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Gastroenterology Quiz Question Answers (Total 20 MCQs)

Gastroenterology Quiz (Medical) 20 Question Answers

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Question 1
All of the following statements about acetaminophen hepatotoxicity are correct except:
A
Blood levels of acetaminophen correlate with the severity of hepatic injury
B
Hepatic injury worsens following starvation
C
Decreased levels of N-acetyl-benzoquinone-imine (NAPQI) are produced in chronic alcoholics after acetaminophen ingestion
D
Survivors of acute acetaminophen overdose usually have no evidence of hepatic sequelae
Question 2
All of the following statements about chronic hepatitis B are correct except:
A
Infection at birth is associated with high chance of chronic infection
B
Among adults with chronic hepatitis B, histologic features are of no prognostic importance
C
Compared to patients with HBeAg-reactive chronic hepatitis B, patients with HBeAgnegative chronic hepatitis B have levels of HBV DNA that are several orders of magnitude lower
D
Level of HBV replication is the most important risk factor for the ultimate development of cirrhosis in both HBeAg-reactive and HBeAg-negative patients
Question 3
All of the following statements about chronic hepatitis D are correct except:
A
Hepatitis D Virus (HDV) does not increase the likelihood of progression to chronic hepatitis B
B
Except for severity, chronic hepatitis B plus D has similar clinical and laboratory features to those seen in chronic hepatitis B alone
C
Distinguishing serologic feature of chronic hepatitis D is the presence in the circulation of antibodies to liver-kidney microsomes (anti-LKM) that is similar to seen in autoimmune hepatitis
D
None of the antiviral agents for hepatitis B-lamivudine, adefovir, and entecavir-are effective in hepatitis D
Question 4
All of the following are risk factors for alcohol liver disease except:
A
Quantity of alcohol
B
Gender
C
Malnutrition
D
Nocturnal drinking
Question 5
Which of the following manifestations of hemochromatosis may reverse after therapeutic phlebotomy?
A
Hepatic fibrosis
B
Arthritis
C
Hypogonadism
D
Diabetes
Question 6
Which of the following statements about celiac disease is correct?
A
Women with untreated celiac disease can present with infertility
B
Epilepsy is not associated with celiac disease
C
Peripheral neuropathy and ataxia usually respond to gluten withdrawal
D
Splenic atrophy occurs commonly in children
Question 7
All of the following statements about primary biliary cirrhosis (PBC) are correct except:
A
The earliest histological lesion is chronic non-suppurative destructive cholangitis
B
Pruritus that presents prior to the development of jaundice indicates severe disease and a poor prognosis
C
Up to 10% of patients with characteristic PBC will have features of autoimmune hepatitis as well and may progress to cirrhosis with the same frequency as typical PBC patients
D
Fatigue of PBC can be successfully treated with UDCA
Question 8
All of the following statements about treatment of ascites in cirrhosis are correct except:
A
Patients with small amounts of ascites can usually be managed with dietary sodium restriction alone
B
Random urine sodium-to-potassium concentration ratio less than 1 predicts that the patient would lose weight if a sodium-restricted diet is followed
C
The 24-hour urinary sodium excretion is a helpful parameter to follow in patients with portal hypertension-related ascites
D
Patients who take 88 mmol per day sodium diet and excrete more than 78 mmol per day of sodium in the urine would lose weight
Question 9
Which of the following statement about Gall Bladder stones is correct?
A
The natural history of gallstones in diabetic patients follows the same pattern observed in non-diabetic persons
B
Escherichia coli infection of the gall bladder cannot lead on to Emphysematous cholecystitis
C
Cholangitis is common in patients with cholecystoenteric fistula
D
ERCP and common bile duct stent placement is indicated in patients with acute cholecystitis
Question 10
Pigment gall bladder stones are commonly seen in all except
A
Gilbert's syndrome
B
Ileal resection
C
Primary biliary cirrhosis
D
Pernicious anemia
Question 11
Acute hepatitis B is characterized by all of the following except
A
IgM anti HBc +
B
HBsAg +
C
IgG anti HBc +
D
Elevated HBV DNA
Question 12
All of the following are consequences of pancreatic duct disruption except
A
Pancreatic ascites
B
Pseudocyst
C
Biliary obstruction
D
External pancreatic fistulae
Question 13
All of the following statements about Wilson's disease are true except
A
The hepatic presentation of Wilson disease is more common in younger patients than in older patients
B
Wilson disease may present in children and young adults with clinical liver disease indistinguishable from autoimmune hepatitis
C
Fulminant Wilson disease is typically characterized by disproportionately high aminotransferase levels at the onset of clinically apparent disease
D
Compared with other chronic liver diseases, Wilson disease is rarely complicated by hepatocellular carcinoma
Question 14
Barrett's esophagus is best diagnosed by
A
Barium swallow
B
Manometry
C
Endoscopy
D
Confocal laser endoscopy
Question 15
Which of the following statements about acute liver failure is correct?
