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MCQ Gastrointestinal 1

Answer questions 1-5 by choosing the correct answers from the list below. Multiple answers may be correct.

a) HBs Ag +ve

b) Anti HepBs Ab +ve

c) HepBc Ag +ve

d) Anti HepBc Ab +ve… IgG

e) Anti HepBc Ab +ve… IgM

f) E Ag +ve

g) Anti Hep E Ab

h) Hep B DNA

i) Anti delta virus

1.In a person with up to date vaccination of Hepatits B, with no history of infection, what would the serology show?

2.What serology would be seen in seen in a person with prior (5years ago) completely resolved Hepatitis B infection?

3.What would the serology show in a currently infected person with acute Hep B?

4.What would the serology show in a Hep B carrier?

5.What would the serology show in chronic active hepatitis?

6.What would the serology show in co infection with delta virus?

7.Which of the above parameters cannot be measured in the serum?

8.Which statement is false regarding hepatitis A?

a) it is usually mild to moderate in severity with adults usually worse than children

b) chronic hepatitis does not occur

c) both vaccination and immunoglobulin are available

d) it is spread by the faecal –oral route

e) it has a high mortality in pregnant women

9.Which is false about hepatitis C?

a) it is usually a mild acute disease

b) the chronicity rate is very high, about 50-80%

c) immunoglobulin is available for contacts

d) there is no vaccine available

e) treatment is symptomatic, interferon being useful for some patients

10.Which drug is not well known to cause acute hepatitis?

a) isoniazid

b) flucloxacillin

c) amioderone

d) chlorpromazine

e) cephalothin

11.Which of the below has been shown to be of benefit in the ED in upper GI bleeding due to duodenal ulceration.

a) antacids

b) proton punp inhibitors

c) H2 antagonists

d) Octroetide

e) None of the above

12.Which is the first line pharmacological agent in the use of upper GI bleeding from oesophageal varices?

a) H2 antagonists

b) Vasopressin

c) Octreotide

d) Proton pump inhibitors

e) Antacids

13.Which statement is false of peptic ulcer disease?

a) helicobacter pylori is found in more duodenal ulcers than gastric ulcers

b) NSAIDS cause more ulcers than helicobacter pylori

c) The rate of release with peptic ulceration if treated with H2 antagonists alone is about 80%

d) NSAIDS cause more gastric ulcers than duodenal ulcers

e) Omeprazole heals ulcers more quickly than H2 antagonists

14.Which is false about hepatic encephalopathy?

a) it is due to ammonia produced in the gut reaching the brain unchanged

b) increased dietary protein and GIT bleeding are both risk factors

c) renal failure is a risk factor

d) neomycin works by removing urease producing gram –ves in the bowel

e) lactulose is the agent of choice, causing increased transit time as well as decreased ammonia production

15.Which statement is false regarding amylase and lipase in pancreatitis?

a) lipase remains elevated longer than amylase

b) lipase is elevated to the same extent in both alcohol and gallstone pancreatitis

c) amylase is elevated more in gallstone pancreatitis than alcholol

d) lipase may be elevated in conditions other than pancreatitis

e) amylase may be elevated in conditions than other pancreatitis

16.Which is not part of Ransons criteria on presentation?

a) AST >150

b) Glucose >11

c) Calcium 55

e) WCC>16 000

17.The recommended antibiotics for acute cholecystitis are?

a) ampicillin ,gentimicin and flagyl

b) ampicillin and gentamicin

c) cefotaxime

d) gentamicin and flagyl

e) ampicillin and cefotaxime

18.Which is NOT true of staph aureus and bacillus cereus gastroenteritis ?

a) They both have a short incubation period

b) They both cause an illness limited to no more than 24 hours

c) Illness is caused by ingesting food with the toxin already produced by these bacteria

d) Illness is caused by ingesting the bacteria which then form the toxin in the gut

e) Antibiotic treatment is not indicated

19.Which statement is FALSE?

a) Enterohemorrhagic E coli gastro is associated with haemolytic ureamic syndrome

b) Giardia Lamblia is usually treated with Norfloxacin in adults

c) Salmonella gastro in children can cause osteomyelitis and meningitis

d) Campylobactor gastro has been associated with reactive arthritis

e) Campylobactor gastro has been associated with guillain-barre syndrome

20.Which of these hernias frequently incarcerate?

a) indirect inguinal

b) direct inguinal

c) femoral

d) umbilical

e) A and C

21.How should a babe with an asymptomatic umbilical hernia be managed?

a) referred for urgent operation

b) referred for operation if still present at 6 months of age

c) referred for operation if still present at 1 year of age

d) referred for operation if still present at 4 years of age

e) referred for operation if still present at 12 years of age

22.Which is the most common hernia in women?

a) indirect

b) femoral

c) umbilical

d) incisional

e) direct

23.Which statement is true?

a) all incarcerated inguinal hernias should be reduced in ED regardless of the duration

b) no incarcerated inguinal hernias should be reduced in ED

c) if there are signs of bowel obstruction an incarcerated inguinal hernias should be reduced in ED

d) if a patients vital signs are unstable an incarcerated inguinal hernia should be reduced in ED urgently

e) if there are signs of bowel obstruction and ischemia an incarcerated inguinal hernias should NOT be reduced ED

24.What is the ost common cause of a large bowel obstruction?

a) adhesions

b) neoplasms

c) volvulus

d) diverticulitis

e) foreign body

25.In patients under 50 hears what is the most common cause of rectal bleeding?

a) haemorhoids

b) anal fissure

c) inflammatory bowel disease

d) carcinoma

e) diverticulosis

26.In patients over 50 years with rectal bleeding and obvious hemorrhoids, how much further should the lower GIT be imaged?

a) no further

b) sigmoidocsopy or all

c) colonscopy for all

d) only investigate further if bleeding still present in 6 months

e) only investigate further if still bleeding in 12 months

27.Which statement is false about inflammatory bowel disease?

a) perianal disease is more common with Crohns disease than UC

b) steroids are used to induce and maintain remission

c) aminosalicylates are used to induce and maintain remission

d) metronidazole can be useful in treating perianal disease

e) the risk of developing UC is higher in smokers than non smokers

28.Which statement is false re IBD?

a) Crohns disease is transmural inflammation

b) UC is mucosal inflammation only

c) Neoplasia is more common with UC than Crohns

d) Total proctocolectomy is curative in both UC and Crohns

e) UC always involves the rectum, Crohns does not

ANSWERS

1)B 2)B,D,G 3)A,E,F,H 4)E 5)A,D,F,H 6)A,E,F,H,I 7)C 8)E

9)C 10)E 11)E 12)C 13)B 14)E 15)D 16)C 17)B 18)D 19)B 20)E

21)D 22)A 23)E 24)B 25)A 26)C 27)B 28)D

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