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GIT Patho Flashcards

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1
Q
  1. A man presented with bilateral painless swelling of the parotid glands for a few months. What is the most likely diagnosis?
    A. Mumps
    B. Sjögren’s syndrome
    C. Warthin tumour
    D. Pleomorphic adenoma
    E. Lymphoma
A

C. – has propensity for bilateral presentation (10%), may be painless
Benign neoplasm of the salivary glands that occur almost exclusively in the superficial lobes of the parotid gland. It is the 2nd most common salivary gland tumour.
-Epidemiology: Male predominant, 50-70 years old
-Morphology: Grossly, Warthin tumour can be bilateral or multifocal. It is soft, pale grey mass that contains cystic spaces filled with milky secretions. Histologically, it has cystic spaces lined by double layer of epithelial cells, resting on dense lymphoid stroma with germinal centers

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2
Q
  1. What is the most favoured location for oral leukoplakia?
    A. Buccal mucosa
    B. Floor of mouth
    C. Ventral surface of tongue
    D. Palate
    E. Gingiva
A

A. About leucoplakia = thickened keratotic hyperplastic mucosa with dull whitish appearance. Histologically, some may show dysplasia or carcinoma-in-situ and 5-25% of them are precancerous. Cannot be scraped off. Found in all options, but most favoured location is buccal mucosa.

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3
Q
  1. Peptic Ulcer Disease is associated with all of the following, EXCEPT:
    A. Helicobacter Pylori-induced hyperchlorhydria
    B. Usage of Non-Steroidal Anti-Inflammatory Drugs
    C. Alcoholic cirrhosis
    D. Chronic Obstructive Pulmonary Disease
    E. Hyperthyroidism
A

E.

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4
Q
  1. The following features are seen in longstanding chronic gastritis EXCEPT:
    A. Oxyntic gland atrophy
    B. Intestinal metaplasia
    C. Dysplasia
    D. Regenerative epithelial changes
    E. Granulomas
A

E. No granulomas, but there is formation of lymphoid aggregates in active inflammation, from which MALT lymphoma can develop. Other components of active inflammation are neutrophils, lymphocytes and plasma cells

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5
Q
  1. Where is the most possible location in which a primary squamous cell carcinoma can arise from?
    A. Kidney
    B. Larynx
    C. Bladder
    D. Stomach
    E. Gallbladder
A

B

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6
Q
  1. What is incorrect of squamous cell carcinoma of oral cavity?
    a) Association with smoking
    b) Frequent chewing of betel nut
    c) Most commonly present as a white patchy area
    d) Metastases most often to the cervical lymph nodes
    e) Occurs more commonly in women
A

E.

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7
Q
  1. Which of the following is the least associated with H Pylori?
    a) Gastritis
    b) Gastric ulcer
    c) Duodenal ulcer
    d) Gastric neuroendocrine tumour
    e) Gastric MALT lymphoma
A

D. Important diseases associated with HP = chronic gastritis, Peptic ulcer disease, gastric carcinoma, gastric MALT lymphoma

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8
Q

What is the rule of 2 for Meckel diverticulum

A
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9
Q

Which of the following is a common precipitating cause of intussusception?
a) Ischemia colitis
b) Intestinal lipoma
c) Strenuous physical activity
d) Irritable bowel syndrome
e) Low fiber diet

A

E. predisposes constipation, predisposing fecalith formation which is an intraluminal mass leading to intussusception

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10
Q

Which of the following statements about conjugated bilirubin is true?
A. It is tightly bound to albumin
B. It is released in hemolytic anemia
C. It is secreted in the urine in obstructive jaundice
D. It is insoluble in water
E. It causes kernicterus

A

C

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11
Q

Which of the following polyps has the highest possibility of malignancy
a) Juvenile polyp
b) Adenomatous polyp
c) Hamartomatous polyp
d) Hyperplastic polyp
e) Inflammatory polyp

A

B.

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12
Q

A 75-year-old man presented with a symptom of fresh bleeding per rectum. He has no history of diarrhoea. What is the LEAST LIKELY reason?
A. Haemorrhoids
B. Diverticular disease
C. Colorectal carcinoma
D. Ulcerative colitis
E. Ischemic bowel disease

A

D.

