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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
Q

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

A

all Bilirubin Increased; Increased Alkaline & Acid Phosphatase; increased both Transaminases

26
Q

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
A

drinking water

27
Q

Transport Medium of Choice for Stool samples: suspected Salmonella and Shigella

A

tetrathionate broth

28
Q

GLUCOSE REFERENCE VALUES: Fasting Blood glucose, Serum or plasma

A

50-110 mg/dL

29
Q

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.
A

Can indicate bleeding of the lower digestive tract or rectum

30
Q

Hypoglycemia may be seen with:

Adrenal insufficiency
Drinking excessive alcohol
Severe liver disease
Hypopituitarism
Hypothyroidism
Insulin overdose
Insulinomas
Starvation
A

All

31
Q

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

A

Salmonella, Shigella, and Campylobacter

32
Q

Transport Medium of Choice for Stool samples: worm infestation

A

saline

33
Q

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
A

Giardia infection or can indicate bowel hyperactivity.

34
Q

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
A

stool sample should be collected during chronic phase of diarrhea

35
Q

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
A

Irritable Bowel Syndrome

36
Q

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
A

Stool sample should be collected in acute phase of diarrhea

37
Q

GLUCOSE REFERENCE VALUES: Random Blood glucose, Serum or plasma

A

45-130 mg/dL

38
Q

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
A

May be caused by bleeding in the upper digestive tract.

39
Q

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

A

may develop Type 1 diabetes later in life

40
Q 
Complications of diarrhea EXCEPT:
• edema
• all the above
• light-headedness
• electrolyte imbalance
• fatigue
• dehydration
A

edema

41
Q

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
A

pregnant women

42
Q 
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
A

fat globules in stool

43
Q

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.

A

Obstruction to bile flow

44
Q

Transport Medium of Choice for Stool samples:
Vibrio cholera

  • saline
  • all the above
  • tetrathionate broth
  • alkaline peptone water
  • Cary Blair medium
  • phosphate buffer
A

alkaline peptone water

45
Q

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
A

check for prognosis of diabetic patients

46
Q

Complications of untreated Diabetes EXCEPT:

  • retinopathy
  • cardiovascular disease
  • neuropathy
  • none of the above
  • hepatic disease
  • nephropathy
A

none

47
Q

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
A

All

48
Q

Transport Medium of Choice for Stool samples: Virus

A

phosphate buffer

49
Q

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
A

random blood glucose is >140mg/dl

50
Q

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
A

All

51
Q

GLUCOSE REFERENCE VALUES: CSF glucose

  • 40-70 mg/dL
  • None of the above
  • 50-110 mg/dL
  • 45-130 mg/dL
A

40-70 mg/dL

CLIN PATH (19 decks)

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