12707028
Descrição
Quiz por Plymouth Med, atualizado more than 1 year ago
|
Criado por Plymouth Med
aproximadamente 6 anos atrás
|
|
Questão 1
Questão
A middle-aged man with longstanding Barrett’s esophagus is referred for specialist review after he reports increasing dysphagia over the last 4 months. He has noted that it initially only affected solids but now struggles with liquids as well. What is the next most important investigation to aid diagnosis?
Responda
-
Blood investigation for tumour markers
-
Barium swallow
-
CT
-
PET
-
Endoscopy
Questão 2
Questão
What is the first line maintenance treatment for Ulcerative Collitis?
Responda
-
Mesalazine
-
Ciclosporin
-
Prednisolone
-
Infliximab
-
Azathioprine
Questão 3
Questão
What do parietal cells produce?
Responda
-
pepsinogen
-
somatostatin
-
gastrin and histamine
-
hydrochloric acid and intrinsic factor
-
histamine only
Questão 4
Questão
An elderly man with a history of alcohol abuse goes to ED with hematemesis for 1 day. He has no abdominal or chest pain. His eyes are reddened and he admits to drinking heavily the night before he vomited several times. What may be the reason for this?
Responda
-
Oesophageal varices
-
Lung Cancer
-
Achalasia
-
Perforated gastric ulcer
-
Mallory-Weiss tear
Questão 5
Questão
A 20-year-old man presents to the ED with fever and severe right lower quadrant (RLQ) pain for 1 day. Prior to this episode, he reports 2 months of crampy abdominal pain, generalized malaise, a 5kg weight loss, and occasional bloody diarrhoea. On physical exam, the patient appears uncomfortable and has a tender mass is in the RLQ. An abdominal CT scan demonstrates normal appendix and inflammation of the distal ileum and several areas of the colon without rectal involvement. Which of the following is the most likely diagnosis?
Responda
-
Crohn's Disease
-
Ulcerative Colitis
-
Appendicitis
-
Diverticulitis
-
Pseudomembranous colitis
Questão 6
Questão
An older woman arrives at ED complaining of abdominal pain. She states that the pain began as a vague aching but has migrated to the left side of her abdomen. She had a fever over the past 3 days and just not feeling like herself. She also complains of being more constipated than usual. Your abdominal exam reveals normal bowel sounds, mild distension, and tenderness over the left lower quadrant. What is most likely the reason for this
Responda
-
Colorectal cancer
-
Diverticulitis
-
Appendicitis
-
Crohn’s disease
-
Duodenal ulcer
Questão 7
Questão
What is the blood supply to the superior rectum?
Responda
-
celiac artery
-
superior mesenteric artery
-
inferior mesenteric artery
-
internal iliac artery
-
external iliac artery
Questão 8
Questão
A elderly man attends your clinic with a three-month history of weight loss of approximately 9 kg despite a normal appetite. A full blood count reveals that his hemoglobin is 9.0 g/dL (previous hemoglobin was 13.5 g/dL one year ago) and the MCV is 71 fL.
The abdominal examination is unremarkable and per rectum exam is unremarkable. The patient states that he has normal bowel habits and has been feeling quite tired lately. What is the most appropriate management?
Responda
-
Reassure and discharge
-
Prescribe iron tablet supplementation
-
have an abdominal ultrasound
-
have an abdominal x-ray
-
have an upper and lower GI endoscopy
Questão 9
Questão
A middle aged woman has a four-month history of diarrhoea and bloating. Associated symptoms include lethargy and weight loss.
Full blood count reveals:
hemoglobin of 9.3 d/gL (13.8 to 17.2)
MCV 70 fL. (77-95)
What other investigation allow proper patient diagnosis?
Responda
-
Anti-mitochondrial antibodies
-
Anti-smooth muscle antibodies
-
Anti-nuclear antibodies
-
Anti-tissue transglutaminase antibodies
-
Anti-neutrophil cytoplasmic antibodies
Questão 10
Questão
You see an elderly man with an acute episode of hematemesis, who was admitted the night before and is awaiting an upper GI endoscopy. You are asked on the ward round about the common causes of upper GI bleeding. From the list below, which of the following is the most common cause of upper GI bleeding?
Responda
-
Mallory–Weiss tear
-
Peptic ulcers
-
Esophageal varices
-
Drug induced
-
Sporadic malignancy
Questão 11
Questão
You see a middle aged woman with Crohn’s disease. Due to a severe attack of Crohn’s which failed to respond to medical therapy, she had a small bowel resection. Your registrar tells you that she is at risk of developing vitamin B12 deficiency as a result of her surgery. Which part of the bowel is responsible for the absorption of vitamin B12?
Responda
-
Ascending colon
-
Terminal ileum
-
Duodenum
-
Jejunum
-
Proximal Ileum
Questão 12
Questão
You see a middle aged man who was admitted for an elective upper GI endoscopy due to longstanding GORD which has failed to improve on antacids and PPIs. Your registrar suspects that this patient may have Barrett’s oesophagus and asks you to define what this is:
Responda
-
Metaplasia of the squamous epithelium of the lower third of the esophagus to columnar epithelium
-
Metaplasia of the columnar epithelium of the upper third of the oesophagus to squamous epithelium
-
Metaplasia of the squamous epithelium of the middle third of the oesophagus to columnar epithelium
-
Metaplasia of the squamous epithelium of the upper third of the oesophagus to columnar epithelium
-
Metaplasia of the columnar epithelium of the lower third of the oesophagus to squamous epithelium
Questão 13
Questão
Which of the following is the most common cause of duodenal ulcers?
