GIT

MCQ
1.1 year old girl presented with history of acute water diarrhea. Rota virus is suspected. What is the mechanism of
action by which the virus exerts its affects?

A.​ Changes in intestinal motility

B.​ Disturbed secretory function of enterocytes
C.​ Inflammation of mucosa
D.​ Production of exotoxin

2.​ Patient presented with water diarrhea. Stool examination showed Pus cells/HPF. What is the likely site of
infection?
A.​ Colon
2.​ Duodenum
3.​ stomach
4.​ rectum

3.​ 28 woman diagnosed with IBD. Which environmental factor is risk factor?
a.​ antibiotics in early childhood
b.​ High fiver diet
c.sunlight exposure
d.sedentary lifestyle

4.​ Middle aged man, paranesthesia of hands and feets, Mee’s lines in nails and rain drop
pigmentation in hands. Toxin?
a.arsenic b.lead c.mercury d.thallium

5 A man with chronic liver disease presents with distended abdomen & jaundice. Sample is taken from his abdomen.
Sample shows high specific gravity with neutrophils.
What is the sample?​
A: transduate
B: exudate (exudate has high sg due to mor proteins)
C:hemorrhagic ​
D: fibronin
6: a man presents with chronic mercury poisoning. What is the characteristic findings? A: brown
something on anterior capsule
B: hyperpigmentation on palms​
C: tremors & shyness & irritation​
D: burtonian lines

7: A child gets bitten by snake. Bite shows 2 fang marks He is taken to the hospital. What is the initial step to be
taken?
A: compression bandage ​
B: anti-venom
C: reassurance ​
D: IV fluids

8.​ A young woman sustains a deep laceration over her right forearm. The wound is cleaned and sutured.
Which of the following proteins helps to stimulate angiogenesis in the healing wound?
A)​ alpha 1 anti trypsin
B)​ caspase-9
C)​ lysozyme
D)​ metalloproteinase

9.​ Stool examination of a child revealed ova of a parasite which is transmitted through the feco-oral
route. Ova of which of the following parasites was seen?
A)​ ancylostoma duodenale (direct contact)
B)​ ascaris lumbricoides (feco-oral)
C)​ necator americanus (direct contact)
D)​ taenia saginata (undercook beef)

10.​ Patient had H. Pylori, which mechanism is disrupted?

a)​ elaboration of prostaglandin
b)​ epithelial regeneration
c)​ Bicarbonate production
d)​ mucosal blood flow
11) Integrins mediate which process?
a)​ Chemotaxis
b)​ Firm Adhesion
c)​ Migration
d)​ Phagocytosis

12.​ 40 yr old man brought in with signs of poisoning. You are a house officer about to perform gastric lavage
but senior medical officer contradicts that. In Which of the following poisoning is gastric lavage contraindicated?
A)​ arsenic poisoning
B)​ phosphorus poisoning
C)​ lead poisoning
D)​ sulphuric acid poisoning

E)​

54 yr old man presents with diarrhea and abdominal cramping. Later blood appears in stool. WOF drug will be
prescribed?
A)​ ondansetron
B)​ mesalamine
C)​ diphenoxylate
D)​ ursodiol

14)​ a patient with hep C. She is prescribed interferon alpha and ribavirin. What will be the plan of action for
 one month follow up:
A)​ CBC count to check for anemia (Ribavarin causes hemolyitc anemia, interferon alpha causes myelosuprresion)
B)​ x-ray for pulmonary fibrosis
C)​ urine RE for pus cells
D)​ ultrasound for fatty liver

15)​ a girl enjoys playing with her pets, recently she had abdominal pain and bloating, what are effective
preventative measures?
a)​ avoiding hand washing after interaction with pets
b)​ feed pets raw meat
c)​ regularly deworm the pets
d)​ allowing pets inside the house

16)​ a group of friends travel around pakistan, the first location they visit has high prevalence for
soil-transmitted helminth disease. what preventative measures should they take?
a)​ swim in freshwater to wash their bodies
b)​ use only bottled water
c)​ take prophylactic antiparasitic drugs
d)​ avoid all local cuisine

17)​ a 72 year old man presented w abdominal fullness, weight loss and anorexia. On examination he had
hepatomegaly and jaundice. On ultrasonography a mass w a size of 2x2 cm was revealed and on tests there was
an increase in alpha fetoprotein. What is the diagnosis of this case?

a, adenoma
b, hepatocellular carcinoma​
c, focal nodular hyperplasia​
d, regenerative hyperplasia

