Download The most likely cause(s) of malaria in Iraq is:

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1. Single choice questions (SCQS): Choose a single best answer:
The malaria in Iraq is commonly caused by:
A. Plasmodium falciparum and vivax.
B. Plasmodium vivax.
C. Plasmodium malariae.
D. Plasmodium ovale and vivax.
E. .Plasmodium falciparum.
All the following medications are useful for treatment of falciparum
malaria, except:
A. Quinine.
B. Mefloquine.
C. Doxycycline.
D. Chloroquine.
E. Primaquine.
In a patient with falciparum malaria, one of the following is unexpected
clinical manifestation:
A. Diarrhea.
B. Cough.
C. Looking seriously ill .
D. Severe and rapid developing anaemia.
E. Hepatocellular Jaundice.
Renal involvement in the form of glomerulonephritis may complicate
malaria caused by:
A. P. vivax.
B. P. malariae.
C. P. malariae and P. falciparum.
D. P. falciparum.
E. P. Ovale.
Essay questions:
Q1: Comment on following aspects of malaria:
a) Radical cure.
b) Diagnosis.
c) Treatment of falciparum malaria (mention doses and duration).
d) Methods of transmission.
Q2: Write briefly on clinical features and complications of falciparum
malaria.
All of the following about hepatic abscess due to E. Histolytica are true,
except:
A. Absence of recent history of diarrhea is usual.
B. The abscess typically contains a chocolate-like material.
C. Medical therapy is unlikely to be effective.
D. The absence of toxicity in the presence of a high swinging fever is
noticeable
E. Antibodies are detectable by immunofluorescence in over 95% of
patients
Amoebic dysentery is characterized by all the following, except:
A. Gradual onset of the disease.
B. Right iliac fossa tenderness.
C. Absence of constitutional symptoms.
D. Passage of unformed and offensive stools.
E. Finding of cysts in stool is diagnostic
Essay questions:
Q3: Write briefly on clinical features of intestinal amoebiasis pointing
out the main differences from bacillary dysentery in referring to history,
clinical examination and investigations. Enumerate complications.
Q4: Comment on clinical features, diagnosis and treatment of amoebic
abscess.
The unlikely cause of unintentional significant weight loss due to
endocrinal disorders is:
A. Hypothyroidism.
B. Phaeochromocytoma.
C. Diabetes mellitus.
D. Diabetes inspidus.
E. Addison's disease.
Among the following list of causes of dysphagia, Upper dysphagia with
nasal regurgitation is most likely due to:
A. Achalasia.
B. Bulbar and pseudo bulbar palsy.
C. Squamous cell carcinoma of oesophagus.
D. Oesophagitis.
E. Post–cricoid oesophageal web.
The most likely expected cause of dyspepsia in a 20-year-old female is:
A. Gastro-esophageal reflux disease (GERD).
B. Functional
C. Hepatobiliary disease.
D. Peptic ulcer disease.
E. H. pylori induced gastritis.
Essay questions:
Q5: How do you define upper gastrointestinal bleeding? Comment on
clinical presentation and causes. Mention a single most important
diagnostic method for such condition.
The least likely cause of severe, acute lower gastrointestinal bleeding is:
A. Colonic diverticular disease.
B. Meckel's diverticulum of small intestine.
C. Inflammatory bowel disease (IBD).
D. Ischaemic colitis.
E. Colonic angiodysplasia in elderly.
All the following are recognized causes of diarrhea due to
malabsorption syndrome, except:
A. Chronic pancreatitis.
B. Obstructive Jaundice.
C. Celiac disease.
D. Ulcerative colitis.
E. lymphangiectasia
Q6: Comment briefly on:
a) Major obscure gastrointestinal bleeding.
b) Occult gastrointestinal bleeding.
Gilbert's disease is characterized by all the following, except:
A. It is an autosomal dominant disease.
B. It is the commonest type of congenital non-haemolytic
hyperbilirubinaemia
C. Caused by decrease in the level of glucuronyl transferase or decrease
bilirubin uptake.
D. Usually follows viral infection or fasting.
E. AST and ALT liver enzymes are slightly elevated.
The early features of obstructive jaundice include all the following,
except:
A. Deep jaundice.
B. Pruritis.
C. Xanthoma and xantholasma.
D. Dark urine.
E. Pale stool.
Q7: What are the features in hemolytic jaundice that differentiate it from
hepatocellular or obstructive jaundice?