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13
Q

In the investigation for severe diarrhea in AIDS patients, which of the following is least likely?
a) CMV enterocolitis
b) Atypical mycobacteria infection
c) Intestinal cryptosporidiosis
d) Histoplama disease
e) Crohn’s disease

A

E. it is less commonly associated with severe diarrhea in AIDS patients compared to the other options listed. In AIDS patients, severe diarrhea is often caused by opportunistic infections or other conditions related to the compromised immune system. Therefore, Crohn’s disease would be the least likely cause among the options provided.

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14
Q

In a gastric biopsy report, which of the following would be of note for H. pylori:
a) Neutrophils (measure of activity)
b) Atrophy
c) Fibrosis
d) Intestinal metaplasia
e) Dysplasia

A

E.

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15
Q

One of the findings of the oesophagus is diagnostic of Barrett oesophagus:
a. Submucosal mucin secreting glands
b. Acid secreting glands
c. High dysplasia squamous epithelium
d. Candida organism on squamous epithelium
e. Columnar epithelium with goblet cells

A

E. Barrett’s esophagus is a condition where the normal squamous epithelium lining of the esophagus is replaced by columnar epithelium with goblet cells. This transformation is often considered to be a response to chronic gastroesophageal reflux disease (GERD). It is diagnosed by the presence of this specific type of epithelium, which is visible upon examination of esophageal biopsies. The presence of goblet cells in the columnar epithelium is a key diagnostic feature of Barrett’s esophagus. Therefore, option E is the most appropriate choice.

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16
Q

Which of the following is the least likely mechanism of small bowel ischemia?
a. Intussusception
b. Hernia
c. Volvulus
d. Perforation of Merkel’s diverticulum
e. Thromboembolism

A

D

17
Q

Small and large colon obstruction is a complication of the following except:
a. TB Colon
b. Crohn’s disease
c. Hemorrhoids
d. Diverticular disease
e. Colon adenocarcinoma

A

C. affect anal canal

18
Q

Which one of the following macroscopic features can be seen in a large bowel resection specimen of a case of ulcerative colitis?
a. Skipped lesions
b. Pseudopolyps
c. Luminal structures
d. Colovesical fistula formation
e. Fat wrapping around the serosal surface

A

B

19
Q

Which of the following statements about amoebiasis is false?
a. Caused by Entamoeba histolytica
b. Involves cecum and ascending colon
c. Spread by fecal-oral transmission
d. Liver abscesses may be present due to ascending infection of the biliary tract and the liver

A

D. hematogenous spread via portal tract

20
Q

What is the commonest site of cancer occurrence that results in obstruction of the GIT?
a. Stomach
b. Jejunum
c. Ileum
d. Cecum
e. Rectosigmoid

A

E. Note that colorectal cancer in proximal colon rarely give rise to obstruction, mainly distal colon give rise to obstruction

21
Q

A 20yr old male who had a total colectomy has a family history of GIT polyps. When resected, his colon is seen to be covered with a carpet of thousands of polyps. Which of the following about his genetic condition is true?
A) loss of function mutation of tumour suppression gene APC
B) epigenetic mutation of MLH 1 tumour suppression gene
C) loss of function mutation of STK11/PBRM1
D) Gain of function mutation of oncogene KIT
E) Point mutation and overexpression of oncogene KRAS

A

A

22
Q

What’s the defining feature of Barrett’s oesophagus?
A) Columnar epithelium with goblet cells
B) Presence of Candida
C)Submucosal mucin secreting glands
D)High grade squamous dysplasi

A

A

23
Q

32 year old patient complains of bloody diarrhea. Flask-shaped ulcers in the lining of the intestines is found. Stain is PAS positive, red blood cell casts and trophozoites seen under histo
A) Entamoeba histolytica
B) Schistosoma japonicum
C) CMV
D) Tuberculosis

A

A

24
Q

Barrett’s esophagus is associated with all the following except
a. persistent gastroesophageal reflux
b. intestinal metaplasia with dysplasia
c. columnar epithelium lined esophagus
d. adenocarcinoma
e. Helicobacter pylori

A

E.

25
Q

The following are associated with pigmented gallstones except:
A. Hemolytic anaemia
B. Unconjugated bilirubin
C. Infection of the biliary tree
D. Ascaris lumbricoides
E. Oral contraceptive use

A

E.

26
Q
A

GIT (11 decks)

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