GIT MCQs Past papers MBBS

PART 1

1.    You will see no anatomic pathology at all in the gut in a

case of

A.   amebiasis

B.   cholera (*)

C.   cryptosporidiosis

D.   ischemic colitis

E.   shigellosis

2.   What is the predominant cell in the small-intestinal lesions

of typhoid fever?

A.   eosinophil

B.   lymphocyte

C.   macrophage (*)

D.   neutrophil

E.   plasma cell

3.   Classic "hypersecretory" gastritis involves primarily the

A.   antrum (*)

B.   cardia

C.   entire mucosa

D.   fundus

E.   muscularis throughout the organ

4.   Metaplasia of the stomach mucosa near a primary fundic

cancer usually resembles

A.   antral mucosa

B.   colon

C.   esophagus

D.   pancreas

E.   small intestine (*)

5.   A tree-like, branching core of smooth muscle distinguishes

a(n)

A.   adenomatous polyp

B.   hyperplastic polyp

C.   juvenile retention polyp

D.   Peutz-Jegher polyp (*)

E.   pseudopolyp

6.   Where's the thrombus in "Budd-Chiari" syndrome?

A.   hemorrhoidal plexus

B.   hepatic vein (*)

C.   inferior mesenteric vein

D.   portal vein

E.   umbilical vein

7.   Infamous for those "flask-shaped ulcers" in the colon?

A.   amoeba  (*)

     B.   Crohn's

C.   shigella

D.   typhoid

E.   ulcerative colitis

8.   Crohn's regional enteritis gets blamed for causing B12

deficiency because it often involves the

A.   colon

B.   duodenum

C.   proximal jejunum

D.   stomach, interfering with intrinsic factor production

E.   terminal ileum (*)

9.   The pentetreotide (octreotide-analogue) nuclear-medicine

scan is a good way to light up

A.   carcinoids (*)

B.   helicobacter

C.   ischemic bowel

D.   premalignant colon polyps

E.   small peptic ulcers

PART 2

1.   Which layer is typically thickened in reflux esophagitis?

*    A.   basal layer of the epithelium

     B.   keratin layer of the epithelium

     C.   muscularis mucosae

     D.   spiny layer of the epithelium

     E.   venous muscular tunic

2.   On endoscopy of the stomach, if the antrum is obviously

inflamed but the fundus seems much

less involved, the cause is probably

     A.   alcohol

     B.   aspirin / NSAIDS

     C.   autoimmunity

*    D.   helicobacter

     E.   Zollinger-Ellison

3.   Which is LEAST LIKELY to result from cancer of the pancreas?

     A.   back pain

     B.   deep vein thrombosis of the upper extremity

     C.   depression

     D.   insulin resistance

*    E.   pseudomyxoma peritonei

4.   True classic Reye's syndrome can be distinguished from the

inborn errors which mimic it by

finding

     A.   elevated blood ammonia levels

     B.   elevated transaminase levels

     C.   fatty change of the liver

     D.   Mallory's hyaline

*    E.   marked mitochondrial swelling

5.   Most patients with hepatoblastoma are

     A.   alcoholics

*    B.   children

     C.   infected with hepatitis B and/or C

     D.   iron-overloaded

     E.   vinyl chloride workers

6.   There is presently some reasonable concern that long-term

administration of medications to

suppress the production of stomach acid can cause

     A.   gastric adenocarcinoma

*    B.   gastric carcinoid

     C.   gastric leiomyosarcoma

     D.   gastric lymphoma

     E.   pancreatic adenocarcinoma

7.   "Acrodermatitis enteropathica" usually results from the

inability to absorb

     A.   long-chain fatty acids

     B.   medium-chain fatty acids

     C.   selenium

     D.   short-chain fatty acids

*    E.   zinc

8.   Boerhaave's disease is rupture of the

     A.   common bile duct

     B.   duodenum

*    C.   esophagus

     D.   gall bladder

     E.   stomach

part 3

1.         Giant mitochondria (the famous "Yokoo bodies") seen in hepatocytes suggest:

*           A.        alcoholism

B.        amyloidosis

C.        Crigler-Najjar syndrome

D.        Gilbert's non-disease

E.        mitochondrial myopathy

2.         Ground glass hepatocytes suggest

A.        acute hepatitis B infection

B.        anabolic steroid use

C.        antitrypsin deficiency

*           D.        chronic hepatitis B infection

E.        toadstool poisoning

3.         Peliosis hepatitis, an infamous hazard of anabolic steroid abuse, consists of

A.        confluent areas of inflammation

B.        confluent areas of necrosis in the periportal regions

C.        multiple hemangiomas

D.        lakes of bile with surrounding liver cell injury

*           E.        lakes of blood without surrounding endothelium

4.         If you were to biopsy livers on 100 anabolic steroid abusers, which would you probably see most often?  Assume that these people are otherwise living squeaky-clean lifestyles.

