Asthma (I)



Asthma

1. Factors that can contribute to asthma or airway hyperreactivity may include any of the following:

1. Chronic sinusitis or rhinitis

2. Aspirin or nonsteroidal anti-inflammatory drug hypersensitivity

3. Use of beta-adrenergic receptor blockers

4. All of above

2. Mechanism of bronchoconstriction during asthma attack includes all, except:

1. mucus plugs

2. airway spasm

3. proliferation

4. swollen middle layer

3. Which statement about asthma is wrong?

1. Asthma is a chronic inflammatory disorder of the airways

2. Airway obstruction is often caused by abnormal sensitivity of cholinergic and peptidergic receptors

3. In asthma, airway obstruction is irreversible

4. Cigarette smoke, cold air, and viral infections can provoke asthma attacks

4. Step 1 – Intermittent asthma is characterized by all except:

1. Intermittent symptoms occurring less than once a week

2. Nocturnal symptoms occurring less than twice a week

3. Asymptomatic with normal lung function between exacerbations

4. FEV1 or PEF rate greater than 80%, with less than 20% variability

5. Step 2 - Mild persistent asthma is characterized by all except:

1. Symptoms occurring more than once a week but less than once a day

2. Nocturnal symptoms occurring more than twice a month

3. Brief exacerbations

4. FEV1 or PEF rate greater than 80% predicted, with variability of 20-30%

6. Step 3 - Moderate persistent asthma is characterized by all except:

1. Weekly symptoms

2. Exacerbations affect activity and sleep

3. Nocturnal symptoms occurring more than once a week

4. FEV1 or PEF rate 60-80% of predicted, with variability greater than 30%

7. Step 4 - Severe persistent asthma is characterized by all except:

1. Symptoms occurring more than once a week but less than once a day

2. Frequent exacerbations

3. Frequent nocturnal asthma symptoms

4. FEV1 or PEF rate less than 60%, with variability greater than 30%

8. A diagnosis of asthma can be confirmed using all investigation, except:

1. Spirometry tests

2. Skin testing

3. A chest x-ray

4. Exhaled nitric oxide (NO)

9. Symptoms of asthma may include the following:

1. Chest tightness

2. Sputum production

3. Decreased exercise tolerance

4. All of above

10. . Pharmacologic treatment of Intermittent asthma include:

1. long-term oral corticosteroid therapy

2. The controller medication is an inhaled corticosteroid (800-2000 mcg)

3. The controller medication is an inhaled corticosteroid (200-500 mcg)

4. A controller medication is not needed

11. Pharmacologic treatment of Mild persistent asthma include:

1. The controller medication is an inhaled corticosteroid (200-500 mcg), cromolyn, nedocromil, or a leukotriene antagonist

2. The controller medication is an inhaled corticosteroid (800-2000 mcg)

3. A controller medication is not needed

4. Long-term oral corticosteroid therapy

12. Pharmacologic treatment of Moderate persistent asthma include:

1. The controller medication is an inhaled corticosteroid (200-500 mcg), cromolyn, nedocromil, or a leukotriene antagonist

2. The controller medication is an inhaled corticosteroid (800-2000 mcg) and a long-acting bronchodilator (either beta-agonist or sustained-release theophylline)

3. The controller medication is an inhaled corticosteroid (800-2000 mcg), a long-acting bronchodilator (beta-agonist and/or theophylline), and long-term oral corticosteroid therapy

4. Long-term oral corticosteroid therapy

13. Pharmacologic treatment of Severe persistent asthma include:

1. The controller medication is an inhaled corticosteroid (500-1000 mcg)

2. The controller medication is an inhaled corticosteroid (800-2000 mcg)

3. The controller medication is an inhaled corticosteroid (800-2000 mcg), a long-acting bronchodilator (beta-agonist and/or theophylline), and long-term oral corticosteroid therapy

4. The controller medication is an inhaled corticosteroid (200-500 mcg) and a long-acting bronchodilator (either beta-agonist or sustained-release theophylline)

14. The short-acting Beta-adrenergic agonists is:

1. Salmeterol

2. Albuterol

3. Theophylline

4. Ipratropium

15. The long-acting Beta-adrenergic agonists is:

1. Salmeterol

2. Ventolin

3. Cromolyn

4. Ipratropium

16. Mast cell stabilizer is:

1. Beclomethasone

2. Ventolin

3. Cromolyn

4. Ipratropium

17. Corticosteroid is:

1. Fluticasone

2. Salmeterol

3. Cromolyn

4. Ipratropium

18. Complications associated with long-term corticosteroid used for asthma may include:

1. Osteoporosis

2. Immunosuppression

3. Weight gain

4. All of above

COPD

1. Risk factors for COPD include:

1. Cigarette smoking

2. Lung infections

3. Exposure to pollutants

4. All the Answers

2. Which statement about COPD is not true?

1. a chronic, slowly progressive disorder characterised by airways obstruction (FEV1 < 80% predicted and FEV1/FVC ratio < 70%)

2. COPD is an important cause of activity limitation in the population

3. obstructive syndrome is completely reversible by bronchodilator

4. The first symptoms of chronic bronchitis are cough and mucus production

3. Mild COPD is characterized by:

1. airflow limitation (FEV1/FVC < 0.70; 50% < FEV1 < 70% predicted)

2. airflow limitation (FEV1/FVC < 0.70; FEV1 70% predicted)

3. airflow limitation (FEV1/FVC < 0.70; 30% < FEV1 < 60% predicted)

4. airflow limitation (FEV1/FVC < 0.70; FEV1 80% predicted)

4. Moderate COPD is characterized by:

1. airflow limitation (FEV1/FVC < 0.70; 50% < FEV1 < 80% predicted)

2. airflow limitation (FEV1/FVC < 0.70; FEV1 . 80% predicted)

3. airflow limitation (FEV1/FVC < 0.70; 30% < FEV1 < 60% predicted)

4. airflow limitation (FEV1/FVC < 0.70; FEV1 < 40% predicted )

5. Severe COPD is characterized by:

1. airflow limitation (FEV1/FVC < 0.70; 50% < FEV1 < 80% predicted)

2. airflow limitation (FEV1/FVC < 0.70; 40% < FEV1 < 60% predicted)

3. airflow limitation (FEV1/FVC < 0.70; 30% < FEV1 < 50% predicted)

4. airflow limitation (FEV1/FVC < 0.70; FEV1 . 80% predicted)

6. Very Severe COPD is characterized by:

1. airflow limitation (FEV1/FVC < 0.70; 30% < FEV1 < 50% predicted)