H. pylori infection is linked with all of the following gastric disorders,
except:
A. Chronic gastritis with intrinsic factor deficiency.
B. Gastric adenocarcinoma.
C. Specific type of gastric lymphoma (MALToma).
D. Duodenal ulcer.
E. Gastric ulcer.
Autoimmune chronic gastritis is associated with all the following,
except:
A. Macrocytic anaemia.
B. Hypothyroidism.
C. Primarily involving the antrum.
D. Predispose to gastric adenocarcinoma.
E. Presence of specific serum antibodies against parietal cells.
All of the following are well recognized risk factors for gastric
adenocarcinoma, except:
A. Dietary factors.
B. Smoking and alcohol consumption.
C. Familial adenomatous polyposis.
D. History of previous gastric surgery.
E. Presence of specific gene mutation.
The most frequent anatomical site for gastric adenocarcinoma is:
A. Antrum.
B. Body toward lessor curvature.
C. Body toward greeter curvature.
D. Fundus.
E. Cardia.
The second most common gastric malignancy is:
A. Lymphoma.
B. Leiomyosarcoma.
C. Carcinoid.
D. Adenoacanthoma.
E. Squamous cell carcinoma.
Essay question:
Q1: Write briefly on causes, clinical manifestations, diagnosis and
treatment of acute gastritis.
Q2: Comment on steps of diagnostic work up (clinical and investigatory)
for suspected adenocarcinoma in a patient presented with chronic
dyspepsia.
Investigations of gastrointestinal diseases (lectures 1 and 2):
Plain X-ray of abdomen is of value in gastroenterology for detection of
following conditions, except:
A. Acute complication of peptic ulcer disease.
B. Acute pancreatitis.
C. Hepatobiliary disease.
D. Small intestinal obstruction.
E. Large intestinal obstruction.
Capsule endoscopy is of particular valve in detection of
A. Proximal colonic lesions.
B. Distal ileal lesions.
C. Crohn's complications.
D. Meckel's diverticulum.
E. Obscure major gastrointestinal bleeding.
The best practical and more convenient test for diagnosis of H. pylori
infection is:
A. Serum antibody detection.
B. Urea breathe test.
C. Stool antigen detection.
D. Biopsy and special staining for H. pylori.
E. Biopsy and urease test.
The best investigatory method for detection of Crohn's fistula is:
A. Endoscopy.
B. CT scan.
C. MRI.
D. Barium study.
E. Capsule endoscopy.
Q3: What are indications, contraindications and complications of
colonoscopy?
Q4: Mention the best single test or investigation for each of the
following gastrointestinal and hepatobiliary disorders:
1) Meckel's diverticulum.
2) Small intestine transit time.
3) Obscure major gastrointestinal bleeding.
4) Biliary and pancreatic ducts disorders.
5) Perforated duodenal ulcer.
6) Hydatid cyst of liver.
7) Crohn's fistula.
8) Active intestinal bleeding.
9) Celiac disease (other than serological tests).
10) Bleeding per rectum.
Q1: A 50-year-old man presented to accident and emergency department
because of a single bout vomiting of coffee-ground like material 3 hours
ago. His condition was preceded with passage of black, tarry coloured,
soft, offensive and small sized stools a day before. Comment on major
causes and emergency non – endoscopic management.
Q2: Write briefly on following aspects of coeliac disease: Atypical (extraintestinal) presentations, associations, methods of diagnosis and long
standing complications.
Q3: Write briefly on: Pathogenesis, clinical manifestation, treatment and
recurrence prevention of a newly diagnosed patient with chronic
duodenal ulcer.
Q4: Comment on causes and consequences of malabsorption.
Q5: Write short notes about small intestinal bacterial overgrowth.
All the following are useful during emergency management of bleeding
varices, except:
A. B-blockers like propranolol.
B. Terlipressin injection.
C. Prophylactic antibiotics.
D. Variceal band ligation.
E. IV fluid.
The following are the measures that are taken to prevent recurrence
after treatment of peptic ulcer disease, except:
A. H. pylori eradication.
B. Discontinuation of NSAIDs.
C. Never re-assume aspirin in ischaemic heart disease even with PPI.
D. Patients with idiopathic ulcers must receive long-term anti-ulcer
therapy.
E. After cure of ulcer is documented anti-ulcer therapy is generally not
given.
All the following are features related to Zollinger-Ellison syndrome,
except:
A. Severe, recurrent peptic ulceration.
B. Hypercalcaemia is associated feature.
C. It is a consequence of gastrinoma of pancreas or duodenal wall.
D. The tumor is rarely malignant.
E. Secretin stimulates gastrin release.
Which of the following is the best investigation or test for fat
malabsorption?
A. Sudan black test.
B. Fecal fat estimation.
C. D-xylose test.
D. Small bowel biopsy.
E. Barium follow-through.