Internal Medicine/ GIT
· Gastroenterology OXF.
I.
Common GI Presentations.
1. The Mouth.
***)
Leukoplakia refers to:
A.
A microscopic lesion
B.
Atrophy
C.
A cancer
D.
A white patch
E.
An ulcer
Answer: D* A white patch
***) All
of the following can cause mouth ulceration, except:
A.
Sarcoidosis
B.
Herpes simplex type I
C.
Syphilis
D.
Crohn's disease
E.
Behchet's disease
Answer: A* Sarcoidosis
***) All
of the following can cause macroglossia, except:
A.
Addison's disease
B.
Hypothyroidism
C.
Down's syndrome
D.
Acromegaly
E.
Amyloidosis
Answer: A* Addison's disease
***) All
of the following are features of herpetic stomatitis, except:
A.
Vesicles and ulcers on the buccal mucosa as well as tongue and palate
B.
Hepatosplenomegaly
C.
Inflamed gums
D.
Pain
E.
Cervical lymph glands enlargement
Answer: B* Hepatosplenomegaly
2. Dysphagia.
***) Dysphagia
may occur in all of the following, except:
A.
Carcinoma of esophagus
B.
Systemic sclerosis
C.
Achalasia
D.
Candida esophagitis
E.
Ulcerative colitis
Answer: E* Ulcerative colitis
3. Esophageal Scleroderma.
***) The
manometric studies in scleroderma patient with esophageal involvement shows: Q2012
A.
Absence
peristalsis, decreased LES tone
B.
Absence
peristalsis, increased LES tone
C.
Positive
peristalsis, decreased LES tone
D.
Positive
peristalsis, increased LES tone
E.
None
of above
Answer: A* Absence
peristalsis, decreased LES tone
4. Achalasia.
***) Concerning
achalasia of the esophagus all of the following are true, except:
A.
It occurs more in women about forty years of age
B.
There is progressive dysphagia but with periods of remissions and
relapses
C.
Regurgitation and aspiration pneumonia are common
D.
Barium swallow shows dilatation of the esophagus above a smoothie
narrowed lower end
E.
Treatment of choice is by giving antispasmodics and antibiotics
Answer: E* Treatment of choice is by
giving antispasmodics and antibiotics
5. Diffuse Esophageal Spasm.
***) A
lady presented with dysphagia to liquids and solids, also chest pain
precipitated by cold drinks and hot tea, by physician prescribes nitroglycerine
which relieves symptoms. Most probably she has:
A.
Pulmonary embolism
B.
Esophageal stricture
C.
Esophageal spasm
D.
Esophageal compression
E.
Ischemic heart disease
Answer: C* Esophageal spasm
6. Vomiting.
***) All
of the following are causes of vomiting, except:
A.
Raised intracranial pressure
B.
Uncomplicated duodenal ulcer
C.
Diabetic ketoacidosis
D.
Hypercalcemia
E.
Digitalis intoxication
Answer: B* Uncomplicated duodenal ulcer
7. Gastroesophageal Reflux Disease.
***) All
of the following are known complications of gastro-esophageal reflux, except:
A.
Anemia
B.
Aspiration
C.
Barret's esophagus
D.
Motility disturbances
E.
Gastric peptic ulcer
Answer: E* Gastric peptic ulcer
8. Diarrhea.
***) Diarrhea
may occur with all of the following, except:
A.
Crohn's disease
B.
Diabetes mellitus
C.
Sarcoidosis
D.
Thyrotoxicosis
E.
Lincomycin intake
Answer: C* Sarcoidosis
***) Diarrhea
may occur with all of the following, except:
A.
Food poisoning
B.
Viral gastroenteritis
C.
Inflammatory bowel disease
D.
Colonic neoplasia
E.
Hypothyroidism
Answer: E* Hypothyroidism
***) Diarrhea
may occur with all of the following, except:
A.
Diabetes mellitus
B.
Hyperparathyroidism
C.
Carcinoid syndrome
D.
Zollinger-Ellison syndrome
E.
Carcinoma of colon
Answer: B* Hyperparathyroidism
***) Bloody
diarrhea is caused by all the following, except:
A.
Bacillary dysentery
B.
Cholera
C.
Colonic carcinoma
D.
Ulcerative colitis
E.
Shistosomiasis
Answer: B* Cholera
***) All
are causes of infectious diarrhea, except:
A.
Giardia lamblia
B.
Shigella sp
C.
