Gastroenterology quiz

1. Quiz - Gastro
Dr.Rohit CK

2. 1
 Which of the following therapies is proven to reduce mortality and morbidity
in bleeding peptic ulcers?
 A. Endoscopic procedures
 B. H2 antagonists
 C. PPIs
 D.Octreotide
 E.Antacids

3.  Which of the following therapies is proven to reduce mortality and morbidity
in bleeding peptic ulcers?
 A. Endoscopic procedures
 B. H2 antagonists
 C. PPIs
 D.Octreotide
 E.Antacids

4. 2.
 Which is not a pre-disposing factor for GERD?
 A. High fatty food intake
 B. Cholinergic drugs
 C. Caffeine
 D. Nicotene
 E. Gastric outlet obstruction

5.  Which is not a pre-disposing factor for GERD?
 A. High fatty food intake
 B. Cholinergic drugs
 C. Caffeine
 D. Nicotene
 E. Gastric outlet obstruction

6. 3.
 Most common cause of peptic ulcer from the following is?
 A. Smoking
 B. NSAIDs
 C. Zollinger Ellison syndrome
 D. Ethanol excess
 E. Family h/o Peptic ulcer disease

7.  Most common cause of peptic ulcer from the following is?
 A. Smoking
 B. NSAIDs
 C. Zollinger Ellison syndrome
 D. Ethanol excess
 E. Family h/o Peptic ulcer disease

8. 4.
 Which of the following suggests a complete large bowel obstruction?
 A. Presence of multiple loops of bowel with plicae circularis on abd Xray.
 B. Bilious vomiting
 C. Distended abdomen, with high pitched bowel sounds with normal flatus
 D. Empty rectum on PR
 E. Dilated loops of bowel with haustra visible

9.  Which of the following suggests a complete large bowel obstruction?
 A. Presence of multiple loops of bowel with plicae circularis on abd Xray.
 B. Bilious vomiting
 C. Distended abdomen, with high pitched bowel sounds with normal flatus
 D. Empty rectum on PR
 E. Dilated loops of bowel with haustra visible

10. 5.
 Which is incorrect regarding inflammatory bowel disease?
 A. The risk of developing ulcerative colitis is higher in non-smokers than
smokers
 B. Patients with Crohn’s disease are more at risk of colorectal cancer than UC
patients
 C. Effectiveness of colonoscopic surveillance in detecting colorectal cancer is
controversial in IBD
 D. Toxic megacolon occurs in Crohn’s and UC
 E. Cobblestone appearance on bowel wall is more characteristic of Crohn’s
disease

11.  Which is incorrect regarding inflammatory bowel disease?
 A. The risk of developing ulcerative colitis is higher in non-smokers than
smokers
 B. Patients with Crohn’s disease are more at risk of colorectal cancer than UC
patients
 C. Effectiveness of colonoscopic surveillance in detecting colorectal cancer is
controversial in IBD
 D. Toxic megacolon occurs in Crohn’s and UC
 E. Cobblestone appearance on bowel wall is more characteristic of Crohn’s
disease

12. 6.
 Which is not a cause of unconjugated hyperbilirubinemia?
 A. Sepsis
 B. Gilberts syndrome
 C. Congestive cardiac failure
 D. Premature neonates
 E. Infectious mononucleosis

13.  Which is not a cause of unconjugated hyperbilirubinemia?
 A. Sepsis
 B. Gilberts syndrome
 C. Congestive cardiac failure
 D. Premature neonates
 E. Infectious mononucleosis

14. 7.
 Which statement regarding spontaneous bacterial peritonitis is incorrect?
 A. The yearly risk with ascites is about 30%
 B. Diagnosis is confirmed by paracentesis with WBC >1000/mm³, and PMN
>250/mm³
 C. Bacteria are rarely grown from ascitic fluid
 D. Most common causative bacteria are anaerobes
 E. Antibiotic choices are Cefotaxime or Ceftriaxone 2gm/day

