GIT Pathology MCQ

Question 1

Which of the following is correct about haematemesis ?

Select one:

a. It is defined as coughing up blood
b. It can be associated with oesophageal varices
c. It is nearly always caused by peptic ulceration of the stomach
d. It is rarely life-threatening
e. The liver results in a decreased breakdown of clotting factors so bleeding stops more quickly in liver disease

Answer 1

b. It can be associated with oesophageal varices

Question 2

Hepatocellular carcinoma is associated with all of the following pathology except;

Select one:

a. hereditary haemochromatosis
b. chronic Hepatitis B infection
c. liver fluke infestation
d. diets including aflatoxins
e. cirrhosis

Answer 2

c. liver fluke infestation

Question 3

Which of the following is correct?

Select one:

a. 80 % of people with cirrhosis of the liver develop hepatocellular carcinoma
b. 5 % of hepatocellular carcinomas are associated with pre-existing Hepatitis B infection
c. people in Asia have a lower association of cirrhosis and hepatocellular carcinoma than those in USA
d. 80 % of hepatocellular carcinomas are associated with pre-existing cirrhosis

Answer 3

d. 80 % of hepatocellular carcinomas are associated with pre-existing cirrhosis

Question 4

Which of the following is incorrect?

Liver cirrhosis results in;

Select one:

a. sinusoidal capillarization
b. hepatocyte islands surrounded by fibrotic septa
c. increasing gaps in endothelial fenestrations
d. Scar tissue filling the space of Disse
e. shunting of the portal and arterial blood supply directly into the hepatic outflow

Answer 4

c. increasing gaps in endothelial fenestrations

Question 5

The consequences of liver cirrhosis includes all of the following except;

Select one:

a. portal hypertension
b. hypoperfusion of the kidneys
c. hepatocellular carcinoma
d. decreased intrahepatic resistance
e. impaired hepatocyte function

Answer 5

d. decreased intrahepatic resistance

Question 6

The most common cause of liver disease in the Western world is;

Select one:

a. Wilson’s disease
b. Non-alcoholic steatohepatitis in obese & diabetic subjects
c. Hemochromatosis
d. Hepatitis B
e. Alcoholic liver disease & Hepatitis C

Answer 6

e. Alcoholic liver disease & Hepatitis C

Question 7

Initial clinical presentation of patients with compensated cirrhosis is most likely characterised by ;

Select one:

a. variceal hemorrhage
b. ascites
c. hepatic encephalopathy
d. A lack of symptoms
e. spontaneous bacterial peritonitis

Answer 7

d. A lack of symptoms

Question 8

Which of the following is correct?

Select one:

a. Pruritus is a common complaint in patients with chronic liver disease
b. Percussion of the abdomen can indicate ascites in liver disease
c. Palmer erythema -mottling of the palms is specific for liver disease
d. spider angiomas are observed also in pregnant women
e. A deficiency in testosterone activity in liver disease may result in gynaecomastia

Answer 8

c. Palmer erythema -mottling of the palms is specific for liver disease

Question 9

Which of the following is correct about hepatocellular carcinoma (HCC)?

Select one:

a. Alfa-fetoprotein (AFP) is a liver-formed glycoprotein that decreases in levels in advanced HCC
b. High -risk individuals that may need 6 monthly surveillance include young males with a heavy drinking habit
c. Advanced HCC commonly spreads to bone, lung and abdominal viscera
d. HCC classically presents early with symptoms thus allowing a good prognosis

Answer 9

c. Advanced HCC commonly spreads to bone, lung and abdominal viscera

Question 10

Which of the following is incorrect?

Select one:

a. Causes of obstructive jaundice includes gallstones and pancreatic cancer
b. Jaundice due to hepatic parenchymal disease typically causes pale stools and dark urine
c. Causes of hepatocellular jaundice includes cirrhosis and hepatitis
d. In obstructive jaundice,conjugated bilirubin is water soluble and is excreted in urine giving it a dark colour
e. Lack of bilirubin entering the GIT results in pale coloured stools

Answer 10

b. Jaundice due to hepatic parenchymal disease typically causes pale stools and dark urine

Question 11

Which of the following is an example of prehepatic jaundice?

Select one:

a. Sickle cell anaemia
b. Pancreatitis
c. Parasites in bile duct
d. Sclerosing cholangitis

Answer 11

a. Sickle cell anaemia

Question 12

What is biliary colic

Answer 12

Pain due to transient obstruction of the cystic duct by a stone when the gallbladder contracts

Question 13

What is Adenomyomatosis?

