THE MEDKEEN SERIES IM-Gastrointestinal & Hepatobiliary medicine mcqs trial

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THE MEDKEEN SERIES IM-Gastrointestinal & Hepatobiliary medicine mcqs trial

A Simulation Test

1.Fibrosis in liver cirrhosis is initiated by activation of

1 point

A. Kupfer cells

B. Stellate cells

C. Astrocytes

D. Hepatic dendritic cells

E. Collagenase

2.In chronic liver disease, spontaneous bacterial peritonitis is a complication of

1 point

A. Ascites

B. Hepato-renal syndrome

C. Hepato-pulmonary syndrome

D. Esophageal varies

3.What is the most likely cause of generalized edema with ascites when the ascites starts with pedal swelling?

1 point

A. Angio-oedema

B. Heart disease

C. Liver disease

D. Lymphedema

E. Renal disease

4..Signs of chronic liver diseases include all of the following except

1 point

A. Splinter hemorrhages

B. Spider naevi

C. Clubbing

D. Leukonychia

E. Gynecomastia

Clear selection

5.Which of these endocrinopathies may result in chronic diarrhea

1 point

A. Diabetic nephropathy

B. Hypothyroidism

C. Crohn’s disease

D. Diabetic autonomic neuropathy

E. Ulcerative colitis

Clear selection

6.While at the E/R, a 14 year-old child presented with complaint of passing loose watery stools since 12 hours to presentation. On examination, the child is floppy, febrile, and has very sunken eyes. What is the level of dehydration in the child and the corresponding percentage?

1 point

A. No dehydration, < 5%

B. Mild-moderate dehydration, 5-10%

C. Severe dehydration, < 10%

D. Severe dehydration, > 10%

E. Mild-moderate dehydration, > 10%

Clear selection

7.A 18 year-old man in a slum community is presented with profuse diarrhea which looks like rice water, and vomiting. What is the most likely diagnosis?

1 point

A. Amoebic colitis

B. Fulminant amoebic colitis

C. Cholera

D. Colon cancer

E. Bacillary dysentery

Clear selection

8.One of the following is not a medical cause of constipation

1 point

A. Drugs such as morphine

B. Chronic laxative use

C. Hyperthyroidism

D. Irritable bowel syndrome

E. Hypercalcaemia

Clear selection

9.The most suitable test for diagnosing peptic ulcer disease and gastro-oesophageal-reflux disease is *

1 point

A. Chest x-ray

B. Oesophago-gastroduodenoscopy

C. Abdominal ultrasound scan

D. Barium meal with fluoroscopy

E. Oesophageal pH monitoring

10. All the following are common symptoms of amoebic liver abscess except *

1 point

A. Fever

B. Anorexia

C. Right upper abdominal pain

D. Jaundice

E. Malaise

11.One of these medications is used in the management of severe pruritus in cholestatic jaundice.

1 point

Hyoscine butylbromide

B. Cholestyramine

C. Paromomycin

D. Diloxanide

E. Metoclopramide

Clear selection

12..A 73-year-old farmer was recently diagnosed with non-complicated hepatitis B at a regional hospital and treatment was started for the diagnosed condition. What will be the follow up management for the patient

1 point

A. Long-term monitoring for disease activity and hepatocellular carcinoma screening with six-monthly Hepatitis B viral DNA quantification, Liver Function Test, abdominal ultrasound and alpha fetoprotein is mandatory for the patient.

B. Long-term monitoring for disease activity and hepatocellular carcinoma screening with twelve-monthly Hepatitis B viral DNA quantification, Renal Function Test, abdominal ultrasound and alpha fetoprotein is mandatory for the patient.

C. Long-term monitoring for disease activity and hepatocellular carcinoma screening with three-monthly Hepatitis B viral DNA quantification, Liver Function Test, abdominal ultrasound and alpha fetoprotein is mandatory for the patient.

D. Short-term monitoring for disease activity and hepatocellular carcinoma screening with monthly Hepatitis B viral DNA quantification, Liver Function Test, abdominal ultrasound and alpha fetoprotein is mandatory for the patient.

Clear selection

13.A 46-year-old man has been diagnosed with hepatitis B in your hospital. In the management of chronic active hepatitis B, which of the following medicines can be used?

1 point

A. Tenofovir

B. Entecavir

C. Pegylated Interferon alfa-2a

D.All the above

Clear selection

14.Which of these drugs is less likely to cause hepatic encephalopathy *

1 point

A. Halothane

B. Isoniazid

C. Paracetamol overdose

D. Ibuprofen

E. Herbal concoction

15.A patient with grade 4 encephalopathy will typically present with *

1 point

A. Stupor but arousal

B. Coma

C. Marked confusion

D. Aggressive burse

E. Inarticulate speech

16.Measures to correct hydration status and nutrition in a patient with hepatic encephalopathy include

1 point

A. Administration of dextrose saline solution and high potency vitamin B

B. Administration of lactulose and liquid paraffin

C. Administration of metronidazole

D. All the above

E. None of the above

17.A diagnosis of spontaneous bacterial peritonitis is established if *

1 point

A. The neutrophil count in the ascetic fluid is < 250 cells/mL and surgically treatable causes are excluded.

B. The leukocyte count in the ascetic fluid is < 250 cells/mL and surgically treatable causes are excluded.

C. The neutrophil count in the ascetic fluid is > 250 cells/mL and surgically treatable causes are excluded.

D. The lymphocyte count in the ascetic fluid is > 250 cells/mL and surgically treatable causes are excluded.

E. The monocyte count in the ascetic fluid is < 250 cells/mL and surgically treatable causes are excluded.

18. Massive ascites in liver cirrhosis with respiratory embarrassment requiring more than 5 litres of fluid drainage should be treated with

1 point

A. Spironolactone

B. Furosemide

C. Salt-poor human albumin solution

D. All of the above

E. None of the above

Clear selection

19. The major risk factor for hepatocellular carcinoma is *

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A. Obesity

B. Diabetes mellitus

C. Liver cirrhosis of any cause

D. Overweight

E. Cholilithiasis

20. A 32-year-old laborer at a construction firm complains of epigastric pains which are worse with meals. He admits using ibuprofen for bodily pains regularly and also has passed some dark stools for weeks. What is the most likely diagnosis?

1 point

A Duodenal ulcer

B Hepatitis

C Gastric ulcer

D inflammatory bowel disease

E Typhoid fever

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