Neurology 4 mrcp questions book - part 2 ppsx

e- Indicated when the PaO2 is below 9 kPa with any level of PaCo2.
Q7: Acute exacerbation of COPD may be presented as one of the followings,
except:
a- An increase in the amount sputum production.
b- An increase in the purulence of the sputum.
c- Simply some patients may present with fluid retention.
d- An increase in the chest tightness and wheeze.
e- Fever.
Q8: Indications for corticosteroids in COPD, all of the followings are true,
except:
a- A previous response to steroids.
b- During an acute exacerbation.
c- Early in the course to lessen progression.
d- Con-commitment asthma.
e- If the patients was already on steroids.
Q9: Regarding the prognosis of COPD, all of the followings are true, except:
a- The best guide to progression of COPD is the rate of decline in FEV1 over time.
b- The prognosis is inversely related to age.
c- The prognosis is directly related to post-bronchodilator FEV1.
d- Atopy patients have a bad prognosis.
e- Pulmonary hypertension in COPD implies a poor prognosis.
Q10: Treatment of acute exacerbation of COPD, all of the followings are true,
except:
a- Prophylactic subcutaneous heparin should be considered.
b- If the blood PH is less than 7.26, and the PaCo2 is rising, consider ventilatory
support,
c- If ventilatory support is needed but not indicated because of poor quality of life or
significant co-morbidity, then doxapram should be considered.
d- Diuretics should be avoided.
e- When giving O2, it is better to be given at a rate of 2 liters / minutes by nasal
prongs.

Q11: Air plane traveling for a patient with COPD, which one is the wrong
statement?
a- There is a risk of expansion of non-functional pulmonary bullae.
b- There is a risk of producing excessive abdominal gases.
c- There is high risk of dryness of the bronchial secretions.
d- All patients with a resting PaO2 of less than 9 kPa on air require supplementary
O2.
e- Hypercapnia is an absolute contraindication to air plane traveling.
Q12: In COPD, which one is the wrong statement?
a- Central cyanosis may bee seen.
b- Peripheral edema may indicate the development of cor pulmonale.
c- Weight loss is uncommon.
d- Only 15% of smokers are likely to develop a clinically significant COPD.
e- Smoker's emphysema is usually seen in the upper zones of the lung.
Q14: Bronchial asthma, during histopathological examination, all of the
followings are true, except:
a- Tthere is smooth muscles hypertrophy and hyperplasia.
b- Desquamation of the epithelium and edema of the sub mucosa.
c- Thickening of the basement membrane is rarely seen.
d- Mucus plugs are common especially in severe episodes.
e- The changes are initially reversible.
Q15: Prophylaxis of exercise induced asthma, all of the followings may be used,
except:
a- Adequate warm up exercises.
b- A pre-treatment with beta 2 agonists.
c- Intravenous steroids.
d- Nedochromil sodium.
e- Monteleukast.
Q16: Chest x ray findings in asthma, all of the followings are true, except:
a- May be totally normal.

b- Proximal bronchiectasis may indicate the presence of allergic bronchopulmonary
aspergillosis.
c- Fluffy transient and patchy changes may indicate an underlying Church-Strauss
vasculitis.
d- During an acute attack of asthma, hyper-lucency is a rare finding.
e- Pneumothorax should always be looked for in severe cases unresponding to
standard treatment
Q17: In preventive measures against asthma episodes, the followings are
considered to be of a HIGH efficiency when used to prevent asthma provocation,
except:
a- Avoid contact with dogs, cats and horses (for animal dander induced cases).
b- Avoid all possible drugs that may induce asthma attack (for drug-induced asthma).
c- Avoid exposure to chemicals or change occupation if necessary (industrial
chemicals for occupational asthma).
d- For feathers in pillows, substitute latex foam pillows (feathers in pillows-induced
asthma).
e- For food, try to identify and eliminate it from diet (for food induced asthma).
Q18: Treatment of an acute asthmatic attack, all of the followings are true,
except:
a- The objective is to maintain a PaO2 above 8 to 8.5 kPa with O2 therapy.
b- High flow high concentration O2 should be given even in the presence of
hypercapnia.
c- Systemic steroids should be given in all acute severe asthmatic attacks.
d- Peak expiratory flow rate has no role in the initial management.
e- Nebulized beta 2 agonists are preferred over the IV route.
Q19: In the treatment of acute severe asthma, still signs of severity are present
after giving an optimal medical therapy,what to do NEXT. All of the followings
are, except:
a- Ipratropium bromide 0.5 mg should be added to the nebulized beta 2 agonists.
b- Magnesium infusion may be considered.