Answer 13

intramural diverticula of gallbladder mucosa

Question 14

What is Choledocholithiasis?

Answer 14

Presence of gallstones in the common bile duct

Question 15

What is Acute cholangitis?

Answer 15

Bacterial infection of biliary tree, typically ascending from the duodenum

Question 16

What is Porcelain gallbladder?

Answer 16

dystrophic calcification of gallbladder wall

Question 17

What is Cholelithiasis?

Answer 17

The presence of gallstones

Question 18

What is Acute cholecystitis?

Answer 18

Inflammation of the gallbladder that develops over hours

Question 19

What is Sclerosing cholangitis?

Answer 19

Inflammation, fibrosis & destruction of the bile ducts

Question 20

What is Chronic cholecystitis?

Answer 20

Prolonged inflammation of the gallbladder, leading to wall thickening

Question 21

What is Biliary sludge?

Answer 21

Excess cholesterol precipitate crystals that embed in gallbladder mucin gel with bilirubinate

Question 22

Which of the following is NOT a short-term complication of acute cholecystitis?

Select one:

a. Empyema of gallbladder
b. Acute pancreatitis
c. Hepatocellular carcinoma
d. Gangrene of the gallbladder
e. Perforation of gallbladder & peritonitis

Answer 22

c. Hepatocellular carcinoma

Question 23

Which of the following is correct?

Select one:

a. Males are more at risk than females
b. Obesity & exercise do not influence the chances of getting gallstones
c. Gallstones are more common in individuals over 40 years of age
d. Pigment stones are more common than cholesterol stones
e. Estrogen and progesterone have a protective effect against gallstones

Answer 23

c. Gallstones are more common in individuals over 40 years of age

Question 24

Hartman’s pouch is located at;

Select one:

a. The junction of the coronary ligament and hepatorenal recess
b. The junction of the falciform liagament and round ligament
c. The junction between lesser and greater omenta
d. The junction of the neck of gallbladder and cystic duct
e. The junction of the right and left paracolic gutters

Answer 24

d. The junction of the neck of gallbladder and cystic duct

Question 25

Which of the following is incorrect about pancreatic cancer?

Select one:

a. malabsorption of food can occur leading to weight loss
b. it tends to be a slow growling cancer that metastasizes late
c. obstructive jaundice can be associated with pruritis and dark urine
d. cancer in head of the pancreas can obstruct the common bile duct leading to obstruction of bile

Answer 25

b. it tends to be a slow growling cancer that metastasizes late

Question 26

The most common type of diabetes in our community is;

Select one:

a. Type 1
b. Type 2
c. Gestational
d. Secondary to haemochromatosis

Answer 26

b. Type 2

Question 27

Which of the following is correct?

Select one:

a. pancreatic cancer presents early because it often obstructs the bile duct
b. pancreatic cancer can often present with nonspecific symptoms of weight loss and abdominal pain
c. 95% of pancreatic cancers are endocrine tumours
d. pancreatic cancer tends not to invade locally but often remains indolent
e. pancreatic cancer generally has a favourable prognosis

Answer 27

b. pancreatic cancer can often present with nonspecific symptoms of weight loss and abdominal pain

Question 28

The most common cause of acute pancreatitis is;

Select one:

a. complications from cystic fibrosis
b. alcohol consumption
c. gallstones blocking the common bile duct
d. autoimmune diseases

Answer 28

b. alcohol consumption

Question 29

Long-term complications of diabetes mellitus include all of the following except;

Select one:

a. peripheral vascular disease
b. chronic pancreatitis
c. neuropathy
d. nephropathy
e. retinopathy

Answer 29

b. chronic pancreatitis

Question 30

In regards to the following image of the exterior view of the liver which of the following is correct?
Select one:
a. You would expect both AST and ALT levels to be normal
b. This is an example of macronodular cirrhosis because the surface is rough and nodules are visible
c. This is an example of a normal liver
d. Fatty change generally does not accompany such pathology
e. This is an example of micronodular cirrhosis because the regenerative nodules are averaging less than 3mm in size

Answer 30

e. This is an example of micronodular cirrhosis because the regenerative nodules are averaging less than 3mm in size

Question 31

Which of the following cells plays the greatest role in fibrogenesis of the liver (resulting in cirrhosis)?

Select one:

a. stellate cell
b. Kupffer cell
c. bile duct epithelial cell
d. endothelial cell
e. hepatocyte

Answer 31

e. hepatocyte