GIT
PATHOLOGY Questions For 2nd year
1. Pathology of Oral cavity & Esophagus…………….……………………………………………………1 2. Diseases of Stomach….…………………………………………………….………….………………….….…6 3. Diseases of Small intestine…………………………….………………………………………….…..…...14 4. Pathology of Colon & Large Intestine……………………….……………….…………………...…28 5. Pathology of Liver…………………………………………………………………………………….…………..32 6. Diseases of Gall Bladder and Pancreas……………..………………………………………………37 Content
Pathology of Oral cavity & Esophagus
Previous exams & Formative:
1- A 23 years old man complained from a slowly growing painless mass in face for 3 weeks. An excisional biopsy of the mass revealed epithelial cells arranged in acinar pattern in myxoid stroma. What is the diagnosis: a. Adenocarcinoma b. Chronic calculous sialadenitis c. Warthin's tumor d. Pleomorphic adenoma 2- Pleomorphic adenoma of salivary gland can recure after excision because: a. It turns to malignant b. A new tumor growth is originated in the gland c. Incomplete excision due to incomplete capsule d. Invasive nature of tumor 3- In portal hypertension, esophageal varices are usually located close to mucosal surface and can be traumatized by swallowed food, resulting in: a. Hemoptysis b. Hemoperitoneum c. Epistaxis d. Hematemesis 1-d 2-c 3-d
1
1
4- Barrett’s esophagus is a:
a. Hyperplastic lesion b. Metaplastic lesion c. Dysplastic lesion d. Neoplastic lesion
5- Mumps is characterized by all of the following except: a. Caused by a bacteria b. Occurs by droplet infection c. Occurs in children d. Enlarged parotid gland
6- Mixed salivary tumor consists of all except: a. Epithelial cells b. Myoepithelial cells c. Cartilage d. Muscles
7- The most important risk factor for adenocarcinoma of the esophagus is: a. Reflux esophagitis b. Esophageal diverticula c. Heavy smoking d. Barrett's esophagus 4-b 5-a 6-d 7-d
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Tuberculous
of the tongue characterized by
of the following except: a. Common
posterior
the tongue b. Under mined edge c. Caused by cough
d. Consist of epithelioid granuloma 8-a Extra: 1- Vincent angina affects the: a. Mouth b. Pharynx c. Esophagus d. Stomach 2- Leukopenia is: a. Benign tumor b. Malignant tumor c. Premalignant tumor d. tumor like lesion 3- Histological features of leukopenia are: a. Hyperkeratosis b. Parakeratosis c. Acanthosis d. All of the above 1-a 2-c 3-d 3
8-
ulcer
all
in
one third of
sputum
4- Mixed salivary tumor is a:
a. Benign epithelial tumor
b. Benign mesenchymal tumor
c. Benign epithelial and mesenchymal d. Malignant tumor
5- Warthin’s tumor means:
a. Pleomorphic oedema
b. Oncocytoma
c. Papillary cystadenoma lymphmatosum
d. Acinic cell carcinoma
6- Warthin’s tumor consist of:
a. Sheets of epithelial cells
b. Mesenchymal elements
c. Papillae covering lymphoid tissue
d. Mixed epithelial and mesenchymal tissue
7- Swiss cheese pattern is a histological feature of:
a. Mucoepidermoid carcinoma
b. Adenoid cystic carcinoma
c. Acinic cell carcinoma
d. Pleomorphic adenoma
4-c 5-c 6-c 7-b
8- Lymphoepithelioma is a:
a. Type of carcinoma
b. Type of lymphoma
c. Benign tumor d. Premalignant lesion
4
9- The following tumor is usually malignant: a. Mixed salivary tumor b. Warthin’s tumor c. Oncocytoma d. Acinic cell tumor
8-a 9-d 10-c 11-b 12-d 5
10- Esophageal varices result from: a. Diverticula of the esophagus b. Congenital malformation c. Portal hypertension d. Tumors 11- The esophageal varices may be fatal due to: a. Malignant transformation b. Severe hematemesis c. Severe hemoptysis d. Fistula formation 12- The commonest type of esophagitis is: a. Fungal esophagitis b. Bacterial esophagitis c. Viral esophagitis d. Reflux esophagitis
Previous Exams & Formatives:
The
Drugs b. Helicobacter
c. Autoimmune d. Chemicals e. Unknown Answer: b
The commonest
of peptic
is the: a. Esophagus b. Stomach c. Duodenum d. Large intestine e. Meckel's diverticulum Answer: c 3- Leather bottle stomach means: a. Diffuse infiltration of the gastric wall by malignancy b. Non-malignant lesion c. Localized infiltrating carcinoma d. Malignant ulcer e. Carcinoma in situ Answer: a
The
Deep ulcer b. With an undermined edge Diseases of Stomach 2 6
1-
commonest cause of chronic gastritis is: a.