Salmonella sp
D.
Yersinia entcrocolitica
E.
Helicobacter pylori
Answer: E* Helicobacter pylori
***) A
25 years old man who just arrived from a trip overseas, complains of bloody
diarrhea for few days. The least likely cause is:
A.
Giardiasis
B.
Shigella enteritis
C.
Amoebic dysentery
D.
Campylobacter infection
E.
Ulcerative colitis
Answer: A* Giardiasis
***) The
most appropriate intervention to prevent dehydration in patients with watery
diarrhea is:
A.
Limit oral intake
B.
Intravenous saline
C.
Oral rehydration salt (ORS) solution
D.
Antimotility agents
E.
Antibacterial agents
Answer: C* Oral rehydration salt (ORS)
solution
9. GI Bleeding.
***) 50
years old male presented with massive hematemesis and found to have
splenomegaly, clubbing and palmar erythema. You must think of bleeding from: Q2012
A.
Mallory-Weiss
tear
B.
Esophageal
varices
C.
Duodenal
ulcer
D.
Gastric
ulcer
E.
Erosive
gastritis
Answer: B* Esophageal varices
***) Which
of the following is the commonest cause of acute upper gastrointestinal
bleeding:
A.
Acute gastric ulcer
B.
Gastric carcinoma
C.
Varices (esophageal)
D.
Duodenal ulcer
E.
Mallory-Weiss syndrome
Answer: D* Duodenal ulcer
***) Hematemesis
and melena may be caused by all of the following, except:
A.
Gastric carcinoma
B.
Gastric ulcer
C.
Mallory-Weiss syndrome
D.
Duodenal ulcer
E.
Hypothyroidism
Answer: E* Hypothyroidism
***) Causes
of hematemesis include all of the following, except:
A.
Peptic ulcer
B.
Acute erosive gastritis
C.
Gastric carcinoma
D.
Pancreatic carcinoma
E.
Mallory-Weiss syndrome
Answer: D* Pancreatic carcinoma
***) Hematemesis
and melena in a patient with liver cirrhosis is likely to be due to all of the
following, except:
A.
Gastric ulcer
B.
Hepatoma
C.
Bleeding esophagus varices
D.
Duodenal ulcer
E.
Abnormal clotting mechanism
Answer: B* Hepatoma
***) Which
of the following is considered as a poor prognostic indicator in upper
gastrointestinal bleeding:
A.
A presentation of melena rather than hematemesis
B.
Young age
C.
Chronic rather than acute ulcer
D.
Duodenal rather than gastric ulcer
E.
Female sex
Answer: D* Duodenal rather
than gastric ulcer
***) All
of the following drugs may produce GI bleeding, except:
A.
Salicylates
B.
Mg trisilicate
C.
Steroids
D.
Anticoagulants
E.
Phenothiazines
Answer: B* Mg trisilicate
***) All
are causes of melena, except:
A.
Esophageal varices
B.
Bleeding duodenal ulcer
C.
Aorto-duodenal fistula
D.
Hematobilia
E.
Hemorrhoids
Answer: E* Hemorrhoids
***) In
acute bleeding from esophageal varices after resuscitation, the treatment of
choice is:
A.
Intra-arterial vasopressin
B.
Balloon tamponade
C.
Endoscopic sclerotherapy
D.
Portocaval shunt
E.
Gastroesophageal devascularization
Answer: B* Balloon tamponade
II.
GI Diseases and Conditions.
1. Esophageal Webs and Rings.
***) The
following are recognized features of Plummer-Vinson syndrome, except:
A.
Dysphagia
B.
Post-cricoid web
C.
Clubbing
D.
Deficiency of iron
E.
Glossitis
Answer: C* Clubbing
2. Barrett's Esophagus.
***) With
regard to Barrett's syndrome esophagus, all are true except:
A.
Occurs when columnar metaplasia epithelium replaced the normal squamous
epithelium
B.
Associated with increased risk of developing esophageal SCC
C.
Esophagectomy is warranted if high grade dysplasia is found
D.
Operative therapy prevents further progression of the disease
E.
It is found in around 10% of patients with long standing GERD
Answer: B* Associated with increased
risk of developing esophageal SCC
3. Gastritis.
***) Acute
erosive gastritis is best diagnosed by:
A.
History
B.
Gastric analysis
C.
Endoscopy
D.
Double-contrast upper GI
E.
Capsule biopsy
Answer: C* Endoscopy
***) Hypochlorhydria
is caused by all of the following, except:
A.