A
Encephalopathy in acute liver failure is because of portosystemic shunting of toxins
B
Upper motor neuron signs suggest a poor prognosis
C
Serial measurement of factor V levels is a sensitive way to monitor recovery of liver function over time
D
Transjugular liver biopsy is recommended for prognosis or staging purposes
Question 16
Which of the following statements about hepatorenal syndrome (HRS) is correct?
A
Type 1 HRS presents as a slowly progressive form of renal dysfunction
B
The degree of arterial hypotension and circulatory dysfunction is less in type 2 HRS than that seen with type 1 HRS
C
Type 1 HRS never develops in patients with type 2 HRS
D
Patients who exhibit high levels of inflammatory response markers prior to the onset of infection are less likely to develop HRS
Question 17
Which of the following statements about liver transplantation is correct?
A
The most common indication for liver transplantation in children is biliary atresia
B
HIV seropositivity is an absolute contraindication for liver transplantation
C
Tissue typing for HLA matching is required prior to cadaveric transplantation
D
Living-donor transplantation of the left lobe (left lateral segment) is major procedure in adults
Question 18
Which of the following is a DNA virus?
A
Hepatitis A virus
B
Hepatitis B virus
C
Hepatitis C virus
D
Hepatitis D virus
Question 19
Autoantibodies are commonly seen in the following liver diseases except
A
Chronic hepatitis B
B
Chronic hepatitis C
C
Chronic hepatitis D
D
Auroimmune hepatitis
Question 20
Which of the following statements about PEG interferon (PEG IFN) in treatment of chronic hepatitis B is true?
A
Viral resistance occurs in 30% of patients at the end of one year
B
The recommended duration of treatment is 6 months
C
The likelihood of HBeAg loss in PEG IFN-treated HBeAg-reactive patients is associated with HBV genotype A > B > C > D
D
The level of HBV DNA inhibition achieved with PEG IFN is much higher than that achieved with oral nucleoside analogues
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Gastroenterology Quiz Question Answers (Total 80 MCQs)

Gastroenterology Quiz (Medical) 80 Question Answers

Congratulations - you have completed Gastroenterology Quiz (Medical) 80 Question Answers. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
All of the following statements about hemorrhoids are correct except
A
Hemorrhoidal cushions are a normal part of the anal canal
B
They do not have any role in maintaining continence
C
The acutely thrombosed hemorrhoid can be excised within the first 72 h by performing an elliptical excision
D
Emergent hemorrhoidectomy for bleeding hemorrhoids is associated with a higher complication rate
Question 2
Which of the following is true about colonic motility?
A
The small intestinal migrating motor complexes (MMC's) continue into the colon
B
High-amplitude propagated contractions (HAPCs) are associated with mixing movements through the colon
C
The predominant phasic contractions in the colon are irregular
D
Short phasic contractions propagate colonic contents
Question 3
Which of the following patients have the highest risk of post ERCP pancreatitis?
A
Patients with cholangiocarcinoma
B
Patients with chronic pancreatitis
C
Patients with sphincter of Oddi dysfunction
D
Patients with pancreatic adenocarcinoma
Question 4
All of the following statements about extra intestinal manifestations in inflammatory bowel disease (IBD) are correct except
A
In erythema nodosum, skin lesions develop after the onset of bowel symptoms, and patients frequently have concomitant active peripheral arthritis
B
Pyoderma gangrenosum usually presents after the diagnosis of IBD and runs a course independent of the bowel disease
C
Peripheral arthritis is more common in ulcerative colitis, and worsens with exacerbations of bowel activity
D
The ankylosing spondylitis activity is not related to bowel activity and does not remit with glucocorticoids or colectomy
Question 5
All of the following is true about spider angiomas except
A
They occur in both acute and chronic liver disease
B
They are superficial, tortuous arterioles
C
They typically fill from the outwards to center
D
They occur only on the arms, face, and upper torso
Question 6
Criggler Najar syndrome Type II is characterized by all of the following except?
