Quiz: another exam

which blood group is associated with an increased risk of gastric cancer ?

A A. B B C AB D O

which of the following statements regarding the etiology of obstructive jaundice is true ?

A A markedly elevated SGOT an SGPT are usually associated with obstructive jaundice B When extra-hepatic biliary obstruction is suspected, the first tests should be endoscopic ultrasonography (EUS). C A Klatskin tumor will result in extra-hepatic ductal dilation only. D Carcinoma of the head of the pancreas can cause deep epigastric or back pain in as many as 80% of patients.

All of The Following are consecunces of Cholestasis except :

A Defeciency of VIT A,D and K B Dark colored stools C Fat Mal absorbtion D ntense Puritis

The Incubation Period Of Hepatits B is

A 2-6 days B 2-6 weeks C 2-6 months D None of the Above

42-year-old male has elevated liver enzymes discovered accidentally on routine check up with the following laboratorytest results: serum bilirubin, total 1 mg/dL anddirect 0.2 mg/dL; serum alkaline phosphatase,500 U/L; serum aspartate aminotransferase(AST) 55 U/L and alanine aminotransferase(ALT) 48 U/L, viral markers were negative, ANA, and SMA were negative and pANCA positive. What is the most likelydiagnosis?

A Gilbert’s syndrome B Dubin-Johnson syndrome C autoimmune hepatitis D Primary sclerosing cholangitis

A 25yearold female currently presented with secondary amenorrhoea presents On examination she had jaundiced, spider naevi are present along with tender hepatomegaly. Blood tests show: elevated liver enzymes AST 115 U/L and alanine aminotransferase(ALT) 148 U/L, viral markers were negative, AMA was negative, ANA, and SMA were positive and pANCA negarive. What is the most appropriate treatment?

A Sorafenib B Ursodeoxycholic acid C Corticosteroid D Methotrexate

Which of the following is false of Primary sclerosing cholangitis?

A Occurs predominantly in males B Is a risk factor for cholangiocarcinoma. C Occurs in 50% patients with crohn’s disease D Has been treated with ursodeoxycholic acid.

Tumors of the pancreas include the following except

A Cystadenoma B Gastrinoma C Insulinoma D Glucagonoma

A 30-year-old woman has a new diagnosis of Autoimmune hepatitis confirmed by liver biopsy. The first choice for single-drug therapy for this patient would be which of the following?

A Prednisone B Azathioprine C Cyclosporine D UDCA

A 54-year-old man comes to the gastroenterology clinic for follow up of his ulcerative colitis. Over the past few months he has lethargy, intense itching. On examination He has jaundice, and some scratch marks, predominantly on his arms. The rest of the physical examination was unremarkable. AST (44 U/L) , ALT (48 U/L) serum alkaline phosphatase,404 U/L. ANA and SMA negative and AMA negative. What is the most likelydiagnosis?

A Autoimmune hepatitis B Wilson disease C T.B cholangitis D Primary sclerosing cholangitis

The typical features of liver cirrhosis include: EXCEPT

A Asmall shrunken liver B Painfull splenomegaly C Central cyanosis D Parotid gland enlargement

Hepatic encephalopathy may be precipitated by the following except

A Massive paracentesis B Sepsis C Gastrointestinal bleeding D Fruit intake

Causesof marked ALT elevation include the following except

A Paracetamol toxicity B Ischemic hepatitis C Cocaine poisoning D Chronic HCV infection

ObstructiveCauses of Acute Pancreatitis NOT includes

A Choledochocele B Pancreas divisum C Parasites (Toxoplasma, Cryptosporidium D Parasites(Ascaris lumbricoides)

Which of the following not a Mucosal Small-Intestine Disease:

A Celiac sprue B Crohn disease C Pancreatic insufficiency D Mastocytosis

The most common site of Colonic diverticulosis is

A Rectum B Sigmoid C Descending colon D Ascending colon

Which of the following not a features of acute (fulminant) liver failure

A Onset within 8 weeks of initial illness. B Hepatosplenomegaly and ascites. C Encephalopathy D Cerebral oedema without papilloedema.