Carcinoma of stomach
B.
Pregnancy
C.
Pernicious anemia
D.
Atrophic gastritis
E.
Duodenal ulcer
Answer: E* Duodenal ulcer
***) Gastrin
is produced primarily in the:
A.
Gastric fundus
B.
Antrum
C.
Pylorus
D.
Liver
E.
Pancreas
Answer: C* Pylorus
4. Zollinger-Ellison Syndrome.
***) The
most common site of origin of the tumor associated with the Zollinger-Ellison
syndrome is:
A.
Stomach
B.
Duodenum
C.
Lymph node
D.
Spleen
E.
Pancreas
Answer: E* Pancreas
5. Peptic Ulcer Disease PUD.
***) Helicobacter
pylori can lead to all the following except: Q2012
A.
MALT
lymphoma
B.
Gastric
ulcers
C.
Duodenal
ulcers
D.
Gastric
cancer
E.
GERD
Answer: E* GERD
***) All
of the following about peptic ulcer diseases are true, except:
A.
Helicobacter pylori is important factor
B.
Duodenal ulcer may become malignant
C.
Omeprazole is helpful in treatment
D.
Zollinger-Ellison is a recognized cause
E.
Relapse may occur
Answer: B* Duodenal ulcer may become
malignant
***) All
of the following have been associated with chronic duodenal ulcer, except:
A.
Hyperparathyroidism
B.
Zollinger-Ellison syndrome
C.
Chronic pulmonary insufficiency
D.
Smoking
E.
Pernicious anemia
Answer: E* Pernicious anemia
***) All
of the following drugs are used in the treatment of duodenal ulcer, except:
A.
Sucralfate
B.
Calcium antagonists
C.
Bismuth
D.
Pirazepine
E.
H2-receptors antagonists
Answer: B* Calcium antagonists
***) The
following drugs are used in the management of peptic ulcer disease, except:
A.
Famotidine
B.
Sucralfate
C.
Omeprazole
D.
Anticholinergic drugs
E.
Salazopyrin
Answer: E* Salazopyrin
***) The
following drugs are used in the management of peptic ulcer disease, except:
A.
Ranitidine
B.
Cimetidine
C.
Famotidine
D.
Omeprazole
E.
Mebendazole
Answer: E* Mebendazole
***) Cimetidine
is:
A.
A histamine analogue
B.
A liberator of histamine from mast cells
C.
An H1-receptor blocker
D.
A selective Hl blocker with much less sedating properties
E.
A selective H2 receptor blocker which inhibits gastric
secretion
Answer: E* A selective H2
receptor blocker which inhibits gastric secretion
***) All
the following drugs are used for H. pylori eradication, except: Q2012
A.
Tetracycline
B.
Metronidazole
C.
Clarithromycin
D.
Amoxicillin
E.
Ciprofloxacin
Answer: E* Ciprofloxacin
***) All
the following are risk factors to develop gastric ulcer except:
A.
Increased fiber in diet
B.
NSAIDs
C.
Stress
D.
Smoking
E.
Alcohol
Answer: A* Increased fiber in diet
***) The
best method to diagnose peptic ulcer disease is:
A.
Barium meal
B.
Upper gastro-intestinal endoscopy
C.
Ultrasonography
D.
Labelled RBCs
E.
CT scanning of the upper abdomen
Answer: B* Upper gastro-intestinal
endoscopy
***) In
chronic gastric ulcer the following are true, except:
A.
Usually affects the patient of more than 40 years of age
B.
Commonly occurs at the lesser curvature of the stomach
C.
Symptomatic relief by H2 blockers is an indication of
healing of ulcer
D.
Endoscopic biopsy must be done to exclude malignancy
E.
Patients may have normal or low values of maximal acid output
Answer: C* Symptomatic relief by H2
blockers is an indication of healing of ulcer
***) Concerning
chronic duodenal ulcer all are true, except:
A.
It is more common in males than females
B.
Pain usually occurs two hours after meals
C.
Vomiting is rare unless stenosis has occurred
D.
Increased high fasting gastric secretion is usual
E.
Malignant change occurs in 5-10% of this ulcer
Answer: E* Malignant change occurs in
5-10% of this ulcer
***) The
most common pathophysiologic mechanism of duodenal ulcer is primarily related
to:
A.
Gastric acid hypersecretion
B.
Hypergastrinemia
C.
