Block 6 Pace Quiz 1 Part 1

26 Questions | Total Attempts: 442

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Block 6 Pace Quiz 1 Part 1 - Quiz

Pace quiz sept 2011 semester


Questions and Answers
  • 1. 
    Dr Adebiyi   A school teacher was posted to a rural school where the classroom windows were not screened. As a result, she got bitten by mosquitoes. What organism was she most probably exposed to as a result of the bites?
    • A. 

      Ascaris lumbricoides

    • B. 

      Leishmania donovani

    • C. 

      Brugia malayi

    • D. 

      Necator americanus

    • E. 

      Trypanosoma gambiense

  • 2. 
    A community health practitioner observed that many school children in a rural area appeared to be lethargic and pale looking. The children spent a lot of time running around bare-footed and often complained of an intense pruritic and erythematous rash on the feet. Many of them had low-grade fever with abdominal pain and intermittent diarrhea. Blood examination showed evidence of hypochromic, microcytic anemia and many ova were found in the stool specimens.   Which of the following organisms was most probably responsible for the infection?
    • A. 

      Ancylostoma duodenale

    • B. 

      Ascaris lumbicoides

    • C. 

      Enterobius vermicularis

    • D. 

      Taenia solium

    • E. 

      Strongyloides stercoralis

  • 3. 
    What type of cell is the M cell found in the intestinal tract?
    • A. 

      A type of macrophage that is responsible for antigen processing and presentation

    • B. 

      A specialized epithelial cell responsible for antigen transcytosis

    • C. 

      An intraepithelial B lymphocyte that may secrete IgA antibody

    • D. 

      A dendritic cell found in the lamina propria

    • E. 

      A scavenger cell that functions like a blood neutrophil

  • 4. 
    Dr Charyk (facilitated by Dr Fitzgerald)   Early symptoms in a case of acute appendicitis usually include:
    • A. 

      Extreme thirst and hunger

    • B. 

      High fever in the range 104°F (40°C)

    • C. 

      Left lower quadrant abdominal pain

    • D. 

      Epigastric or periumbilical pain and nausea

    • E. 

      Diarrhea

  • 5. 
    Treatment of peptic ulcer disease should include:
    • A. 

      NSAID (nonsteroidal anti-inflammatory drug)

    • B. 

      Antibiotics

    • C. 

      Lactose free diet

    • D. 

      Alka-Seltzer

    • E. 

      B12 administration

  • 6. 
    Dr White   As part of an investigation, a patient undergoes esophageal manometery. At one recording site, the pressure before a swallow (at rest) was above atmospheric.  Following the initiation of a swallow, the pressure at this site decreased transiently, then increased above that at rest before returning to the at rest pressure. Where was the manometer sensor most likely to have been situated?
    • A. 

      The upper esophageal sphincter

    • B. 

      The proximal stomach

    • C. 

      The thoracic esophagus

    • D. 

      The abdominal esophagus

    • E. 

      The lower esophageal sphincter

  • 7. 
    Use of OTC drugs such as ibuprofen is a significant factor in the development of peptic ulcer disease. What is the most likely mechanism by which ibuprofen leads to this condition?
    • A. 

      Inhibition of lipoxygenase – thereby increasing gastric acid and decreasing bicarbonate secretion

    • B. 

      Inhibition of cyclooxygenase – thereby increasing gastric acid secretion and decreasing bicarbonate secretion

    • C. 

      Inhibition of lipoxygenase – thereby decreasing gastric acid secretion and increasing bicarbonate secretion

    • D. 

      Inhibition of cyclooxygenase – thereby decreasing gastric acid secretion and decreasing bicarbonate secretion

  • 8. 
    In a laboratory experiment the rate of galactose absorption is being measured across a sheet of jejunum. What will be the most likely effect of the following maneuvers on the rate of absorption of this monosaccharide?
    • A. 

      Addition of fructose to the mucosal bathing solution will inhibit galactose uptake

    • B. 

      Addition of a sodium-pump (Na/K-ATPase) inhibitor to the mucosal solution will decrease galactose uptake

    • C. 

      Addition of glucose to the mucosal solution will stimulate galactose uptake

    • D. 

      Addition of an inhibitor of enterokinase will inhibit galactose uptake

    • E. 

      Substitution of K+ by Na+ ions in the basolateral solution will inhibit galactose uptake

  • 9. 
    A rise in the pH of the duodenal contents will most likely have which of the following effects on pancreatic duct cell function?
    • A. 

      Increased apical bicarbonate – chloride exchange due to reduced release of secretin

    • B. 