Complications of GERD in infants include the following. EXCEPT

A Iron deficiency anemia B Aspiration pneumonia C Metabolic acidosis D Esophageal strictures

f total colectomy is not done in Familial adenomatous polyposis of the colon, it turns malignancy in

A 25% of the patients B 50% of the patients C 60% of the patients D 100% of the patients

The most accurate diagnosis test for Zollinger Ellison syndrome is

A Fasting serum gastrin B Computed tomography scan C Endoscopy D Secretin stimulation test

The following is true of Crohn's disease:

A The rectum is not always affected. B Less Commonly affects the terminal ileum C More common than ulcerative colitis D Can result in vitamin B12 deficiency

Laparoscopic cholecystectomy is indicated for symptomatic gallstones in which of the following conditions ?

A Cirrhosis B Prior upper abdominal surgery. C Suspected carcinoma of the gallbladder D Morbid obesity.

which blood group is associated with an increased risk of gastric cancer ?

A A B B C AB D O

The typical features of liver cirrhosis include: EXCEPT

A Asmall shrunken liver B Painfull splenomegaly C Central cyanosis D Parotid gland enlargement

A 9-years old child comes to the emergency room with a fulminant upper gastro-intestinal bleeding . the hemorrhage is most likely to be the result of :

A Esophageal varices. B Mallory- Weiss syndrome C Gastritis D gastric ulcer

The most common cause of recurrent abdominal pain in children is

A Renal stone B Familial Mediterranean fever C Intestinal parasites D Inflammatory bowel diseases

10 day old male presents with billousemesis. What is the most likely diagnosis?

A Appendicitis B Pyloric stenosis C Malrotation with midgut volvulus D Feeding intolerance

Which of the following tends to cause bloody diarrhea?

A Cholera B Enter-toxigenic E. coli C Shigella D Rota virus

Which of the following statements most accurately describes the current therapy for pyogenic hepatic abscess ?

A Antibiotics alone are adequate for the treatment of most caseS B All patients require open surgical drainage for optimal manage. C Optimal treatment involves treatment of not only the abscess but the underlying source as well D Percutaneous drainage is more successful for multiple lesions than for solitary one

Standard supportive measures for patients with mild pancreatitis include the following

A Intra-venous fluid and electrolyte therapy. B With-holding of analgesics to allow serial abdominal examinations C Subcutaneous Octreotide therapy D Naso-gastric decompression

The most appropriate test to confirm a clinical diagnosis of early chronic pancreatitis is which of the following ?

A Serum amylase determination. B Calculation of urinary amylase clearance. C Measurement of para-amino benzoic acid absorption. D Endoscopic retrograde Cholangio-Pancreatography

Painful oral ulcers include:

A Monilial stomatitis B Herpetic gingivostomatitis C Traumatic ulcer of tooth D All of the above

Stricture of colon is a complication of:

A Trichuristrichura B Ascarislumbericoides C Ancylostomaduodenale D Entamebahistolytica

which of the following statements is True about the weight of Human liver?

A 1.30 kg to 1.56 kg. B 1.44 Rg to 1.66 kg. C 1.36 kg to 1.71 kg. D 1.68 kg to 1.86 kg.

which of the following is the function of liver ?

A production of the Bile B Metabolism of fat. C CHO D All of the above

Albumin is the most important protien in Blood stream sorum It is produced By ?

A Heart B lung C liver D Endocrine Glands

where is the liver located in The Human Body?

A Beside Heart B Beside pancreas. C kidney D Above The Abdominal cavity

which of the following vitamins is stored in the liver?

A vitaminA B vitamin D C vitamin E D All of the above

Cirrhosis is a liver Disease Described By The Abnormal Structure and functioning of the liver This mainly Diagnosed By..?

A Blood Test B liver Biopsy C physical Examination D All of the above

The most common Type of incurable viral Hepatitis in US is ?

A Hepatitis A B Hepatitis B C Hepatitis c D Hepatitis D

severe, acute or incurable liver Disease result in ?

A Blood Clotting B production of Blood prot C Estimation of water, Drugs and Toxins from Body D All of the above.

Drinking too much Alcohol over long period of time Result in

A Facialiasis B fatty liver Disease C Alcohol liver Disease D primary sclerosing cholan.

which of the following is not an Example of liver Disease ?

