Unit 4 - MC Flashcards
1
Q
A patient presents with dysphagia, halitosis, and a feeling of a lump in the neck. What is the most likely diagnosis? A. Mallory-Weiss B. Reflux esophagitis C. Zenker diverticulum D. Achalasia
A
Zenker diverticulum
2
Q
Hirschsprung disease is best described as…
A. Congenital absence of ganglion cell in the large intestines
B. Failure of abdominal wall closure and herniation
C. Autoimmune destruction of enteric nervous system
D. Multiple ulcerations of the large intestine
A
Congenital absence of ganglion cell in the large intestines
3
Q
In CREST syndrome, which gastrointestinal disorder is not present? A. Raynaud’s phenomenon B. Crohn’s disease C. Esophageal dysmotility D. Stenosis of the pylorus
A
Crohn’s disease
4
Q
Schatzki rings are... A. Found in the large intestine B. Associated with Plummer-Vinson syndrome C. Associated with Barrett’s esophagus D. A form of esophageal atresia
A
Associated with Barrett’s esophagus
5
Q
Pathogenesis of GERD is best associated with…
A. Conditions that decrease lower esophageal sphincter tone
B. Increase gastric emptying
C. Conditions that decrease abdominal pressure
D. Impaired gastrin production
A
Conditions that decrease lower esophageal sphincter tone
6
Q
The most common cause of esophageal varices is ... A. Hepatitis A infection B. Esophageal dysmotility C. Infectious esophagitis D. Alcoholic cirrhosis
A
Alcoholic cirrhosis
7
Q
Which congenital anomaly would most likely present regurgitation but not aspiration?
A. Isolated esophageal atresia
B. Esophageal atresia with proximal tracheal fistula
C. Tracheoesophageal fistula
D. Esophageal atresia with double tracheoesophageal fistula
A
Isolated esophageal atresia
8
Q
A 3-month old male infant was born at term with no congenital anomalies noted. His mother now notes that he has marked abdominal enlargement along with infrequent bowel movements for the past week. On examination, the abdomen is distended but there does not appear to be appreciable tenderness. A plain film abdominal radiograph reveals marked colonic dilation. What pathologic findings would be most likely found in this setting? A. Aganglionic colonic segment B. Volvulus C. Intussusception D. Meconium ileus
A
Aganglionic colonic segment
9
Q
The congenital anomaly in which abdominal contents herniate into the umbilical cord membranous sac. A. Gastroschisis B. Meckel’s diverticulum C. Hirshprung D. Omphalocele
A
Omphalocele
10
Q
A 35-year-old HIV-positive known woman has had pain on swallowing for the past week. No abdominal physical examination findings are noted. Upper GI endoscopy is preformed. There are 3 sharply circumscribed 0.3-0.8cm ulcers in the lower esophagus. She is most likely to have an infection with which of the following organisms? A. Helicobacter pylori B. Herpes simplex virus C. Cytomegalovirus D. Cryptococcus neoformans
A
Herpes simplex virus
11
Q
Gram-negative bacilli that normally conlonize the GI tract, but enterohemorrhagic strains can be life threatening. A. E coli B. Salmonella enterica C. Yersinia enterocolitica D. Campylobacter enterocolitis
A
E coli
12
Q
A 43-year-old previously healthy woman has noted bouts of sharp upper abdominal pain along with nausea for 3 weeks. On physical examination, she has tenderness to palpation of the RUQ. She has yellowish discoloration of the sclera. A liver biopsy is performed and on microscopic examination shows intracanalicular cholestasis in the centrilobar regions, along with swollen liver cells and portal tract edema. There is no necrosis and no fibrosis. Which of the following is the most likely diagnosis? A. Chronic passive congestion B. Extrahepatic biliary atresia C. Hepatic veno-occlusive disease D. Choledocholithiasis
A
Choledocholithiasis
13
Q
The inherited syndrome which increases polyp formation and greatly increases colon cancer risk. A. Diverticulosis B. Inflammatory bowel disease C. Zollinger-Ellison syndrome D. Familial adenomatous polyposis
A
Familial adenomatous polyposis
14
Q
Select the disorder that is least likely to cause visible pathologic changes in the intestinal tract. A. Irritable bowel syndrome B. Crohn’s disease C. Celiac disease D. Barrett esophagus
A
Irritable bowel syndrome
15
Q
Edema secondary to liver failure is most likely due to... A. Hyperammonemia B. Hyperestogenemia C. Hypoalbuminemia D. Hyposecretion of clotting factors
A
Hypoalbuminemia
16
Q
Select the disease that is most likely to present with melena. A. Internal hemorrhoids B. Acute gastritis C. Ulcerative colitis D. Diverticulitis
A
Acute gastritis
17
Q
Autoimmune gastritis interferes with HCL production and vitamin B12 absorption due to antibodies against... A. Chief cells B. Pancreatic islet cells C. Parietal cells D. Goblet cells
A
Parietal cells
18
Q
Positive serology (antibodies) and villous atrophy are found in this disease. A. Acute pancreatitis B. Celiac disease C. Acute gastritis D. Ischemic bowel disease
A
Celiac disease
19
Q
A “twisting” of a segment of bowel (most commonly the sigmoid colon). A. Volvulus B. Intestinal atresia C. Intussusception D. Omphalocele
A
Volvulus
20
Q
Bouts of retching and vomiting as a binge drinker is best associated with this acute esophageal bleeding problem? A. Mallory-Weiss syndrome B. Esophageal varices C. Achalasia D. Barrett esophagus
A