15.  Which statement regarding spontaneous bacterial peritonitis is correct?
 A. The yearly risk with ascites is about 30%
 B. Diagnosis is confirmed by paracentesis with WBC >1000/mm³, and PMN
>250/mm³
 C. Bacteria are rarely grown from ascitic fluid
 D. Most common causative bacteria are anaerobes
 E. Antibiotic choices are Cefotaxime or Ceftriaxone 2gm/day

16. 8.
 Which is not part of Ransons criteria at initial presentation?
 A. Calcium <1.9mm/L
 B. Age >55yr
 C. WBC > 16,000
 D. LDH > 400IU
 E. Glucose >11mmol/l

17.  Which is not part of Ransons criteria at initial presentation?
 A. Calcium <1.9mm/L
 B. Age >55yr
 C. WBC > 16,000
 D. LDH > 400IU
 E. Glucose >11mmol/l

19. 9.
 In a patient with liver cirrhosis , the recommended diet is
 A. Low protein
 B. High protein
 C. High fat
 D. Low fiber

20.  In a patient with liver cirrhosis , the recommended diet is
 A. Low protein
 B. High protein
 C. High fat
 D. Low fiber

21. 10
 Neuropsychiatric symptoms/signs of hepatic encephalopathy include:
 A. Reverse sleep pattern
 B. Argyll-Robertson pupils
 C. Myelopathy with paraplegia
 D. Diagnostic EEG abnormalities

22.  Neuropsychiatric symptoms/signs of hepatic encephalopathy include:
 A. Reverse sleep pattern
 B. Argyll-Robertson pupils
 C. Myelopathy with paraplegia
 D. Diagnostic EEG abnormalities

23. 11.
 Most common cause of death in acute liver failure is:
 A. Fungal infection
 B. Cerebral edema and brainstem herniation
 C. Electrolyte imbalance
 D. Renal failure

24.  Most common cause of death in acute liver failure is:
 A. Fungal infection
 B. Cerebral edema and brainstem herniation
 C. Electrolyte imbalance
 D. Renal failure

25. 12
 In obstructive jaundice, LFTs usually show:
 A. Elevated indirect bilirubin and ALP
 B. Elevated indirect bilirubin and GGT
 C. Elevated direct bilirubin and ALP
 D. Elevated direct bilirubin and ALT
 E. Elevated direct bilirubin and AST

26.  In obstructive jaundice, LFTs usually show:
 A. Elevated indirect bilirubin and ALP
 B. Elevated indirect bilirubin and GGT
 C. Elevated direct bilirubin and ALP
 D. Elevated direct bilirubin and ALT
 E. Elevated direct bilirubin and AST

27. 13.
 Standard supportive measures for patients with acute pancreatitis include the
following : (more than 1 correct answer)
 A. IV fluids and electrolyte therapy
 B. Analgesics as pethidine
 C. Somatostatin therapy
 D. Nasogastric decompression
 E. Prophylactic antibiotics

28.  Standard supportive measures for patients with acute pancreatitis include the
following : (more than 1 correct answer)
 A. IV fluids and electrolyte therapy
 B. Analgesics as pethidine
 C. Somatostatin therapy
 D. Nasogastric decompression
 E. Prophylactic antibiotics

29. 14.
 A 50 yr old man develops acute pancreatitis due to alcohol abuse. The patient
is noted to have recurrent fever (100⁰F), progressive leucocytosis
(18,500/mm³) and tachypnea. Most appropriate management includes:
 A. Laparotomy with pancreatic debridement
 B. Abdominal CT and serum lipase are useful
 C. ERCP with sphincterotomy and placement of biliary stent
 D. IV Amphotericin B

30.  A 50 yr old man develops acute pancreatitis due to alcohol abuse. The patient
is noted to have recurrent fever (100⁰F), progressive leucocytosis
(18,500/mm³) and tachypnea. Most appropriate management includes:
 A. Laparotomy with pancreatic debridement
 B. Abdominal CT and serum lipase are useful
 C. ERCP with sphincterotomy and placement of biliary stent
 D. IV Amphotericin B

31. 15.
 Effective ulcer treatment which works without action on gastric acid
secretion is :
 A. Lactulose
 B. Aluminium hydroxide
 C. Sucralfate
 D. Lactitol
 E. Magnesium trisilicate