Deficient duodenal buffers
D.
Rapid gastric emptying
E.
Hyperpepsinogen secretion
Answer: A* Gastric acid
hypersecretion
6. Inflammatory Bowel Diseases IBD.
***) All
of the following about Crohn's disease are true, except:
A.
May involve the esophagus
B.
Is a transmural inflammation
C.
Does not predispose to malignancy
D.
Causes a characteristic cobble stones appearance of the mucosa
E.
Perforation may occur
Answer: C* Does not predispose to malignancy
***) Concerning
Crohn's disease, all the following are true, except:
A.
It is a chronic transmural granulomatous inflammation
B.
It involves the terminal ileum only
C.
It commonly presents an abdominal mass, bloody diarrhea and anemia
D.
Internal fistula is common
E.
Commonly associated with perianal suppuration
Answer: B* It involves the terminal
ileum only
***) In
ulcerative colitis all of the following are true, except:
A.
Arthritis may be present
B.
Rectum is usually not involved
C.
Steroids are used in the treatment
D.
It is a pre-malignant condition
E.
Toxic megacolon may occur
Answer: B* Rectum is usually not
involved
***) Which
of the following is true about ulcerative colitis:
A.
D-penicillamine is an effective treatment
B.
Rectum is involved in most cases
C.
Fistula formation is a common problem
D.
Skin lesion is characteristic
E.
Inflammation involves all the layers of the colon even in early stages
Answer: B* Rectum is involved in most
cases
***) Systemic
complications of ulcerative colitis include all of the following, except:
A.
Ankylosing spondylitis
B.
Sclerosing cholangitis
C.
Keratoderma blenorrhagica
D.
Episcleritis
E.
Pericarditis
Answer: C* Keratoderma
blenorrhagica
***) Recognized
complications of ulcerative colitis include all of the following, except:
A.
Cholangitis
B.
Arthropathy
C.
Toxic megacolon
D.
Increased incidence of carcinoma of colon
E.
Erythema marginatum
Answer: E* Erythema marginatum
***) Complications
of ulcerative colitis include:
A.
Increased incidence of carcinoma of colon
B.
Pyoderma gangrenosum
C.
Arthropathy
D.
Cholangitis
E.
All of the above
Answer: E* All of the above
***) Definite
diagnosis of inflammatory bowel diseases by:
A.
History
B.
Clinical and rectal examination
C.
Colonoscopic findings
D.
Abdominal ultrasound
E.
Histopathology
F.
Answer: E* Histopathology
***) All
of the following symptoms are associated with ulcerative colitis, except:
A.
Heartburn
B.
Bloody diarrhea
C.
Abdominal pain
D.
Fatigue
E.
Weight loss and anemia
Answer: A* Heartburn
***) All
of the following investigations are beneficial in the diagnosis of ulcerative
colitis, except:
A.
Stool studies
B.
Upper endoscopy
C.
Colonoscopy
D.
Abdominal X-Ray
E.
Serologic studies (ANCA)
Answer: D* Abdominal X-Ray
***) All
of the following complications are associated with ulcerative colitis, except:
A.
Pyoderma gangrenosum
B.
Uveitis
C.
Primary sclerosing cholangitis
D.
Vitamin B12 deficiency
E.
Renal stones
Answer: E* Renal stones
***) In
long standing ulcerative colitis, all are seen except:
A.
Shortening of bowel
B.
Contracted, thickened mesentery
C.
Large lymph nodal mass
D.
Dull and grayish serosal surface
E.
Perforation with abscesses along mesenteric margins
Answer: B* Contracted,
thickened mesentery
***) Cigarette
smoking is a risk factor for all of the following, except:
A.
Emphysema
B.
Peripheral vascular disease
C.
Ischemic heart disease
D.
Ulcerative colitis
E.
Cancer of bladder
Answer: D* Ulcerative colitis
***) 70
years old male presented abdominal pain; on examination he has irregularly
irregular pulse and bloody diarrhea. He gives history of CVA, peripheral
vascular disease and MI. You must think of: Q2012
A.
Ulcerative
colitis
B.
Pancreatitis
C.
Inferior
MI
D.
Acute
mesenteric ischemia
E.
Diverticulitis
Answer: D* Acute mesenteric ischemia
III.
Liver Diseases and Conditions.
1. Hepatic Encephalopathy.
***) Hepatic
encephalopathy may be precipitated by all of the following, except:
A.
Barbiturate
B.