pylori
2-
site
ulcer
4-
characteristic feature of dysplastic ulcer is being: a.
c. A precancerous lesion
d. Associated with leukoplakia
e. Multiple and painful
Answer: e
5- Peptic ulcer does NOT occur in:
a. Esophagus b. Stomach c. Duodenum d. colon e. Meckel’s diverticulum Answer: d
6- Gastric adenocarcinoma is classified according to Lauren classification into:
a. Well and poorly differentiated grades b. Intestinal and diffuse types c. Superficial and deep types d. Exophytic and endophytic Answer: b
7- The following is NOT a feature of chronic gastritis:
a. Chronic inflammation b. Glandular hypertrophy c. Metaplasia d. Dysplasia
e. All of the above Answer: b
8- H. pylori infection is a predisposing factor for:
a. Acute gastritis b. Chronic gastritis c. Carcinoma of the stomach d. Lymphoma e. All of the above
7
Answer: e
9- Chronic atrophic gastritis showed:
a. Hyperplasia of the gastric mucosal glands
b. Metaplasia of the gastric mucosa
c. Ulceration of the gastric mucosa d. Acute inflammatory cell infiltration of the lamina propria e. Malignant invasion by invasion by neoplastic cells
Answer: b
10- Chronic gastric ulcer is caused by:
a. Hyperacidity
b. Gasterinoma
c. Duodeno-gastric reflex d. Zollinger-Ellison syndrome
e. Increased vagus nerve tone
Answer: c
11- A 50 years-old man complained of heart burn after meal with hematemesis for 6 months. endoscopy showed a large gastric ulcer with raised everted edges and necrotic floor . A biopsy from the lesion showed:
a. Necrotic tissue b. Granulation tissue c. Acute inflammatory cells d. Chronic inflammatory cells e. Neoplastic epithelial cells
Answer: e
12- The type of the inflammation in case of acute gastritis is:
a. Membranous
b. Serous c. Catarrhal d. Necrotizing e. None of the above Answer: c
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13- A patient has a gastric ulcer due to bacterial pathogen. which characteristic appears to play a central role in the ability of this organism to colonize the stomach :
a. Phospholipase production
b. Urease production
c. Microaerophilic lifestyle d. Capsular antigens
Answer: b
Extra:
1- Chronic atrophic gastritis is characterized by:
a. Atrophy of the glandular epithelium
b. Atrophy of the muscle layer
c. All of the above d. None of the above
Answer: a
2- Activity in chronic gastritis means:
a. Excess infiltration by lymphocytes
b. Excess infiltration by plasma cells
c. Infiltration by polymorphs d. Proliferation of fibroblasts
e. Dysplastic changes
Answer: c
3- The premalignant change in chronic gastritis is:
a. Extensive inflammation
b. Activity
c. Atrophy
d. Intestinal metaplasia
e. Presence of helicobacter
Answer: d
4- Helicobacter pylori are:
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a. Rod-shaped bacilli
b. S-shaped bacilli
c. Fusiform bacilli d. Spirochetes
e. None of the above Answer: b
5- The commonest cause of chronic gastritis is:
a. Drugs b. HeIicobacter pylori c. Autoimmune d. Chemicals e. Unknown Answer: b
6- Pathogenicity of Helicobacter pylori is due to:
a. Direct cytopathic effect b. induction of cell-mediated hypersensitivity reaction c. Production of urease enzyme d. Production of coagulase enzyme e. Production of fibrinolysins
Answer: c
7- Granulomatous gastritis is NOT due to:
a. Tuberculosis b. Crohn's disease c. Foreign body d. Helicobacter pylori e. Sarcoidosis
Answer: d
8- Peptic ulcer does NOT occur in the:
a. Esophagus
