GIT ASSESSMENT

Question 1

Irrespective of the cause, this is the most common feature of malabsorption:

Answer 1

steatorrhea

Question 2

These tests are used to confirm eradication of H. pylori after treatment:

• rapid urease testing
• hydrogen breath tests
• urea breath testing
• serum antibodies

Answer 2

ALL

Question 3

The important enzymes involved in disaccharidase deficiency are:

• sucrase isomaltase & ancreatic amylase only
• maltase-glucoamylase & pancreatic amylase
• lactase-phlorizin hydrolase , sucrase isomaltase and maltase-glucoamylase only
• all of the above

Answer 3

all of the above

Question 4

This glycogen storage disease can cause Cirrhosis of the liver

Answer 4

IV (Andersen)

Question 5

These orally administered medications can cause a secondary disaccharidase deficiency:

Answer 5

Neomycin

Question 6

The following statements are CORRECT regarding Helicobacter pylori gastritis EXCEPT:

• H. pylori are found in 90% of chronic gastritis
• H. pylori are usually seen as cocci in pairs
• The presence of H. pylori increases acid secretion resulting to peptic ulcer disease. Its presence also
confers increased risk of gastric cancer
• Its incidence of infection correlates with sanitation and hygiene

Answer 6

H. pylori are usually seen as cocci in pairs

Question 7

This type of pepsinogens are present in the urine.

Answer 7

pepsinogen A

Question 8

These FBS levels taken on two occasions are suggestive of diabetes mellitus.

• 7.0 mmol/L
• 126 mg/dL & 100mg/dL only
• 100mg/dL
• 126 mg/dL
• 100mg/dL & 7.0 mmol/L only
• Any of the above

Answer 8

• 7.0 mmol/L

- 126 mg/dL

Question 9

By “ fasting” for FBS, it means no caloric intake for at least:

Answer 9

8 hours

Question 10

A patient came complaining of passing out a watery, sour-smelling stool this morning He suspected it was the
milk that he drank earlier. After challenging him to drink another glass of milk, which Stool Analysis result,
using Clinitest Tablet, will most confirm his suspicion?

Answer 10

0.25 g/dL

Question 11

The concentration of these gastrin forms quadruples following a meal, altering the results of the assay.

• mini gastrin & medium gastrin only
• big gastrin & little gastrin only
• big gastrin & medium gastrin only
• None of the above
• big gastrin & mini gastrin only

Answer 11

None

Question 12

Which of the following features of the organism has linked H. pylori infection to gastric cancer?

• Cytotoxin-associated gene A
• Flagella
• Adhesins
• none of the above
• All of the above
• Urease

Answer 12

Cytotoxin-associated gene A

Question 13

The Pathogenesis of this Diabetes involves destruction of B-cells of the Pancreas by the patient’s own
immune system:

choice # 1 - Type 1 Diabetes
choice # 2 - Type 1.5 Diabetes
choice # 3 - Type 2 Diabetes
• All of the above
• None of the above
• choice # 1 & choice # 2 only
• choice # 2 & choice # 3 only

Answer 13

Choices 1 and 2.

Question 14

An important consequence of this condition is the accumulation of the by-product galactilol which contributes
to cataract formation:

• none of the above
• glucosemia
• fructosemia
• galactosemia
• glycogenemia

Answer 14

galactosemia

Question 15

This does NOT lead to Fasting hypoglycemia:

• exaggerated insulin release
• insulinomas
• Neuroglycopenic decreased rate of glucose production by the liver
• All of the above
• large consumption of ethanol
• none of the above

Answer 15

none

Question 16

During starvation, all possible pathways are utilized by the body in this order just to ensure that the level of
glucose in the circulation is within normal range:

• degradation of stored triglycerides, glycogenolysis, gluconeogenesis, proteolysis spared
• proteolysis spared, glycogenolysis, gluconeogenesis, degradation of stored triglycerides
• glycogenolysis, gluconeogenesis, degradation of stored triglycerides, proteolysis spared
• none of the above
• glycogenolysis, degradation of stored triglycerides, proteolysis spared, gluconeogenesis

Answer 16

glycogenolysis, gluconeogenesis, degradation of stored triglycerides, proteolysis spared

Question 17

This test can be used to check gastric HCL acid secretion:

Answer 17

serum pepsinogen levels & gastric pH

Question 18

The currently mainstay in the diagnostic testing for H. pylori include the following:

• biopsy tissue sampling
• urea breath tests
• fecal antigen detection
• CAG-A gene detection
• Serum antibodies
• fecal antigen detection & CAG-A gene detection only
• none of the above
• biopsy tissue sampling, urea breath tests & fecal antigen detection only
• all of the above
• CAG-A gene detection & Serum antibodies only

Answer 18

ALL

Question 19

The most common causative agent for Antibiotic-associated diarrhea

Answer 19

Clostridium difficile

Question 20

How long is the maximum glucose level usually reached after a meal?