2. airflow limitation (FEV1/FVC < 0.70; FEV1 < 40% predicted

3. airflow limitation (FEV1/FVC < 0.70; FEV1 < 30% predicted

4. airflow limitation (FEV1/FVC < 0.70; FEV1 < 50% predicted

7. Complications of COPD include:

1. Pulmonary bullae

2. pneumothorax

3. Respiratory failure

4. All the Answers

8. The physical sighs of Emphysema are all, except:

1. decrease vesicular breath

2. tympanic sound

3. dullness on percussion

4. shortness of breath on exertion

9. Management of Stable COPD includes:

1. Smoking Cessation

2. Pharmacological Therapy

3. Long-Term Oxygen Therapy

4. All the Answers

10. The Management of Mild COPD includes:

1. Smoking Cessation

2. oxygen therapy

3. corticosteroids

4. long-time bronchodilator

11. The Management of Severe COPD includes:

1. Smoking Cessation

2. oxygen therapy

3. corticosteroids

4. All the Answers

12. A diagnosis of COPD can be confirmed using all investigation, except:

1. Pulmonary function test

2. Skin testing

3. A chest x-ray

4. Blood gas levels

Pneumonia

1. Wich of the following organisms should be suspected in patients with community-acquired pneumonia:

1. mycobacterium tuberculosis

2. histoplasma capsulatum

3. p.carinii

4. Steptococcus

2. Nosocomial pneumonia is:

1. Tuberculosis in a a patient suffering from AIDS

2. infection of a nasal cavity in immuno compromised patient.

3. Hospital acquired pneumonia

4. A type of community acquired pneumonia

3. Which of the following condition predispose to Aspiration pneumonia ?

1. head trauma

2. all the answers

3. altered conciousness

4. cerebrovascular accident

4. Wich of the following organisms should be suspected in an immunocompromised patient which shows diffused infiltrates on the chest Xray?

1. p.carinii

2. legionalle

3. herpes zoster virus

4. All the Answers

5. Which of the following condition predispose to pneumonia in immuno compromised patients?

1. head trauma

2. all the answers

3. AIDS

4. cerebrovascular accident

6. Risk factors for Hospital-acquired pneumonia?

1. mechanical ventilation,

2. prolonged malnutrition,

3. underlying heart and lung diseases

4. All the Answers

7. Which is the most common cause of hospital-acquired pneumonia?

1. str.pneumonіae

2. All the Answers

3. S. aureus

4. malignancy

8. Wich of the following organisms should be suspected in patient whith homogeneous opacity localised to the one lobe on the chest Xray?

1. p.carinii

2. str.pneumonіae

3. herpes zoster virus

4. All the Answers

9. Which is the most common cause for a focal lesion on a chest x ray?

1. benign lesion

2. All the Answers

3. bacterial infection.

4. malignancy

10. Pneumatoceles is a feature of pneumonia due to:

1. H. influenza

2. E. coli

3. S. aureus

4. Abscess formation

11. Complications of pneumonia includes:

1. Respiratory and circulatory failure

2. acute respiratory distress syndrome

3. pleural effusion

4. All the Answers

12. Complications of pneumonia includes all except:

1. septic shock

2. lung abscess

3. sepsis

4. rheumatoid arthritis

13. Drug of choice in mycoplasma pneumonia

1. streptomycin

2. tetracycline

3. erythromycin

4. moxalactam

14. Drug of choice in patient with I gr. of Community-acquired pneumonia is:

1. streptomycin

2. tetracycline

3. Trimethoprim-sulfamethoxazole

4. amoxicillin

15. Drug of choice in patient with II gr. of Community-acquired pneumonia is:

1. tetracycline

2. erythromycin

3. cefuroxim

4. Trimethoprim-sulfamethoxazole

Lung abscesses and bronchiectasis

1. Bronchiectasis associated with tuberculosis is usually called dry bronchiectasis and is

seen most commonly in the:

1. Lower lobes

2. Upper lobes

3. Middle lobes

4. all the answers

2. The diagnostic modality of choice for demonstrating or ruling out bronchiectasis is:

1. Chest radiography

2. High-resolution computed tomography

3. Bronchography

4. Results of sputum culture

3. The first generation cephalosporins include:

1. cefaclor,

2. cefamandole

3. cefazolin

4. cefixime

4. The second generation cephalosporins include:

1. cefaclor

2. cefadroxil

3. cefoperazone,

4. cefotaxime

5. The third generation cephalosporins include:

1. cefaclor

2. cefadroxil

3. cefoperazone

4. cephalothin

6. The fourth generation cephalosporins include:

1. cefaclor,

2. cefamandole

3. cefepime

4. cefixime

7. Fluoroquinolones include all, except:

1. ciprofloxacin

2. cefquinome

3. levofloxacin

4. lomefloxacin

8. Macrolide antibiotics are all, except:

1. erythromycin,

2. clarithromycin,

3. doxycycline,

4. roxithromycin

9. Which of the following is/are a cause of acquired bronchiectasis

1. Marfan syndrome

2. Williams-Campbell syndrome

3. Foreign Body

4. Cystic Fibrosis

10. In a patient with long standing, severe, bronchiectasis and infection, which of the following would be elevated?

1. WBC

2. RBC

3. Hematocrit

4. All the above

11. Mucolytics agents are commonly used to enhance the mobilization of secretions

in patients with bronchiectasis. Which of the following is/are classified as a

mucolytic agent(s)?