Responda
-
NSAIDs
-
Alcohol Abuse
-
Helicobacter pylori
-
Chronic corticosteroid therapy
-
Zollinger-Ellison syndrome
Questão 14
Questão
A middle-aged lorry driver presents to the GP with chest pain that usually occurs after having a meal. He has no major past medical history and he takes ibuprofen regularly. He is otherwise fit and healthy. What is the most important next step in management?
Responda
-
Urgent referral to endoscopy.
-
Routine referral to endoscopy.
-
Prescribe omeprazole, a PPI.
-
Perform a H. pylori urea test.
-
Perform a 12-lead ECG
Questão 15
Questão
You see a middle aged lorry driver, who presents to you with a three-month history of heartburn after meals which has not been settling with antacids and PPIs. You suspect that the patient has a hiatus hernia. The most appropriate investigation for diagnosing a hiatus hernia is:
Responda
-
CT scan
-
Chest x-ray
-
Barium meal
-
Ultrasound
-
Upper GI endoscopy
Questão 16
Questão
A middle-aged woman is referred for upper gastrointestinal (GI) endoscopy following a four-month history of epigastric pain despite treatment with antacids and proton pump inhibitors (PPIs). The results demonstrate a duodenal ulcer coupled with a positive campylobacter-like organism (CLO) test. The patient has no past medical history and has no known drug allergies. What is the most appropriate treatment?
Responda
-
Seven-day course of twice daily omeprazole 20 mg, 1 g amoxicillin and 500 mg clarithromycin
-
Seven-day course of twice daily omeprazole 20 mg
-
Seven-day course of twice daily omeprazole 20 mg and 1 g amoxicillin
-
Seven-day course of twice daily omeprazole 20 mg and 500 mg clarithromycin
-
Seven-day course of twice daily 1 g amoxicillin and 500 mg clarithromycin
Questão 17
Questão
You see a middle aged man with a three-month history of epigastric dull abdominal pain. The pain is worse in the mornings and is better after meals. There is no history of weight loss and the patient’s bowel habits are normal. His abdomen is soft and experiences moderate discomfort on palpation of the epigastric region. What is the most likely diagnosis?
Responda
-
Gastric ulcer
-
Gastro-oesophageal reflux disease (GORD)
-
Gastritis
-
Gastric carcinoma
-
Duodenal ulcer
Questão 18
Questão
You see an elderly man who comes to ED with epigastric pain. The pain started 3 days ago and today his stools color has changed to a ‘tarry-black’ color. Associated symptoms include nausea and lethargy.
The patient is alert and orientated with a pulse rate of 99 and blood pressure of 98/69, respiratory rate of 18, oxygen saturations of 98 per cent on room air and temperature of 37.2°C.
The abdomen is soft with marked tenderness in the epigastric region and bowel sounds are present. The rectum is empty, on PR examination, with some traces of melaena. The patient has been started on high flow oxygen and has been given some oral analgesia. The most appropriate next step in managing this patient is:
Responda
-
ECG
-
Intravenous omeprazole
-
Request an erect chest x-ray
-
Keep nil by mouth and arrange endoscopy
-
Intravenous cannulation and fluids
Questão 19
Questão
As you palpate the right upper quadrant (RUQ) of a middle aged woman’s abdomen, you notice that she stops her inspiration for a brief moment. The patient states that over the last 2 days she gets pain in her RUQ that radiates to her back shortly after eating.
Her vitals are temperature 38°C, heart rate (HR) 95, blood pressure (BP) 130/75, respiratory rate (RR) 16. What is the initial diagnostic modality of choice for this disorder?
Responda
-
Plain film radiograph
-
CT scan
-
Ultrasound
-
MRI
-
ERCP
Questão 20
Questão
A middle-aged woman at ED complains of pain in her RUQ that is steady but gets worse with eating over the past 2 days. The pain also radiates to the right side of her mid-back. No vomiting. Her only medication is an oral contraceptive.
Her BP is 140/75 mm Hg, HR is 80 beats per minute, temperature is 37°C, and RR is 16 breaths per minute. Laboratory tests are within normal limits. What is the most likely diagnosis?
Responda
-
Cholangitis
-
Pancreatitis
-
Cholecystitis
-
Peptic ulcer disease
-
Biliary colic
Questão 21
Questão
A 50-year-old man presents to the ED complaining of abrupt onset of epigastric pain that radiates to his back. He describes the pain as constant and associated with nausea and vomiting. The pain improves mildly if he leans forward. He has a 20-pack-year smoking history and consumes a 6-pack of beer daily for more than 5 years. His BP is 150/80 mm Hg, HR is 98 beats per minute, temperature is 37.8°C, and his RR is 18 breaths per minute. He is tender to palpation in the epigastric area. His WBC count is normal and lipase 520 U/L (0-160 U/L). What is the most likely diagnosis?
Responda
-
Cholecystitis
-
Bowel perforation
-
Mesenteric ischemia
-
Abdominal aortic aneurysm
-
Pancreatitis
Questão 22
Questão
A 55-year-old man presents to the ED complaining of mild diffuse abdominal pain. The pain began upon waking up and is associated with some nausea. He denies fever, vomiting, diarrhoea, and rectal bleeding. His BP is 143/71 mm Hg, HR is 87 beats per minute, temperature is 36°C, and RR is 16 breaths per minute. His abdomen is tense but only mildly tender. You order baseline labs. His chest radiograph is seen below. Which of the following is the most likely diagnosis?