A
Largest fraction of bilirubin being unconjugated
B
Kernicterus being unusual
C
The hepatic histology being normal
D
Phenobarbital decrease bilirubin by >25%
Question 7
Which of the following statements about fatty acid diarrhea is correct?
A
The ileal disease is usually limited
B
The bile acid pool size is normal
C
There is no response to cholestyramine
D
The fecal bile acid secretion is decreases
Question 8
Which of the following statements about diverticula is correct?        
A
The most common type of diverticulum affecting the colon is the pseudodiverticulum
B
Diverticula commonly affect the descending colon
C
The diagnosis of diverticulitis is best made on colonoscopy
D
Younger patients have a benign form of the disease
Question 9
Which of the following statements is true about aminotransferases?      
A
The aminotransferases (transaminases) are not a sensitive indicators of liver cell injury
B
There is a good correlation between the degree of liver cell damage and the level of the aminotransferases
C
Minimal alanine aminotransferase (ALT) elevations in asymptomatic blood donors usually indicate severe liver disease
D
In most acute hepatocellular disorders, the alanine aminotransferase (ALT) is higher than or equal to the aspartate aminotransferase (AST)
Question 10
Which of the following statements about enterohepatic circulation of bile acids is correct?
A
The secondary bile acids in humans are cholic acid and chenodeoxycholic acid
B
Bile acids can be absorbed by non-carrier-mediated transport processes in the jejunum, ileum, and colon
C
Decreased bile acid synthesis is not seen in chronic liver disease
D
Bile acids absorbed from the intestine return to the liver via the lymphatics
Question 11
Which of the following statements about regurgitation is correct?
A
It is effortless appearance of esophageal contents in the mouth
B
Regurgitation of tasteless mucoid fluid material occurs in severe gastroesophageal reflux
C
Water brash is a form of regurgitation
D
Regurgitation of sour or bitter-tasting material is associated with incompetence of only the LES
Question 12
Which of the following statements is true about Zenker's diverticulum?
A
It is a congenital condition
B
It is seen commonly in second and third decade of life
C
Squamous cell cancer may develop in Zenker's diverticula
D
Patients with small asymptomatic or minimally symptomatic diverticula should be treated because progressive enlargement is common
Question 13
Highest risk of perinatal infection is observed with:
A
Hepatitis A infection
B
Hepatitis B infection
C
Hepatitis C infection
D
Hepatitis D infection
Question 14
Which of the following statements about Me'ne'trier's disease is correct?
A
The mucosal folds in Me'ne'trier's disease are often most prominent in the body and antrum
B
Histologically, massive foveolar hyperplasia is noted, which replaces most of the chief and parietal cells
C
Overt bleeding is common
D
Me'ne'trier's disease is considered a form of gastritis
Question 15
All of the following is true about Ascaris lumbricoides except
A
Its eggs rapidly die in boiling water
B
Ascaris eggs multiply in the humans intestine
C
Mature male A. lumbricoides are smaller than females
D
Ascaris lumbricoides is the largest of the nematode parasites that colonize humans
Question 16
Which of the following is a cause of oropharyngeal mechanical dysphagia?
A
Congenital microganthia
B
Tetanus
C
Aminoglycosides
D
Basilar meningitis
Question 17
All of the following is true about upper gastrointestinal bleed (UGIB) except    
A
Varices are the most common cause of UGIB
B
Bleeding is self-limited in 80% of patients with UGIB, even without specific therapy
C
Bleeding from Mallory-Weiss tears is usually on the gastric side of the gastroesophageal junction
D
Blatchford Score is a pre endoscopic scoring system for risk stratification
Question 18
All of the following are useful for treatment of vomiting because of gastroparesis except:
A
Metoclopramide
B
Tegaserod
C
Aprepitant
D
Erythromycin
Question 19
All of the following is true about acute mesenteric ischemia (AMI) except
A
Early in the course of disease, the pain is disproportionate to the physical findings
B
A normal white blood cell (WBC) count excludes early AMI
C
Plain films of the abdomen usually are normal in AMI before infarction
D
Laparoscopy can be misleading early in the ischemic injury because of the normal appearance of the serosal aspect of the bowel even if the mucosa is necrotic
Question 20
Which of the following statements about liver development is not correct?