18, a 62 year old man presented with HBV infection, fever, weight loss of 9 kgs in 5 weeks. On examination he had
hepatomegaly and jaundice. CT revealed nodular liver with a dominant mass of 3cm in the right lobe. Which of the
blood markers will be useful in making the diagnosis?
A, 5' nucleotidase
B, ALP
C, Alpha fetoprotein D,
total protein
19) a 72 year old man presented w abdominal fullness, weight loss and anorexia. On examination he had
hepatomegaly and jaundice. On ultrasonography a mass w a size of 2x2 cm was revealed and on tests there was
an increase in alpha fetoprotein. What is the diagnosis of this case?
a, adenoma
b, hepatocellular carcinoma​
c, focal nodular hyperplasia ​
d, regenerative hyperplasia
 q20, a 62 year old man presented with HBV infection, fever, weight loss of 9 kgs in 5 weeks. On examination he had
hepatomegaly and jaundice. CT revealed nodular liver with a dominant mass of 3cm in the right lobe. Which of the
blood markers will be useful in making the diagnosis?
A, 5' nucleotidase B,
ALP
C, Alpha fetoprotein D,
total protein

21)​ 28F pregnant on nsaids has black pigmented stools complains of epigastic pain. What medication
will you prescribe?
A.​ Al(OH)
B.​ CaCO3
C.​ metronidazole
D.​ L se koi PPI

22)​ child of 1 year with 2 days of diarrhea, lethargy and dehydration. What vaccine?
A.​ Mmr
B.​ Noro
C.​ Polio
D.​ Rota (Rota Virus has vaccine, Noro does not)

23)​ A chronic alcoholic of many years developed severe epigastric pain. He wants to take an H2 antagonist to
relieve his pain
Which would you prescribe?
A)​ famotidine
B)​ cimetidine
C)​ ranitidine
D)​ nixatidine

24)​ A person discovered that he had family history for many GI disorders including cancer. Taking his
family history into account, what would you suggest?
A)​ increased processed food intake
B)​ regular surveillance and screening
c) stop smoking

25)​ A young man complained of blood mixed with mucus and blood. Amoebic dysentery was suspected. What
finding in stool will confirm this?
A)​ mucus
B)​ RBCs
C)​ pear shaped structures with flagella
D)​ trophozites with ingested RBC
26)​ Health authorities are looking into disinfection methods on a large-scale. What advantage does
chlorination provide in relation to other disinfectants?
A.​ It provides natural taste in water
B.​ Minimal equipment is required
C.​ It removes suspended particles
D.​ It provides residual protection against pathogen

27)​ A 14 year old girl has been working in a metal scrapyard for over a year. Recently she was rushed to the
ER with pallor and generalized weakness. On examination blue black lines were observed at the junction of gums
and teeth. Which of the following is the most likely causative toxin?
A.​ Arsenic
B.​ Copper
C.​ Lead
D.​ Mercury

28)​ women with IBS/constipation treated with polyethylene glycol. what is the mechanism of action of the
drug
a)​ acetylcholine blockage
b)​ increased intestinal water (osmotic laxative)
c)​ increased stool surface tension

29)​ 45 year old female with jaundice and hepatomegaly. Increased ALP and anti mitochondrial antibodies.
What causes cholestasis
a)​ primary biliary cirhosis
b)​ primary seclorising choliangitis
c)​ gall stones

30)​ urban slum, water contaminated, causing childhood diarrhea. What public health intervention
most useful:
a) sanitation infrastructure improved​
b)effective waste disposal
c) proper handwashing

31- 6 year old got a bee sting. Pain due to histamine release. Which cells release it:
A) mast cells
b)lymphocyte
c)neutrophils
 32)​ 30 year old farmer presented to OPD with neurological symptoms, stool examination showed ova,
MRI scan showed cysts in brain, what is the treatment of choice​
Albendazole
Ivermectin ​
Praziquantel
Dicyclcarabazine something

​
(THIS IS OLD BOOK. NEW VERSION SAYS ALBENDAZOLE ALONE OR IN COMBI WITH PRAZI. SO WE
CHOOSE ALBENDAZOLE)

33)​ opoid abuser, started on diphenoxylate, however he cannot reuse becuz of addition of one drug. What is
the drug
Atropine
Aluminum hydroxide
Diloxanide Furoate
Paromycin

34)​ 11 month old baby 8 kg weight, is presented to OPD to check for kwashiorkor. What sign will confirm the
diagnosis
Alert baby
Extreme muscle wasting Old
face
Changes in skin and hair

