Meckel's diverticulum most commonly presents as:
A. Gastrointestinal bleeding.
B. Obstruction.
C. Diverticulitis.
D. Intermittent abdominal pain.
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All of the following statements about the embryology of Meckel's diverticulum are true except:
A. Meckel's diverticulum usually arises from the ileum within 90 cm. of the ileocecal valve.
B. Meckel's diverticulum results from the failure of the vitelline duct to obliterate.
C. The incidence of Meckel's diverticulum in the general population is 5%.
D. Meckel's diverticulum is a true diverticulum possessing all layers of the intestinal wall.
Patients with established, complete, simple, distal small bowel obstruction usually have the following findings on plain and upright abdominal radiographs:
A. Distended small bowel identifiable by the valvulae conniventes.
B. Multiple air-fluid levels.
C. Modest amount of gas in the pelvis.
D. Peripheral, rather than central, distribution of gas.
E. Prominent haustral markings.
F. Free air.
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History and physical examination permit the diagnosis of intestinal obstruction in most cases. Which of the following are important for the clinical diagnosis of small bowel obstruction?
A. Crampy abdominal pain.
B. Fever.
C. Vomiting.
D. Abdominal distention.
E. Leukocyte count above 12,000.
F. Abdominal tenderness.
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Complete mechanical small bowel obstruction can cause dehydration by:
A. Interfering with oral intake of water.
B. Inducing vomiting.
C. Decreasing intestinal absorption of water.
D. Causing secretion of water into the intestinal lumen.
E. Causing edema of the intestinal wall.
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Which of these statements about the digestion of fat are true?
A. Micellar solution provides an optimal environment for the action of pancreatic lipase.
B. Decreasing the pH below 5.5 increases the effectiveness of pancreatic lipase in hydrolyzing fat.
C. Co-lipase blocks triglyceride hydrolysis.
D. Lipase catalyzes the hydrolysis of dietary triglyceride into 2-monoglyceride and fatty acids.
Which of the following statements about carbohydrate digestion are true?
A. Amylopectin has 1-4 straight chains and 1-6 side chains.
B. Amylase has 1-4 straight chains and 1-6 side chains.
C. Amylase breaks 1-4 glucose linkages.
D. Amylase breaks 1-6 side chains.
E. An adult may ingest about 350 gm. of carbohydrate daily.
F. Dietary starch contains two glucose polymers, amylopectin and amylase.
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The intestinal epithelial cells, 22 to 26 mm. tall, exhibit a striated luminal border (brush border). The brush border microvilli:
A. Produce the brush border appearance.
B. Contain amylase.
C. Contain dissacharidases.
D. Increase absorptive area.
E. Play an important role in digestion.
F. Contain trypsinogen.
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The lamina propria between the intestinal epithelium and the muscularis mucosae contains:
A. Blood and lymph vessels.
B. Undifferentiated epithelial cells.
C. Nerve fibers.
D. Enterochromaffin cells.
E. Macrophages.
F. Connective tissue.
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Vigorous bleeding from a small bowel lesion is most likely caused by:
A. Adenocarcinoma.
B. Arteriovenous malformation.
C. Leiomyoma.
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The most common site of adenocarcinoma of the small intestine is the:
A. Duodenum.
B. Jejunum.
C. Ileum.
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The most common benign tumor of the small intestine is:
A. Adenoma.
B. Hemangioma.
C. Leiomyoma.
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In a patient with gastroparesis, what measure is most useful in treating chemotherapy-induced vomiting?
a) prochlorperazine
b) Serotonin (5-HT3) receptor antagonists
c) erythromycin
d) oral botulinum toxin
e) Gastric electric stimulation
Answer
Tags: MCQS, Gastroenterology, Gastroparesis
In the treatment of vomiting in a patient with gastroparesis, what measure acts on the central antidopaminergic mechanism in the area postrema of the brain ?
a) prochlorperazine
b) Serotonin (5-HT3) receptor antagonists
c) erythromycin
d) oral botulinum toxin
e) Gastric electric stimulation
Answer
Tags: MCQS, Gastroenterology, Gastroparesis
6 months ago a 36 year old plumber was prescribed cimetidine for his peptic ulcers. Now he presents to his general practitioner because of he has had repeated episodes of diarrhoea where his stools failed to flush away properly. On questioning , he admits that the drug treatment is 'not doing me any good' and he still suffers from severe heart burn. Which of the following syndromes should the physician now be suspecting?