A
The liver develops at three to four weeks' gestation as an outgrowing bud of proliferating endodermal cells from the ventral wall of the foregut
B
It develops in response to signals from the adjacent stomach
C
The hepatoblast are bipotential cells that will differentiate into hepatocytes and cholangiocytes
D
The hepatoblasts intermingle with endothelial cells as this interaction is necessary to support hepatic morphogenesis
Question 21
All of the following correctly describes the pathophysiology of clinical manifestations of malabsorption disorders except
A
Flatus: Bacterial fermentation of unabsorbed carbohydrate
B
Dermatitis: Deficiency of essential fatty acid
C
Amenorrhea: Impaired absorption of iron, folate, vitamin B 12
D
Glossitis, cheilosis, stomatitis: Deficiency of iron, vitamin B 12 , folate, and vitamin A
Question 22
Which of the following statements is true about oral manifestations in HIV infection?
A
For oral candidiasis treatment with oral azoles for one to two weeks is usually effective, even in the late stages of HIV infection
B
Hairy leukoplakia appears as corrugated white lesions on the middle of the tongue
C
Hairy leukoplakia is usually symptomatic
D
Hairy leukoplakia effectively responds to oral acyclovir and it leads to permanent cure
Question 23
All of the following statements about mesenteric vascular anatomy and pathophysiology are correct except
A
Collateral vessels within the colon meet at the splenic flexure and descending/sigmoid colon
B
Collateral vessels within the small bowel are numerous and meet within the duodenum and the bed of the pancreas
C
Sudeck point is located at splenic flexure
D
Emboli originate from the heart in majoirty of cases and lodge preferentially just distal to the origin of the middle colic artery from the superior mesenteric artery
Question 24
Which of the following statements about refractory peptic ulcer disease is correct?
A
A gastric ulcer (GU) that fails to heal after 8 weeks is considered as refractory
B
A duodenal ulcer (DU) that fails to heal after 12 weeks is considered as refractory
C
More than 90% of refractory ulcers (either DUs or GUs) heal after 8 weeks of treatment with higher doses of PPI
D
Eosinophilic gastroenteritis is not a cause of refractory ulcers
Question 25
Which of the following cause of diarrhea is correctly matched with its etiological infectious agent?
A
Diarrhea because of eating of undercooked hamburger: Salmonella
B
Diarrhea because of eating of fried rice: Vibrio
C
Diarrhea because of eating of mayonnaise or creams: Staphylococcus aureus
D
Diarrhea because of eating of eggs: enterohemorrhagic E. coli (O157:H7)
Question 26
Which of the following statements is true about post operative ileus?
A
The small intestine resumes activity first followed by stomach
B
Return of bowel sounds ensures propulsive activity
C
Intravenous fluid overload during or after surgery has no effect on recovery of gastrointestinal function
D
When compared with open surgical procedures, laparoscopy has no effect on the duration of postoperative ileus
Question 27
Which of the following statements about physiology of weight regulation is true?
A
About 30% of caloric intake is used for dietary thermogenesis
B
TNF alpha mobilizes energy from skeletal muscles
C
Adipose tissue decreases with age
D
Beginning at about age 60, body weight declines by an average of 0.5% per year
Question 28
All of the following are true for hepatitis B x antigen (HBxAg) except?
A
It is a large particulate protein
B
It is capable of transactivating the transcription of both viral and cellular genes
C
In the cytoplasm it effects calcium release
D
It transactivates human interferon gamma gene and class I major histocompatibility genes
Question 29
Which of the following is not a cause of steatorrhea because of impaired intra luminal digestion?
A
Whipple's disease
B
Cystic fibrosis
C
Somatostatinoma
D
Cirrhosis
Question 30
All of the following causes diffuse small intestinal lesions and can be specificallydiagnosed on intestinal biopsy except?
