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29‏/11‏/2011

GIT SECTION A: Read each question carefully and record the answer "TRUE" "FALSe

GIT
SECTION A: Read each question carefully and record the answer "TRUE" "FALSe

1.   In patients with Helicobaoter pylori (HP) infection
a)    the diagnosis can be confirmed by decreased urease concentrations In the gastric mucosa
b)    the presence of oesophagitis indicates the need for HP eradication therapy
c)    HP eradication is enhanced by sustained elevation of gastric pH
d)    amoxycillin plus metronidazole therapy is more effective than amoxycillin alone
e)    HP eradication reduces recurrence rates of both duodenal and gastric ulcers

2.    Typical features of peptic ulcer dyspepsia Include
a)    pain relieved by eating
b)    well-localised pain relieved by vomiting
c)    pain-free remissions lasting many weeks
d)    nausea and retrosternal pain relieved by belching
e)    nocturnal pain causing frequent night waking

3.   When acute gastroduodenal haemorrhage is suspected
a)    a pulse rate of 120/minute is most likely to be due to anxiety
b)    hypotension without a tachycardia suggests an alternative diagnosis
c)    the absence of anaemia suggests the volume of blood loss is modest
d)    naso-gastric aspiration provides an accurate estimate of blood loss
e)    endoscopy is best deferred pending blood volume replacement

4.   In resuscitating a patient with an acute gastrointestinal bleed
a)    sedation is mandatory before endoscopy
b)    transfusion requires whole blood rather than packed red cells
c)    volume replacement with colloids is preferable to crystalloids
d)    monitoring central venous pressure and/or urine output is advisable
e)    surgical intervention should be deferred in younger patients

5.    Perforation of a peptic ulcer Is typically associated with
a)    acute rather than chronic ulcers
b)    duodenal more often than gastric ulcers
c)    abdominal pain unrelated to the extent of peritoneal soiling
d)    the absence of nausea and vomiting
e)    symptomatic improvement several hours following onset

6.   Recognised causes of acute pancreatitis include
a)    Mumps & coxsackie B viral infections
b)     hypothermia and hyperlipidaemie
c)    gallstones in the common bile duct
d)    azathioprene therapy
e)    alcohol abuse

7.   In the treatment of ileo-cascal Crohn's disease
a)    surgical bypass is preferable to localized resection
b)    antibiotic therapy should be avoided
c)    corticosteroid therapy is contraindicated in the acute phase
d)    cholestyramine reduces the diarrhoea but increases steatorrhoea
e)    sulphasalazine reduces the risk of small bowel obstruction

8.    Recognised complications of Crohn's disease include
a)    pernicious anaemia
b)    erythema nodosum
c)    enteropathic arthritis
d)    aphthous mouth ulcers
e)    small bowel lymphoma

9.    The typical features of the irritable bowel syndrome Include
a)    nocturnal diarrhoea and weight loss
b)    onset after the age of 45 years
c)    history of abdominal pain in childhood
d)    right iliac fossa pain and urinary frequency
e)    abdominal distension, flatulence and pellety stools

IO.Characteristic features of ulcerative colitis include
a)    invariable involvement of the rectal mucosa
b)    segmental involvement of the colon and rectum
c)    pseudo-polyposis following heating of mucosal damage
d)    inflammation extending from the mucosa to the serosa
e)    entero-cutaneous and entero-enteric fistulae
11.    Ulcerative colitis differs from Crohn's colitis in that
a)    the disease occurs at any age
b)    tobacco consumption is not associated with ulcerative colitis
c)    toxic dilatation only occurs in ulcerative colitis
d)    aphthous_stomatitis is less common than in Crohn's disease
e)    colonic strictures do not occur in ulcerative colitis

12. Gallstones are a recognised pomplication of
a)    obesity
b)    oral contraceptive therapy
c)    chronic haemolytic anaemia
d)    terminal ileac disease
e)    rapid weight loss

13.      Ultasonography is the diagnostic method of choice In
a)    detecting gall bladder stones
b)    searching for a mass in the lower part of common bile duct
c)    diagnosing vegetations of subacute bacterial endocarditis
d)    detecting ascites
e)    diagnosis of bronchogenic carcinoma

14.      These diagnostic techniques can be used safely during pregnancy
a)      C.T scanning of the abdomen
b)    hepatobiliary ultrasonography
c)    radionuclide imaging of the thyroid
d)      Magnetic Resonance Imaging of the skull
e)      color dupplex sonography of venous system of the lower limbs

15.      Color doppler sonography can detect
a)    tumour vascularity after treatment by local destructive procedures
b)      velocity and direction of flow in the portal vein
c)       flow in common bile duct
d)    malignant change in a thyroid nodule
e)    torsion of the testis

16. Abdominal sonography can be used to detect
a)    a mass in the fundus of the stomach
b)    hydronephrosis
c)    pleural effusion
d)    ulcerative colitis
e)    retroperitoneal lymph nodes

