Block 6 Pace Quiz 1 Part 2

22 Questions | Total Attempts: 305

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Block 6 Pace Quiz 1 Part 2 - Quiz

From sept 2011 semester


Questions and Answers
  • 1. 
    Dr Mallik (Ext 6479) 10am   A known patient of irregularly treated but persistent achalasia for about last the 20 years presents with recent onset of worsening of dysphagia. For the last 5 years he did not attend any clinic. What is your investigation of choice?
    • A. 

      Upper GI endoscopy

    • B. 

      Barium swallow

    • C. 

      Esophageal manometry

    • D. 

      Video fluoroscopy

    • E. 

      X-Ray chest and abdomen

  • 2. 
    Dr White (Ext6330) 10:05am   As part of a diagnostic test, a gastroenterologist uses an endoscope to deliver a bolus of dilute acid into the distal esophagus. The bolus is sufficient to cause esophageal dilatation. In a normal individual, the bolus will be cleared from the esophagus predominantly by which of the following?
    • A. 

      Primary peristalsis

    • B. 

      Swallowing

    • C. 

      Relaxation of the upper esophageal sphincter

    • D. 

      Receptive relaxation

    • E. 

      Secondary peristalsis

  • 3. 
    A scientist genetically engineers a mouse to lose expression of S cells. Compared with a normal animal, which of the following would be expected to be increased in the mutant mouse?
    • A. 

      PH of pancreatic ductular secretion

    • B. 

      Volume of pancreatic secretion

    • C. 

      Susceptibility to duodenal erosions and ulcerations

    • D. 

      PH of duodenal contents

    • E. 

      Gallbladder contractibility

  • 4. 
    During dinner you notice that you have an intense impulse to defecate. Where in the gastrointestinal tract does the sensory signal that triggers this sensation take place?
    • A. 

      Brain

    • B. 

      Pharynx

    • C. 

      Esophagus

    • D. 

      Stomach

    • E. 

      Duodenum

  • 5. 
    In a laboratory experiment, galactose absorption was studied under physiological conditions in a segment of jejunum isolated from human intestine and maintained in a gut bath. The rate of galactose absorption was determined initially at a sub-maximal rate. Which of the following interventions would increase the rate of absorption of galactose?
    • A. 

      Absorption would be increased by adding equimolar amounts of glucose to the luminal solution

    • B. 

      Absorption would be increased by the addition of NaCl to the luminal fluid

    • C. 

      Absorption would be increased by adding ouabain (an inhibitor of the Na,K-ATPase) to the bath

    • D. 

      Absorption would be increased by depletion of ATP from the tissue

    • E. 

      Absorption would be increased by adding equimolar amounts of fructose to the luminal solution

  • 6. 
    A patient with a history of gastroesophageal reflux disease has been treated chronically with a proton pump inhibitor. Compared with a normal individual, the patient will be at increased risk of which of the following?
    • A. 

      Fat malabsorption

    • B. 

      Carbohydrate malabsorption

    • C. 

      Lactose intolerance

    • D. 

      Enteric infections

    • E. 

      Cystic fibrosis

  • 7. 
    A patient undergoes surgery which involved the removal of a portion of the distal ileum. In this patient, what will be the direct consequence on bile acid metabolism or turnover?
    • A. 

      There will be an increased concentration in hepatic venous blood

    • B. 

      There will be an increase level in portal venous blood

    • C. 

      There will be increased storage in hepatocytes

    • D. 

      There will be increased absorption in the gall bladder

    • E. 

      There will be increased synthesis by hepatocytes

  • 8. 
    Dr Charyk (Ext 6328) 10:10am   You are seeing a patient with chronic dyspepsia who comes in because his symptoms have been much worse recently, and he has felt very poorly the past 24 hours. He looks pale, worried, weak, and ill. Which of the following physical exam/lab tests would be most helpful in determining if he is experiencing an active GI bleed?
    • A. 

      Abdominal exam

    • B. 

      Vital signs

    • C. 

      Neurological exam

    • D. 

      Blood test for coagulopathy

    • E. 

      Blood test for Helicobacter pylori infection

  • 9. 
    The breath test used to diagnose lactose intolerance:
    • A. 

      Measures breath samples for CO2 released by the hydrolysis of urea.

    • B. 

      Is positive if there is no significant rise in breath hydrogen on serial measurements over the 3 hours of the test

    • C. 

      Must be done while the patient is on a lactose free diet

    • D. 

      Relies on the presence of normal amounts of commensal colon bacteria, so recent use of antibiotics can cause a false negative result

    • E. 

      Involves ingestion of a labeled carbon isotope prior to collection of breath samples

  • 10. 
    Mr. Bill had a large peptic ulcer several years ago which was located in the region of the pyloric channel, and which healed with a lot of scarring, resulting in a marked narrowing of the gastric outlet. His chronic symptoms are most likely to mimic those of:
    • A. 