A
Whipple's disease
B
Agammaglobulinemia
C
Abetalipoproteinemia
D
Mastocytosis
Question 31
All of the following statements about autoimmune hepatitis are correct except
A
The mainstay of management in autoimmune hepatitis is glucocorticoid therapy
B
Azathioprine alone is effective in achieving remission
C
Treatment is not indicated in the mild forms of chronic hepatitis
D
Antibodies to soluble liver antigen (anti-SLA), actin (anti-actin), chromatin (antichromatin), asialoglycoprotein receptor (ASGPR), and liver cytosol type 1 (anti-LC1) have been associated with poor treatment response
Question 32
All of the following drugs can be used for treatment of constipation predominanirritable bowel syndrome (IBS) except
A
Calcium polycarbophil
B
Alosteron
C
Lubiprostone
D
Polyethylene glycol 3350
Question 33
All of the following causes of vomiting have no organic basis except:
A
Chronic idiopathic nausea
B
Functional vomiting
C
Intestinal pseudoobstruction
D
Cyclic vomiting syndrome
Question 34
All of the following statements about acute appendicitis are correct except
A
Recurrent acute appendicitis does not occur
B
Tenderness is sometimes absent in the early visceral stage of the disease, it ultimately always develops and is found in any location corresponding to the position of the appendix
C
Hyperesthesia of the skin of the right lower quadrant and a positive psoas or obturator sign are late findings
D
The absence of leukocytosis does not rule out acute appendicitis
Question 35
Which of the following statements correctly describes the liver test patterns in various hepatobiliary disorders?
A
Gilbert's syndrome: No bilirubinuria, normal liver aminotransferases, elevated alkaline phosphatase and normal prothrombin time
B
Alcoholic hepatitis: No bilirubinuria, elevated liver aminotransferases, normal or elevated alkaline phosphatase and prolonged prothrombin time
C
Intra hepatic cholestasis: Bilirubinuria present, normal to moderate elevation of liver aminotransferases, elevated alkaline phosphatase and normal prothrombin time
D
Chronic hepatocellular disorders: No bilirubinuria, elevated liver aminotransferases, normal or elevated alkaline phosphatase and prolonged prothrombin time
Question 36
Which of the following statements about Schilling test is correct?
A
It is dependent on normal renal and bladder function
B
In pernicious anemia, the schilling test becomes normal with intrinsic factor, antibiotics but not with pancreatic enzymes
C
In chronic pancreatitis, the schilling test becomes normal with intrinsic factor, antibiotics as well as pancreatic enzymes
D
In ileal disease, the schilling test becomes normal with intrinsic factor but not with antibiotics and pancreatic enzymes
Question 37
Which of the following statements about celiac disease is correct?
A
Presence of DQ2 confirms the diagnosis of celiac sprue
B
The small intestinal histopathological features are diagnostic of celiac disease
C
Almost all patients with dermatitis herpetiformis (DH) have histologic changes in the small intestine consistent with celiac sprue
D
Patients with collagenous sprue generally respond to a gluten-free diet
Question 38
All of the following esophageal lesions/changes are seen in scleroderma except?
A
Atrophy of smooth muscle
B
Sub normal resting pressure of the LES with abnormal sphincter relaxation
C
Weakness in the lower two-thirds of the esophagus
D
Incompetence of the lower esophageal sphincter (LES)
Question 39
Which of the following statements about Gastric anatomy is correct?
A
Majority of gastric glands are found within the antral mucosa
B
Gastric glands within gastric cardia comprise of mucous neck, parietal, chief, endocrine, and enterochromaffin cells
C
The resting, or unstimulated, parietal cell has prominent cytoplasmic tubulovesicles and intracellular canaliculi
D
The parietal cell is usually found in the fundus of the oxyntic gland
Question 40
Which of the following statements about results of various diagnostic tests in steatorrhea is correct?
A
Chronic pancreatitis: abnormal D Xylose, normal histology, abnormal Schilling test
B
Bacterial overgrowth syndrome: normal D Xylose, normal histology, abnormal Schilling test
C
Ileal disease: normal D Xylose, normal histology, normal Schilling test
D
Intestinal lymphangiectasia: normal D Xylose, normal histology, abnormal Schilling test
Question 41
Which of the following statements about peptic ulcer disease is correct?
A
Abdominal pain has a good predictive value for the presence duodenal ulcer
B
Pain that awakes the patient from sleep (between midnight and 3 A.M.) is the most discriminating symptom of patients with duodenal ulcer and is not seen in patients with non-ulcer dyspepsia
C
Gastric ulcers tend to penetrate into the left hepatic lobe
D
Nausea and weight loss occur more commonly in duodenal ulcer patients as compared to gastric ulcer patients
Question 42
Which of the following statements about achalasia cardia is correct?