Mallory-Weiss syndrome
21
Q
The inflammatory bowel disease that is described as “continuous” and always involves the rectum. A. Mallory-Weiss syndrome B. Celiac disease C. Ulcerative colitis D. Crohn’s
A
Ulcerative colitis
22
Q
Zollinger-Ellison syndrome is best described as... A. Gastrinoma B. Infection by H. Pylori C. Menetrier disease D. Linitis plastic
A
Gastrinoma
23
Q
Any older patient with iron deficiency anemia should be evaluated for \_\_\_\_\_. A. GI cancer B. Hepatitis C. Crohn’s disease D. Gluten hypersensitivity
A
GI cancer
24
Q
Upper abdominal pain that feels like it is boring through to the back refers to the left shoulder. In a patient with a history of alcohol use or choledocholithiasis, this is likely... A. Ulcerative colitis B. Hepatitis A C. Acute pancreatitis D. Crohn’s disease
A
Acute pancreatitis
25
Q
Which can be described as an out-pocketing of the colonic wall that may be prevented with a diet rich in fiber? A. Diverticulosis B. Benign colon polyps C. Hamartomas D. Adenocarcinoma
A
Diverticulosis
26
Q
This autosomal dominant gene is associated with numerous colorectal polyps that often appear by the early teens. A. FAP (APC) B. P53 C. HNPCC D. KRAS
A
FAP (APC)
27
Q
Squamous cancers of the anus are associated with which infection? A. E coli B. Human papillomavirus C. Staphylococcus D. Cytomegalovirus
A
Human papillomavirus
28
Q
This type of hernia is common in males, where a loop of intestines protrudes into the inguinal canal itself. A. Epigastric hernia B. Indirect inguinal hernia C. Direct inguinal hernia D. Femoral hernia
A
Indirect inguinal hernia
29
Q
Which viral hepatitis is least likely to progress to chronic liver disease or hepatocarcinoma? A. HAV B. HBV C. HCV D. All are equally likely
A
HAV
30
Q
Liver “statosis” means... A. Development of hyperplastic nodules B. Biliary stasis C. Fatty change D. Portal hypertension
A
Fatty change
31
Q
A mother brings her 2-month-old infant in to the ER that has been crying all day and has vomited multiple times and passed loose bloody stool. On examination, the infant has a mild fever and a sausage-shaped mass in the abdomen. What would be the possible diagnosis? A. Volvulus B. Hernia C. Appendicitis D. Intussusception
A
Intussusception
32
Q
Kayser-Fleisher rings are associated with which disorder? A. Non-alcoholic fatty liver disease B. Wilson disease C. Hemochromatosis D. Cirrhosis
A
Wilson disease
33
Q
The majority of gallstones are comprised of... A. Oxidized polymers of calcium slats B. Unconjugated bilirubin C. Cholesterol D. Mucin glycoprotein
A
Cholesterol
34
Q
A mother brings her 6-month-old child to the ER with abdominal distention and signs of circulatory collapse. When asked about the history of the condition the mother mentions that she started oral feeding 2 days ago. The child possibly has A. Volvulus B. Necrotizing entercolitis C. Appendicitis D. Parasitic entercolitis
A
Necrotizing entercolitis
35
Q
A 23-year-old primigravida gives birth at term following an uncomplicated pregnancy to a male infant with no apparent congenital anomalies. At 3 weeks of age, the infant begins to exhibit projectile vomiting after each feeding. The infant had been fine previously and gaining weight normally. Which of the following conditions is the probable cause for his vomiting? A. Congenital duodenal atresia B. Mallory-Weiss syndrome C. Tracheoesophageal fistula D. Pyloric stenosis
A
Pyloric stenosis
36
Q
The most frequent etiologies for hemorrhoids in a young person is/are A. Constipation or pregnancy B. Liver disease C. Pancreatitis D. Diarrhea or steatorrhea
A
Constipation or pregnancy
37
Q
Skip lesions are characteristic of which of the following? A. Diverticulosis B. Crohn’s disease C. Ulcerative colitis D. Adenocarcinoma
A
Crohn’s disease
38
Q
The disease least commonly associated with chronic malabsorption is... A. Pancreatic insufficiency B. Celiac disease C. Crohn’s disease D. Ulcerative colitis
A
Ulcerative colitis
39
Q
A 25-year-old man has noted cramping abdominal pain for the past week associated with fever and low-volume diarrhea. On physical examination, there is RLQ tenderness. Bowel sounds are present. His stool is positive for occult blood. A colonoscopy reveals mucosal edema and ulceration having a cobblestone appearance in the ascending colon, but the transverse and descending portions of the colon are not affected. Which of the following microscopic findings is most likely to be present in biopsies from his colon? A. Crypt abscesses B. Adenocarcinoma C. Non-caseating granulomas D. Necrotizing vasculitis
A
Non-caseating granulomas
40
Q
A 25-year-old man complains of a low volume but chronic, foul smelling diarrhea for the past year. He has no nausea or vomiting. On physical examination, there is no abdominal pain or masses and bowel sounds are present. His stool is negative for occult blood. Laboratory studies include a quantitative stool fat of 10g/day. Upper GI endoscopy is performed with biopsies taken of the duodenum, and on microscopic examination show villous atrophy, increased surface intraepithelial lymphocytes, and hyperplastic appearing crypts. Which of the following therapies is most likely to be useful for this man? A. Antibiotics B. Gluten-free diet C. Selective vagotomy D. Corticosteroids
A
Gluten-free diet
