Gastro Patho EXAM 2005 QUESTIONS

Gastro Patho EXAM 2005 QUESTIONS - Gastrointestinal...

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1 Gastrointestinal Pathophysiology Exam 2005 Tufts University School of Medicine Please select the one BEST answer. 1. A 21 year old man has weight loss and episodic bloody diarrhea. The bloody diarrhea has become more frequent recently. A colonoscopy shows erythema and diffuse small ulcers from the rectum to the mid-transverse colon. Biopsies show architectural distortion and cryptitis. The most likely diagnosis is which of the following? A. Ischemic colitis B. AIDS-associated gastroenteritis C. Clostridium difficile colitis D. Crohn’s disease E. Collagenous colitis (lymphocytic colitis) F. Amebiasis G. Ulcerative colitis H. Cytomegalovirus colitis I. Ulcerative jejunoileitis 2. A 42 year old man abuses intravenous drugs. He complains of 2 weeks of anorexia and nausea. He noted that his urine turned dark and his stool turned light. Blood work is consistent with acute viral hepatitis. Serologic studies are done: Hepatitis A IgG: positive Hepatitis A IgM: negative Hepatitis C Antibody: negative Hepatitis B surface antigen: positive Hepatitis B surface antibody: negative Hepatitis B core IgM antibody: positive Which of the following best explains the mechanism of hepatic injury in this patient? A. Direct viral cytotoxic effect B. Immune mediated hepatocyte damage C. Direct inhibition of hepatocyte DNA replication D. Direct inhibition of hepatocyte mRNA translation E. Antibody destruction of virus 3. A barium study on a 55 year old man is shown below:
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2 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 4. A 66 year old woman has profuse watery diarrhea which has lasted more than 6 weeks. The diarrhea does not improve when oral intake is limited. She has had a 5 pound weight loss. She drinks two glasses of wine nightly. All stool cultures are negative. Fecal leukocytes are negative. A Sudan stain performed on a stool specimen is negative. The D-Xylose test shows 10 grams of xylose in the urine. Stool electrolytes are checked: stool sodium concentration is 85mmol/l and stool potassium concentration is 50mmol/l. Which of the following is the most likely diagnosis? A. Irritable bowel syndrome B. Chronic pancreatitis C. Carcinoid syndrome D. Small intestinal bacterial overgrowth syndrome E. Abuse of lactulose 5. A 65 year old man comes to the emergency room with the acute onset of peri-umbilical abdominal pain, nausea, and vomiting. He drinks alcohol regularly. He takes no medications. On exam, he has a low grade temperature but other vital signs are stable. He has tenderness in the mid-abdomen without rebound or guarding. His lab tests are: ALT 58 U/l AST 95 U/l Total bilirubin 1.1 mg/dl Alkaline phosphatase 89 U/l Amylase 1105 U/l Lipase 1404 U/l
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3 Which of the following is the most likely pathophysiologic mechanism to explain the condition which is causing this patients pain? A.
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This note was uploaded on 02/19/2011 for the course BMGT 360 taught by Professor Spina during the Spring '07 term at Maryland.

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Gastro Patho EXAM 2005 QUESTIONS - Gastrointestinal...

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