Responda
-
Ascending cholangitis
-
Acute pulmonary edema
-
Ruptured aneurysm
-
Pancreatitis
-
Perforation with pneumoperitoneum
Questão 23
Questão
A 33-year-old man presents to the ED complaining of lower abdominal pain. He states that last night he ate pizza with pepperoni for dinner, went to sleep, and awoke several hours later with a vague, periumbilical pain. The pain has been constant since its onset and has migrated to his lower abdomen more on the right than left. Since eating the pizza he has no appetite. He is nauseated and vomited twice in the ED. His BP is 125/70 mm Hg, HR is 88 beats per minute, temperature is 38°C, and his RR is 16 breaths per minute. On exam, his RLQ is tender to palpation. What is the most likely diagnosis?
Responda
-
Cholangitis
-
Appendicitis
-
Diverticulitis
-
Pancreatitis
-
Acute cholecystitis
Questão 24
Questão
Patient presents with painless jaundice and palpable RUQ mass. Which of the following is the most likely diagnosis
Responda
-
Cholecystitis
-
Cholangitis
-
Abdominal aortic aneurysm
-
Crohn’s disease
-
Gall bladder carcinoma
Questão 25
Questão
A 71-year-old obese man is brought to the ED complaining of constant left middle quadrant abdominal pain with radiation into his back. His past medical history is significant for hypertension, peripheral vascular disease, and kidney stones. He smokes a pack of cigarettes daily. His BP is 145/80 mm Hg, HR is 90 beats per minute, temperature is 37.2°C, and RR is 16 breaths per minute. Abdominal exam shows a pulsatile abdominal mass. An abdominal radiograph reveals normal loops of bowel. Which of the following is the most likely diagnosis?
Responda
-
Biliary colic
-
Diverticulitis
-
Pancreatitis
-
Small bowel obstruction
-
Abdominal aortic aneurysm
Questão 26
Questão
A 78-year-old woman is brought to the ED by EMS complaining of vomiting and abdominal pain that began during the night. EMS reports that her BP is 90/50 mm Hg, HR is 110 beats per minute, temperature is 38°C, and RR is 18 breaths per minute. After giving her a 500 mL bolus of normal saline, her BP is 115/70 mm Hg. During the exam, you notice that her face and chest appear jaundiced. What is the most likely diagnosis?
Responda
-
Cholecystitis
-
Acute hepatitis
-
Cholangitis
-
Pancreatic cancer
-
Bowel obstruction
Questão 27
Questão
What is NOT true regarding GI anatomy?
Responda
-
The foregut is from the distal (abdominal) esophagus to hepatopancreatic ampulla of the duodenum (2nd part of the duodenum.)
-
The mesentery includes the liver, gallbladder, pancreas, and spleen
-
Midgut ends at 2/3rds along the transverse colon.
-
The Hindgut ends at the anus.
Questão 28
Questão
The GI wall, from the [blank_start]lower[blank_end] [blank_start]espohagus[blank_end] to the [blank_start]anus[blank_end], has the same 4 layers (from outermost to innermost)
1. [blank_start]Serosa[blank_end]
2. [blank_start]Muscularis[blank_end]
3. [blank_start]Submucosa[blank_end]
4. [blank_start]Mucosa[blank_end]
Responda
-
lower
-
espohagus
-
anus
-
Serosa
-
Muscularis
-
Submucosa
-
Mucosa
Questão 29
Questão
The foregut is supplied by the [blank_start]celiac[blank_end] [blank_start]trunk[blank_end], which comes off the aorta at level [blank_start]T12[blank_end].
The midgut is supplied by the [blank_start]superior[blank_end] [blank_start]mesenteric[blank_end] artery, which comes off the aorta at level [blank_start]L1[blank_end].
The hindgut is supplied by the [blank_start]inferior[blank_end] [blank_start]mesenteric[blank_end] artery, which comes off the aorta at level [blank_start]L3[blank_end].
Responda
-
celiac
-
trunk
-
T12
-
superior
-
mesenteric
-
L1
-
inferior
-
mesenteric
-
L3
Questão 30
Questão
The GI tract lymphatics and vasculature is about the same.
Responda
- True
- False
Questão 31
Questão
Which is NOT a major lymph structures involved with abdominal drainage?
Responda
-
Celiac nodes
-
Superior Mesenteric Aortic/Caval nodes
-
Inferior Mesenteric Aortic/Caval nodes
-
Renal nodes
Questão 32
Responda
-
right
-
left
-
hastura
-
tenie coli
-
sigmoid
-
omental appendices
Questão 33
Questão
Large Intestine Blood Supply:
[blank_start]Superior[blank_end] rectal artery is a branch of the [blank_start]inferior[blank_end] [blank_start]mesenteric[blank_end] artery.
However, the [blank_start]middle[blank_end] rectal and [blank_start]inferior[blank_end] rectal arterys are both branches of [blank_start]internal[blank_end] [blank_start]iliac[blank_end] artery.
Responda
-
inferior
-
mesenteric
-
internal
-
iliac
-
Superior
-
middle
-
inferior
Questão 34
Questão
What is true regarding the esophagus' histology?