A
Valsalva maneuver impedes the passage of the food bolus into the stomach
B
The presence of gastroesophageal reflux suggests achalasia
C
Cholecystokinin (CCK) paradoxically causes relaxation of the LES (the CCK test)
D
Sildenafil provides symptomatic relief
Question 43
Which of the following is true about history and physical examination in a patienwith indigestion?
A
Patients with acid reflux on esophageal pH testing always report heartburn
B
The physical exam in patients with GERD is usually abnormal
C
Odynophagia excludes esophageal infection
D
Poor dentition may be seen with prolonged acid regurgitation
Question 44
The ascitic fluid with <25g/l protein concentration, SAAG <1.1, absence of red blood cells, less than 250 cells/cc and cells being usually mesothelial and lymphocytes is seen in :
A
Nephrosis
B
Congestive Heart failure
C
Cirrhosis
D
Budd Chiari Syndrome
Question 45
Which of the following statements about Herpes simplex esophagitis is correct?
A
Herpes simplex virus (HSV) type 2 occasionally causes esophagitis in immunocompetent individuals
B
Endoscopic biopsy should be taken from the base of the ulcer for correct diagnosis
C
PCR assays are more sensitive than viral cultures for HSV diagnosis
D
Endoscopy shows deep and large ulcers
Question 46
Which of the following statements about human hepatocyte is not correct?
A
Few of normal human hepatocytes are also binucleate
B
The canalicular domains of two adjacent hepatocytes are sealed at the periphery by tight junctions (desmosomes), thereby delimiting the bile canaliculus,
C
The flow from hepatocytes into the bile canaliculi is bidirectional
D
There is a bidirectional exchange of liquids and solutes between the plasma and hepatocytes at the sinusoidal surface
Question 47
All of the following are alarm symptoms in gastroesophageal reflux disease (GERD) except:
A
Odynophagia
B
Halitosis
C
Recurrent vomiting
D
Occult or gross gastrointestinal bleeding
Question 48
All of the following statements about intestinal obstruction are correct except
A
In intestinal obstruction, intestinal gas is composed mainly of nitrogen
B
The pain may become less severe as distention progresses in acute intestinal obstruction
C
When strangulation is present, the pain is usually more localized and may be steady and severe without a colicky component
D
Abdominal distention is least marked in colonic obstruction
Question 49
Which of the following is true about esophageal dysphagia?
A
Dysphagia is always present when the esophagus cannot distend beyond 2 cm
B
Circumferential lesions produce dysphagia similar to lesions that involve only a portion of circumferences of the esophageal wall
C
Diseases of the striated muscle do not involve the cervical part of the esophagus but involve the oropharyngeal muscles
D
Dysphagia due to esophageal muscle weakness is often associated with symptoms of gastroesophageal reflux disease (GERD)
Question 50
All of the following is true about blood ammonia except
A
Striated muscle along with liver plays a role in detoxification of ammonia
B
There is poor correlation between either the presence or the severity of acute encephalopathy and elevation of blood ammonia
C
There is good correlation of the blood serum ammonia and hepatic function
D
Elevated arterial ammonia levels have been shown to correlate with outcome in fulminant hepatic failure
Question 51
Which of the following events occur during vomiting?
A
The gastric cardia herniates across the diaphragm
B
Larynx moves downwards
C
Frequency of slow-wave increases
D
Abolition of orally propagating spike occurs
Question 52
Which of the following statements about lactose intolerance is correct?
A
Skim milk is more commonly associated with symptoms of lactose intolerance than whole milk
B
Slow small intestinal transit increases symptoms of lactose intolerance
C
Reduced levels of colonic microflora decreases symptoms of lactose intolerance
D
Glucose/galactose absorption is rate-limiting step in lactose absorption
Question 53
All of the following statements about Crohn's disease are correct except    
A
It may also involve the liver and the pancreas
B
It is a transmural disease
C
Surgical resection reveals granulomas in all the cases
D
Not all patients with perianal fistula will have endoscopic evidence of colonic inflammation
Question 54
Which of the following viruses does not cause chronic liver disease?
A
Hepatitis A virus
B
Hepatitis B virus
C
Hepatitis C virus
D
Hepatitis E virus
Question 55
All of the following statements about diagnostic criteria of irritable bowel syndrome (IBS) are correct except
A
Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months
B
Onset associated with a change in frequency of stool
C
Onset associated with a change in form (appearance) of stool
D
Criteria fulfilled for the last 3 months with symptom onset at least 9 months prior to diagnosis
Question 56
Which of the following correctly describes lower esophagus and lower esophageal sphincter?