b. Stomach c. Duodenum d. Large intestine
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Answer: d
9- The commonest cause of peptic ulcer is: a. Increased gastric acid b. Drugs c. Helicobacter pylori d. Smoking e. Autoimmune reaction Answer: c
10- The histologic features of peptic ulcer include all EXCEPT: a. inflammatory cell infiltrate b. Granulation tissue formation c. Proliferation of the smooth muscle fibers d. Fibrosis Answer: c 11- The edges of acute peptic ulcer are: a. Everted b. Inverted c. Clear cut d. Undermined Answer: c 12- Complications of duodenal peptic ulcer do NOT include: a. Hemorrhage b. Perforation c. Stenosis d. Malignant transformation Answer: d
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13- The following factors predispose to gastric carcinoma EXCEPT: a. Adenoma b. Leiomyoma c. Intestinal metaplasia d. Dysplasia
Answer: b
14- The commonest mesenchymal tumor of the stomach is:
a. Fibroma
b. Lipoma c. Leiomyoma d. Rhabdomyoma e. Hemangioma Answer: c
15- Gastric carcinoma metastasizes to the ovary mainly by:
a. Direct spread b. Lymphatic spread c. Blood spread d. Transcoelomic spread Answer: d
16- Transcoelomic spread of gastric carcinoma goes mainly to:
a. Liver b. Kidney c. Ovary d. Uterus e. Intestine Answer: c
17- A solitary sharply demarcated 2-cm gastric antral ulcer found on upper endoscopy in a 40-year-old male will be most commonly associated with which of the following findings:
a. Islet adenoma of pancreas
b. Crohn's disease c. Lymph node metastases
d. Gastric achlorhydria
e. Hematemesis Answer: e
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18- At the time of upper endoscopy with biopsy, chronic atrophic gastritis of autoimmune etiology (type A) can be associated with each of the following findings EXCEPT:
a. Helicobacter infection
b. Risk for adenocarcinoma
c. Achlorhydria
d. High serum gastrin levels e. Pernicious anemia
Answer: d
19- Linitis plastica means:
a. Localized infiltrating carcinoma
b. Non-malignant lesion
c. Carcinoma in situ
d. Diffuse infiltration of the gastric wall by malignancy e. Malignant ulcer
Answer: d
20- Patients of benign gastric ulcer generally have:
a. Normal-to-high gastric acid
b. Absence of gastric acid
c. Normal-to-low gastric acid d. High gastric acid
Answer: c
21- A gastric biopsy demonstrates the appearance of neoplastic signet ring cells seen with H&E stain. Which of the following statements regarding possible findings associated with this biopsy is INCORRECT:
a. The patient had a past history of pernicious anemia
b. The biopsy was probably taken from the antrum
c. Nitrite ingestion may have played a role in development
d. A polypoid, fungating mass lesion is probably present e. The patient was at increased risk because he was blood group A
Answer: d
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Diseases of Small intestine
Typhoid fever:
1- The commonest site of Salmonella typhi infection is:
a. Duodenum b. Jejunum c. Ileum d. Cecum e. Colon
Answer: c
2- Method of infection in typhoid fever is:
a. Droplet infection b. Blood transfusion c. Direct contact d. Oral route e. None of the above
Answer: d 3- The Salmonella typhi organisms multiply in the: a. Peyer's patches. b. Liver. c. Spleen. d. Lymph nodes. e. All of the above.
Answer: e
4- In typhoid fever, the intestinal mucosa is mainly infiltrated by: a. Eosinophils. 3 14
b. Polymorphs. c. Lymphocytes. d. Macrophages. e. Plasma cells.