• choice #1 - 1 hour - true
• choice #2 - 1 1/2 hours
• choice # 3 - 2 hours

Answer 20

Choice 1 and 2

Question 21

This level of C-peptide also suggests hyperinsulinism which is characterized by severe hypoglycemia:
• >9.1 ng/mL
• none of the above
• >1.9 ng/mL
• >1.5 ng/mL
• > 5.1 ng/mL

Answer 21

> 1.9 ng/mL

Question 22

Normally, the glucose values throughout the day is

• choice #1 - 45-130 mg/dL
• choice #2 - 2.5-7.2 mmol/L
• choice #3 - 50-110mg/dl

Answer 22

choice #1 & choice #2 only

Question 23

Trace the probable pathogenesis of Acute Pancreatitis by arranging in order the following events:

1) local fat necrosis Injuring myofibroblasts. stellate cells, & leukocytes
2) Leaky microvasculature leading to vascular insufficiency & ischemia
3) pro-inflammatory cytokines released
4) Increased obstructed intraductal pressure
5) accumulation of active lipase
• 1-2-3-4-5
• 3-5-1-2-4
• 2-4-1-3-5
• 4-5-1-3-2
• 4-5-2-1-3
• 4-5-1-2-3

Answer 23

4-5-1-3-2

Question 24

Intraoperative testing for gastrin has the following benefits over serum testing:

• patients with gastrinomas cannot tolerate serum testing
• gastrin has a short half-life & a drop in its levels post-resection is indicative of cure
• All of the above
• gastrinomas can be multiple & maybe located surgically & gastrin has a short half-life & a drop in its levels
post-resection is indicative of cure only

Answer 24

All

Question 25

The highest rise in blood glucose level after a meal is only

Answer 25

10-15 mg/dL

Question 26

These diagnostic testing relies on the fact that the H. pylori organism has urease activity, which metabolizes urea to? ``` bicarbonate and ammonia rapid urease testing hydrogen breath tests urea breath testing serum antibodies ```

Answer 26

Rapid urea testing and urea breath testing only

Question 27

This test can be used to detect whether the patient is really having diarrhea or had just ingested

Answer 27

Stool alkalinization

Question 28

It is also called the juvenile Onset Diabetes mellitus

Answer 28

IDDM

Question 29

How should the patient be prepared before testing for serum Gastrin levels? * patient must be resting for 12 hours * patient must be avoiding acidic foods for 12 hours * patient must be fasting for 12 hours * patient must not be taking any medications for 12 hours

Answer 29

patient must be fasting for 12 hours

Question 30

Oral glucose tolerance test (OGTT) is indicated in cases of the following EXCEPT: * unexplained glycosuria particularly in pregnancy, * unequivocal fasting or random blood glucose concentrations * in the diagnosis of acromegaly. * galactose intolerance * none of the above * All of the above

Answer 30

Galactose intolerance

Question 31

``` Which specimen should be tested for the presence of C. difficile toxin A or B virulence factors? • none of the above • Stool • Plasma • Serum • Urine • Vomitus ```

Answer 31

Stool

Question 32

Which does NOT refer to hypoglycemia in a first week old baby? • <45 mg/dL from birth to first 72 hours • <35mg/dL in full-term neonate • <25 mg/dL - pre-term/low-birth weight infant • < 55mg/dl in a 24 hours old infants • none of the above

Answer 32

< 55mg/dl in a 24 hours old infants

Question 33

Antibiotic-associated diarrhea can present the following signs & symptoms: * All of the above * watery diarrhea, pseudomembranous colitis and toxic megacolon * watery diarrhea, fever and malaise and occult gastrointestinal bleeding * pseudomembranous colitis and toxic megacolon * toxic megacolon, fever and malaise and occult gastrointestinal bleeding

Answer 33

All

Question 34

Which of these staining would you request to identify the presence of H. pylori in gastric biopsy specimens of your patient? * Hematoxylin –Eosin staining * Steiner silver staining * All of the above * Warthin-Starry staining * Giemsa staining * None of the above

Answer 34

All

Question 35

following findings are considered positive for gastrinomas, & thus probable Zollinger-Ellison syndrome : serum gastrin levels >150 ng/L gastric pH values <3 increased in gastrin of 200 ng/L within 15 minutes of secretin injection serum pepsinogen levels > 107 µg/L • gastric pH values < 3 & increased in gastrin of 200 ng/L within 15 minutes of secretin injection only • increased in gastrin of 200 ng/L within 15 minutes of secretin injection & serum pepsinogen levels > 107 µg/ L only • All of the above • serum gastrin levels >150 ng/L & gastric pH values < 3 only

Answer 35

gastric pH values < 3 & increased in gastrin of 200 ng/L within 15 minutes of secretin injection only

Question 36

The level of glucose in a fasting individual is maintained within the range of: * 50-110 mg/dL * 6.2 -8.2 mmol/L & 95-120 mg/dL only * any of the above * 95-120 mg/dL * 50-110 mg/dL & 6.2 -8.2 mmol/L only * 6.2 -8.2 mmol/L

Answer 36

50-110 mg/dL

Question 37

Most common tumor in the liver

Answer 37

Cavernous Hemangioma