A
Neurotransmitters of the excitatory nerves is vasoactive intestinal peptide (VIP)
B
Peristalsis at the lower esophagus consists of a sequence of inhibition followed by contraction
C
Neurotransmitters of the inhibitory nerves is acetylcholine
D
Striated muscle of the diaphragmatic crura have no role as LES
Question 57
Which of the following statements about dumping syndrome is correct?
A
Vasoactive intestinal polypeptide, neurotensin, and motilin play an important role in the pathogenesis of delayed dumping syndrome
B
Dumping syndrome is most noticeable after meals rich in fats syndrome
C
Dietary modification is not an important modality of treatment for patients with dumping
D
Excessive insulin release plays an important role in the pathogenesis of delayed dumping syndrome
Question 58
Which of the following statements about Whipple's disease is not correct?
A
Whipple's disease is caused by a small gram-positive bacillus
B
The development of dementia is a relatively late symptom
C
The presence of the T. whipplei bacillus outside of macrophages is a more important indicator of active disease than is their presence within the macrophages
D
The bacillus, an actinobacterium, has low virulence and low infectivity
Question 59
Which of the following statements about serum bilirubin measurements is correct?
A
In normal persons almost 100% of the serum bilirubin is unconjugated
B
In jaundiced patients with hepatobiliary disease, the total serum bilirubin concentration measured by new, more accurate methods is similar to the values found with diazo methods
C
In jaundiced patients with hepatobiliary disease, diglucuronides of bilirubin predominate over the monoglucuronides
D
None of the direct-reacting bilirubin fraction includes conjugated bilirubin that is covalently linked to albumin
Question 60
All of the following cause xerostomia except?
A
Tricyclic antidepressants
B
Sodium carboxymethyl cellulose
C
Diuretics
D
Radiation therapy
Question 61
Which of the following statements about bilirubin metabolism is not correct?
A
Majority of bilirubin is formed from the breakdown of hemoglobin in senescent red blood cells and prematurely destroyed erythroid cells in the bone marrow
B
Bilirubin formed in the reticuloendothelium is water soluble
C
The initial steps of bilirubin metabolism occur predominantly in the spleen.
D
The transport of conjugated bilirubin is transported across the canalicular membrane is the only energy-dependent step in bilirubin metabolism
Question 62
Which of the following correctly describes aphagia?
A
Sensation of "sticking" or obstruction of the passage of food in the pharynx
B
Complete esophageal obstruction
C
Fear of swallowing
D
Sensation of a lump lodged in the esophagus
Question 63
All of the following statements about serological markers in inflammatory bowel disease are correct except
A
The antigens to which pANCA antibodies are directed are distinct from those associated with vasculitis
B
pANCA positivity is more often associated primary sclerosing cholangitis (PSC)
C
Omp C-positive patients are more likely to have internal perforating disease
D
Around 50% of patients with ulcerative colitis have serum reactivity to Cbir1, whereas Crohn's disease patients have little or no reactivity to this flagellin
Question 64
Which of the following statements about Barrett's esophagus is correct?
A
Finding intestinal metaplasia with goblet cells in the esophagus is diagnostic of Barrett's esophagus
B
Its incidence decreases with age
C
Established metaplasia regresses with antisecretory treatment
D
Long-segment disease is commoner than the short-segment disease
Question 65
Which of the following statements about Helicobacter pylori is correct?
A
It is a gram-negative microaerophilic rod
B
It is not capable of transforming into a coccoid form
C
Transmission of H. pylori does not occur from person to person
D
H. pylori infection is virtually always associated with peptic ulceration
Question 66
The process of deglutition reflex involves:
A
Contraction of the inferior pharyngeal constrictor against the contracted soft palate to initiate a peristaltic contraction
B
Closure of the lower esophageal sphincter (LES) as the food enters the esophagus
C
Moving backwards of the larynx as the food bolus is propelled backward by the tongue
D
Activation of oropharyngeal sensory receptors that initiate the deglutition reflex
Question 67
Which of the following statements about short bowel syndrome is not correct?