Responda
-
made of nonkeratinized squamous epithelium
-
upper skeletal sphincter
-
lower smooth sphincter
-
upper 1/3 skeletal muscle
-
middle 1/3 skeletal and smooth muscle
-
lower 1/3 smooth muscle
-
cyclic mucus secretions
-
upper 1/3rd squamous cells
Questão 35
Questão
Pharyngeal Pouch ([blank_start]Zenker[blank_end] diverticulum) is an out-pouching (diverticulum) that develops from the [blank_start]posterior[blank_end] wall of the [blank_start]pharynx[blank_end] just prior to the [blank_start]esophagus[blank_end].
Responda
-
posterior
-
pharynx
-
esophagus
-
Zenker
Questão 36
Questão
What is true regarding Zenker diverticulum?
Responda
-
management: surgery
-
investigation: barium swallow
-
management: corticosteroids
-
dysphagia
-
halitosis
-
stomach gurgling upon palpatation
-
constipation
-
diarrea
Questão 37
Questão
What is true regarding achalasia?
Responda
-
affects esophageal motility
-
lower esophageal sphincter unable to relax
-
gradual dysphagia to solids and liquids
-
weight loss
-
form of acid reflux--> damages esophageal cells
-
vomiting
-
prolonged dysphagia
-
drugs trtment: nitrates
-
drugs trtment: caclium channel blockers
-
investiagtion: manometry and endoscopy
Questão 38
Questão
[blank_start]Gastroesophageal[blank_end] [blank_start]Reflux[blank_end] [blank_start]Disease[blank_end] (GERD/GORD) is a condition in which the stomach contents are regurgitated back the esophagus, usually because the [blank_start]lower[blank_end] [blank_start]esophageal[blank_end] sphincter is unable to fully close after swallowing.
Responda
-
Gastroesophageal
-
Reflux
-
Disease
-
esophageal
-
lower
Questão 39
Questão
What is true regarding GORD?
Responda
-
dyspepsia is main symptom
-
preferable investigation via endoscopy
-
manage via lifestyle changes
-
manage via proton pump inhibitors
-
manage via gastrin inhibitors
-
risk factors = smoking, alcohol, and obesity
-
risk factor = chocolate
-
risk factor= pregnancy
-
preferable investigation via blood tests
-
preferable investigation via sputum culture
Questão 40
Questão
A Mallory-Weiss Tear is when there is bleeding from a laceration in the [blank_start]mucosa[blank_end] at the junction of the [blank_start]stomach[blank_end] and [blank_start]esophagus[blank_end]. This is usually caused by severe [blank_start]vomiting[blank_end], such as from [blank_start]alcoholism[blank_end], bulimia, or food [blank_start]poisoning[blank_end].
The signaling symptom is painful hematemesis. It is diagnosed by endoscopy.
Responda
-
mucosa
-
stomach
-
esophagus
-
vomiting
-
alcoholism
-
poisoning
Questão 41
Questão
Label the diagram showing the GI venous drainage. (the colors are just to differentiate between the various vessels)
Responda
-
inferior mesenteric vein
-
superior mesenteric vein
-
hepatic portal vein
-
splenic vein
-
splenic vein
Questão 42
Questão
The liver is supplied by the hepatic portal vein (which is made up of the [blank_start]splenic[blank_end] vein and the [blank_start]superior[blank_end] [blank_start]mesenteric[blank_end] vein) and the hepatic artery.
[blank_start]75[blank_end]% of blood going to the liver is from the hepatic portal vein while [blank_start]25[blank_end]% is from the hepatic artery.
However, [blank_start]oxygenated[blank_end] blood is split ~50:50 between the portal vein and hepatic arteries.
Responda
-
splenic
-
mesenteric
-
superior
-
75
-
25
-
oxygenated
Questão 43
Questão
Which of these does NOT directly come off of the celiac trunk?
Responda
-
splenic artery
-
common hepatic artery
-
left gastric artery
-
proper hepatic artery
Questão 44
Questão
The common hepatic artery becomes the proper hepatic artery after the gastroduodenal artery branch.
Responda
- True
- False
Questão 45
Questão
Label the parts of the GI arterial vasculature. (max amnt words for any answr is 3)
Responda
-
abdominal aorta
-
celiac artery
-
splenic artery
-
left gastric artery
-
Superior Posterior Pancreatoduodenal
-
Superior Anterior Pancreatoduodenal
-
Superior pancreatoduodenal artery
-
Right gastroepiploic artery
-
common hepatic artery
-
Hepatic artery proper
-
Right gastric artery
-
Gastroduodenal artery
Questão 46
Questão
Which comes first in the development of a carcinoma?
Responda
-
metaplasia
-
dysplasia
Questão 47
Questão
[blank_start]Metaplasia[blank_end] is the reversible change of one cell type to another
[blank_start]Dysplasia[blank_end] is abnormal changes in the cell and disorganized [blank_start]growth[blank_end]
Carcinoma is the eventual transformation into malignant [blank_start]neoplastic[blank_end] cells.
Responda
-
Metaplasia
-
growth
-
Dysplasia
-
neoplastic
Questão 48
Questão
[blank_start]Barrett’s[blank_end] [blank_start]Esophagus[blank_end] is a pre-malignant condition of the lower esophagus. This happens when the [blank_start]squamous[blank_end] cells go through metaplasia and become [blank_start]columnar[blank_end] cells. This change usually happens as defence against an [blank_start]acidic[blank_end] environment, which may be due to conditions like [blank_start]GERD[blank_end]. This condition puts the patient of increased risk of esophageal [blank_start]adenocarcinoma[blank_end].
