2. Gi Diseases and Conditions.

1. Esophageal Webs and Rings.

***) The following are recognized features of Plummer-Vinson syndrome, except:

1. Dysphagia

2. Post-cricoid web

3. Clubbing

4. Deficiency of iron

5. Glossitis

Answer: C* Clubbing

2. Barrett's Esophagus.

***) With regard to Barrett's syndrome esophagus, all are true except:

1. Occurs when columnar metaplasia epithelium replaced the normal squamous epithelium

2. Associated with increased risk of developing esophageal SCC

3. Esophagectomy is warranted if high grade dysplasia is found

4. Operative therapy prevents further progression of the disease

5. It is found in around 10% of patients with long standing GERD

Answer: B* Associated with increased risk of developing esophageal SCC

3. Gastritis.

***) Acute erosive gastritis is best diagnosed by:

1. History

2. Gastric analysis

3. Endoscopy

4. Double-contrast upper GI

5. Capsule biopsy

Answer: C* Endoscopy

***) Hypochlorhydria is caused by all of the following, except:

1. Carcinoma of stomach

2. Pregnancy

3. Pernicious anemia

4. Atrophic gastritis

5. Duodenal ulcer

Answer: E* Duodenal ulcer

***) Gastrin is produced primarily in the:

1. Gastric fundus

2. Antrum

3. Pylorus

4. Liver

5. Pancreas

Answer: C* Pylorus

4. Zollinger-Ellison Syndrome.

***) The most common site of origin of the tumor associated with the Zollinger-Ellison syndrome is:

1. Stomach

2. Duodenum

3. Lymph node

4. Spleen

5. Pancreas

Answer: E* Pancreas

5. Peptic Ulcer Disease pud.

***) Helicobacter pylori can lead to all the following except: Q2012

1. MALT lymphoma

2. Gastric ulcers

3. Duodenal ulcers

4. Gastric cancer

5. GERD

Answer: E* GERD

***) All of the following about peptic ulcer diseases are true, except:

1. Helicobacter pylori is important factor

2. Duodenal ulcer may become malignant

3. Omeprazole is helpful in treatment

4. Zollinger-Ellison is a recognized cause

5. Relapse may occur

Answer: B* Duodenal ulcer may become malignant

***) All of the following have been associated with chronic duodenal ulcer, except:

1. Hyperparathyroidism

2. Zollinger-Ellison syndrome

3. Chronic pulmonary insufficiency

4. Smoking

5. Pernicious anemia

Answer: E* Pernicious anemia

***) All of the following drugs are used in the treatment of duodenal ulcer, except:

1. Sucralfate

2. Calcium antagonists

3. Bismuth

4. Pirazepine

5. H₂-receptors antagonists

Answer: B* Calcium antagonists

***) The following drugs are used in the management of peptic ulcer disease, except:

1. Famotidine

2. Sucralfate

3. Omeprazole

4. Anticholinergic drugs

5. Salazopyrin

Answer: E* Salazopyrin

***) The following drugs are used in the management of peptic ulcer disease, except:

1. Ranitidine

2. Cimetidine

3. Famotidine

4. Omeprazole

5. Mebendazole

Answer: E* Mebendazole

***) Cimetidine is:

1. A histamine analogue

2. A liberator of histamine from mast cells

3. An H₁-receptor blocker

4. A selective H_l blocker with much less sedating properties

5. A selective H₂ receptor blocker which inhibits gastric secretion

Answer: E* A selective H₂ receptor blocker which inhibits gastric secretion

***) All the following drugs are used for H. pylori eradication, except: Q2012

1. Tetracycline

2. Metronidazole

3. Clarithromycin

4. Amoxicillin

5. Ciprofloxacin

Answer: E* Ciprofloxacin

***) All the following are risk factors to develop gastric ulcer except:

1. Increased fiber in diet

2. NSAIDs

3. Stress

4. Smoking

5. Alcohol

Answer: A* Increased fiber in diet

***) The best method to diagnose peptic ulcer disease is:

1. Barium meal

2. Upper gastro-intestinal endoscopy

3. Ultrasonography

4. Labelled RBCs

5. CT scanning of the upper abdomen

Answer: B* Upper gastro-intestinal endoscopy

***) In chronic gastric ulcer the following are true, except:

1. Usually affects the patient of more than 40 years of age

2. Commonly occurs at the lesser curvature of the stomach

3. Symptomatic relief by H₂ blockers is an indication of healing of ulcer

4. Endoscopic biopsy must be done to exclude malignancy

5. Patients may have normal or low values of maximal acid output

Answer: C* Symptomatic relief by H₂ blockers is an indication of healing of ulcer

***) Concerning chronic duodenal ulcer all are true, except:

1. It is more common in males than females

2. Pain usually occurs two hours after meals

3. Vomiting is rare unless stenosis has occurred

4. Increased high fasting gastric secretion is usual

5. Malignant change occurs in 5-10% of this ulcer

Answer: E* Malignant change occurs in 5-10% of this ulcer

***) The most common pathophysiologic mechanism of duodenal ulcer is primarily related to:

1. Gastric acid hypersecretion

2. Hypergastrinemia

3. Deficient duodenal buffers

4. Rapid gastric emptying

5. Hyperpepsinogen secretion

Answer: A* Gastric acid hypersecretion