      Early appendicitis

    • B. 

      Gastroparesis

    • C. 

      Lactose intolerance

    • D. 

      Chronic pancreatitis

    • E. 

      Achalasia

  • 11. 
    Dr Dhiman (Ext 6482) 10:15am   Which of the following 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 to the lower ribs?
    • A. 

      External oblique

    • B. 

      Pyramidalis

    • C. 

      Internal oblique

    • D. 

      Rectus abdominis

    • E. 

      Transversus abdominis

  • 12. 
    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. 

      Short gastric

    • D. 

      Right gastric

    • E. 

      Right gastroepiploic

  • 13. 
    A 34-year-old man reached hospital after a fall from a motor bike. His x-ray shows fracture of the left ribs, 9th and 10th. Which of the following organs would most likely get damage?
    • A. 

      Ascending colon

    • B. 

      Spleen

    • C. 

      Duodenum

    • D. 

      Left kidney

    • E. 

      Left lobe of the liver

  • 14. 
    The deep inguinal ring is an evagination of which of the following layers?
    • A. 

      Transversalis fascia

    • B. 

      Camper’s fascia

    • C. 

      Parietal peritoneum

    • D. 

      Scarpa’s fascia

    • E. 

      Visceral peritoneum

  • 15. 
    Dr Buxbaum (Ext 6429)10:25am   The DRI of Vitamin A for an 18a old | is: EAR 625ag/d, RDA 900ag/d and UL 2800ag/d. A patient of that group taking on average 950ag/d will suffer from symptoms of
    • A. 

      Poisoning with a probability of about 50%

    • B. 

      Deficiency with a probability of about 2%

    • C. 

      Poisoning with a probability of about 2%

    • D. 

      Deficiency with a probability of about 98%

    • E. 

      Deficiency with a probability of about 50%

  • 16. 
    A.B. is on chitosan to help him reduce weight. He may have to supplement his diet with which of the following compounds?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 17. 
    Dr Yin (Ext 6292) Lecturing   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 on the GI tract. Based on the observation, which part of GI tube is under examination?
    • 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

  • 18. 
    Periodontal ligaments are derived from
    • A. 

      Mesoderm

    • B. 

      Endoderm

    • C. 

      Odontoblasts

    • D. 

      Neural crest

    • E. 

      Ectoderm

  • 19. 
    An ideal hepatocyte stacked in a hepatic cord is being viewed schematically. Four sides of this hepatocyte abut the adjoining hepatocytes, and the other two sides of this hepatocyte are left facing_____ directly.
    • A. 

      Bile canaliculus

    • B. 

      Portal triad

    • C. 

      Hepatic sinusoids

    • D. 

      Central vein

    • E. 

      Space of Disse

  • 20. 
    Dr Adebiyi (Ext6230) PBL   What type of cell is the M cell found in the intestinal wall and what is its main function?
    • A. 

      A specialized epithelial cell responsible for antigen transcytosis

    • B. 

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

    • C. 

      An intraepithelial B lymphocyte that may secrete IgM antibody

    • D. 

      A dendritic cell found in the lamina propria

    • E. 

      A scavenger cell that functions like a blood neutrophil

  • 21. 
    System-based practice Measurement of healthcare systems occurs on many levels. Measurement may be used for research, for judgment, and for improvement of care. Here is a table comparing outcomes of care at a state level with a composite score, acute myocardial infarction (AMI), chronic heart failure (CHF) and pneumonia. Table. Technical Process Quality Measure Scores (0-100; low—hi) State Composite AMI CHF Pneumonia California 86 93 94 72 Connecticut 80 90 84 61 Massachusetts 93 96 95 87   This is an example of what type of measurement?
    • A. 

      Research

    • B. 

      Judgment

    • C. 

      Improvement

    • D. 

      Combination of judgment and improvement

  • 22. 
    You are working with a team in mental health to improve the access time for new patients in psychiatry clinic. Over the past several months, the clinic has seen an increase in the number of patients, but this has led to long wait times for some patients to get seen in the clinic. The clinic has set a goal of referral to appointment date of 21 days. You examine the number of days from a patient's referral until he or she is seen in the clinic and chart the past 30 patient referrals on the following run chart. You notice a trend with 8 increasing data points from patient 18 through patient 25. What is the appropriate next step for the team?
    • A. 

      Ignore the special cause as it is likely not important .

    • B. 

      Although the trend was upward, it isn’t important since the most recent data (patients 28- 30) show that the process is improving.

    • C. 

      Start a patient access committee for mental health

    • D. 

      Patient access to appointment is not a physician's responsibility This work should be referred to administrative staff.

    • E. 

      Investigate the special cause signal to find why the time from referral to appointment increased.

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