c- Loading dose aminophyllin may be used even in those who are already on oral
theophyllin.
d- iv beta 2 agonists may be used.
e- There is a place for mechanical ventilation.
Q20: Indications for mechanical ventilation in acute severe asthma, all of the
followings are true, except:
a- Exhaustion, confusion and drowsiness.
b- Coma.
c- Sudden respiratory arrest.
d- Peek expiratory flow rate below 50% of the patient previous best value.
e- PaCo2 of more than 6 kPa and rising.
Q21: In bronchiectasis , all of the followings are true, except:
a- May be caused by pulmonary sequestration.
b- May be caused by bronchomalacia.
c- Hemoptysis is common and may be life threatening.
d- Clubbing is uncommon.
e- Dry bronchiectasis indicates upper lobe bronchiectasis and may be caused by TB.
Q22: Cystic fibrosis, all of the followings are true, except:
a- The commonest mutation is the delta 508 in CFTR gene on chromosome 17.
b- Staphyllococcal infections tend to occur early in the course while pseudomonas
infections tend to occur later.
c- Spontaneous pneumothorax should be suspected in any sudden deterioration.
d- Nasal polypi are common.
e- Amyloidosis may be seen.
Q23: In cystic fibrosis, which one is the wrong statement?
a- Treatment with recombinant human DNAase has been shown to decrease the
infective exacerbation in a sub group of patients.
b- Treatment with recombinant human DNAase has been shown to improve the
pulmonary function and the sense of wellbeing in a subgroup of patients.
c- Recombinant human DNAase is delivered to the bronchial tree by a nebulizer.

d- Treatment with recombinant human DNAase has been shown to be effective in
cystic fibrosis as well as other causes of bronchiectasis.
5- Treatment with recombinant human DNAase has been shown to be expensive.
Q24: Community acquired pneumonias, all of the followings are, except:
a- The commonest cause is streptococcus pneumoniae.
b- Staph aureus is a rare cause.
c- Many organisms produce an overlapping clinical picture.
d- It is easily to differentiate between typical and atypical pneumonias on clinical
grounds alone.
e- In any severe community acquired pneumonia; legionella infection has to be
excluded.
Q25: Objectives in the management of pneumonias in general, all of the
followings are, except:
a- Obtain a radiological confirmation of the diagnosis.
b- Exclude other conditions which may mimic pneumonias.
c- Obtain a microbiological diagnosis.
d- Asses the severity of pneumonia.
e- Looking for the development of complications is usually a minor thing.
Q26: The following microbiological investigations should be done routinely in all
cases of community acquired pneumonias, except one investigation:
a- Sputum for gram stain and culture.
b- Sputum for acid fast bacilli and culture.
c- Pleural fluid aspirate.
d- Blood cultures.
e- Seorology with acute and convalescent titers to diagnose mycoplasma, chlamydia,
legionella and viral pneumonias.
Q27: Features suggestive of high mortality in pneumonias, all of the followings
are true, except:
a- Respiratory rate more than 30 cycles / minute.
2- Systolic blood pressure below 90mmHg and or Diastolic blood pressure below 60