A.        apoptotic cells (Councilman bodies)

*           B.        cholestasis

C.        fatty change

D.        Mallory's hyaline

E.        granulomas

5.         At autopsy of a child with Reye's syndrome, the liver would show

A.        cholestasis with otherwise-healthy hepatocytes

*           B.        extensive fatty change

C.        Mallory hyaline and granulomas

D.        massive necrosis

E.        PAS-positive granules

6.         The most feared side effect of ddI (didanosine), the anti‑HIV medication, is

A.        achalasia

B.        gastrointestinal bleeding

C.        ischemic colitis

D.        massive hepatic necrosis

*           E.        pancreatitis

7.         Your patient survived an acetaminophen overdose, but required a twelve-day hospitalization and had transaminases reaching into the 5000's.  That was a year ago, and things are much better now, but he wants to know just how much damage he did.  If you were to choose to do a follow-up liver biopsy, what would you expect to see?

A.        central scarring without bridging

B.        cirrhosis or at least bridging

*           C.        normal liver with no scarring

D.        periportal scarring without bridging

E.        scarring of portal zones themselves

8.         It is your first autopsy on your senior pathology elective. Your patient is a football linebacker who has been sick for a few weeks but refused to see the doctor.  His liver weighs only 450 grams, is amazingly limp, and is a pale reddish color. You suspect

*           A.        acetaminophen suicide

B.        acute herpes 2 infection    

C.        cirrhosis from years of hidden drinking

D.        those anabolic steroids finally caught up with him

E.        way too much beer over that wild weekend

9.         In common (familial) hemochromatosis, the iron is most abundant in the

A.        bile duct epithelium

*           B.        hepatocytes

C.        Ito cells

D.        Kupffer cells

E.        portal triad fibroblasts

10.       A known risk factor for cancer of the external bile ducts is

A.        amiodarone administration

B.        coffee drinking

C.        iron overload

D.        previous administration of halothane anesthetic

*           E.        ulcerative colitis

part 4

1.      What is CA-19-9?

A.        a stain to distinguish the more dangerous Barrett's cases

*        B.        a tumor marker for pancreatic cancer

C.        one of the "microsatellite instability" genes

D.        the mutated protein in cystic fibrosis

E.        the mutated protein in most cases of hemochromatosis

2.      Which electrolyte disturbance is well-known to trigger pancreatitis?

*        A.        hypercalcemia

B.        hypermagnesemia

C.        hyperphosphatemia

D.        hypocalcemia

E.        hypokalemia

3.      Phosphorus poisoning, acute iron poisoning, and eclampsia produce a distinctive necrosis of the

A.        central hepatocytes

B.        hepatic venous radicles

C.        midzonal hepatocytes

*        D.        periportal hepatocytes

E.        portal-area bile ducts

4.      There is typically very little or no inflammatory response in hepatitis due to

A.        anti-smooth-muscle antibody disease

B.        hepatitis D

C.        hepatitis E

D.        leptospirosis

*        E.        yellow fever

5.      In kala-azar, the leishmania organisms are found primarily in the

A.        hepatocyte cytoplasm

B.        hepatocyte nuclei

C.        Ito cells

*        D.        Kupffer cells

E.        vascular endothelium

6.      Hepatic fatty change with extreme edema of the mitochondria is diagnostic of

A.        hepatitis C

B.        lead poisoning

C.        non-alcoholic steatohepatitis

*        D.        Reye's

E.        total parenteral nutrition lesion

7.      If you get to examine a section of gastro-esophageal junction from a patient with achalasia, you will most likely see

*        A.        chronic inflammation of the myenteric plexus

B.        edema of the smooth muscle cells

C.        fibrosis of the smooth muscle with scar contraction

D.        hypertrophic skeletal muscle

E.        viral inclusions in the neuronal bodies

8.      The most abundant inflammatory cell in the mucosa in ulcerative colitis is usually the

A.        eosinophil

B.        macrophage

C.        neutrophil

D.        lymphocyte

*        E.        plasma cell