35)​ In a rural community setting, healthcare workers plan on arranging an educational outreach programme.
Which of the following would be most likely to reduce diarrhea in the community?
A.​ Antibiotic use with infection
B.​ Increased consumption of fruits
C.​ Exclusively breastfeeding for the first 6 months of life.
D.​ Early weaning of infants

36)​ A pregnant woman with Hepatitis B. How to prevent transmission to newborn baby?
a)​ prevent breastfeeding
b)​ maternal immunization
c)​ baby immunoglobulins
d)​ baby immunization
(YOU GIVE IMMUNOGLOBULINS + IMMUNIZATION, NOT OPTION)
37​ A 49 year old women presents with vomiting and abdominal pain for 4 weeks and reports 2 similar
previous incidences. colonoscopy reveals mononuclear infiltrates, abscesses and distorted crypts. Vomit contains
blood, mucus. Diagnosis?
a)​ ?
b)​ rectal cancer
c)​ adenocarcinoma colon
d)​ signet ring carcinoma

38​ Patient with poison used for electoplating. Metallic taste, grey-white mucosal membranes, Erosion of
mouth and throat. Sample collected from hair and nails. Poison?
a)​ arsenic
b)​ lead
c)​ mercury
d)​ sulphuric acid

39​ 40 year old man presents with uni-locular well circumscribed cyst in epigastrium.acute pancreatitis
for last 4 weeks.WOF pancreatic cystic lesion is present
A-pancreatic pseudocyst
B-mucinous cyst neoplasm
C-interaductual mucinous neoplasm

Q40 Acute appendicitis case.histopathological examination showed trasmural neutrophils.which of the following play
role in chemotaxis of neutrophils
A-C5a complement
B-bradykinin
C-prostagladin
 41.​ A young patient reports with positive HbsAg. What advice would you give?
a)​ administer immunoglobulins
b)​ administer vaccine
c)​ carry out liver biopsy
d)​ test for HbsAg after 6 months

THIS IS CHATGPT

42) which drug augments the action of GABA leading to paralysis of parasite?
a)​ ivermectin
b)​ niclosamide
c)​ praziquantal
d)​ ozasalazine

43.​ You are in a team investigating the epidemiology of mumps in a city. In which situation will you declare
the investigation complete?
a)​ no case for 2 incubation periods
b)​ less than half the case
c)​ no complications of cases
d)​ less than normal cases in hospital

44​ 14 y old child with abdominal pain, nausea, vomiting since morning. On physical exam periumblicial
pain and rebound tenderness in right lower quadrant. What is seen on lab diagnostic tests
A)​ Leukucytosis
B)​ Amylase
c) ALP

45​ Chronic Gallstones most common cause of Acute Pancreatitis. Which enzyme causes the cascade of
inflammation
A)​ elastase
B)kallikrein​
C)Lipase​
D)Trypsin

46.​ In a community health discussion medical students dicuss management of kitchen waste, cattle dung,
straw and leaves. Which of the following is the best solid waste strategy?
A)​ incineration
B)​ manure pits
C)​ sloping landfills
D)​ trench method

47.​ A 45 year old female presents to the OPD with alternating constipation and diarrheaand abdominal
cramps and bloating. For pain the doctor prescribed a drug that reduces GIT contractions by blocking Ach
action. Which drug?
A)​ dicyclomine
B)​ fluoxetine
C)​ loperamide
D)​ polyethylene glycol

48)​ A 40 year old patient presented flushing,diarrhea,abdominal pain. She was diagonsed with Carcinoid
Tumor. Which drug given to her?
aprepitant
metronidazole,
octreotide (somatostatin
analog)​
pantoprazole

49)​ Pt presentated with Ulcerative colitis. Had second flare. Was already taking olsalazine, prednisone .
Which drug group should be added to the regimen?
Azathioprine (see pyramid above)
Bismuth​
Octeroide​
Sucralfate

50)​ Patient is on Hep C treatment, taking drugs to treat, develops flu like symptoms, which drug is he taking?
INFa

51)​ Mechanism of action of ribavarin: caps viral mRNA and GTP something

52)​ Growth factor invovled in proliferation of blood vessels?