Morphine
C.
High protein diet
D.
Lactulose
E.
Gastrointestinal hemorrhage
Answer: D* Lactulose
***) The
following can precipitate hepatic encephalopathy in a patient with liver
cirrhosis, except:
A.
Infection
B.
High carbohydrate diet
C.
Gastrointestinal bleeding
D.
Hypokalemia
E.
Sedation
Answer: B* High
carbohydrate diet
***) Hepatic
encephalopathy in a cirrhotic patient may be precipitated by all of the
following, except:
A.
Use of diuretics
B.
Constipation
C.
Narcotics
D.
Neomycin
E.
Paracentesis
Answer: D* Neomycin
***) All
of the following are factors precipitating portosystemic encephalopathy,
except:
A.
Diarrhea
B.
Infection
C.
Diuretic therapy
D.
Narcosis
E.
Shunt operations
Answer: A* Diarrhea
***) Hepatic
encephalopathy in cirrhosis is typically precipitated by all the following,
except:
A.
Infection
B.
Hypokalemia
C.
Gastrointestinal bleeding
D.
Lactulose therapy
E.
Abdominal surgery
Answer: D* Lactulose therapy
2. Cirrhosis.
***) All
of the following can cause liver cirrhosis, except:
A.
Hemochromatosis
B.
Hepatitis B, C
C.
Budd-Chiary syndrome
D.
Hepatitis A
E.
Biliary cirrhosis
Answer: D* Hepatitis A
***) All
of the following are signs of chronic liver disease, except:
A.
Parotid gland enlargement
B.
Increase of body hair
C.
Spider Naeyia
D.
Gynecomastia
E.
Palmar erythema
Answer: B* Increase of body hair
***) The
Budd-Chiary syndrome is due to occlusion of the:
A.
Hepatic veins
B.
Portal veins
C.
Mesenteric veins
D.
Pancreatic veins
E.
Splenic veins
Answer: A* Hepatic veins
***) All
of the following can cause hemorrhagic ascites, except:
A.
Malignancy
B.
Liver cirrhosis
C.
Ruptured ectopic pregnancy
D.
Abdominal trauma
E.
Acute pancreatitis
Answer: B* Liver cirrhosis
3. Hemochromatosis.
***) A
35 years old male comes for evaluation of abdominal discomfort, tiredness and
arthralgia. The examination reveals slate-grey skin pigmentation, hepatomegaly
and hypogonadism. Random blood sugar is 250mg/dl. The most likely diagnosis is:
A.
Cirrhosis
B.
Wilson disease
C.
Hemochromatosis
D.
SLE
E.
Chronic pancreatitis
Answer: C* Hemochromatosis
4. Autoimmune Hepatitis.
***) 30
years old female (DM type 1) presented with jaundice, labs show increased in ALT,
AST, positive ANA, ASMA, negative antimitochondrial antibodies and normal
alkaline phosphatase. The most likely diagnosis is: Q2012
A.
Primary
biliary cirrhosis
B.
Primary
sclerosing cholangitis
C.
Viral
hepatitis
D.
Autoimmune
hepatitis
E.
Hepatocellular
carcinoma
Answer: D* Autoimmune hepatitis
5. Wilson's disease.
***) Wilson
disease is a disorder of plasma protein of one of the following elements:
A.
Iron
B.
Cobalt
C.
Zinc
D.
Copper
E.
Magnesium
Answer: D* Copper
6. Jaundice.
***) Causes
of conjugated hyperbilirubinemia include: Q2012
A.
Crigler
Najar syndrome type 1
B.
Gilbert's
syndrome
C.
Hemolysis
D.
Dubin-Johnson
syndrome
E.
Carotenemia
F.
Answer:
D* Dubin-Johnson syndrome
***) Bilirubin
in the plasma is tightly bound to which of the following:
A.
Gamma globulin
B.
Albumin
C.
Haptoglobin
D.
Ceruloplasmin
E.
Fibrinogen
Answer: B* Albumin
***) All
of the following are etiologies of conjugated hyperbilirubinemia, except:
A.
Dubin-Johnson syndrome
B.
Methyltestosterone ingestion
C.
Rotor's syndrome
D.
Gilbert's syndrome
E.
Carcinoma of the ampulla of Vater's nipple
Answer: D* Gilbert's syndrome
***) All
of the following are manifestations with indirect hyperbilirubinemia, except:
A.
Gilbert's syndrome
B.
Dubin Johnson syndrome
C.