Answer: d
5- In typhoid fever, there is a lack of:
a. Eosinophils. b. Polymorphs. c. Lymphocytes. d. Macrophages. e. Plasma cells. Answer: b
6- Typhoid ulcer is:
a. Parallel to the long axis of the intestine. b. Perpendicular to the long axis of the intestine. c. Oblique. d. Irregular. Answer: a
7- The most important local complication of typhoid fever is:
a. Ulceration. b. Perforation. c. Hyperplasia of Peyer's patches. d. Malignant transformation. e. Intestinal obstruction.
Answer: b
8- The systemic complications of typhoid fever are due to:
a. Bacteremia. b. Septicemia.
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c. Toxemia.
d. Pyemia.
e. None of the above
Answer: c
9-
Which of the following is true about typhoid fever:
a. The intestine develops pseudomembranous inflammation.
b. The lesions are characterized by dense infiltrates of neutrophils. c. Peripheral blood usually shows leucocytosis with lymphopenia. d. Cholecystitis and bronchopneumonia may complicate the disease.
Answer: d
10-
Typhoid fever is commonly acquired by:
a. Droplet infection.
b. Transplacental. c. Contaminated food and drink. d. Air borne. e. dirty toilet seats.
Answer: c
11-
Which bacteria is involved in the typhoid fever:
a. Salmonella Typhi. b. Salmonella Paratyphi. c. both a and b. d. None of the above.
Answer: a
12-
All are true about typhoid ulcers EXCEPT:
a. Mainly affects ileum.
b. Multiple ulcers and transverse.
c. Perforation occurs at third week. d. Perforation treated by surgery.
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Answer: b
13- All are complications of typhoid ulcers EXCEPT:
a. Perforation.
b. Stricture Formation.
c. Hemorrhage. d. Sepsis.
Answer: b
14- If typhoid is not treated properly for 2-3 weeks, what would be possible hazards that may happen to the patients:
a. Intestinal perforation and bleeding.
b. Bleeding and high fever. c. High fever and vomiting. d. Pink color spots in the body and high fever. Answer: a
15- S. typhi is carried by ------- to the liver , gall bladder and spleen:
a. RRBC. b. WBC. c. Lymphatic node. d. None of the above.
Answer: b
16- Typhoid patients may develop pink color spots in the body after---- days of typhoid fever:
a. 5 days. b. 12 days. c. 7 days. d. 11 days. Answer: c
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Dysentery:
1- Bacillary dysentery is a:
a. Suppurative inflammation.
b. Membranous inflammation.
c. Granulomatous inflammation. d. Fibrinous inflammation. e. Allergic inflammation.
Answer: b 2- The most important feature of bacillary dysentery is:
a. Lack of polymorphs. b. Ulceration. c. Pseudomembrane formation. d. Hyperplasia of the lymphoid tissue. e. None of the above.
Answer: c
3- The following is NOT a complication of amoebic dysentery:
a. Ulceration. b. Perforation c. Toxemia. d. Stricture formation. e. Bleeding per rectum
Answer: c
4- Amoebic dysentery may lead to:
a. Amoebiasis of the liver.
b. Amoebiasis of the spleen. c. Amoebiasis of the lung. d. All of the above. e. None of the above.
Answer: d
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5- Amoeba secretes:
a. Proteolytic enzymes.
b. Coagulase enzyme.
c. Exotoxins. d. Endotoxins. e. None of the above.
Answer: a
6- Ulcers of the small intestine include all EXCEPT:
a. Peptic ulcer.
b. Typhoid ulcer. c. Malignant ulcer. d. Amoebic ulcer. e. Tuberculous ulcer.
Answer: d
7- The following ulcer does NOT occur in the large intestine:
a. Peptic ulcer. b. Malignant ulcer. c. Bilharzial ulcer. d. Amoebic ulcer. e. Bacillary dysentery.
Answer: a
8- Which of the following act as mechanical carriers to transmit Entamoeba histolytica?
a. Housefly. b. Caterpillar. c. Birds. d. Butterfly.
Answer: a
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9- Bacillary dysentery is caused by:
a. Salmonella organism.
b. Shigella organism.
c. Clostridium difficle. d. Treponema pallidum.