mmHg.
3- Blood urea more than 17 mmol/L.
4- Hypoalbuminaemia.
5- Positive blood culture.
Q28: Differential diagnosis of acute pneumonias, all of the followings are true,
except:
1- Pulmonar infarction.
2- Pleural / pulmonary TB.
3- Certain types of pulmonary edema, usually atypical types.
4- Subphrenic abscess.
5- Paracolic abscess.
Q29: Hospital acquired pneumonia, all of the followings are wrong, except:
a- Does not include post operative pneumonia.
b- Does not include a new pneumonia while the patient is on a ventilator.
c- Includes certain types of aspiration pneumonias.
d- Occurs in up to 20% of in-hospital admitted patients.
e- Usually gram negative organisms predominate.
Q30: Cryptic military TB, all of the followings are true, except:
a- Usually occurs in old females.
b- Chest signs are rare.
c- Leukemoid reaction may be seen.
d- Pancytopenia may be seen.
e- Chest x ray is usually abnormal.
Q31: False negative tuberculin test may be seen in all of the followings, except :
a- Miliary TB.
b- Immune suppressive therapy.
c- Early in the course of TB meningitis.
d- Elderly patients.
e- AIDS patients.
Q32: In the treatment of pulmonary TB, which one is the true statement?

a- Thiacetazone is not used in AIDS patients in poor resources developing countries
b- Optic neuritis is usually caused by pyrazinamide.
c- Hemolytic anemia with rifampicin is common.
d- Streptomycin mainly affects hearing rather than vestibular function.
e- Pyridoxin should be given to all patients receiving isoniazide.
Q33: Allergic broncho-pulmonary aspergillosis, all of the followings are true,
except:
a- Serum IgG precipitins is usually strongly positive.
b- It is an immune complex disease, not an invasive one.
c- Esosinphilia is very common.
d- Is not caused by aspirgillus clavatus.
e- Usually there is a preexistent lung disease.
Q34: Lung cancer, all of the followings are true, except:
a- Passive smoking is responsible for 5% of all lung cancers.
b- Exposure to naturally occurring radon is responsible for 5 % of all lung cancers.
c- May be caused by chromium and cadmium exposure.
d- The incidence is slightly higher in rural than urban dwellers.
e- The incidence of adenocarcinoma is rising.
Q35: In lung Cancer, all of the following are true, except:
a- Responsible for 25% of all cancer deaths.
b- 80% of cancer deaths in women and 40% cancer deaths in men.
c- The commonest cause of cancer death in men.
d- The most rapidly increasing cause of cancer death in women.
e- More than 3 folds increase in cancer deaths since 1950.
Q36: Chest X ray findings in lung cancer, all of the followings are true, except:
a- Totally normal films virtually exclude lung cancer.
2- Pleural effusion.
3- Lung, lobe or segmental collapse.
4- Broadening of the mediastinum.
5- Rib destruction.

Q37: Contraindications to surgery in non-small cell lung cancer, all of the
followings are true, except:
a- Esophageal invasion.
b- FEV1 less than 2.8 L.
c- Malignant pleural effusion.
d- Severe ischemic heart disease.
e- Contralateral mediastinal lymph node involvement.
Q39: Posterior mediastinal mass on chest x ray includes all of the followings,
except:
a- Paravertebral abscess.
b- Neurogenic tumors.
c- Foregut duplication.
d- Diaphragmatic hernia through foramen of Morgagni.
e- Diaphragmatic hernia through foramen of Bockdaleck.
Q40: Presentation of sarcoidosis, all of the followings are true, except:
a- May be asymptomatic and discovered incidentally by an x ray film in up to 30 % of
cases.
b- Ocular symptoms in 5-10 % of patients.
c- Skin sarcoids in 5 % of cases.
d- Symptoms of hypercalcemia in 30% of cases.
e- Superficial lymph node enlargement in 5 % of cases.
Q41: Indications of treatment of sarcoidosis with steroids, all of the followings
are true, except :
a- Hypercalcemia .
b- Ocular sarcoidosis.
c- CNS involvement.
d- Stage I or II disease.
e- Cardiac sarcoidosis.
Q42: Cryptgenic fibrosing alveolitis, all of the followings are true, except:
a- Twice as common among cigarette smokers than in nonsmokers.