Crigler Najar syndrome
D.
ABO incompatibility
E.
Physiologic neonatal jaundice
Answer: D* Dubin Johnson syndrome
***) Direct
hyperbilirubinemia may be associated with all the following except:
A.
Hemolysis
B.
Periampullary neoplasm
C.
Common bile duct stricture
D.
CA head of pancreas
E.
Stone in common bile duct
Answer: A* Hemolysis
IV.
GI and Nutritional Disorders.
1. Nutritional Disorders.
***) One of
the following is not a feature of celiac disease: Q2012
A.
Anemia
B.
Weight
loss
C.
Fever
D.
Diarrhea
E.
Hypocalcemia
Answer: C* Fever
***)
The disease characterized by the three symptoms: diarrhea, dementia, and
dermatitis are caused by:
A.
Ariboflavinosis
B.
Beriberi
C.
Scurvy
D.
Pellagra
E.
Kwashiorkor
Answer: D* Pellagra
2. GI Malabsorption.
***) One of
the following is not dependent on bile salts for its absorption: Q2012
A.
Vitamins
A
B.
Vitamin
B
C.
Vitamin
K
D.
Vitamin
D
E.
Vitamin
E
Answer: B* Vitamin B
***) Young
female presented with leg pain, gum bleeding and Ecchymosis. The most
appropriate vitamin deficiency is: Q2012
A.
Vitamin
A
B.
Vitamin
B12
C.
Vitamin
C
D.
Vitamin
D
E.
Vitamin
E
Answer: C* Vitamin C
***) Iron
is absorbed at: Q2012
A.
Stomach
B.
Duodenum
& Jejunum
C.
Ileum
D.
Colon
E.
Descending
colon
Answer: B* Duodenum & Jejunum
***) Causes
of malabsorption include all of the following, except:
A.
Celiac disease
B.
Pancreatic insufficiency
C.
Intestinal lymphoma
D.
Crohn's disease
E.
Irritable bowel syndrome
;
Answer: E* Irritable bowel syndrome
***) Causes
of malabsorption include all of the following, except:
A.
Gluten enteropathy
B.
Systemic sclerosis
C.
Bacterial overgrowth
D.
Lymphoma
E.
Cholecyctitis
Answer: E* Cholecyctitis
***) Causes
of malabsorption include all of the following, except:
A.
Tropical sprue
B.
Giardia lamblia
C.
Acute pancreatitis
D.
Systemic sclerosis
E.
Pancreatic carcinoma
Answer: C* Acute pancreatitis
***) Vitamin
B12 is absorbed at:
A.
Stomach
B.
Jejunum
C.
Ileum
D.
Colon
E.
Duodenum
Answer: C* Ileum
***) Calcium,
iron and folates are absorbed at:
A.
Stomach
B.
Upper small intestine
C.
Ileum
D.
Caecum
E.
Descending colon
Answer: B* Upper small intestine
***) Primary
site of folate absorption is:
A.
Jejunum
B.
Duodenum
C.
Large bowel
D.
Stomach
E.
Esophagus
Answer: A* Jejunum
***) Regarding
vitamins deficiency, one is not matching:
A.
Vitamin D deficiency - Rickets
B.
Vitamin A deficiency - Night blindness
C.
Vitamin K deficiency - Hemorrhage disease of newborn
D.
Vitamin B12 deficiency - Megaloblastic anemia
E.
Biotin - Pellagra
Answer: E* Biotin – Pellagra
***) Concerning
hypovitaminosis all of the following statements are correct, except:
A.
Vitamin A deficiency leads to xerophthalmia
B.
Vitamin Bl (thiamine) deficiency leads to beriberi
C.
Vitamin C deficiency leads to scurvy
D.
Vitamin K deficiency leads to bleeding
E.
Vitamin B12 deficiency leads to microcytic anemia
Answer: E* Vitamin B12
deficiency leads to microcytic anemia
***) Which
of the following mineral deficiencies is not matching:
A.
Fluoride - Dental caries
B.
Iodine - Congenital thyroid goiter
C.
Potassium - Osteoporosis
D.
Zink - Acrodermatitis enteropathica
E.
Iron - Spoon nail
Answer: C* Potassium – Osteoporosis
***) All
of the following statements concerning bile acid are true, except:
A.
It is degradation product of old RBC
B.
It is essential for digestion and absorption of fat and fat
soluble-vitamins
C.
It stimulates peristaltic movements
D.
