41- A 32 year-old woman with Crohn's Disease has a history of a right hemicolectomy for ileo-colonic disease. Since the operation she has had frequent diarrhoea but no blood in the stools.
Investigations show:
ESR 10
PLT 240
serum CRP 7 (<10)
Which is the best treatment?
1) Cholestyramine
2) Mesalazine
3) Metronidazole
4) Omeprazole
5) Prednisolone
Answers-1
42- A 24 year old woman was referred with tiredness and intermittent bloody diarrhoea and a past history of cerebral venous thrombosis. On examination, the sclera of the right eye was inflamed, and multiple mouth ulcers were noted. At the colonoscopy, which confirmed colitis, two large vulval ulcers were noted. Which is the most likely diagnosis?
1) Behcet's disease.
2) Crohn's disease.
3) HIV infection
4) Syphilis
5) Ulcerative colitis.
Answers-1
43- Which of the following is the commonest cause of traveller's diarrhoea?
1) E. Coli
2) Entamoeba Histolytica
3) Giardia Lamblia
4) Shigella Flexneri
5) Yersinia enterocolitica
Answers-1
44- A 59 year old woman has had insulin dependent diabetes mellitus for over two decades. The degree of control of her disease is characterized by the laboratory finding of a HbA1c of 10.1%. She complains of repeated episodes of abdominal pain following meals. These episodes have become more frequent and last for longer periods over the last couple of months.
On physical examination, there are no abdominal masses or organomegaly and no tenderness to palpation.
Which of the following findings is most likely to be present?
1) Acute pancreatitis
2) Chronic renal failure
3) Hepatic infarction
4) Mesenteric artery occlusion
5) Ruptured aortic aneurysm
Answers-4
45- Which of the following is true of Spontaneous bacterial peritonitis?
1) A survival rate of over 50% is expected at one year
2) Gentamicin is the treatment of choice
3) is characteristically caused by aerobic bacteria.
4) is diagnosed by culture of ascitic fluid.
5) is due to intestinal perforation
Answers-3
46- A 30 year old caucasian male presents with a six month history of weight loss, abdominal pain, and diarrhoea. On examination you note finger clubbing. Which of the following diagnoses is least likely.
1) Crohn's disease
2) Ulcerative colitis
3) Coeliac disease
4) Whipple's disease
5) Ileo-caecal TB
Answers-5
47- Reflux oesophagitis of gastric contents
1) is a cause of asthma
2) can be improved by Helicobacter pylori eradication
3) Occurs during transient relaxation of the lower oesophageal sphincter
4) Is neutralised by bicarbonate secreted by the oesophageal mucosa
5) Can be excluded by a normal appearance at endoscopy
Answers-3
48- Which statement is true concerning iron?
1) Iron absorption is mainly in the distal jejunum.
2) Parenteral iron is indicated if the haemoglobin level is not raised within 3 days by oral iron.
3) Sustained release preparations are useful if larger doses are required.
4) 200mg iron sulphate has more elemental iron than an equal dose of iron gluconate.
5) Absorption is prevented by ascorbic acid.
Answers-4
49- Following factors decrease large intestinal motility:
1) Parasympathetic activity
2) Anticholinergic agents
3) Gastric Distension
4) CCK-PZ
5) Laxatives.
Answers-2
50- Which of the following statements is correct of hepatitis C virus infection?
1) Cell cultures of virus are routinely used to assess response to drug therapy
2) High antibody titres are an indication for therapy
3) Less than 5% of cases lead to chronic infection
4) More likely to be transmitted by the sexual route than hepatitis B virus
5) Treatment with ribavirin and interferon alpha is more effective than interferon alpha alone
Answers-5
Investigations show:
ESR 10
PLT 240
serum CRP 7 (<10)
Which is the best treatment?
1) Cholestyramine
2) Mesalazine
3) Metronidazole
4) Omeprazole
5) Prednisolone
Answers-1
42- A 24 year old woman was referred with tiredness and intermittent bloody diarrhoea and a past history of cerebral venous thrombosis. On examination, the sclera of the right eye was inflamed, and multiple mouth ulcers were noted. At the colonoscopy, which confirmed colitis, two large vulval ulcers were noted. Which is the most likely diagnosis?
1) Behcet's disease.
2) Crohn's disease.
3) HIV infection
4) Syphilis
5) Ulcerative colitis.
Answers-1
43- Which of the following is the commonest cause of traveller's diarrhoea?
1) E. Coli
2) Entamoeba Histolytica
3) Giardia Lamblia
4) Shigella Flexneri
5) Yersinia enterocolitica
Answers-1
44- A 59 year old woman has had insulin dependent diabetes mellitus for over two decades. The degree of control of her disease is characterized by the laboratory finding of a HbA1c of 10.1%. She complains of repeated episodes of abdominal pain following meals. These episodes have become more frequent and last for longer periods over the last couple of months.
On physical examination, there are no abdominal masses or organomegaly and no tenderness to palpation.
Which of the following findings is most likely to be present?
1) Acute pancreatitis
2) Chronic renal failure
3) Hepatic infarction
4) Mesenteric artery occlusion
5) Ruptured aortic aneurysm
Answers-4
45- Which of the following is true of Spontaneous bacterial peritonitis?
1) A survival rate of over 50% is expected at one year
2) Gentamicin is the treatment of choice
3) is characteristically caused by aerobic bacteria.
4) is diagnosed by culture of ascitic fluid.
5) is due to intestinal perforation
Answers-3
46- A 30 year old caucasian male presents with a six month history of weight loss, abdominal pain, and diarrhoea. On examination you note finger clubbing. Which of the following diagnoses is least likely.
1) Crohn's disease
2) Ulcerative colitis
3) Coeliac disease
4) Whipple's disease
5) Ileo-caecal TB
Answers-5
47- Reflux oesophagitis of gastric contents
1) is a cause of asthma
2) can be improved by Helicobacter pylori eradication
3) Occurs during transient relaxation of the lower oesophageal sphincter
4) Is neutralised by bicarbonate secreted by the oesophageal mucosa
5) Can be excluded by a normal appearance at endoscopy
Answers-3
48- Which statement is true concerning iron?
1) Iron absorption is mainly in the distal jejunum.
2) Parenteral iron is indicated if the haemoglobin level is not raised within 3 days by oral iron.
3) Sustained release preparations are useful if larger doses are required.
4) 200mg iron sulphate has more elemental iron than an equal dose of iron gluconate.
5) Absorption is prevented by ascorbic acid.
Answers-4
49- Following factors decrease large intestinal motility:
1) Parasympathetic activity
2) Anticholinergic agents
3) Gastric Distension
4) CCK-PZ
5) Laxatives.
Answers-2
50- Which of the following statements is correct of hepatitis C virus infection?
1) Cell cultures of virus are routinely used to assess response to drug therapy
2) High antibody titres are an indication for therapy
3) Less than 5% of cases lead to chronic infection
4) More likely to be transmitted by the sexual route than hepatitis B virus
5) Treatment with ribavirin and interferon alpha is more effective than interferon alpha alone
Answers-5
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