      Decreased basolateral bicarbonate– chloride exchange due to increased release of secretin

    • C. 

      Increased basolateral bicarbonate – chloride exchange due to reduced release of secretin

    • D. 

      Decreased apical bicarbonate-chloride exchange due to reduced release of secretin

  • 10. 
    Entry of fats to the duodenum is associated with which of the following DIRECT effects on smooth muscle cells of the gall bladder and sphincter of Oddi?
    • A. 

      Relaxation of the gall bladder mediated by nitric oxide and relaxation of the sphincter of Oddi mediated by CCK

    • B. 

      Contraction of the gall bladder mediated by acetylcholine and contraction of the sphincter of Oddi mediated by Acetycholine and CCK

    • C. 

      Relaxation of the gall bladder mediated by CCK and contraction of the sphincter of Oddi mediated by nitric oxide

    • D. 

      Contraction of the gall bladder mediated by nitric oxide and relaxation of the sphincter of Oddi mediated by CCK

    • E. 

      Contraction of the gall bladder mediated by acetylcholine and relaxation of the sphincter of Oddi mediated by nitric oxide

  • 11. 
    Mrs. Lambert   A 24-year-old medical student with a known history of long-standing Crohn’s Disease comes to see his Gastroenterologist, reporting a 3 month history of increasing numbness in his fingertips and “pins and needles” in his feet (Peripheral Neuropathy).  Based on this patient’s history and chief symptoms, what is the most likely vitamin or mineral deficiency that would explain these symptoms?
    • A. 

      Vitamin K

    • B. 

      Vitamin C

    • C. 

      Phosphorus

    • D. 

      Vitamin B12

    • E. 

      Iron

  • 12. 
    Dr Dhiman   The muscles of the anterior abdominal wall have a distinct anatomic arrangement. One named muscle of the anterior abdominal wall arises along the inguinal ligament and iliac crest, whose fibers travel upward and medially to insert in the midline at the linea alba and superiorly on the borders of the lower three ribs. What is the name of the muscle described?
    • A. 

      External oblique

    • B. 

      Pyramidalis

    • C. 

      Rectus abdominis

    • D. 

      Transversus abdominis

    • E. 

      Internal oblique

  • 13. 
    A 13-year-old boy is brought into the emergency department with blunt trauma to the left side of the chest during an attack by members of a rival street gang. X-ray shows fracture of the 9th and 10th ribs. Which of the following organs would most likely be damaged?  
    • A. 

      Ascending colon

    • B. 

      Spleen

    • C. 

      Duodenum

    • D. 

      Left kidney

    • E. 

      Left lobe of the liver

  • 14. 
    A 42-year-old man has been a chronic alcoholic for over 20 years. He presents to the emergency room with sudden onset of massive ascites. He is diagnosed with portal hypertension secondary to cirrhosis of liver. He underwent surgery. Which of the following surgical connections is involved in shunting portal blood around the liver?
    • A. 

      Superior mesenteric vein to the inferior mesenteric vein

    • B. 

      Portal vein to the superior vena cava

    • C. 

      Splenic vein to the left renal vein

    • D. 

      Portal vein to the left renal vein

    • E. 

      Superior rectal vein to the left colic vein

  • 15. 
    A large tumor mass impinges on the splenic artery and its branches. Branches of which of the following arteries would most likely be affected by the pressure on the splenic artery?  
    • A. 

      Left gastric

    • B. 

      Left gastroepiploic

    • C. 

      Right gastric

    • D. 

      Right gastroepiploic

    • E. 

      Short gastric

  • 16. 
    Dr Yin   A transition from simple columnar epithelium with simple tubular glands (predominant cell type is goblet) to non-keratinized stratified squamous epithelium is revealed in a histological slide. The specimen is taken from one location in the GI tract. Based on the observation, which part of GI tube is under inspection?
    • A. 

      Junction of esophagus and cardia of stomach

    • B. 

      Junction of pylorus and duodenum

    • C. 

      Pectinate line

    • D. 

      Junction of excretory duct of salivary glands and oral cavity

    • E. 

      Junction of sigmoid colon and rectum

  • 17. 
    Periodontal ligaments are derived from
    • A. 

      Ectoderm

    • B. 

      Endoderm

    • C. 

      Odontoblasts

    • D. 

      Neural crest

    • E. 

      Mesoderm

  • 18. 
    An ideal hepatocyte stacked in a hepatic cord is being viewed schematically. With four sides of this hepatocyte abutting other hepatocytes, the remaining two sides of this hepatocyte are left facing_____ directly.
    • A. 