a) Sjorgen's syndrome
The Following have been shown to trigger Irritable Bowel Syndrome except
A. Metronidazole.
B. Wheat bran.
C. Milk.
D. Nystatin.
E. Stress.
Answer
Tags: MCQ, Gastroenterology, Irritable Bowel Syndrome, IBS
A 27-year-old man with a history of IV drug use was found to have abnormal liver function tests
Further work-up including serologic tests for viral hepatitis show
Hepatitis B surface antibody (HBsAb) negative
Hepatitis B surface antigen (HBsAg) positive
Hepatitis core antibody (HBcAb) positive
Hepatitis B surface antibody (HBsAb) negative
Hepatitis B e antibody (HBeAb) positive
Hepatitis B e antigen (HBeAg) negative
A 23-year-old woman experienced watery diarrhea, nausea, vomiting, and abdominal cramps 6 hours after eating a salad and a hamburger in a local restaurant. The most likely organism causing her disease is
A. Vibrio vulnificus
B. Listeria monocytogenes
C. Yersinia enterocolitica
D. Clostridium welchii
E. Staphylococcus aureus
Answer
Tags: MCQ, Gastroenterology, Food Poisoning
A 35-year-old man presents with diarrhea for 10 days, characterized by frequent, low-volume stools with the presence of mucus. He also complained of subjective fever and lower abdominal pain. The presence of leukocytes in stool is consistent with which organism?
a. Clostridium perfringens
b. S. aureus
c. Giardia lamblia
d. Enterobius vermicularis
e. Entamoeba histolytica
Answer
Tags: MCQ, Gastroenterology, Diarrhea
Acetaminophen is an important cause of acute hepatic failure. All of the following statements about acetaminophen toxicity are correct, except
A. Significant liver injury usually occurs with doses of more than 10 - 15 g.
B. Alcoholics are more susceptible to liver injury even with a low dose.
C. N-acetylcysteine is most effective when administered within 10 hours of ingestion.
D. Hemodialysis is effective in the management of hepatotoxicity.
Which statement about esophageal cancer is true?
A. Dysphagia is an early manifestation.
B. The most common type of esophageal cancer in the United States is adenocarcinoma.
C. Esophageal cancer is most commonly located in the proximal third of the esophagus.
D. Most esophageal cancers are not resectable at presentation.
E. Barrett's syndrome is associated with squamous carcinoma.
Answer
Tags: MCQ, Gastroenterology, Oesophagus, Esophagus
A 42-year-old man presents with intermittent dysphagia to solids and liquids and regurgitation of food. He has lost 4 pounds in 2 months. His physical exam is normal. A barium swallow reveals a dilated esophageal body, with the distal esophagus terminating in a narrow end. Which one of the following options is the most appropriate long-term therapy?
A. Isosorbide dinitrate
B. Metoclopramide
C. Dilation with balloon
D. Nifedipine
E. Dilation with rubber tube (bougie)
Answer
Tags: MCQ, Pharmacology, Achalasia
A 45-year-old male executive comes to your office complaining of epigastric pain for 2 months. His primary physician prescribed him H2-blockers 3 weeks ago, which have produced only partial relief of his symptoms. His weight is stable. His physical exam is normal. An upper endoscopy reveals a 1-cm duodenal ulcer. Which of the following risk factors is not associated with the development of ulcer disease?
A. Daily use of nonsteroidal anti-inflammatory drugs (NSAIDs)
A 20-year-old white woman presents with jaundice and malaise of 2 weeks' duration. Her boyfriend had some form of hepatitis several months before. Initial laboratory studies reveal alanine transaminase (ALT) of 211 U/L, aspartate transaminase (AST) of 194 U/L, and bilirubin of 5.4 mg/dL. HBsAg and anti-HBc IgM are positive. Which of the following statements regarding acute hepatitis B is false?
A. About 90% of patients with acute hepatitis B will recover completely.
A 51-year-old woman presents with abdominal pain, weight loss, early satiety, and night sweats. On physical exam she appears cachectic, multiple enlarged lymph nodes are present in her neck (supraclavicular area), and a mass is palpated in the epigastrium. Laboratory data reveal a hemoglobin of 8 g/dL and a normal WBC count. Which of the following is the most appropriate next step in establishing the diagnosis?
A. Upper GI series
B. Peripheral blood smear
Which of the following features best distinguishes Crohn's disease from ulcerative colitis?
A. Oral ulcers
B. Rectal bleeding
C. Continuous colonic involvement on endoscopy
D. Noncaseating granulomas
E. Crypt abscesses
Answer
Tags: MCQ, Gastroenterology, Crohn's, Ulcerative Colitis