32.  Effective ulcer treatment which works without action on gastric acid
secretion is :
 A. Lactulose
 B. Aluminium hydroxide
 C. Sucralfate
 D. Lactitol
 E. Magnesium trisilicate

33.  Studies in both humans and animals have indicated that sucralfate forms a
complex that binds to protein-rich exudate found on the surface of ulcers. It
binds to albumin and fibrinogen preventing blood clot lysis by stomach acid
(hydrochloric acid).
 Sucralfate increases the tissue levels of fibroblast growth factors and
epidermal growth factors, leading to an increase in prostaglandins at the
gastrointestinal tract lining, which promote the healing of gastrointestinal
ulcers

34.  Sucralfate, given at therapeutic doses for ulcers, decreases pepsin activity in
gastric fluids by 32%.
 Pepsin has been shown to be damaging to tissues, further aggravating ulcer
lesion inflammation.
 Bile salts have been implicated in mucosal injury to the gastrointestinal tract.
 Sucralfate has also been shown to adsorb bile salts in the laboratory setting,
which could further contribute to its beneficial effects in ulcer healing.

35. 16.
 Which of the following parasitic infestations can lead to malabsorption
syndrome?
 A. Amoebiasis
 B. Ascariasis
 C. Hookworm
 D. Giardiasis

36.  Which of the following parasitic infestations can lead to malabsorption
syndrome?
 A. Amoebiasis
 B. Ascariasis
 C. Hookworm
 D. Giardiasis

37. 17.
 Morphological features of Crohns disease include:
 A. Skip lesions
 B. Left sided disease
 C. Broad based ulcers
 D. Pseudopolyps

38.  Morphological features of Crohns disease include:
 A. Skip lesions
 B. Left sided disease
 C. Broad based ulcers
 D. Pseudopolyps

42. 18.
 What is the best approach when treating chronic diarrhea with opiate
antidiarrheal drugs?
 A. Use a large dose of potent opiates (eg codeine, morphine) first, then
titrate down
 B. Use a small dose of potent opiates (eg codeine, morphine) first, then
titrate up
 C. Use low potency opiates (eg loperamide) first, on an as-needed basis
 D. Use low potency opiates (eg loperamide) first, on a scheduled basis

43.  What is the best approach when treating chronic diarrhea with opiate
antidiarrheal drugs?
 A. Use a large dose of potent opiates (eg codeine, morphine) first, then
titrate down
 B. Use a small dose of potent opiates (eg codeine, morphine) first, then
titrate up
 C. Use low potency opiates (eg loperamide) first, on an as-needed basis
 D. Use low potency opiates (eg loperamide) first, on a scheduled basis

44.  Codeine, morphine or opium are not optimal because of the risks of
dependency and abuse, albeit uncommon.
 Low-potency opiates tht do not risk abuse or dependency, and can be given
regularly to prevent diarrhea, are the best approach

45. 19.
 A 40 yr old gentleman presents with dysphagia to both solids and liquids. He
sometimes regurgitates his food. No h/o weight loss. Barium swallow – dilated
esophagus with narrowing at the end of esophagus. What is the most
appropriate long term management ?
 A. Balloon dilatation
 B. Botox injection
 C. Oesophagectomy
 D. Nifedipine
 E. Isosorbide mononitrate

46.  A 40 yr old gentleman presents with dysphagia to both solids and liquids. He
sometimes regurgitates his food. No h/o weight loss. Barium swallow – dilated
esophagus with narrowing at the end of esophagus. What is the most
appropriate long term management ?
 A. Balloon dilatation
 B. Botox injection
 C. Oesophagectomy
 D. Nifedipine
 E. Isosorbide mononitrate

47. 20
 Which of the following is associated with CA pancreas?
 A. CA 19 9
 B. CEA
 C. AFP
 D. CA 125
 E. None of the above

48.  Which of the following is associated with CA pancreas?
 A. CA 19 9
 B. CEA
 C. AFP
 D. CA 125
 E. None of the above