      Bile canaliculus

    • B. 

      Portal triad

    • C. 

      Space of Disse

    • D. 

      Hepatic sinusoids

    • E. 

      Central vein

  • 19. 
    The appendix is supplied by which of the following structures?
    • A. 

      Celiac trunk

    • B. 

      Inferior mesenteric artery

    • C. 

      Superior mesenteric artery

    • D. 

      Internal iliac artery

    • E. 

      Portal vein

  • 20. 
    The cells labeled with the asterisks in the accompanying EM function in
    • A. 

      Producing mucus

    • B. 

      Secreting HCl

    • C. 

      Producing gastrin

    • D. 

      Producing lysozyme

    • E. 

      Immune defense

  • 21. 
    Dr Mallik (facilitated by Dr Fitzgerald)   A 45-year-old male complains of difficulty in swallowing both liquids and solids for past 10 years, which has worsened gradually over the time. He also suffers from nocturnal cough, which disturbs his sleep as well as regurgitation of undigested food eaten several hours earlier. Physical examination does not reveal much. Barium studies are performed which shows dilated lower esophagus, loss of esophageal peristalsis, and smooth tapering of the distal esophagus. You divided the esophageal sphincter for treatment and after 3 months the patient presents with pain in the chest and heart burn. What is the complication of the treatment?
    • A. 

      Cancer esophagus

    • B. 

      Hiatus hernia

    • C. 

      Reflux esophagitis

    • D. 

      Esophageal diverticulum

    • E. 

      Diffuse esophageal spasm

  • 22. 
    Dr Kirera   A 25-year- old woman was admitted to the hospital with complaints of pain over the periumbilical region. She was febrile (39.5 C), nauseated and had non-violent vomiting.  Physical examination revealed a positive psoas sign and deep tenderness at the McBurney’s point. She was diagnosed with acute appendicitis.  Trace the path of pain sensation elicited by an inflamed appendix to the central nervous system (CNS).
    • A. 

      Appendix → superior mesenteric plexus → lesser splanchnic nerve → white ramus communicans → anterior primary ramus → dorsal root ganglion → T10 spinal level

    • B. 

      Appendix → superior mesenteric plexus → posterior vagal trunk → right vagus nerve → brainstem medulla

    • C. 

      Appendix intrinsic ganglia → pelvic splanchnic nerve → inferior hypogastric plexus → S2-S4 anterior rami

    • D. 

      Appendix-superior hypogastric plexus → inferior mesenteric plexus → least splanchnic nerve → anterior roots of T1-L2 spinal levels

    • E. 

      Appendix → greater splanchnic nerve → superior mesenteric ganglion → paravertebral ganglia → gray rami communicans → T10-T12 intermediolateral nuclei

  • 23. 
    A 60-year old man is admitted in the emergency department after he was involved in an automobile accident. He suffered blunt trauma to his abdomen and complains of generalized lower abdominal pain. There is no evidence of hematochezia or bowel obstruction.  The surgeon decides to perform an exploratory laparoscopy of the infracolic compartment. On examination, the surgeon finds out that the patient has a Meckel’s diverticulum. Which of the following statement is correct about this diverticulum?
    • A. 

      It is located 2 feet distal to the ligament of Treitz

    • B. 

      It is mostly found in the cecum

    • C. 

      It develops mostly after the age of 50

    • D. 

      It may contain gastric mucosa

    • E. 

      It is located 2 inches from the appendix

  • 24. 
    Dr Buxbaum   The DRI of Vitamin A for an 18a old ♂ is: EAR 625 ug/d, RDA 900 ug/d and UL 2800 ug/d. A patient of that group taking on average 950 ag/d will suffer from symptoms of
    • A. 

      Poisoning with a probability of about 50%

    • B. 

      Poisoning with a probability of about 2%

    • C. 

      Deficiency with a probability of about 98%

    • D. 

      Deficiency with a probability of about 2%

    • E. 

      Deficiency with a probability of about 50%

  • 25. 
    A 4-month-old male was admitted to the hospital in a coma. Blood analysis taken on admission revealed a blood glucose of 15 mg/dL (normal 60-100 mg/dL).  He had no acidosis or ketosis. A 24 hour fast produced a dramatic drop in blood glucose and a rise in serum triglycerides. Liver and muscle biopsy showed accumulation of fat. This infant most likely has
    • A. 

      Fructose intolerance

    • B. 

      Hormone sensitive lipase deficiency

    • C. 

      Type 1 glycogen storage disease

    • D. 

      Fat malabsorption

    • E. 

      Carnitine deficiency

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