Responda
-
Barrett’s
-
Esophagus
-
squamous
-
columnar
-
acidic
-
GERD, GORD
-
adenocarcinoma
Questão 49
Questão
The management of Barret's Esophagus is to do a [blank_start]biopsy[blank_end].
Premalignant changes are indicative of high-grade [blank_start]dysplasia[blank_end]. The treatment for this in younger and more fit individuals is an [blank_start]esophageal[blank_end] [blank_start]resection[blank_end]. For others, it's [blank_start]mucosal[blank_end] [blank_start]ablation[blank_end].
If there are no premalignant channges, the patient will have regular [blank_start]endoscopy[blank_end], biopsy, and other anti-reflux measures, including long term [blank_start]proton[blank_end] [blank_start]pump[blank_end] [blank_start]inhibitors[blank_end] (drugs).
Responda
-
endoscopy
-
proton
-
pump
-
inhibitors
-
dysplasia
-
esophageal
-
resection
-
ablation
-
mucosal
-
biopsy
Questão 50
Questão
What is true regarding esophageal carcinoma?
Responda
-
symptom: vomiting
-
symptom: weight loss
-
symptom: anorexia
-
presentation: progressive dysphagia
-
investigation: chest xray
-
investigation: urgent endoscopy + biopsy
-
investigation: CT or MRI chest and upper abdomen
-
symptom: hoarse voice
-
symptom: excessive acid reflux
-
investigation: neck ultrasound
Questão 51
Questão
The stomach has 2 muscle layers: inner oblique and outer longitudinal
Responda
- True
- False
Questão 52
Questão
The stomach is lined by simple squamous epithelial cells
Responda
- True
- False
Questão 53
Questão
What controls the secretion of gastric acid?
Responda
-
the parasympathetic nervous system
-
gastrin
-
histamine
-
PGE2
-
PGI2
-
pepsinogen concentration
-
gut bacteria
Questão 54
Questão
Prostaglandins increase acid secretion
Responda
- True
- False
Questão 55
Questão
A side effect of NSAIDs is peptic ulcers.
Responda
- True
- False
Questão 56
Questão
Which of these are considered GI drugs?
Responda
-
proton pump inhibitors
-
histamine receptors
-
synthetic prostaglandins
-
antacids
-
amoxicillin
-
metronidazole
-
clarithromycin
-
calcium channel blockers
-
beta blockers
-
pepto bismol
Questão 57
Questão
Fill in which drugs go into which parts of the cycle to help with acid control:
Responda
-
histamine
-
prostaglandin analogues
-
muscarinic acetylcholine
-
proton pump inhibitors
-
gastrin receptor
Questão 58
Questão
What is not a sign of dyspepsia?
Responda
-
epigastric pain
-
bloating
-
heartburn
-
burning sensation during defecation
Questão 59
Questão
Worrying symptoms of dyspepsia:
A [blank_start]anemia[blank_end]
L loss of weight
A [blank_start]anorexia[blank_end]
R recent [blank_start]progressive[blank_end] [blank_start]symptoms[blank_end]
M [blank_start]melena[blank_end] (tarry feces) and [blank_start]hematemesis[blank_end]
S wallowing difficulty
Responda
-
anemia
-
anorexia
-
progressive
-
symptoms
-
melena
-
hematemesis
Questão 60
Questão
What are ways to manage dyspepsia?
Responda
-
simple antacids for 4 weeks
-
test for H. Pylori and eliminate if possible
-
Proton pump inhibitors for 4 weeks
-
urgent endoscopy
-
biopsy
-
blood works
Questão 61
Questão
Label the different types of hiatus hernias
Responda
-
sliding
-
rolling
Questão 62
Questão
Barium swallow via fluoroscopy is how one is able to diagnose a hiatus hernia.
Responda
- True
- False
Questão 63
Questão
What is true regarding peptic ulcers?
Responda
-
include duodenal ulcers
-
include gastric ulcers
-
complication: hemorrhage
-
complication: ulcer perforation
-
complication: malignancy (tumor)
-
include jejunal ulcers
-
gastric ulcers > common than duodenal ulcers
Questão 64
Questão
What is true regarding duodenal ulcers?
Responda
-
epigastric tenderness
-
epigastric pain before meals
-
relief via milk
-
epigastric pain better at night
-
relief via lemon soda
Questão 65
Questão
Gastric ulcers:
- happens mainly in [blank_start]elderly[blank_end]
- [blank_start]epigastric[blank_end] pain (dependent on [blank_start]meals[blank_end] and can be relieved by antacids)
- weight gain or loss
Responda
-
elderly
-
epigastric
-
meals
Questão 66
Questão
What is this sign and what is indicative of?
Responda
-
Virchow's node
-
gastric cancer
Questão 67
Questão
What is true regarding zollinger-ellison syndrome?
Responda
-
gastrinoma--> peptic ulcer
-
usually in duodenum
-
usually in pancreas
-
investigation: endoscopy
-
investigation: very high fasting and then serum gastrin level investigation
-
investigation: biopsy
-
management: surgery
-
management: proton pump inhibitors
-
management: antacids
-
usually in ileum
Questão 68
Questão
iron is absorbed in the jejunum.
Responda
- True
- False
Questão 69
Questão
[blank_start]Celiac[blank_end] [blank_start]disease[blank_end] is an inflammation of the proximal small intestine mucosa in response to dietary gluten.