1. Acetylcysteine

2. Cromolyn Sodium

3. Beclomethasone

4. Trimethoprim-sulfamethoxazole

12. Which of the following is a cause of acquired bronchiectasis

1. Marfan syndrome

2. Young syndrome

3. bronchopulmonary aspergillosis

4. Cystic Fibrosis

13. The treatment bronchiectasis includes:

1. Antibiotics

2. Surgical Care

3. Bronchodilators

4. All of the above

Pleuritis

1. The causes of pleural transudates are all except:

1. Congestive heart failure

2. Cirrhosis (hepatic hydrothorax)

3. Atelectasis (which may be due to malignancy or pulmonary embolism)

4. Parapneumonic causes

2. The causes of pleural transudates are all except:

1. Hypoalbuminemia

2. Asbestos exposure  

3. Nephrotic syndrome

4. Peritoneal dialysis

3. The causes of pleural exudates are all except:

1. Congestive heart failure

2. Malignancy (carcinoma, lymphoma, mesothelioma)

3. Pulmonary embolism

4. Collagen-vascular conditions (rheumatoid arthritis, lupus)

4. The causes of pleural exudates are all except:

1. Myxedema

2. Trauma

3. Postcardiac injury syndrome

4. Esophageal perforation

5. The clinical picture of pleuritis may include:

1. Pleuritic chest pain,

2. Vague discomfort

3. Sharp pain that worsens on inspiration

4. All of above

6. The clinical picture of pleuritis may include all except:

1. Dyspnea

2. A pleural friction rub

3. Absent tactile fremitus

4. Bronchial sound above dulness

7. Which of the following investigations would be of greatest use in establishing a diagnosis of pleural effusion?

1. Lateral chest X-ray

2. Serum rheumatoid factor, anti-nuclear factor and anti-DNA antibodies

3. Pleural aspiration

4. Arterial blood gas

8. Light's criteria of Exudative Pleural Effusions include all except:

1. Fluid LDH* ≥ 2/3 ULN for serum LDH

2. Fluid total protein ≥ 3 g/dL

3. Fluid cholesterol ≥ 80 mg/dL

4. Pleural fluid: serum total protein ratio ≥ 0.5

9. Light's criteria of Exudative Pleural Effusions include all except:

1. Fluid LDH* ≥ 2/3 ULN for serum LDH

2. Fluid total protein ≥ 5 g/dL

3. Fluid cholesterol ≥ 60 mg/dL

4. Pleural fluid: serum total protein ratio ≥ 0.5

10. Light's criteria of Exudative Pleural Effusions include all except:

1. Fluid LDH* ≥ 2/3 ULN for serum LDH

2. Fluid total protein < 3 g/dL

3. Fluid cholesterol ≥ 60 mg/dL

4. Pleural fluid: serum total protein ratio ≥ 0.5

Anemia

1. In Ukraine normal Hb concentration for men is:

A. 120-140 g/L

B. 140-160 g/L

C. 150-170g/L

D. 160-180 g/L

2. Which anemia is Macrocytic:

A. Aplastic anemia

B. Anaemia of chronic disease

C. Vitamin B12 deficiency

D. Iron deficiency

3. The signs of Sideropenic syndrome include all, except:

A. concave nails (koilonychias)

B. cheilosis, angular stomatitis

C. altered taste

D. dyspnea

4. The iron transporting protein, which can transport iron from cells (intestinal, macrophages) to specific receptors on erythroblasts and liver cells, is:

A. hemosiderin

B. transferrin

C. ferritin

D. all of above

5. Laboratory Studies in diagnostic of iron deficiency:

A. low serum iron and ferritin with an elevated total iron-binding capacity

B. low serum iron and high ferritin with an decreased total iron-binding capacity

C. high serum iron and ferritin with an elevated total iron-binding capacity

D. low serum iron and ferritin with an decreased total iron-binding capacity

6. The most common causes of megaloblastic anemias are, exclude:

A. iron deficiency

B. disturbances in folic acid metabolism

C. folic acid deficiency

D. deficiency of vitamin B12

7. Neurological symptoms of Vitamin B12 deficiency megaloblastic anemias include:

A. loss of proprioception

B. Optic atrophy - blindness

C. Glove and stocking paraesthesiae

all of above

8. Blood film of megaloblastic anemia exclude:

A. neutrophil hypersegmentation

B. oval macrocytosis

C. hypochromic red cells

D. decreased reticulocyte count

9. The most dangerous side effect of parenteral use of iron-carbohydrate complexes is:

A. anaphylactic reactions

B. dyspepsia

C. constipation

D. all of above

10. Pica chlorotica is characterized by:

A. altered taste

B. dry, hyperemic or “geographic” tongue

C. sparse hair, falling out

D. concave nails (koilonychias)

11. The most important storage pool of iron is:

A. Transferrin

B. hemosiderin

ferritin

myoglobin

12. Drugs that can cause megaloblastic anemia are, except:

A. Amyodarone

B. 6-Mercaptopurine

C. Methotrexate

D. 5-Fluorouracil, 5-azacytidine

13. Anaemic (hypoxic) Syndrome exclude:

A. Fatigue, weakness

B. Bradycardia

C. Dyspnea

D. Dizziness

14. Hemolysis produce:

Unconjugated (indirect) hyperbilirubinemia

Decrease LDH serum levels

C. Direct bilirubinemia

D. Discolored, acholic stool

15. The signs of hemolytic anemia include all, except:

A. Jaundice

B. Gallstones

C. Altered taste

D. General pallor

16. The direct Coombs' test is used to detect:

A. IgG antibodies against RBCs in a patient's serum

B. RBC-binding antibody IgG is present on RBC membranes of patient

C. IgG antibodies against complement

D. Deficiency of IgG antibodies in a patient's serum

17. Specific treatment for Hereditary spherocytosis is:

A. azathioprine

B. splenectomy

C. cyclophosphamide

D. prednisolone

18. Vaso-occlusive crisis are typical sign of:

A. Sickle Cell Anemia

B. Thalassaemia

C. Hereditary spherocytosis

D. Autoimmune haemolytic anaemia

19. Target cells are the most specific for:

A. Sickle Cell Anemia

B. Thalassaemia

C. Acquired aplastic anemia

D. Autoimmune haemolytic anaemia

20. The drug for the treatment of Sickle Cell Anemia is:

A. Hydroxyurea

B. azathioprine

C. prednisolone

D. cyclophosphamide

21. The most common syndromes in patients with aplastic anemia are all, except:

A. Hepatosplenomegaly

B. Recurrent infections

C. Anemia

D. Haemorrhagic syndrome

22. Bone marrow biopsy in middle-aged individuals with aplastic anemia is:

A. >30% cellular

B. 10,000/μL in blood and ≥ 30% lymphocytes in bone marrow, Hb ≥ 10 g/dL; Platelets ≥ 100,000/μL with 3-5 involved sites of lymphoid enlargement is:

A. Stage A 

B. Stage B

C. Stage C

D. Stage III

5. Acute phase, or blast crisis of Chronic myeloid leukaemia is characterized by:

A. peripheral blood blasts of 10%

B. peripheral blood blasts of 20%

C. peripheral blood blasts of 30%

D. peripheral blood blasts of 50%

6. CBC count with peripheral blood smear in patients with Chronic myeloid leukaemia isn’t characterized by:

A. absolute eosinophilia and basophilia

B. presence of the different midstage progenitor cells

C. leukemic gap

D. myeloblasts

7. The first-line therapy in chronic phase Chronic myeloid leukaemia is:

A. Hydroxyurea

B. Busulfan

C. Vincristine

D. Imatinib

8. Initial therapy of CLL include:

cyclophosphamide

chlorambucil

C. rituximab

D. all of above

9. Symptoms of Polycythemia vera don’t include:

A. Plethora

B. Pruritus

C. Pallor

D. Splenomegaly

10. Criteria for Diagnosis of Polycythemia Vera include, except:

A. Splenomegaly

B. Enlarged megakaryocytes

C. Panmyelosis

D. Plethora

11. Chronic lymphocytic leukemia is a monoclonal disorder, which is characterized by:

A. progressive accumulation of functionally competent B-lymphocytes

B. progressive accumulation of functionally incompetent nonproliferative lymphocytes

C. progressive accumulation of T-lymphocytes with increase immunoglobulin production

D. progressive accumulation of lymphocytes precursor

12. Chronic lymphocytic leukemia hallmark don’t include:

A. sustained, absolute peripheral mature lymphocytosis > 5 × 109/l

B. autoimmune hemolytic anemia

increased lymphocytes (> 30%) in the bone marrow

signs duration > 3 months

13. According to the Rai-Sawitsky staging system of Chronic lymphocytic leukemia: Absolute lymphocytosis of > 10,000/μL in blood and ≥ 30% lymphocytes in bone marrow plus hepatomegaly or splenomegaly is:

A. Stage 0

B. Stage I

C. Stage II

D. Stage IV

14. Complete cytogenetic response in patients with Chronic myeloid leukaemia is produced by:

A. Busulfan

B. Imatinib

C. Vincristine

D. Cytosine arabinoside

15. Criteria for Diagnosis of Polycythemia Vera include:

A. Erythrocytosis

B. Platelet count < 400,000 μL

A. asymptomatic lymphadenopathy

B. Plasma erythropoietin level < 4 mUnits/mL

Lymphomas, Multiple myeloma

1. Multiple myeloma is a malignant proliferation of:

functionally competent B-lymphocytes

atypical megakaryocytes

C. atypical plasma cells that produce monoclonal immunoglobulin

D. typical plasma cells that produce polyclonal immunoglobulin

2. The most common organ involvement of Multiple myeloma include, except:

kidney

bone

C. bone marrow

D. gastrointestinal system

3. The most common Laboratory Studies result of Multiple myeloma is high:

A. RBC

B. WBC

C. platelet counts

D. ESR

4. Bence Jones protein is:

A. free monoclonal κ or λ light chains in the urine

B. heavy chains γ or α in the serum

C. monoclonal immunoglobulin in the serum

D. polyclonal immunoglobulin

5. In patients without serum M protein, myeloma is indicated by, except:

A. absolute peripheral lymphocytosis > 5 × 109/l

B. Bence Jones proteinuria > 300 mg/24 h

C. osteolytic lesions

D. sheets or clusters of marrow plasma cells

6 According to the Salmon-Durie staging system for multiple myeloma: Calcium level > 2,75 mM/L, X-ray showing advanced lytic bone disease, Plasma cell in bone marrow > 60% of nuclear cells is:

A. Stage I

B. Stage II

C. Stage III

D. Stage IV

7 The most appropriate treatment of Skeletal lesions in patient with Multiple myeloma is:

A. Allopurinol

B. phluossen

C. vit. D3

D. bisphosphonate

8 "B symptoms" in patient with Hodgkin lymphoma include, except:

A. fever

B. night sweats

C. jaundice

D. unexplained weight loss

9 The main Symptom of Hodgkin lymphoma is:

A. pallor

B. painless lymphadenopathy

C. bleeding, purpura

D. bone pain

10. According to the Ann Arbor classification for Hodgkin lymphoma 2 or more lymph node areas on the same side of the diaphragm is:

A. Stage I

B. Stage II

C. Stage III

D. Stage IV

11. A mediastinal mass greater than one third of the intrathoracic diameter (on a chest radiograph) according to the Ann Arbor classification for Hodgkin lymphoma is denoted as:

"A" designation

"B" designation

"E" designation

"X" designation

12. Treatment of Hodgkin lymphoma include:

A. Chemotherapy

B. stem cell transplantation

C. Radiation therapy

D. all of above

13. According to the Ann Arbor classification for Hodgkin lymphoma the involvement of the spleen is denoted as:

"S" designation

"B" designation

"E" designation

"X" designation

14. Pathognomic sign of Hodgkin lymphoma in Biopsy is:

A. Bence Jones protein

B. Target cells

C. Reed-Sternberg cells

D. Clusters of plasma cells

Platelet and coagulation disorders

1. The most common hereditary coagulation disorder is:

A. von Willebrand's disease

B. haemophilia

C. disseminated intravascular coagulation

D. Immune thrombocytopenic purpura

2. Hemophilia A is a congenital deficiency of:

A. factor VIII

B. factor IX

C. factor VIII and IX

D. factor V

3. Coagulation factor VIII is:

A. Prothrombin

B. Christmas factor

C. Fibrinogen

D. Antihemophilic globulin

4.The most common symptoms of hemophilia are, except:

A. recurrent haemarthroses

B. prolonged bleeding

C. petechiaes

D. muscle haematomas

5. In a patient presenting with a bleeding disorder, which of the following clinical features would be most suggestive of a coagulation defect as opposed to a platelet disorder?