Epithelial growth factor
PDGF
VEGF

53)​ 6 year old hindu girl in diwalai playing with firecrackers got poisoned due to phosphorus. What is
contraindicted?
Vitamin K KmnO4
Demlucents
Activated charcoal​

54)​ Peads clinic in a low income, doctor sees children with malnutrition. What to do? ​
Delay weaning
Introduce cow milk
Offer diverse nutrient rich diet High
 carbs

55)​ 84. Farmer with hypochromic microcytic anemia…. what advise will u give him? Dont walk
barefeet

56)​ 65. Patient comes with ibd which of the conditions would've been causing the symptoms
A) Antibiotic use in early childhood

57 )A study is being carried out in a rural area and there is an increased incidence of neural tube defects in the
children in that area, food fortification is planned, which supplement will be used for fortification
A)​ folic acid ( DEFICIENCY CAUSE NTD defects)
B)​ iron
C)​ B 12

58.​ A group of students is volunteering in a semi urban area and they find out that an industry is polluting the
water sources of that area what should be the management
A)​ polluter pays
B)​ bangalore method

59)​ 67 year old lady with ovarian cancer. 5HT3 receptor antagonist given as antinemetic therapy.
Which one is the drug?
A)​dropenidol
B)​ scopolamine
C)​ palonosetron (5ht3 receptor antagonist)
D)​ chlorpamazine

60)​Transdermal patch used by a person for motion sickness?

A)​ Scopolamine
B)​ odansetron
C)​ dropenidol
D)chlorpamazine

61). A 12 year old girl came to ED. She was unconscious when she arrived. It was a case of poisoning. What will be
the first step in her management?
A.​ Clearing of airway (FIRST ABCD)
B.​ Gastric lavage
C.​ Induce emesis
 D.​ Forced diuresis

62.​ Rotavirus is the most common cause of diarrhoeal illness in children. What's the mechanism by which this
virus causes diarrhea?
A.​ Production of exotoxin
B.​ Secretory diarrhea
C.​ Mucosal invasion

63) Female presented with substernal burning pain following meals for last two months. Endoscopy shows
intestinal mucosa. Which antecedent condition is strongly associated
GERD (BARRET ESOPHAGUS DUE TO ACID REFLEX)
Esophageal Varices
Congenital Anomaly
HSV Infection
63)​ 45 year old lady with heart burn and regurgitation. She smokes 10 cigarettes a day for the past 10 Years and is a
social drinker. Which lifestyle modification would improve her symptoms
Smoking cessation
Decreased alcohol intake
Decreased Physical activity
Increased consumption of spicy food

64)​ Man presented with flushing, sweating, dyspepsia and diarrhea. His ultrasound showed marked thickening of
gastric mucosa along lesser curvature. Endoscopy revealed positivity for Synaptophysin and Chromogranin. What
condition does he most likely have?
Adenoma
Adenocarcinoma
Carcinoid
Signet Cell carcinoma
66 A patient had slow aggressive malignant tumor of parotid gland, which progressed to involve facial nerve. Histology
shows basaloid cells with cribiform appearance. Which type of tumor is it?

Adenoid Cystic carcinoma

Warthin tumor ​
Pleomorphic adenoma
Squamous cell carcinoma

67 What is the mechanism of action by which h pylori affects mucosal barriers?

Dec blood supply

Loss of epethelial regenration ​
Loss of bicarb production​
Dec prostaglandins

68.​ Case of chronic alcohol intake. Patient had hepatitis. AST>>ALT(5:2). Which of the following contributes to
the biochemical pattern seen in this case?
A.​ Decreased triglyceride synthesis
B.​ Increased mitochondrial fatty acid oxidation
 C.​ Increased NADPH production
D.​ Increased lipoproteins

69 60 year old male alcoholic has pain and hematemesis. Physical examination reveal jaundice, distended abdomen
and coarse flapping tremor. Labs received increased serum ALT and alkaline phosphate. Liver biopsy reveal nodular
regeneration and scarring. What is diagnosis?
a.​ Bile duct adenoma
b.​ Hepatic adenoma
c.​ Liver abscess
d.​ Cirhosis

70 A 28 y old female recent onset depression take entire bottle of acetaminophen. What liver complications will be in
this patient?

a.​ bridging fibrosis

b.​ extensive centrilobular necrosis
c.​ portal chronic inflammation
d.​ Spotty necrosis

71 patient presented with anorexia, weight loss and a nodule in liver.which marker can be used to diagnose the
condition.
alpha feto protein
b)nucleotidase ​
c)alp

72 patient presents with recurrent jaundice especially in ramzan.no history of blood transfusion alt ast normal.

a)​dubin johsnon
b) crigler najar​
c) Gilbert ​
d)wilson