Answer: b 10- Bacillary dysentery is:
a. Acute suppurative inflammation
b. Acute fibrinous inflammation.
c. Acute pseudomembranous inflammation. d. Acute necrotizing inflammation.
Answer: c 11- Multiple small flask shaped ulcers in the intestine is a feature of:
a. Amoebic dysentery. b. Bacillary dysentery. c. Bilharzial ulcers. d. Typhoid fever.
Answer: a 12- Which of the following lesions predispose to intussusception:
a. Amoebic dysentery. b. lntestinal polyps. c. Gastroenteritis. d. All of the above.
Answer: d
13- The most common site for amoebiasis is:
a. Cecum.
b. Sigmoid colon.
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c. Transverse colon. d. Hepatic flexure.
Answer: a
Crohn’s Disease & Ulcerative Colitis:
1- Etiology of the inflammatory bowel disease is:
a. Virus. b. Bacteria. c. Autoimmune. d. Unknown. e. Parasite.
Answer: d
2- Crohn's disease affects:
a. Stomach. b. Small intestine. c. Large intestine. d. Anal canal. e. Any part of the gastrointestinal tract.
Answer: e
3- Features of Crohn's disease include all EXCEPT:
a. Skip lesions. b. Cobble stone appearance. c. Superficial ulcers. d. Granuloma formation. e. Transmural inflammation
Answer: c
4- The most important histologic feature of ulcerative colitis is:
a. Ulceration.
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b. Diffuse inflammation.
c. Crypt abscess. d. Fibrosis. e. Crypt atrophy
Answer: c
5- The following is NOT a feature of ulcerative colitis:
a. Pseudopolypi. b. Skip lesions. c. Ulceration. d. Crypt abscess. e. Crypt atrophy.
Answer: b
6- Crypt abscess is filled with:
a. Pus. b. Polymorphs. c. Lymphocytes. d. Organisms. e. Cascous material.
Answer: b
7- The following intestinal ulcer may be precancerous:
a. Peptic ulcer. b. Typhoid ulcer. c. Tuberculous ulcer. d. Ulcer of Crohn's disease. e. Ulcer of ulcerative colitis.
Answer: e
8- Lesion which may predispose to colorectal cancer include:
a. Crohn's discase.
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b. Ulcerative colitis.
c. Schistosomiasis.
d. Diverticular disease.
e. Hirschsprung's disease.
Answer: b 9- One of the following features is NOT true about inflammatory bowel disease:
a. It is a chronic condition resulting from abnormal mucosal immune responses. b. It embraces 2 conditions; Crohn’s disease & ulcerative colitis.
c. Crohn’s disease commonly affects the large intestine. d. Ulcerative colitis commonly affects the rectosigmoid region.
Answer: c 10- Which of the following intestinal diseases is most liable for malabsorption:
a. Crohn's disease.
b. ulcerative colitis. c. Typhoid fever. d. All of the above
Answer: a 11- Features of Crohn’s disease:
a. Transmural inflammation.
b. Diffuse distribution.
c. No granulomas.
d. Associated with toxic megacolon.
Answer: a 12- Features of ulcerative colitis:
a. Transmural inflammation.
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b. Skip lesions.
c. Marked pseudo polyps. d. Mouth to anus distribution.
Answer: c 13- The following ulcers affect the large intestine EXCEPT:
a. Bilharzial ulcer.
b. Ulcers in Bacillary dysentery. c. Amoebic ulcer. d. Tuberculoid ulcer. e. Ulcerative colitis.
Answer: d 14- In ulcerative colitis, inflammation is limited to the:
a. Mucosa. b. Serosa. c. Submucosa. d. Transmural layer.
Answer: a 15- A 25-year-old male complained of intermittent diarrhea and lower abdominal pain. An upper G-I series showed segmental narrowing in the ileum. Microscopic findings of the lesion showed inflammation from the mucosa to the serosa with the presence of non-caseating granulomas. The most likely diagnosis is:
a. celiac sprue.
b. Tropical sprue. c. Crohn's disease. d. whipples disease.