It has antiseptic action
E.
It is absorbed mostly in the terminal ileum
Answer: D* It has antiseptic action
***) The
terminal ileum is the absorptive site for which of the following:
A.
Glucose
B.
Folic acid
C.
Bile salts
D.
Xylose
E.
Iron
Answer: C* Bile salts
***) Diseased
or surgically resected terminal ileum will significantly reduce the absorption
of one of the following:
A.
Iron
B.
Bile salts
C.
Folic acid
D.
Vitamin
E.
Calcium
Answer: B* Bile salts
***) Which
of the following has the greatest effect on enhancing calcium absorption from
the gastrointestinal tract:
A.
25-hydroxycholecalciferol
B.
24,25-dihydrocholecalciferol
C.
1.25-dihydrocholecalciferol
D.
Parathyroid hormone
E.
Calcitonin
Answer: C*1.25-dihydrocholecalciferol
***) All
are fat-soluble vitamins, except:
A.
Vitamins A
B.
Vitamin B12
C.
Vitamin K
D.
Vitamin D
E.
Vitamin E
Answer: B* Vitamin B12
***)
Regarding Vitamin A, all the following are true, except:
A.
Deficiency can cause keratinization of mucous membrane and skin
B.
Overdose may cause pseudotumor cerebri
C.
Craniotabes is characteristic in vitamin A deficiency
D.
Bile is necessary for absorption
E.
Xerophthalmia is a feature of vitamin A deficiency
Answer: C* Craniotabes is
characteristic in vitamin A deficiency
V.
Toxicology.
1. Acute Poisoning.
***) Induction
of vomiting is contraindication in patients poisoned with:
A.
Kerosene
B.
Paint
C.
Wax
D.
Floor polish
E.
All of above
Answer: E* All of above
***) Gastric
lavage is contraindicated in one of the following:
A.
Aspirin poisoning
B.
Diazepam poisoning
C.
Corrosive alkali
D.
Iron tablet poisoning
E.
Paracetamol poisoning
Answer: C* Corrosive alkali
***) Gastric
lavage is urgent when a child ingests:
A.
Caustic soda
B.
Sulphuric acid
C.
Twenty tablets of iron
D.
Kerosene
E.
Half a bottle of oral penicillin suspension
Answer: C* Twenty tablets of iron
***) Abdominal
pain is a feature of all of the following, except:
A.
Methanol toxicity
B.
Acute arsenic poisoning
C.
Acute lead poisoning
D.
Acute iron poisoning
E.
Typhoid fever
Answer: B* Acute arsenic
poisoning
***) Kerosene
poisoning may be characterized by all, except:
A.
Bleeding from GI tract
B.
Dryness of throat
C.
Fever
D.
Pneumonia
E.
Smell of kerosene from the mouth and vomit
Answer: B* Dryness of throat
***) Antidotes
for each drug are matching except:
A.
Paracetamol - Acetylcysteine
B.
Iron - Desferrioxamine
C.
Organophosphorus - Atropine
D.
Digoxin - Fat antibody binding fragment
E.
Tricyclic antidepressant - Diazepam
Answer: E* Tricyclic antidepressant -
Diazepam
***) Glue
sniffers are liable to show the following clinical features, except:
A.
Euphoria
B.
Dizziness
C.
Headache
D.
Ataxia
E.
Major epileptic fits
Answer: E* Major epileptic fits
***) All
of the following are well recognized complications of heroin addiction, except:
A.
Viral hepatitis
B.
Bacterial endocarditis
C.
Tetanus
D.
Acute sinusitis
E.
Thrombophlebitis
Answer: D* Acute
sinusitis
***)
Minamata disease is caused by:
A.
Arsenic
B.
Mercury
C.
Nitrates
D.
Lead
E.
Cobalt
Answer: B* Mercury
2. Organophosphate Poisoning.
***) Organophosphate
poisoning can manifest by all of the following, except:
A.
Pulmonary edema
B.
Constipation
C.
Bradycardia
D.
Convulsions
E.
Muscular weakness
Answer: B* Constipation
***) All
of the following are features of organophosphate poisoning, except:
A.
Tachycardia
B.
Lacrimation
C.
Salivation
D.
Constricted pupils
E.
Diaphoresis
Answer: A* Tachycardia
***) The
dose of atropine that should be given in case of organophosphorus compounds
poisoning is:
A.
Atropine 1 mg
B.
Atropine 2-4 mg
C.
