Gastro Patho EXAM 2006 QUESTIONS

Gastro Patho EXAM 2006 QUESTIONS - Gastrointestinal...

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1 Gastrointestinal Pathophysiology Exam 2006 Tufts University School of Medicine Instructions: please select the one BEST answer. 1. Three days into the hospitalization for an acute illness a CT scan is performed on a 32 year old woman. She initially presented to the emergency room with severe periumbilical pain, nausea, and vomiting. She denied any alcohol use and was on no medications. She had previously been feeling well. She was treated with intravenous fluids and kept nothing by mouth. An initial ultrasound exam of the abdomen revealed gallstones within the gallbladder and a mildly dilated common bile duct. Because her symptoms persisted and she developed a fever the CT scan was obtained. Which of following statements best describes the pathophysiology of this condition? A. Obstruction of the cystic duct due to gallstones B. Activation of pancreatic enzymes within the pancreas C. Obstruction of the pancreatic duct due to proteinaceous plugs D. Reduction in pancreatic enzyme synthesis and secretion E. Reduction in stimulation of intracellular calcium signaling pathways 2. A 52 year old man has had heartburn for over 20 years. He reports no dysphagia or odynophagia. An upper endoscopy shows no significant hiatal hernia. Which of the following esophageal motility test findings would you most likely expect to see in this patient? A. Frequent transient lower esophageal sphincter relaxations B. Elevated resting lower esophageal sphincter pressure
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2 C. Reduced resting lower esophageal sphincter pressure D. Infrequent transient lower esophageal sphincter relaxations E. High amplitude peristalatic contractions in the esophageal body 3. A 46 year old patient is referred for evaluation of abnormal liver function tests. The ALT is elevated at 115 U/l. His prior physician informed him that he has chronic hepatitis B and C. The physician also said that the hepatitis B is inactive (not actively replicating) and therefore medical therapy is not indicated. Which of the follow sets of viral hepatitis serologies is most likely in this patient? Hepatitis B surface antigen Hepatitis B surface antibody Hepatitis B core IgM antibody Hepatitis B e antigen Hepatitis B e antibody Hepatitis C antibody A Negative Positive Positive Positive Negative Positive B Positive Negative Positive Positive Negative Positive C Positive Negative Negative Negative Positive Positive D Positive Negative Negative Positive Negative Positive E Negative Positive Negative Negative Positive Negative 4. A barium swallow x-ray on a 55 year old woman is shown below. Which of the following would you most likely expect this patient to have? A. Dysphagia to solids and liquids B. Dysphagia to liquids C. A hiatal hernia D. A duodenal ulcer E. Esophageal cancer 5. A 65 year old woman has primary biliary cirrhosis and is awaiting liver transplantation. She has ascites and spider angiomata on physical examination and large esophageal
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Gastro Patho EXAM 2006 QUESTIONS - Gastrointestinal...

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