Answer: c
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Malabsorption syndromes:
1- The following is NOT a cause of malabsorption:
a. Coeliac disease. b. Tropical sprue. c. Hirschsprung's disease. d. Whipple’s disease.
Answer: c
2- Coeliac disease is due to:
a. Infection. b. Autoimmune reaction. c. Unknown cause. d. Gluten sensitivity. e. Fava beans sensitivity.
Answer: d
Tumors Of the Small Intestine:
1- Carcinoid tumor arises from:
a. Goblet cells. b. Absorptive cells. c. Argentaffin cells. d. All of the above. e. None of the above.
Answer: c
2- The metastatic potential of carcinoid tumor depends mainly on:
a. Tumor site. b. Tumor size. c. Histologic grade. d. Histologic type. e. None of the above.
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Answer: b
3- The commonest site of carcinoid tumor is:
a. Stomach.
b. Small intestine. c. Appendix. d. Large intestine. e. Anal canal.
Answer: c
4- Carcinoid syndrome occurs in:
a. Non-metastatic carcinoid tumor.
b. Carcinoid tumor with lymph node metastases. c. Carcinoid tumor with blood-borne metastases. d. All of the above. e. None of the Above.
Answer: c
5- All the following are features of carcinoid tumor EXCEPT:
a. Arises from argentaffin cells.
b. It can be located in any site of the gastrointestinal tract. c. It can be located in the bronchi. d. It is always associated with carcinoid syndrome. e. May turn malignant.
Answer: d
6- Most common malignant tumor of the small intestine is:
a. carcinoid tumor.
b. Lymphoma. c. Adenocarcinoma. d. Malignant tumors.
Answer: a
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7- Carcinoid syndrome is characterized by all of the following EXCEPT:
a. Mitral stenosis.
b. Pulmonary stenosis.
c. Bronchospasm.
d. Diarrhea.
e. Skin flushing.
Answer: a
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d.
e.
a. Adenocarcinoma b. Mucinous
c. Signet ring
carcinoma d. Undifferentiated
e. None
Invagination
a. Strangulation b. Intussusception c. Mesenteric vascular occlusion d. Volvulus e. None
d.
4
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Previous exams & Formative: 1- Which of the following is an example of benign epithelial colonic neoplasm? a. Leiomyoma b. Benign gastrointestinal tumor (GIST) c. Colorectal carcinoma
Juvenile rectal polyp
Villous adenoma 2- The commonest microscopic type of colorectal carcinoma is:
carcinoma
cell
carcinoma
of the above 3-
of one loop of intestine to another loop is called:
of the above 4- The most Important prognostic factor in colon cancer is: a. Mitotic activity. b. Tumor size. c. Glandular formation.
Extent of tumor invasion
Pathology of Colon & Large Intestine
1-e 2-a 3-b 4-d
5- McBurney sign is seen with:
a. Acute appendicitis.
b. Pseudomembranous Colitis.
c. Ulcerative colitis
d. Crohn's disease
6- Carcinoid syndrome can be seen with:
a. Carcinoid in stomach.
b. Carcinoid in intestine.
c. Carcinoid metastasis in liver. d. Carcinoid in appendix.
7- Krukenberg's tumor is a:
a. Primary benign tumor of colonic mucosa
b. Primary malignant tumor of colon mucosa
c. Metastatic benign tumor from the colon d. Metastatic malignant tumor from the colon e. None of the above
5-a 6-c 7-d
Extra:
1- The colonic segment having no ganglion cells shows:
a. Dilatation
b. Obstruction c. Stenosis d. Ulceration e. Normal appearance
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2- Carcinoid tumor arises from:
a. Goblet cells
b. Absorptive cells c. Argentaffin cells d. All of the above
1-b 2-c
3- The commonest site of carcinoid tumor is:
a. Stomach b. Small intestine c. Appendix d. Large intestine
4- Carcinoid syndrome occurs in:
a. Non-metastatic carcinoid tumor b. Carcinoid tumor with lymph node metastases c. Carcinoid tumor with blood-borne metastases d. All of the above
5- The metastatic potential of carcinoid tumor depends mainly on:
a. Tumor site b. Tumor size c. Histologie grade d. Histologic type
6- Meckel's diverticulum is....
a. Intestinal fistula. b. Intestinal hernia. c. Congenital anomaly of the intestine. d. Preformation of the intestine.