A) Epistaxis

B) Haemarthrosis

C) Menorrhagia

D) Purpura

6 In hemophilia:

A. fibrinogen level is increased

B. platelet count are decreased

C. prothrombin times is shortened

D. activated partial thromboplastin times (aPTTs) is prolonged

7. In Moderate hemophilia factor VIII or IX level is:

A. < 1% of normal

B. 1 to 5% of normal

C. 5 to 25% of normal

D. 10 to 50% of normal

8. Long-term Complications of Hemophilia exclude:

A. Hepatosplenomegaly

B. Arthropathy of large joints

C. Atrophy of muscles secondary to haematomas

D. Mononeuropathy resulting from pressure by haematomas

9. The best treatment of hemophilia is:

A. Fresh frozen plasma

B. Replacement of the deficient factor

C. desmopressin

D. antifibrinolytic drug

10. Petechiae is a result of:

A. easy bruising

B. bleeding

C. extravasation of blood from capillaries into skin and mucous membranes

D. muscle hematoma

11. The hallmark of Immune thrombocytopenic purpura is:

A. thrombocytopenia, neutropenia

B. isolated thrombocytopenia

C. thrombocytopenia, anemia

D. pancytopenia

12. The symptoms of Immune thrombocytopenic purpura don’t include:

A. Widespread petechiae and ecchymoses

B. gingival bleeding

C. Konchalovsky syndrome

D. Haemarthrosis

13. Immune thrombocytopenic purpura may occur due to:

A. NSAIDs

B. viral upper respiratory infection

C. hepatitis virus

D. all above

14. Treatment of chronic Immune thrombocytopenic purpura doesn’t includes:

A. Splenectomy

B. Rituximab, a monoclonal antibody

C. Methylprednisolone

D. Cephalosporins

Gastritis

1. The aetiological factor of gastritis are, except:

A. Klebsiella

B. non-steroidal anti-inflammotory drugs

C. Helicobacter pylori

D. smoking

2. Helicobacter pylori produce enzyme:

A. lipase

B. somatostatin

C. lactase

D. urease

3. The effects of Helicobacter pylori are, except:

A. reduce gastric mucosal resistance

B. reduce gastrin release from G cells

C. release cytotoxins

D. increase acid secretion

4. The production of ammonia from urea by Helicobacter pylori:

A. reduce the pH around the bacterium

B. raise the pH around the bacterium

C. raise gastric mucosal resistance

D. reduce acid load to duodenum

5. The best diagnostic test for Helicobacter pylori is:

A. histology

B. serology

C. urea breath test

D. rapid urease test

6. Helicobacter pylori exclusively colonises:

A. gastric-type epithelium

B. intestinal epithelium

C. duodenum epithelium

D. esophageal epithelium

7. The urea breath test is useful in the diagnosis of which one of the following conditions?

A. Bacterial overgrowth

B. Helicobacter pylori infection

C. Lactose intolerance

D. Coeliac disease

8. For urea breath test are used:

A. C14

B. C13

C. J131-hyppuran

D. Tc99-sulphur

9. H2-receptors antagonists drugs are used:

A. 6-hourly

B. 8-hourly

C. 12-hourly or at night

E. once weakly

10. H2-receptors antagonists drugs are, except:

A. ranitidine

B. omeprazole

C. cimitidine

D. famotidine

11. Misoprostol is:

A. H2-receptors antagonists

B. syntetic prostaglandin analogues

C. antacid

D. H+/K+ ATPase inhibitor

12. Autoimmune gastritis is characterized by:

A. hyperacidity

B. severe pain

C. mucus hypertrophy

D. hypoacidity

13. The most powerful inhibitors of gastric secretion are:

A. antacids

B. proton pump inhibitors

C. H2-receptors antagonists drugs

D. M-cholin-receptor antagonists drugs

14. Which one of the following statements concerning the bacterium Helicobacter pylori is true?

A. It is a Gram-positive rod

B. It produces an enzyme called 'urease' that lowers the surrounding pH

C. It exclusively colonises gastric-type epithelium

D. On colonising the stomach it induces increased secretion of somatostatin from D cells

Peptic ulcer disease

1. The etiological factor of peptic ulcer is:

A. Candida

B. (-hemolytic streptococcus

C. Helicobacter pylori

D. all answers are true

2. Invasive diagnostic test for Helicobacter pylori is:

A. serology

B. rapid urease test

C. urea breath test

D. all answers are true

3. Abdominal pain in the patients with the gastric or duodenal ulcer is characterized by, except:

A. relationship to food

B. localization to the epigastrium

C. permanent

D. episodic occurrence

4. Abdominal pain in the patients with the duodenal ulcer isn’t:

A. nocturnal pain

B. late pain

C. hunger pain

D. early pain

5. The generalized “board-like” rigidity of abdomen is observed in:

A. gastric cancer

B. gastric bleeding

C. perforation

D. gastric outlet obstruction

6. Upper GI radiography with a double-contrast barium study shows the only direct symptom of ulcer:

A. Radiating folds

B. Ulcer crater

C. Nitch symptom

D. Pyloristenosis

7. Complications of the peptic ulcer is, except:

A. bleeding

B. perforation

C. gastric outlet obstruction

D. ascitis

8. Free air beneath the diaphragm in erect chest radiograph is observed in:

A. perforation

B. gastric cancer

C. gastric outlet obstruction

D. gastric bleeding

9. The cornerstone of therapy for peptic ulcers is:

A. prokinetic effect

B. enhance mucosal defence

C. inhibit acid secretion

D. Helicobacter pylori eradication

10. Primary (first-line) H. pylori eradication therapy include, except:

A. clarithromycin

B. omeprazole

C. bitsmuth

D. amoxicillin

11. The most optimal Management of Upper gastrointestinal bleeding to provide Hemostasis is:

A. Dicinon

B. Rheopolyglucini

C. Fresh frozen plasma

D. Ac. Aminocapronici

12. The cardinal features of gastric outlet obstruction are, except:

A. nausea

B. vomiting

C. abdominal distension

D. ascitis

13. Primary (first-line) H. pylori eradication therapy include:

A. omeprazole, amoxicillin or metronidazole, clarithromycin

B. clarithromycin, misoprostol, bitsmuth

C. aspirin, amoxicillin or tetracycline, clarithromycin

D. omeprazole, tetracycline, ranitidine

14. Treatment of non-Hp ulcer include:

A. PPI for 4 weeks

B. PPI for 8 weeks

C. PPI for 52 weeks

D. Bismuth for 2 weeks

15. Quadruple therapies for H pylori infection include, except:

A. Bismuth 525 mg qid, Metronidazole 500 mg qid, PPI bid, clarithromycin 500 mg qid

B. Bismuth 525 mg qid, PPI bid, Metronidazole 500 mg qid, Tetracycline 500 mg qid

C. Metronidazole 500 mg qid, PPI bid, clarithromycin 500 mg qid

D. PPI bid, Bismuth 525 mg qid, Tetracycline 500 mg qid,

16. Maintenance therapy of peptic ulcer include, except:

A. Long-term treatment

B. On-demand treatment

C. Prolong 52-weeks treatment

D. Week-end therapy

CHOLECYSTITIS

1. An overweight 41-year-old woman with a body mass index of 32 presents with a 5-day history of severe right upper quadrant pain. Initially the pain was intermittent, lasting for 2 hours then subsiding, but for the past 12 hours it has been constant. On examination she is pyrexial (38.5°C) and there is tenderness and rigidity in the right upper quadrant. Her white cell count is 18 × 109/l and C-reactive protein 130 mg/l. Liver function tests (LFTs) and amylase are within the normal range. Which of the following diagnoses is most likely?

Biliary colic

Acute pancreatitis

Acute cholecystitis

Choledocholithiasis

2. Which one of the following hormones causes contraction of the gallbladder and release of bile acids in the fed state?

Insulin

Cholecystokinin

Glucagon

Noradrenaline (norepinephrine) fed

3. Which of the following patterns of symptoms is most characteristic of acute blockage of the cystic duct by a gallstone?

Recurrent epigastric pain, radiating to the back, lasting 2 hours then subsiding spontaneously

Constant severe epigastric pain and recurrent vomiting

Intermittent burning epigastric pain relieved by drinking milk

Crushing, heavy epigastric pain radiating to the jaw associated with sweating, nausea and a terror of imminent death

4. Which of the following investigations is most appropriate for the initial diagnosis of acute symptomatic gallstone disease?