A
A significant increase in renal calcium oxalate calculi is observed in patients with a small- intestinal resection with an intact colon
B
Gastric hypersecretion of acid occurs in many patients following large resections of the small intestine
C
Removal of the ileum and especially the ileocecal valve is often associated with more severe diarrhea than jejunal resection
D
Absence of the ileocecal valve is associated with a increase in intestinal transit time
Question 68
All of the following statements about anorectal abscess are correct except
A
The development of a perianal abscess is more common in men than women
B
A prostatic abscess may present with similar complaints as peri anal abscess
C
The disease is more prevalent in patients with hematologic disorders
D
Most common locations is intersphincteric
Question 69
Idiopathic ulcerative colitis is characterized by all of the following (IUC) except
A
Patients with disease that is limited to the distal colon do better than those with extensive colitis
B
Appendectomy is protective
C
Diarrhea is always present in patients with IUC
D
For following clinical changes in IUC, C reactive protein (CRP) is more sensitive than ESR
Question 70
Which of the following statements about leptin is true?
A
Leptin increases expression of hypothalamic neuropeptide Y
B
Leptin decreases expression of alpha MSH
C
Leptin deficiency causes inhibition of hypothalamic thyrotropin-releasing hormone (TRH) and gonadotropinreleasing hormone (GnRH)
D
Leptin is produced by stomach
Question 71
All of the following correctly describes the epidemiology of ulcerative colitis except
A
The male to female ratio is 1:1
B
There is increased risk with oral contraceptives
C
Smoking may prevent the disease
D
There is low concordance in monozygotic twins
Question 72
Which of the following statements about Zollinger Ellison syndrome (ZES) is correct?
A
Duodenal tumors constitute the most common non-pancreatic lesions
B
Duodenal tumors are smaller, faster-growing, and more likely to metastasize than pancreatic lesions
C
Diarrhea is the most common clinical manifestation of ZES
D
Patients with higher gastrin levels (>10,000 pg/mL) have better prognosis
Question 73
Which of the following statements about hepatitis B virus is not correct?
A
It has its own endogenous DNA polymerase
B
It replicates in the liver but exist in extrahepatic sites
C
The envelope protein expressed on the smaller spherical and tubular structures is referred to as hepatitis B surface antigen (HBsAg)
D
The antigen expressed on the surface of the nucleocapsid is referred to as hepatitis B e antigen (HBeAg)
Question 74
Which of the following statements about treatment of varices is correct?    
A
Endoscopic sclerotherapy is the preferred local therapy for control of esophageal variceal bleeding
B
Bleeding from large gastric fundic varices is best treated by band ligation
C
Pharmacologic therapies that decrease portal pressure have similar efficacy as endoscopic therapy in preventing re bleeds
D
Endoscopic band ligation has higher complications rate than endoscopic sclerotherapy
Question 75
Which of the following statements about jaundice is correct?
A
The degree of serum bilirubin elevation cannot be estimated by physical examination
B
The ability to detect scleral icterus is easy if the examining room has fluorescent lighting
C
As serum bilirubin levels rise, the skin can eventually become green
D
In carotenoderma the yellow coloration of the skin is uniformly distributed over the body
Question 76
Which of the following is true about gastrointestinal motility at different anatomic levels?
A
Ascending and transverse colon: reservoirs
B
Descending colon: reservoir
C
Sigmoid colon: conduit
D
Synchronized migrating motor complexes (MMCs) in fed state
Question 77
Which of the following statements about medium chain fatty acids is correct?
A
It is present in large amounts in diet
B
The stomach is predominant site of absorption
C
It requires pancreatic lipolysis for absorption
D
It is not present in stool
Question 78
The ultrasound is an inexpensive imaging modality that can detect dilation of the intra- and extrahepatic biliary tree with a high degree of sensitivity and specificity. However, it may yield false negative results in:
A
Choledochal cyst
B
Autoimmune pancreatitis
C
Primary sclerosing cholangitis
D
Mirizzi syndrome
Question 79
All of the following are diagnostic modalities for evaluation of small bowel bleeding except:
A
Spy glass endoscopy
B
Capsule endoscopy
C
Spiral endoscopy
D
Single balloon endoscopy
Question 80
Which of the following statements about pyrosis is correct?
A
It is not a characteristic symptom of reflux esophagitis.
B
It is relieved by lying recumbent.
C
It improves after meals.
D
It can be reproduced by infusion of neutral hyperosmolar solutions into the esophagus.
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