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part of
31
7- Intussusception is defined as...... a. Rotation of the omentum along its axis. b. Protrusion of the omentum through a weak area in the abdomen. c. A loop of intestine twists around itself and its mesentery d. A part of the intestine slides into an adjacent
the intestine. 3-c 4-c 5-c 6-c 7-d 8- One of the functional causes of acute intestinal obstruction is: a. Adhesions b. Strangulated hernia c. Paralytic ileus d. Thrombosis or embolism of mesenteric artery 9- All of the following are causes of chronic intestinal obstruction except: a. Fibrous stricture following Crohn's disease b. Annular stricture carcinoma c. Hirschsprung discase d. Strangulated hernia 8-c 9-d
Pathology of liver 5
Previous exams & Formative:
1- The commonest type of viral hepatitis in Egypt:
a. Hepatitis b virus b. Hepatitis d virus c. Hepatitis a virus d. Hepatitis c virus
2- The following type of viral hepatitis is transmitted by fecal oral route:
a. Hepatitis a b. Hepatitis c c. Hepatitis b d. Hepatitis d
3- The following type of viral hepatitis is not parenterally transmitted:
a. Hepatitis a b. Hepatitis c c. hepatitis g d. hepatitis b 1-d 2-a 3-a
4- Chronic hepatitis does not occur in case of infection by:
a. Hepatitis a b. Hepatitis c c. Hepatitis g
32
Calcium
Fat
d. Apoptotic
4-a 5-c 6-a
33
d. Hepatitis b 5- Hepatitis d virus infection is always associated with infection by: a. Hepatitis a b. Hepatitis c c. Hepatitis b d. Hepatitis g 6- Carrier state does not occur in: a. Hepatitis a b. Hepatitis c c. Hepatitis g d. Hepatitis b 7- Acidophilic bodies are: a.
deposits b.
droplets c. Amyloid deposits
bodies
7- d 8- Lymphoid follicles in portal tracts are commonly seen in: a. Hepatitis a b. Hepatitis c c. Hepatitis g d. Hepatitis b 9- The following is not a feature of chronic active hepatitis: a. A severe form of chronic hepatitis b. May proceed to cirrhosis c. The hepatic architecture is preserved d. The limiting plate is intact
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10- Ground glass appearance of the liver cells is characteristic of: a. Hepatitis a b. Hepatitis c c. Hepatitis g d. Hepatitis b 11- The commonest cause of chronic viral hepatitis is: a. Hepatitis b b. Hepatitis d c. Hepatitis a d. Hepatitis c 8-b 9-d 10-d 11-d Extra: 1- Piece-meal necrosis means necrosis of: a. Single liver cells b. A limited zone of the hepatic lobule c. Groups of liver cells in the hepatic lobule d. Hepatocytes at the limiting plate between parenchyma and portal cells 2- The type of hepatocytes necrosis in viral hepatitis is: a. Focal necrosis b. Piece-meal necrosis c. Bridging necrosis d. Any of the above 3- Cholemia means: a. Cholestatic liver disease b. Cirrhosis c. Liver cell failure d. Cholangiocarcinoma
1-d 2-d 3-c
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4- The cause of death in patients with cirrhosis is: a. Liver cell failure b. Esophageal varices c. Hepatocellular carcinoma d. any of the above 5- The most dangerous complication of portal hypertension is: a. Ascites b. Piles c. Caput medusae d. Esophageal varices 6- The risk factors of hepatocellular carcinoma include: a. Aflatoxin b. HBV infection c. Cirrhosis d. All of the above 7- Metabolic causes of chronic hepatitis include all the following except: a. Alpha antitrypsin deficiency b. Cryptogenic c. Hemochromatosis d. Wilson disease 4-d 5-d 6-d 7-b 8- The most common cause of chronic hepatitis is: a. Viral hepatitis b. Autoimmune hepatitis
c. Drug-induced hepatitis d. Metabolic hepatitis
9- Which of the following hepatic viruses produce concomitant infection (co-infection):
a. HBV-HAV b. HBV-HCV c. HBV-HDV d. HBV-HEV
