or rectum. * Obstruction to bile flow
May be caused by bleeding in the upper digestive tract.
39
This is NOT included among the complications of baby born from mothers with untreated gestational diabetes: • baby hypoglycemia • All of the above • Still birth • macrosomia • may develop Type 1 diabetes later in life
may develop Type 1 diabetes later in life
40
``` Complications of diarrhea EXCEPT: • edema • all the above • light-headedness • electrolyte imbalance • fatigue • dehydration ```
edema
41
Hemolytic uremic syndrome caused by a common bacteria in stool, Escherichia coli, is most frequently seen in the following population EXCEPT: * pregnant women * immunocompromised * elderly pathogenic GI * None of the above * children
pregnant women
42
``` This is NOT among the most common symptoms of a pathogenic GIT bacterial infection: • prolonged diarrhea • fat globules in stool • bloody diarrhea • abdominal pain and cramping • mucus in the stool • all the above ```
fat globules in stool
43
STOOL COLOR: Yellow • May be caused by bleeding in the upper digestive tract. • Obstruction to bile flow • All of the above • Giardia infection or can indicate bowel hyperactivity. • Can indicate bleeding of the lower digestive tract or rectum.
Obstruction to bile flow
44
Transport Medium of Choice for Stool samples: Vibrio cholera * saline * all the above * tetrathionate broth * alkaline peptone water * Cary Blair medium * phosphate buffer
alkaline peptone water
45
This is NOT among the uses for testing the blood glucose level: * screen for both hyperglycemia and hypoglycemia * All of the above * monitor glucose levels in persons with diabetes * check for diabetes that occurs during pregnancy * check for prognosis of diabetic patients * help diagnose diabetes
check for prognosis of diabetic patients
46
Complications of untreated Diabetes EXCEPT: * retinopathy * cardiovascular disease * neuropathy * none of the above * hepatic disease * nephropathy
none
47
What are the clinical uses of “digital rectal exam”? * checking blood in stool * for identifying abnormal masses in anorectal area * for detection of Prostate cancer in men & for identifying abnormal masses in anorectal area * for detection of Prostate cancer in men. * All of the above
All
48
Transport Medium of Choice for Stool samples: Virus
phosphate buffer
49
This is NOT included in the Diagnostic Criteria for Diabetes Mellitus, in the Oral Glucose Tolerance Testing: * fasting plasma glucose is >126mg/dL * None of the above * a level between 0-2hours is >200mg/dl. * 2-hr glucose value is ≥ 200mg/dL * random blood glucose is >140mg/dl
random blood glucose is >140mg/dl
50
Though, together with other known normal flora, an increase in the population of this organism may still lead to diarrhea. * All of the above * Clostridium difficile * Escherichia coli * Lactobacilli
All
51
GLUCOSE REFERENCE VALUES: CSF glucose * 40-70 mg/dL * None of the above * 50-110 mg/dL * 45-130 mg/dL
40-70 mg/dL

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