A Facíoliasis B chicken Box. C Fatty Liver Disease D Glibert's syndrome

which of the following statements is True about Human liver ?

A liver is Triangular in shape B only visceral organ hat can Regenerate C The largest and The internal organ of the B D All of the above.

As Consequence of severe liver Damage Hepatic Amino acid Handling is Deranged, in this situation plasma levels of which of the following are likely to be lower than normal..?

A Amania B Alanine C Ammonium D urea

The Typical features of acute fulminant. Hepatic failure include Except ?

A onset within 8 weeks of the intial illness. B Hepatomegaly and Ascites C Encephalopathy and fotor Hepaticus D ausea vomiting and Renal failure. E-cerebral Edema without papilloedema

The Typical features of Hepatic Cirrhosis include Except?

A Small Sunken liver. B painful Splenomegaly C peripheral Blood macrocytosis D Central cyanosis.

The Management of Ascites Due to Hepatic cirrhosis

A The Dietery Na should be Restricted to 140mmoil B paracentesis and Albumin improve survival Rate C The Daily Calorie intake should Restricted to 1500 D The protien intake should be at least 40 g/d unless Encoph

prevention of Recurrent variceal Bleeding is achievable using Except?

A Somatostatins B TIPES C Adrenoreceptors Blockers D Sclerotherapy

which of the following is the most common Cause of upper GI Bleeding.?

A Mallory -weiss Tear B Dieulafoy lesion. C Varicaal Hemmorrhage. D peptic ulcer Disease.

SAAG is > 1.19/di in all Except..?

A TB peritonitis B liver Cirrhosis. C CHF D Budd_chiari Syndrome

which of the following is the most common Symptom on or Sign of Liver Disease..?

A Fatigue B Itching C jaundice D upper quadrant pain.

All of The following statements are True of ascites Except?

A High protein content in ascites is useful in Alcoholic livor Discase. B Ascites Resistant to Diuretics is charactnstic of Hepatic vein Thrombosis. C Ascites Sometimes associated with pleural Effusion D Ascites is a Risk factor for Bact. peritonitis.

A 53 years and man with known Esophageal varices presents with a large GL Bleed what is the first step you should take ?

A urgent cross match B Urgent Endoscopy and Banding C Insert a large Bore Canula and Give fluid D U/S to assess portal vein Thrombosis

A CT scan performed in pt with chronic liver forty Disease has identified a mass lesion suspecious of HCC what is the next investigation you should consid

A MRI B AFP measurement C laparoscopy D liver Biopsy

A45 year and female presents with painful Hepatome and ascites. what imaging finding would you predict..?

A an Irregular liver on CT B Hepatic Artery Thrombosis C Hepatic venous Thrombosis D Isolated Gastric varices.

Elevation in all the following laboratory studios. would Be indicative of liver Disease Except..?

A 5-nucleotidase - Conjugated Bilirubin B AST C Urina Bilirubin D Oun conjugated Bilirubin

A 25 42 year old man with cirrhosis Related to Hepatitis and ascites Requiring frequent volume paracentesis. All the following indicated Except..?

A fluid Resuscitation to Less Than 2 L Daily. B furosemide 40 mg Daily C spironolactone 200 mg Daily. D if medical Therapy fails.

26) A 56 years old pt with cirrhosis presents with massive Hematemesis. Somatostatins, fluids and Bload products are adminsterated and the pt is intubated. Emergency endoscopy Reveals Esophageal varices "Bleeding", The pt Become stable But Still Bleeding. The Most appopriate next step is .. ?

A propranolol B vasopressin C Endoscopic injection Sclerotherapy. D -Endoscopic Band ligation

Three weeks after a meal at a fast food cafe, a 21- year-old man develops malaise, fatigue, and loss of appetite. He notes passing dark urine. On examination, he has scleral icterus and right upper quadrant tenderness. Lab studies show serum AST of 62 U/L and ALT of 58 U/L. The total bilirubin concentration is 3.9 mg/dL, and the direct bilirubin concentration is 2.8 mg/dL. His symptoms aver the next 3 weeks. On returning, he finds tha has n closed by the city's health department. Whish of following serologic test results is most likely o e positive in this patient?