10- Hepatitis E virus (HEV) is commonly transmitted by: a. Blood and blood components b. Sexual route c. Trans placentally d. Enterically 11- Primary biliary cirrhosis is caused by: a. Viral b. Extra-hepatic bile duct obstruction c. Metabolic disease d. Autoimmune 8-a 9-c 10-d 11-d
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Diseases of Gall Bladder & Pancreas
Previous exams & Formative:
1- Pigment stones occur in:
a. Hypercholesterolemia
b. Infection
c. Hemolytic anemia
d. Diabetes mellitus
e. Hepatocellular carcinoma
2- Rokitansky Aschoff sinuses are:
a. Seen in acute pancreatitis
b. Seen in chronic cholecystitis
c. Seen in carcinoma of gall bladder d. Neoplastic glands of the wall of gall bladder e. None of the above
3- Pancreatic duct adenocarcinoma is characterized by:
a. Common perineural invasion
b. Most frequently located in the tail of pancreas
c. Not associated with lung metastasis d. Not associated with liver metastasis
e. None of the above
4- Acute hemorrhagic pancreatitis occurs due
a. A stone impacted in ampulla of Vater
b. An enlarged lymph node pressing on cystic duct
c. Rokitansky Aschoff sinuses
d. Acute emphysematous cholecystitis
e. In association with acute viral hepatitis
to:
6 37
1-c 2-b 3-a 4-a
5- A 45-year-old man developed severe abdominal pain, he was found to be hypotensive and in shock. He was unresponsive to therapy and died 2 days later. Post mortem biopsy revealed diffuse fat necrosis of the omentum and peritoneum. Based upon these data, which of the following most likely initiated this sequence of events?
a. Acute hemorrhagic pancreatitis b. Splenic infarct c. Liver cirrhosis d. Gastric ulcer e. Gall stones
6- A 15-year-old boy has an acute onset of upper quadrant abdominal pain; sonography revealed a dilated bladder filled with calculi. After cholecystectomy, the gallbladder opened revealed ten multifaceted dark greenish black gallstones. Which of the following underlying conditions does this boy most likely have?
a. Hypercholesterolemia b. Crohn’s disease c. Hemolytic anemia d. Hyperparathyroidism e. Biliary cirrhosis
7- With which one of the following do gall stones not have a recognized association?
a. Intestinal obstruction b. Hepatitis B infection c. Hemolytic anemia d. Acute pancreatitis 5-a 6-c 7-b
38
b. Diabetes c. Weight
d. Back
d.
c.
d.
8-c 1-b 2-a 3-b 39
8- Which is true regarding cholecystitis? a. Pigment stones are associated with hypercholesteremia b. Chronic non-calculous cholecystitis is more common than calculous cholecystitis c. Gall stones may lead to intestinal obstruction d. Cholesterol stones may be associated with sickle cell disease Extra: 1- Pancreatic carcinoma could be clinically presented by all of the following except: a. Jaundice
loss
pain 2- Majority of pancreatic carcinoma arise in: a. Head of the gland b. Body of the gland c. Tail of the gland
Body & tail of the gland 3- Faceted gall stones are: a. Cholesterol stones b. Mixed stones
Black pigment stones
Brown pigment stones
4- Which of the following statements is true about cholecystitis? a. Gall stones predispose to cholecystitis & cholecystitis predispose to gall stones formation b. Chronic cholecystitis may be associated with contracted gall bladder c. Chronic cholecystitis may be associated with distended gall bladder d. All of the above 5- The enzyme responsible for calcification in case of acute pancreatitis: a. Lipase b. Amylase c. Acid phosphatase d. Alkaline phosphatase e. Creatine kinase 6- Ascites causes fluid to accumulate where? a. Abdomen b. Chest c. Brain d. Lung 7- The cause of acute pancreatitis? a. Virus b. Bacteria c. Fungus d. Autoimmune e. None of the above 4-d 5-a 6-a 7-e 40
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