It is Hypersensitivity [blank_start]IV[blank_end]. It is a disease of the small intestines in which [blank_start]prolamin[blank_end] [blank_start]intolerance[blank_end] causes villous atrophy and [blank_start]malabsorption[blank_end].
Responda
-
Celiac
-
disease
-
IV
-
prolamin
-
intolerance
-
malabsorption
Questão 70
Questão
What are symptoms of Celiac's Disease?
Responda
-
diarrhea
-
malaise
-
abdominal discomfort
-
iron deficiency anemia
-
weight loss
-
steatorrhea
-
weariness
-
concentrated pain
-
bursts of energy
Questão 71
Questão
Celiac disease makes you at more risk of colon cancer and lymphoma.
Responda
- True
- False
Questão 72
Questão
Crohn's Disease treatment is a gluten free diet and necessary vitamin supplements.
Responda
- True
- False
Questão 73
Questão
Which of the following is not a way to diagnose Celiac's disease?
Responda
-
duodenal biopsy via endoscopy
-
blood test: abnormally high levels of IgA endomysial
-
blood test: if anti-tissue transglutaminase antibodies are found
-
abdominal x-ray
Questão 74
Questão
What is true regarding diverticulitis?
Responda
-
only in relation to the large intestine
-
inflammation of colon's diverticulae
-
more common in elderly patients
-
more common in those chronically constipated
-
more common in women
-
more common in those with acute constipation
-
commonly associated with anal fissures
Questão 75
Questão
Which are symptoms of diverticulitis?
Responda
-
lower left quadrant pain
-
lower left quadrant tenderness
-
fever
-
tenesmsus
-
diarrhea
-
constipation
Questão 76
Questão
How can you investigate for diverticulitis?
Responda
-
barium enema
-
colonoscopy
-
CT colonogram
-
rectal biopsy
Questão 77
Questão
Treatment of diverticulitis:
mild:
at home with [blank_start]paracetamol[blank_end], fluids, and [blank_start]oral[blank_end] [blank_start]antibiotics[blank_end].
severe or ill patients:
admission to hospital (cannot manage [blank_start]pain[blank_end], problems with [blank_start]dehydration[blank_end], [blank_start]frail[blank_end])
Responda
-
paracetamol
-
antibiotics
-
oral
-
pain
-
dehydration
-
frail
Questão 78
Questão
What are these two colon related conditions?
Responda
-
diverticulitis
-
diverticulosis
Questão 79
Questão
Which conditions make up inflammatory bowel disease?
Responda
-
Crohn's disease
-
Celiac's disease
-
Ulcerative Colitis
-
Diverticulitis
-
Peptic Ulcers
Questão 80
Questão
[blank_start]Crohn’s[blank_end] is a chronic inflammatory bowel disease affecting all layers of the GI tract ([blank_start]transmural[blank_end]). Its key characteristic is [blank_start]skip[blank_end] [blank_start]lesions[blank_end], and on a colonscopy there is a “[blank_start]cobblestone[blank_end] [blank_start]appearance[blank_end]." ANY part of the GI tract but most commonly the [blank_start]terminal[blank_end] [blank_start]ileum[blank_end] (can cause [blank_start]vitamin[blank_end] [blank_start]B12[blank_end] deficiency).
Responda
-
Crohn’s, Crohn's Disease
-
transmural
-
skip
-
lesions
-
cobblestone
-
appearance
-
terminal
-
ileum
-
B12
-
vitamin
Questão 81
Questão
What are symptoms of Crohn's Disease?
Responda
-
diarrhea
-
abdominal pain
-
right lower quadrant mass
-
perianal disease
-
mouth ulcers
-
extra-intestinal manifestations
-
pale and bulky stools
-
right lower quadrant pain
Questão 82
Questão
What is not an investigation for Crohn's Disease?
Responda
-
stool sample
-
colonscopy and biopsy
-
endoscopy and biopsy
-
Blood: CRP/ESR
-
Blood: FBC
-
Blood: LFTs
-
Blood: B12
-
Blood: ferritin
-
Barium swallow
Questão 83
Questão
Management of Crohn Disease attacks:
Mild attacks: [blank_start]Prednisolone[blank_end]
Severe attacks: IV [blank_start]steroids[blank_end], nil by mouth, and IV [blank_start]hydration[blank_end].
Responda
-
Prednisolone
-
steroids
-
hydration
Questão 84
Questão
Label the parts of the biliary tree?
Responda
-
liver
-
right hepatic tree
-
left hepatic duct
-
common hepatic duct
-
common bile duct
-
pancreatic
-
pancreatic duct
-
duodenum
-
sphincter of Oddi
-
cystic duct
-
gallbladder
Questão 85
Questão
Bile is produced by [blank_start]hepatocytes[blank_end] and is stored in the [blank_start]gallbladder[blank_end]. Bile [blank_start]emulsifies[blank_end] the fat and allows fat absorption in [blank_start]enterocytes[blank_end]. An example of fat soluble vitamins: [blank_start]ADEK[blank_end]
Responda
-
hepatocytes
-
gallbladder
-
emulsifies
-
enterocytes
-
ADEK
Questão 86
Questão
An [blank_start]enterogastrone[blank_end] is any hormone secreted by the [blank_start]duodenum[blank_end] mucosa in response to dietary lipids that inhibits the caudal (or "forward, analward") motion of the contents of [blank_start]chyme[blank_end].