SECTION B: Only one Item appropriately applies to the Statement.
17. Dyspepsia Include all of the following EXCEPT
a)    Upper abdominal discomfort
b)      Upper abdominal pain
c)    Change of bowel habits
d)    Nausea and vomiting
e)    Eructation

18. In functional dyspepsia we should
a)    Exclude gastric and duodenal patrhology
b)      Exclude gall bladder disease
c)       Exclude uremia
d)      Exclude diabetes
e)      All of the above

19. The following is implicated in the pathogenesis of functional dyspepsia EXCEPT
a)    Delayed gastric motility
b)    Helicobacter pylori infection
c)    Erosive gastritis
d)    Psychological stress
e)    Antroduodenal reflux

20. Symptoms of ulcer-like dyspepsia
a)    Pain in epigastrium
b)    Pain on fasting or after meals
c)       Pain relieved by antacid or proton pump Inhibitor (PPI)
d)      Pain associated with haematemesis
e)    Pain associated with heartburn

21. Dysmotility-like dyspepsia include the following
a)      Nausea and vomiting
b)    Eructation
c)    Upper abdominal discomfort
d)    Bloating
e)    All of the above

22.   Warning sign of functional dyspepsia include the following EXCEPT
a)      Haematemesis
b)      Age above 50 years
c)       Loss of weight
d)      Female
e)      Elevated ESH

23.   Investigations of functional dyspepsia should be done in the following cases
a)      Melena
b)      Cachexia
c)       Recent onset
d)      None of the above
e)      All of the above

24.   Goals of treatment of functional dyspepsia include the following EXCEPT
a)      Reassurance
b)      Understanding tho patient concerns
c)       Relieving the the symptoma
d)      Eradication of symptoms
e)      All of the above

25.   Investigations for dyspepsia include
a)      Upper endoscopy
b)      Abdominal ultrasound
c)       Blood urea
d)      Fasting and 2hrs postprandial blood sugar
e)      All of the above

26.      In cholestatic liver diseases, indications of liver transplantation are all of the following except:
a)    Hyperbilirubinemia.
b)      Hyperlipidemia.
c)       Bony diseases.
d)    Growth retardation.
e)    Intactable pruritis.
27. In IBS red flag signs include all of the following except:
a)      Bleeding/rectum.
b)      Loss of weight..
c)    Nocturnal pain.
d)    Systemic illness.
e)    Diarrhea.

28.   The following manifestations may occur in crohn's disease:
a)      Loss of weight.
b)    Diarrhea.
c)       Abdominal pain.
d)    Bleeding perrectum.
e)    All of the above.

29. All of the following manifestations frequently occur in ulcerative colitis, except:
a)      Bleeding.
b)      Abdominal pains,
c)    Loss of weight
d)      Intestinal fistulae..
e)    Tenesrnus.

30. All of the following organs may be felt as a firm border In the abdomen EXCEPT:
a)    Left hepatic lobe
b)      Spleen
c)    Omentum,
d)    Transverse colon
e)    Right hepatic lobe

31. The most common cause of acute pancreatitis Is:
a-    corticosteroids
b-      gallstone impaction at the ampullary region.
c-       hypocalcemia
d-    diabetes mellitus

32. In abdominal pain due to acute pancreatitis all are true except:
a-      epigastric pain radiating to the back
b-      usually associated with nausea and vomiting
c-    reduced by leaning forwards
d-    increased with fasting

33.   About serum amylase level all are true except:
a-    elevated after one week in acute pancreatitis
b-      can be high in perforated duodenal ulcer
c-       it is more sensitive than serum lipase
d-    level is increased in renal failure

34. All of the following can be a complication of chronic pancreatitis except:
a-    Pancreatic pseudocyst,
b-    Pancreatic cancer
c-       malabsorption syndrome
d-    hypercholestermia

35. Common causes of dysphagia Include all except :
a)    Cancer.
b)    Cervical Spondylosis    
c)    Achalasia.
d)    Post-corrosive

36.   GERG may present by
a)      Heart burn
b)      Chest Pain
c)       Eplgastric pain
d)      Bronchial asthma
e)      all of the above

37. Mechanisms of diarrhea include the following except:
a-    Malabsorption.
b-    Increased fluid intake.
c-    Mucosal injury
d-    Motility disorder.

38. Osmotic Gap increase in:
a)    Malabsorption diarrhea
b)    Motility disorder.
c)    Secretory diarrhea.
d)    Osmotic diarrhea.
39. First battery of investigations in chronic diarrhea include all except:
a)    occult blood
b)    Barium follow through
c)    Sigmoidoscopy
d)    Stool electrolytes

40. The following are symptoms of constipation except:
a)    Hard Stools >1/4 times of defecation.
b)    Incomplete Evacuation >1/4 times of defecation.
c)    Soiling of cloths
d)    Straining in >1/4 times of defecation Hard Stools >1/4 times of defecation.

41. The following may be a cause of constipation except:
a)    Ignoring urge.
b)    Antispasmodics.
c)    Irritable bowel synderome.
d)    Thyrotoxicosis.


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Good Luck