Atropine 1 ampoule
D.
Atropine should be administered until full atropinization occur
E.
Atropine should be administered until cyanosis disappear
Answer: D* Atropine
should be administered until full atropinization occur
***) Which
of the following in the treatment of organophosphate poisoning is true:
A.
Atropine should not be given unless the diagnosis is confirmed by lab
B.
Poisoned patient has low tolerance to large amounts of atropine
C.
Atropine should be administered until tachycardia, flushing and dry
mouth occur
D.
Atropine reverses the phosphorylation of cholinesterase
E.
All of above
Answer: C* Atropine should be
administered until tachycardia, flushing and dry mouth occur
***) A
20 years old farmer was found in a semi comatose state with constricted pupils
and frothy sputum. One of the following should be considered as first line of
treatment:
A.
Verapamil
B.
Diazepam
C.
Atropine
D.
Morphine
E.
Dexamethasone
Answer: D* Atropine
***) Symptoms
of atropine poisoning include each of the following, except:
A.
Blurred vision
B.
Hot flushed skin
C.
Muscular incoordination
D.
Delirium
E.
Hypothermia
Answer: E* Hypothermia
***) Ingestion
of plants which contain atropine alkaloids (like Datura) can produce all of the
following symptoms, except:
A.
Hallucinations
B.
Flushing of the skin
C.
Tachycardia
D.
Pin point pupils
E.
Dry mouth
Answer: D* Pin point pupils
3. Salicylate Poisoning.
***) In
salicylates poisoning all are true, except:
A.
Hyperpnoea is the most frequent sign
B.
A ferric chloride test on urine is positive
C.
Plasma salicylate concentration is not value in assessing of the
poisoning severity
D.
Sodium bicarbonate IV can clearly increase the urinary excretion of
salicylates
E.
In an alert patient vomiting should be increased to prevent continued
salicylate absorption
Answer: C* Plasma salicylate
concentration is not value in assessing of the poisoning severity
4. Paracetamol Poisoning.
***) All
the following about paracetamol poisoning are true, except: Q2012
A.
Metabolic
acidosis
B.
Hypoglycemia
C.
Bronchospasm
D.
Hepatic
failure
E.
Acute
renal tubular necrosis
Answer: C* Bronchospasm
***) The
antidote treatment for paracetamol poisoning is: Q2012
A.
Ethanol
B.
Atropine
C.
Naloxone
D.
Acetylcysteine
E.
Protamine
sulfate
Answer: D* Acetylcysteine
***) The
most dangerous complication of paracetamol poisoning is:
A.
Hypoglycemia
B.
Arrhythmia
C.
Hepatic toxicity
D.
Respiratory failure
E.
Renal failure
Answer: C* Hepatic toxicity
***) All
the following about paracetamol poisoning are true, except:
A.
The clinical features in the first 3-4 hrs are nausea and vomiting
B.
Acute liver failure occurs after 3-4 days
C.
Death may occur after ingestion of 25 grams of paracetamol
D.
Naloxone is the treatment of choice
E.
Prothrombin time is the best guide to the severity of liver damage
Answer: D* Naloxone is the treatment of
choice
***) Acetaminophen
toxicity is characterized by all except:
A.
Anorexia and vomiting
B.
Abnormal liver function in stage 3
C.
The antidote is N-acetyl-L (mucomyst)
D.
High index of suspicion is needed to diagnose the condition
E.
Can cause Reye syndrome
Answer: E* Can cause Reye syndrome
5. Lead Poisoning.
***) Toxicity
of lead:
A.
Mainly in children
B.
An occupational hazard in liquid batteries manufacturers
C.
Affect the inelegancy
D.
Can cause anemia
E.
All of the above
Answer: E* All of the above
***) All
of the following are clinical features of lead poisoning, except:
A.
Anorexia and vomiting
B.
Anemia
C.
Diarrhea
D.
Wrist and foot drop
E.
Encephalopathy
Answer: C* Diarrhea
***) All
of the following are the features of chronic lead poisoning, except:
A.
Anemia
B.
Attacks of abdominal colic
C.
Emphysema
D.
Constipation
E.
Arthralgia
Answer: C* Emphysema
***) Chronic
lead poisoning in children may cause all the following, except:
A.
Mental retardation
B.
Seizure disorders
C.
Aggressive behavior disorders
D.
Diarrhea
E.
Chronic abdominal pain
Answer: D* Diarrhea
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