Responda
-
enterogastrone
-
duodenum
-
chyme
Questão 87
Questão
Relapsing inflammatory disorder of [blank_start]colonic[blank_end] mucosa which usually begins in the [blank_start]rectum[blank_end] and doesn’t spread past the [blank_start]ileocaecal[blank_end] valve is ulcerative colitis. This inflammation is not [blank_start]transmural[blank_end] and is [blank_start]continous[blank_end].
Responda
-
colonic
-
rectum
-
ileocaecal
-
transmural
-
continous
Questão 88
Questão
What is true regarding ulcerative colitis?
Responda
-
bloody diarrhea
-
abdominal pain
-
tenesmus
-
bathroom urgency
-
malaise
-
weight loss
-
extra-intestinal features
-
pale and bulky stool
-
dehydration
Questão 89
Questão
Which is not a way to investigate for ulcerative colitis?
Responda
-
FBC
-
liver function tests
-
urea and electrolytes profile
-
erythrocyte sedimentation rate
-
c reactive protein
-
ferritin
-
B12
-
folate
-
histamine
Questão 90
Questão
You can investigat for ulcerative colitis via sigmoidscopy or colonoscopy.
Responda
- True
- False
Questão 91
Questão
Management of Ulcerative Colitis:
[blank_start]Mesalazine[blank_end] (also known as 5-aminosalicylate) and steroids (such as [blank_start]prednisolone[blank_end]) to induce remission.
Surgery ([blank_start]colectomy[blank_end] for those non-responsive to drugs)
Mesalazine to maintain remission.
Responda
-
Mesalazine
-
colectomy
-
prednisolone
Questão 92
Questão
Pancreatic secretions are controlled by the [blank_start]parasympathetic[blank_end] nervous system.
[blank_start]Secretin[blank_end] in response to H+ in the duodenum causes the pancreas to secrete [blank_start]bicarbonate[blank_end].
In response to [blank_start]fats[blank_end] and [blank_start]amino[blank_end] [blank_start]acids[blank_end] in the duodenum, the pancreas releases CCK cholecystokinin (CCK). CCK also causes [blank_start]gallbladder[blank_end] contractions.
These proteolytic enzymes are released inactively as [blank_start]zymogens[blank_end] to protect the pancreatic tissue from being destroyed.
Responda
-
parasympathetic
-
Secretin
-
bicarbonate
-
gallbladder
-
fats
-
amino
-
acids
-
zymogens
Questão 93
Questão
Which of these are pancreatic enzymes?
Responda
-
trypsinogen
-
chymotripsinogen
-
procarboxypeptidase
-
pancreatic amylase
-
pancreatic lipase
-
gastrin
-
pepsinogen
Questão 94
Questão
pancreatic enzymes:
trypsin, chymotrypsin, carboxypeptidase: act on [blank_start]proteins[blank_end]
pancreatic lipase acts on [blank_start]fat[blank_end]
pancreatic amylase acts on [blank_start]carbohydrates[blank_end]
ribonucleoase/deoyribonuclease acts on nucleic acids
Responda
-
proteins
-
fat
-
carbohydrates
Questão 95
Questão
What are examples of tumor markers?
Responda
-
CEA
-
alpha fetoprotein (aFP)
-
CA 1999
-
beta HCG
-
Ca 125
-
BRCA 2
-
Ca 187
Questão 96
Questão
Tumor suppressor genes cause tumors to actually progress.
Responda
- True
- False
Questão 97
Questão
p53 is a tumor suppressor gene that is important because it can trigger apoptosis.
Responda
- True
- False
Questão 98
Questão
What is the condition that describes a type of pain related to the gallbladder that occurs when a gallstone temporarily obstructs the cystic duct and the gallbladder contracts?
Responda
-
Biliary Colic
-
Cholangitis
-
Cholecystitis
-
Courvoisier's syndrome
Questão 99
Questão
What is true regarding biliary colic?
Responda
-
goldstone investigation: ultrasound of right upper quadrant
-
manage: analgesia
-
manage: rehydrate
-
medication given via orally
-
manage: elective cholecystectomy
-
nausea and vomiting
-
indigestion symptoms
-
pain after a fatty meal
-
right upper quadrant pain which radiates
-
acid reflux
Questão 100
Questão
[blank_start]Acute[blank_end] cholecystitis:
Due to stone impaction in the gallbladder neck
Symptoms:
Continuous [blank_start]RUQ[blank_end] pain or [blank_start]Epigastric[blank_end] pain which radiates to the right shoulder
[blank_start]vomiting[blank_end]
fever
Investigation: [blank_start]Ultrasound[blank_end]
Treatment: Nil by mouth: analgesia; antibiotics; and [blank_start]cholecystectomy[blank_end]
Responda
-
Acute
-
RUQ
-
Epigastric
-
vomiting
-
Ultrasound
-
cholecystectomy
Questão 101
Questão
[blank_start]Chronic[blank_end] cholecystitis:
Stones cause chronic inflammation of gallbladder +/- [blank_start]colic[blank_end] inflammation
Symptoms:
Abdomen discomfort
[blank_start]distension[blank_end]
nausea
[blank_start]flatulence[blank_end]
fat intolerance
Investigation: [blank_start]Ultrasound[blank_end]
Treatment: [blank_start]cholecystectomy[blank_end]
Responda
-
Chronic
-
colic
-
distension
-
Ultrasound
-
cholecystectomy
-
flatulence
Questão 102
Questão
Courvoisier's law is that the possible malignancy of the [blank_start]gallbladder[blank_end]/[blank_start]pancreas[blank_end], such as swelling, is not probably due to [blank_start]gallstones[blank_end].