CT of the abdomen

Abdominal ultrasound scan

Chest X-ray

Plain abdominal X-ray

5. Risk factors for calculous cholecystitis are all except:

1. Male sex

2. Obesity or rapid weight loss

3. Drugs (especially hormonal therapy in women)

4. Pregnancy

6. Complications of acute cholecystitis are all except:

1. Empyema of gallbladder

2. Emphysematous cholecystitis

3. Perforated gallbladder

4. Primary sclerosing cholangitis

7. Which one of the following statements concerning biliary colic is incorrect:

1. Sudden and complete obstruction of the cystic duct by stone

2. Severe pain, the patient twists in agony until the pain resolves

3. A bout of vomiting often precedes the beginning of the attack

4. History of previous similar episodes

8. Which one of the following statements concerning cholecystitis is incorrect:

1. Physical examination may reveal fever, tachycardia, and tenderness in the RUQ or epigastric region

2. A palpable gallbladder or fullness of the RUQ is present in 30-40% of cases.

3. Jaundice may be noted in approximately 15% of patients.

4. The absence of physical findings rules out the diagnosis of cholecystitis.

Intestine diseases

1. Functions of the small intestine are, except:

A. absorption

B. digestion

C. protection against ingested toxins

D. production of bile

2. Diarrhoea is:

A. frequent porridge-like stool

B. watery stool

C. the passage of more than 200 g of stool daily

D. pellety stool

3. The symptoms of malabsorption related to deficiency of iron are, except:

A. anaemia

B. angular stomatitis

C. koilonychia

D. proximal myopathy

4. The symptoms of malabsorption related to deficiency of vitamin B12 are, except:

A. peripheral oedema

B. peripheral neuropathy

C. anaemia

D. angular stomatitis

5. The symptom of night blindness related to deficiency of:

A. iron

B. vitamin D

C. vitamin A

D. albumin

6. The symptom osteomalacia in malabsorption related to deficiency of:

A. zink

B. calcium

C. protein

D. vitamin K

7. The symptoms of malabsorption related to deficiency of protein are, except:

A. peripheral oedema

B. poor wound healing

C. muscle-wasting

D. follicular hyperkeratosis

8. The sings of malabsorption are, except:

A. hypoalbuminaemia

B. increased prothrombin time

C. hypocalciaemia

D. increased hemoglobin

9. An immunologically mediated inflammatory disorder of the small bowel occurring in genetically susceptible individuals is:

A. celiac disease

B. Whipple’s disease

C. Crohn’s disease

D. ulcerative colitis

10. A multisystem disease with fat malabsorption, protein-losing enteropathy and gastrointestinal, nervous, pulmonary and musculoskeletal involvement is:

A. ulcerative colitis

B. celiac disease

C. Whipple’s disease

D. Crohn’s disease

11. Whipple’s disease is characterized by, except:

A. constipation

B. low-grade fever

C. arthropathy

D. steatorrhoea

12. A lifelong gluten-free diet - the only known effective treatment of :

A. ulcerative colitis

B. celiac disease

C. Whipple’s disease

D. Crohn’s disease

13. An idiopathic chronic recurring inflammatory process of the bowel that often leads to segmental transmural granulomatosis, fibrosis and obstructive symptoms, which can affect any part of the gastrointestinal tract is:

A. ulcerative colitis

B. celiac disease

C. Whipple’s disease

D. Crohn’s disease

14. The most common gastrointestinal tract involvement in Crohn’s disease is:

A. esophagus

B. pylorus and duodenum

C. sigmoid and rectum

D. terminal ileum

15. Which disease is characterized endoscopically by segmental lesions, separated by healthy areas - cobblestone:

A. celiac disease

B. ulcerative colitis

C. Crohn’s disease

D. Tropical sprue

16. Complications of Crohn's Disease don’t include:

A. Hypersplenism

B. Fistulae

C. Acute toxic megacolon

D. Intestinal obstruction

Bowel diseases

1. Functions of the colon are, except:

A. absorption water

B. protein digestion

C. absorption electrolytes

D. propelling the faecal bolus

2. The bowel frequency of the normal population ranges:

A. once day

B. from 2 movements per day to 1 bowel action every second day

C. from 3 movements per day to 1 bowel action every third day

D. from 3 movements per day to 1 bowel action every week

3. In the assessment of diarrhoea, which one of the following clinical features most strongly suggests a colonic aetiology?

1. Right iliac fossa pain

2. Undigested food in stool

3. Blood and mucus in stool

4. Large-volume stool

4. Which one of the following physical consequences of malabsorption is incorrectly matched with the corresponding vitamin or mineral deficiency?

1. Acrodermatitis enteropathica - Zinc

2. Purpura and bruising - Vitamin K

3. Peripheral neuropathy - Vitamin C

4. Night blindness - Vitamin A

5. Which of the following would be least expected to provoke a relapse ('flare') of ulcerative colitis?

1. Loss of job

2. Cigarette smoking

3. Viral laryngitis

4. Course of antibiotics for falsely suspected urinary tract infection

6. A 19-year-old male presents with a 10-day history of bloody diarrhoea and lower abdominal pain associated with fever, malaise and anorexia. Which of the following investigations would be least helpful in establishing a diagnosis?

1. Stool culture and microscopy

2. Sigmoidoscopy and rectal biopsy

3. Blood cultures and serological tests of infection

4. Serum albumin

7. Which one of the following statements concerning intestinal complications of inflammatory bowel disease (IBD) is incorrect?

1. In ulcerative colitis, colonic perforation may occur without the development of toxic megacolon

2. The risk of developing colon cancer in ulcerative colitis is related to both the extent and the duration of colitis

3. Both conditions may present with acute life-threatening haemorrhage

4. Diarrhoea in ulcerative colitis may be due to enteroenteric fistulae

8. Which one of the following systemic complications of inflammatory bowel disease is not related to the activity of bowel disease?

1. Conjunctivitis

2. Primary sclerosing cholangitis

3. Arthralgia

4. Pyoderma gangrenosum

9. Which one of the following clinical features is least suggestive of irritable bowel syndrome (IBS)?

1. Colicky abdominal pain relieved by defaecation

2. Sensation of incomplete defaecation

3. Symptoms disturbing sleep

4. Alternating diarrhoea and constipation

10. Regarding the management of irritable bowel syndrome (IBS), which one of the following statements is true?

1. Patients with constipation as the predominant symptom benefit most from tricyclic antidepressant therapy

2. Elimination diets are the mainstay of treatment

3. Reassurance alone may lead to resolution of symptoms

4. All patients should be advised to increase dietary fibre

11. A functional bowel disorder in which abdominal pain is associated defaecation or a change in bowel habit with features of disordered defaecation and distension:

A. ulcerative colitis

B. Whipple’s disease

C. celiac disease

D. irritable bowel syndrome

12. Irritable bowel syndrome is characterized by, except:

A. depression

B. colicky abdominal pain

C. bowel bleeding

D. feeling of incomplete defaecation

13. Irritable bowel syndrome is wide overlap with, except:

A. non-ulcer dyspepsia

B. fever

C. chronic fatigue syndrome

D. dysmenorrhoea

14. The patient has severe ulcerative colitis with bloody diarrhoea and lower abdominal pain associated with fever, malaise and anorexia.. Which one of the following is true regarding the management?