A Anti-HBs B IgM anti-HDV C Anti-HCV D IgM anti-HAV

A 41 -year-old woman who works as a tattoo artist, has had increasing malaise and nausea for 2 weeks. On physical examination, she has icterus and mild right upper quadrant tenderness. Laboratory studies show serum AST of79 U/L. ALT of 85 U/L, total bilirubin of 3.3 mg/dL, and direct bilirubin of mg/dL. She continues to have malaise for the next year. A liver biopsy is undertaken, and the biopsy specimen shows minimal hepatocyte nec old steatosis, and minimal portal bridgin fibrosis infection with which of the following most likely to produce these findings?

A HAV B HBV C HCV D HEV

Seven years ago. a 30-year-old man saw his GP With malaise. fever, and jaundice On examination there were needle tracks in the left antecubital fossa mitral test results were positive tor HBSAg. HBV DNA and •gG anti+1BC He did not return for follow-up_ Two years later, he was sen in ALE with hematemesis and ascites. Test results were similar to those reg»rted earlier. Sclerotherapy to treat esophageal varices Was performed, and he was discharged. He again failed to return for Five years after episc&, he now sees a physician because Of a 5•kg weight loss. worsening pain, and rapid enlargement of the over the examination shows a the follmying lab tests I Physical liver span. Which of kely to diagnostic Of this last phase Of his disease?

A prolonged prothrombin time B Elevated a-fetoprotein level C Elevated serum ALT level D Elevated serum alkaline phosphatase level

A 40-year-old woman wishes to donate to help alleviate the chronic shortage Of She is found to be positive for HBsAg and is as a She feels fine. There are no significant physical findings. Lab findings for total serum bilirubin. AST, ALT. alkaline phosphatase and abumin are normal. Further serologictest results are negative for IgM anti-HAV. anti-HBC. and anti-HCV. Repeat testing 6 months later yields the same results. Which of the following is the most appropriate statement the physician can make to this patient?

A You must have been vaccinated in past for HBV B You win develop clinically overt. Infectious Hepatitis within 1 year C you probably have a chronic carrier state frocn rtical transmission D These test results are probably and to be repeated

E44-year-old woman has increasingly severe generalized pruritus for the past 8 months. Serum levels Of alkaline phosphatase and cholesterol are elevated; antimitochondrial antibody titer is elevated, but ANAS are not present The serum total bilirubin concentration increases_ A liver biopsy is done, and the biopsy shows nonsuppurative. granulomatous destruction ducts. which of the following most likely to produce these findings?

A a1 -Antitrypsin deficiency B Autoimmune hepatitis C Primary biliary cirrhosis D Primary sclerosing cholangitis

A 41 -year-old man has experienced passive fatigue. pruritus, and icterus for several months. On physical examination. he now has generalized jaundice. The abdomen is not distended; on palpation, there is no abdominal pain and no masses. Studies Show a setum alkaline phosphatase level Of 285 1-I/L. with normal transaminases. He is positive ANCA, but Other autoantibody what is most appropriate initial investigation

A MRCP B Liver biopsy C Viral hepatitis screen D Abdominal US

A 31 -year-old woman has increasing malaise for the past 4 months. She has AST and ALT (AST ALT). with mildly raised ALP. Results of testing for HAV, HBV, and HCV are negative. Test resutts for ANA and anti-smooth muscle (ASM) antibody what is most appropriate initial investigation

A Livet biopsy B MRCP C Liver USS D Blood alcohol level

A 54-year-old male presents in A&E with profound hematemesis and a pressure Of 90/60 mmHg which does not to Ouid resuscitation. On examination. you notice dilated veins around his umbilicus and suspect a variceal hemorrhage, secondary to cirrhosis. Which of the following drugs should administered immediately to control bleeding?

A vasopressin B Terlipressin C Propanolol D Bisoprolol

A 63-year-old lady with a BMI of 28 presents to the GP with persistent fatigue and mild right upper quadrant abdominal pain. The GP a set Of routine blood tests which are within normal range apart from her ALT which is mildly raised. What would be the next in the management of this patient?

A Offer lifestyle medication advices to loss of wight and die B Refer for a liver biopsy C perform additional tests such as antibodies (AMR CANCA etc) D Refer to hematologist a for further management

Sign in required