Responda
-
gallbladder
-
pancreas
-
gallstones
Questão 103
Questão
What is not true regarding cholangitis?
Responda
-
inflammation of the common bile duct due to gall stones obstruction
-
investigation: ERCP
-
Charcot's triad
-
investigation: ultrasound
Questão 104
Questão
Pancreatitis is due to injuries that lead to autodigestion of the pancreas by its own [blank_start]enzymes[blank_end].
[blank_start]Acute[blank_end] pancreatitis is characterized by reversible pancreatic [blank_start]parenchymal[blank_end] injury associated with inflammation. [blank_start]Biliary[blank_end] [blank_start]tract[blank_end] disease and alcoholism account for approximately 80% of cases of [blank_start]acute[blank_end] pancreatitis in Western countries.
[blank_start]Chronic[blank_end] pancreatitis is defined as prolonged inflammation of the pancreas associated with irreversible destruction of [blank_start]exocrine[blank_end] parenchyma, [blank_start]fibrosis[blank_end], and, in the late stages, the destruction of [blank_start]endocrine[blank_end] parenchyma. The most common cause of [blank_start]chronic[blank_end] pancreatitis by far is long-term [blank_start]alcohol[blank_end] abuse
Responda
-
enzymes
-
Acute
-
Chronic
-
parenchymal
-
tract
-
Biliary
-
acute
-
chronic
-
alcohol
-
exocrine
-
endocrine
-
fibrosis
Questão 105
Questão
What is NOT true regarding pseudocyst?
Responda
-
most common complication of pancreatitis
-
is the accumulation n of fluid within and around the pancreatic tissue.
-
trtment: drainage of fluid into stomach's lumen
-
investigation: type II MRI
Questão 106
Questão
Which of these can cause chronic pancreatitis?
Responda
-
alcohol
-
cystic fibrosis
-
hemochromastosis
-
pancreatic duct obstruction
-
renal failure
-
liver disease
-
obesity
Questão 107
Questão
Ultrasound and CT to check for pancreatic calcifications is how to investigate for chronic pancreatitis.
Responda
- True
- False
Questão 108
Questão
What are symptoms of chronic pancreatitis?
Responda
-
epigastric pain radiating to the back
-
epigastric pain is less when sitting forward
-
epigastric pain is less with hot water bottles
-
bloating
-
weight loss
-
brittle diabetes
-
steatorrhea
-
manage: lipase and fat soluble vitamins
-
manage: low fat diet
-
manage: surgery
Questão 109
Questão
CAUSES for acute pancreatitis:
GET SMASHED:
[blank_start]Gallstones[blank_end] (38%)
[blank_start]Ethanol[blank_end] (35%)
[blank_start]Trauma[blank_end] (1.5%)
[blank_start]Steroids[blank_end]
[blank_start]Mumps[blank_end]
[blank_start]Autoimmune[blank_end]
Scorpion venom
Hyperlipidaemia/[blank_start]hypothermia[blank_end]/ hypercalcaemia
[blank_start]ERCP[blank_end] and emboli
Drugs.
Responda
-
Gallstones
-
Ethanol
-
Trauma
-
Steroids
-
Autoimmune
-
Mumps
-
hypothermia
-
ERCP
Questão 110
Questão
What are the signs and symptoms of acute pancfdatitis?
Responda
-
tachycardia
-
fever
-
jaundice
-
Cullen's sign
-
Gray Turner's sign
-
gradual epigastric pain
-
severe epigastric man
-
vomiting
-
central abdominal pain which radiates to the back
-
investigation: dropped serum levels of amylase
Questão 111
Responda
-
cullen's sign
-
turner's sign
Questão 112
Questão
Serum lipase is the most reliable investigating factor for pancreatitis.
Responda
- True
- False
Questão 113
Questão
Management of acute pancreatitis:
Nil by mouth: [blank_start]analgesia[blank_end]
[blank_start]ERCP[blank_end] + [blank_start]gallstone[blank_end] [blank_start]removal[blank_end] may be needed if progressive jaundice.
Responda
-
analgesia
-
ERCP
-
gallstone
-
removal
Questão 114
Questão
Those at an increased risk of developing cancer often are born with one defective copy of a [blank_start]tumor[blank_end] [blank_start]suppressor[blank_end] gene.
Responda
-
tumor
-
suppressor
Questão 115
Questão
An oncogene is when a proto-oncogene becomes mutated.
Responda
- True
- False
Questão 116
Questão
Oncogenes cause uncontrolled tumor growth.
Responda
- True
- False
Questão 117
Questão
Appendicitis:
presentation:
[blank_start]Fever[blank_end]
RLQ pain or [blank_start]umbulical[blank_end] pain
nausea
vomiting
KEY: loss of appetite
investigation: [blank_start]Xray[blank_end]
Responda
-
Xray, x-ray
-
umbulical
-
Fever
Questão 118
Questão
How does ischemic bowel NOT present?
Responda
-
severe abdominal pain
-
tachycardia + hypotension
-
raised leukocyte count
-
fever intervals
Questão 119
Questão
Murphy's sign is for acute cholecystitis.
Murphy's sign is that on palpation of the RUQ, patient stops inspiration for a moment.
Responda
- True
- False
Quer criar seus próprios Quizzes gratuitos com a GoConqr? Saiba mais.