1. Nutritional support, if required, should be provided intravenously rather than enterally

2. The patient should be treated with intravenous corticosteroids

3. Surgery should not be considered until he has had at least 10 days of maximal medical therapy

4. Sulfasalazine overcomes the need for surgery in around 80% of patients who fail to respond to corticosteroids

Hepatitis

1. Which of the following is not a function of the liver?

1. Synthesis of clotting factors

2. Production of vitamin K

3. Production of glucose during fasting

4. Storage of copper

2. What a maintenance dose of prednisolone in chronic autoimmune hepatitis?

1. 100 mg

2. 0,1 mg

3. 1 mg

4. 10 mg

3. Which of the following viruses is not capable of causing infection without concurrent infection with another hepatitis virus?

B) Hepatitis B

C) Hepatitis C

D) Hepatitis D

E) Hepatitis E

4. Which is the morphological feature of alcoholic liver disease?

1. Gystiolymfoplazmocyt’s infiltration of portal fields

2. The presence of eosinophylic hyaline alcohol particles (Melory’s particles )

3. Moderate fibrosis combined with degeneration of liver cells

4. Hyperplasia of stellate retikuloendoteliots

5. What are the normal sizes of liver (by Kurlov?)

1. . 14-14-15 см

2. 7-6-6 см

3. 14-9-12 см

4. 10-9-8 см

6. Which antibiotics are most hepatotoxic?

1. Natural penicillins

2. Semisynthetic penicillins

3. Cephalosporins

4. Tetracyclines

7. Raising of wich lab test isn’t apply to cytolytic syndrome?

1. ALT

2. LDD

3. C-reactive protein

4. GGT

8. Which one of the following statements about hepatitis B infection is true?

The route of infection does not affect clinical course

It is caused by an RNA virus

No vaccine is available

It may cause cirrhosis

9. The drug of choice for treatment of chronic viral hepatitis in the phase of virus replication?

1. (-interferon

2. Voltaren

3. Vinpocetine

4. Cyclophosphan

10 Which drug is the drug of choice for treatment of autoimmune hepatitis?

1. Perlinganit

2. Prednisolone

3. Papaverine

4. Prazozin

11. What morphological change is not characteristic of chronic hepatitis B?

1. Gistiolimfoplazmotsit’s infiltration of portal fields

2. Hyperplasia of stellate retikuloendoteliots

3. Moderate fibrosis combined with degeneration of liver cells

4. Lesion of lobular structure of liver

12. A hospital inpatient is noted to have an elevated gamma-glutamyl transferase (GGT) with otherwise normal liver function tests. She is taking the following regular medications. Which one is most likely to have caused this abnormality?

1. Omeprazole

2. Paracetamol

3. Phenytoin

4. Ibuprofen

13. Of the following conditions, which is the most likely cause of jaundice accompanied by a seven-fold elevation of alanine aminotransferase and two-fold elevation of alkaline phosphatase?

Viral hepatitis

Acute cholecystitis

Gilbert's syndrome

Pancreatic carcinoma

14. Which one of the following is most suggestive of haemolysis as the cause of jaundice?

Raised alanine aminotransferase (ALT)

Presence of spider naevi

Bilirubinuria

Raised reticulocyte count

15. Which one of the following coagulation factors depends on vitamin K for complete synthesis in the liver?

Factor V

Factor VIII

Factor IX

Factor XI

16. A patient notices that the whites of her eyes have become yellow, her urine has been very dark for several days. Which of the following diagnoses is the most likely explanation for these symptoms?

Cholestatic jaundice

Hyperbilirubinaemia secondary to Gilbert's syndrome

Rhabdomyolysis

Dehydration

17. Which one of the following statements is true of hepatitis C infection?

It is usually sexually transmitted

Once infected, cure is impossible

Liver transplantation is contraindicated due to the risk of reinfection of the transplanted liver

Acute infection is usually asymptomatic

18. World-wide, which of the following is the most important risk factor for hepatocellular carcinoma?

Alcoholic liver disease

Haemochromatosis

Non-alcoholic steatohepatitis (NASH)

Chronic viral hepatitis

19. A 34-year-old woman is referred to the gastrointestinal clinic after her GP discovers abnormal liver function tests. She denies alcohol abuse or sexual risk factors. She received a blood transfusion in the UK in 2002 following a road traffic accident. Her past medical history includes obesity (body mass index = 42), type 2 diabetes mellitus and anxiety/depression. What is the most likely cause of her deranged LFTs?

Occult drug overdose

Alcoholic liver disease

Non-alcoholic fatty liver disease

Hepatitis B infection

Cirrosis

1. What is the normal level of serum total protein?

1. 60-85 g /l

2. 20-45 g /l

3. 80-105 g /l

4. 100-125 g /l

2. Which of the following tests provides the most information about hepatic synthetic function within the last 12 hours?

Activated partial thromboplastin time (APTT)

Albumin

Fibrinogen

Prothrombin time (PT)

3. Which of the following is the first-line drug of choice to treat chronic ascites secondary to hepatic cirrhosis?

Furosemide

Spironolactone

Digoxin

Vasopressin

4. Which of the following statements about primary biliary cirrhosis is true?

It is more common in men

Pruritus is a more common presenting feature than jaundice

A positive antinuclear antibody is diagnostic

Immunosuppression prevents disease progression

5. Group designation B of Criteria for Child-Pugh classification includes Serum bilirubin (µmol/L):

A. 20-34

B. 30-45

C. 34.2-51

D. 40-55.5

6. Group designation B of Criteria for Child-Pugh classification includes Serum albumin (g/L):

A. 20-30

B. 30-35

C. 35-40

D. 35-55

7. Hypersplenism result in:

A. Spleen enlargement

B. hypoproteinemia

C. pancytopenia

D. cholestasis

8. Complications of cirrhosis don’t include:

A. secondary erytrocytosis

B. variceal hemorrhage

C. ascites

D. hepatic coma

9. Bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy is:

A. Xanthelasmata

B. spider nevi

C. fetor nepaticus

D. Asterixis

10. The hallmark of

Primary biliary cirrhosis

:

A. serum antimitochondrial antibodies

B. cholesterol

C. bilirubin

D. alkaline phosphatase

11. Management of

Primary biliary cirrhosis don’t include:

A. Ursodeoxycholic acid

B. Corticosteroids

C. Cholestyramine

D. Omeprasol

12. According to Grading of Hepatic encephalopathy:

Subtle personality change; gross deficits in ability to perform mental tasks with intermittent disorientation for time or place is:

A. Mild confusion

B. Lethargy or apathy

C. Somnolence to semistupor

D. Coma

13. According to Grading of Hepatic encephalopathy: Marked confusion; gross disorientation, unable to perform mental tasks, disorientation to time and place, amnesia is:

A. Mild confusion

B. Lethargy or apathy

C. Somnolence to semistupor

D. Coma

14. Management of Hepatic encephalopathy includes:

A. Lactulose

B. Antibiotics

C. Aminosteril-N-hepa

D. all of above

15. Lactulose is:

A. Enzymatic drug without bile acids

B. Antibiotic

C. diuretic

D. osmotic laxative

Pancreatitis

1. The most-common symptoms of chronic pancreatitis:

1. Abdominal pain

2. Steatorrhea

3. Nausea

4. All symptoms

2. The specific pancreatic enzymes:

1. Amylase

2. Elastase-1

3. Lipase

4. Phosphatase

3. The normal level of ph of pancreatic juice:

1. 1,0-1,2

2. 3,0-3,5

3. 7,5-9,0

4. 5,0-6,5

4. The daily volume of pancreatic juice:

1. 0,2-0,4

2. 0,8-1,2

3. 1,5-2,0

4. 0,6-0,8

5. The main symptoms of endocrine pancreatic insufficiency:

1. Hyperinsulinizm

2. Hypercorticoidism

3. Gipokortitsizm

4. Gipoinsulinizm

6. The main causes of chronic pancreatitis:

1. Alcoholism

2. Stenosis of the ampulla of Vater

3. Hereditary

4. All causes

7. The main tests to establish the diagnosis of chronic pancreatitis:

1. Ultrasound

2. CT

3. Abdominal X-ray

4. All tests

8. The main tests of pancreatic function:

1. Collection of pure pancreatic juice after secretin injection

2. Faecal pancreatic chymotrypsin or elastase

3. Oral glucose tolerance test

4. All tests

9. The complications of chronic pancreatitis:

1. Pseudocysts and pancreatic ascites

2. Extrahepatic obstructive jaundice

3. Duodenal stenosis

4. All complications

10. The complications of chronic pancreatitis:

1. Goblet cell intestinal metaplasia or Barretts esophagus

2. Portal or splenic vein thrombosis

3. Esophageal adenocarcinoma

4. All complications

11. The basic principles of the treatment of chronic pancreatitis:

1. Pain control

2. Bowel rest and hutritional support

3. Antibiotics

4. All

12. The diet for chronic pancreatitis:

1. A diet low in fat and high in protein and carbohydrates.

2. Include a daily diet of 2000-3000 calories, consisting of 1.5-2.0 g/kg of protein, 5-6 g/kg of carbohydrates, and 20-25% of total calories consumed as fat (about 50-75 g) per day.

3. Oral supplementation of fat soluble vitamins (A, D, E, and K) and vitamin B-12 is recommended.

4. All recommendations

13. Which of the following tests is most useful in the assessment of pancreatic exocrine function?

1. Faecal elastase

2. CT scan of abdomen

3. Fasting blood glucose

4. Lactose hydrogen breath test

14. A 55-year-old male presents with a 6-hour history of severe, constant upper abdominal pain radiating to the back. He drinks approximately 80 units of alcohol per week. On examination there is marked epigastric tenderness but no guarding or rebound tenderness. Which of the following tests is likely to be most useful in reaching a positive diagnosis?

1. Plain abdominal X-ray

2. C-reactive protein

3. ECG

4. Serum amylase

Gastro-oesophageal reflux disease (GORD)

1. The most-common symptoms of gastroesophageal reflux disease:

1. Heartburn

2. Regurgitation

3. Trouble swallowing (dysphagia)

4. All symptoms

2. The most-common complications of gastroesophageal reflux disease:

1. Esophageal strictures

2. Barrett's esophagus

3. Esophageal adenocarcinoma

4. All complications

3. The atypical symptoms of gastroesophageal reflux disease:

1. Chronic cough, laryngitis, asthma

2. Jaundice

3. Ascites

4. All symptoms

4. The atypical symptoms of gastroesophageal reflux disease:

1. Erosion of dental enamel

2. Dentine hypersensitivity

3. Sinusitis

4. All symptoms

5. Factors that can contribute to gastroesophageal reflux disease:

1. Hiatal hernia

2. Obesity

3. Zollinger-Ellison syndrome

4. All factors

6. Factors that can contribute to gastroesophageal reflux disease:

1. Cachexia

2. Hypercalcemia

3. Portal hypertension

4. All factors

7. Medications of gastroesophageal reflux disease:

1. Proton pump inhibitors

2. Gastric H2 receptor blockers

3. Antacids

4. All

8. Medications of gastroesophageal reflux disease:

1. Glucocorticosteroids

2. Prokinetics

3. Hepatoprotectors

4. All

9. The standard surgical treatment of gastroesophageal reflux disease:

1. The Nissen fundoplication

2. Highly selective vagotomy

3. Transoral incisionless fundoplication

4. All

10. The surgical treatment of gastroesophageal reflux disease:

1. The Nissen fundoplication

2. Highly selective vagotomy

3. Transoral incisionless fundoplication

4. All

11. Another names of gastroesophageal reflux disease:

1. Gastro-oesophageal reflux disease (GORD)

2. Gastric reflux disease

3. Acid reflux disease

4. All names

12. The main investigations of gastroesophageal reflux disease:

1. Ambulatory esophageal pH monitoring

2. Barium swallow X-rays

3. Esophagogastroduodenoscopy

4. All investigations

13. Biopsies of gastroesophageal reflux disease may show:

1. Lymphocytic inflammation

2. Neutrophilic inflammation

3. Eosinophilic inflammation

4. All kinds of inflammation

14. Biopsies of gastroesophageal reflux disease may show:

1. Edema and basal hyperplasia

2. Goblet cell intestinal metaplasia or Barretts esophagus

3. Dysplasia or pre-cancer

4. All

15. GERD is caused by:

1. Failure of the cardia of the stomach

2. Incompetence of the higher esophageal sphincter

3. Changes in the barrier between the duodenum and the stomach

4. All

16. Which one of the following factors does not predispose to gastro-oesophageal reflux disease (GORD)?

1. Pregnancy

2. High intake of coffee

3. Weight loss

4. Hiatus hernia

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