b- Bronchoalveolar lavage shows predominance of neutrophils.
c- Clubbing is seen in 60% of cases.
d- Query association with Epstien Barr virus infection.
e- LDH is elevated in a minority of patients.
Q43: In extrinsic allergic alveolitis and other lung diseases due to exposure to
organic dusts, which one of the following associations is true?
a- Byssinosis-penicillium cassie.
b- Malt worker's lung –aspirgillus fumigatus.
c- Maple bark stripper's lung-cryptostroma corticale.
d- Cheese worker's lung –thromophilic actinomycetes.
e- Bird fancier's lung –aspirgillus clavatus.
Q44: In asbestosis, all of the followings are true, except:
a- The commonest type of asbestos fibers produced world-wide is the white one
(chrysotile).
b- Exposure mainly occurs through mining and milling of the mineral.
c- Greatly increases the risk of lung adenocarcinomas especially in smokers.
4- Greatly increases the risk of pleural mesotheliomas especially in smokers.
5- The overall risk of malignancy is higher in smokers than non-smokers.
Q45: Pulmonary eosinophilia may be seen in all of the followings , except:
a- Nitufurantoin.
b- Mansonella steptocerca.
c- Wuchereria Bancrofti.
d- Phenylbutazon.
e- Wegner's granulomatosis.
Q46: In alveolar proteinosis, all of the followings are true, except:
a- Spontaneous remission occurs up to 30 %.
b- Fever and hemoptysis are common.
c- The is a 5 % remission rate after whole lung lavage.
d- Air bronchogram on chest x ray is a common finding.
e- Diffuse bilateral shadowing mainly around the hili is the usual cheat x ray finding.

Q47: Lymphangioleiomyomatosis, all of the followings are true, except:
a- Usualy seen in females during their child bearing age.
b- Chylous pleural effusions are common.
3- Recurrent pneumothoraces are seen.
4- Hormonal ablation therapy and progestins are highly effective in the treatment.
5- Hemoptysis is seen.
Q48: Uncommon causes of pleural effusions, all of the followings are true,
except:
1- Yellow nail syndrome.
2- Meig's syndrome.
3- Aacute rheumatic fever.
4- Subphrenic abscess.
5- Myxedema.
Q49: Indication for tube drainage in Pneumothorax , all of the followings are
true, except:
a- Tension type.
b- More than 2-5 liters of air aspirated.
c- If you faced resistant during aspiration.
d- Pneumothorx with underlying COPD.
e- Any degree of dyspnea.
Q50: Causes of elevation of a hemi diaphragm, all of the followings are true,
except:
a- Severe pleuritic pain.
b- Subphrenic abscess.
c- Pulmonary infarction.
d- Eventration of the diaphragm.
e- Intercostal nerve palsy.
Q51: Common causes of solitary lung nodule include all of the followings, except:
a- Single metastasis.
b- Bronchial carcinoma.

c- Wegner's granuloma.
d- Tuberculoma.
e- Lung abscess.
End of Chapter II
Written by Dr. Osama Amin
All Rights Reserved.

Chapter III / Gastro-Enterology
Q1: In gut hormones, all of the followings are true, except:
a- Gastrin is mainly secreted by the gastric antral G cells.
b- Sectretin inhibits gastric acid secretion.
c- Somatostatin stimulates insulin secretion.
d- Motilin secretion is stimulated by dietary fat.
e- Gastric inhibitory polypeptide is secreted from deuodenum and jujenum to inhibit
gastric acid secretion and stimulate insulin secretion.
Q2: Contrast radiology is commonly used in clinical gastroenterology, all of the
followings are true, except:
a- The main limitations of barium swallow are risk of aspiration and poor mucosal
details.
b- The main limitations of barium meal are the low sensitivity to detect early cancer
and inability to assess H pylori status.
c- The main limitations for barium follow through are being time consuming and
greater risk of radiation exposure.
d- The main limitations for barium enema are being difficult in elderly or those with
incontinence and being some what uncomfortable.
e- Barium enemas usually miss polyps less than 5 cm in size.
Q3: In upper Gastrointestinal endoscope, all of the followings are
contraindications, except:
a- Severe shock.
b- Recent myocardial infarction.

c- Severe respiratory disease.
d- Possible visceral perforation.
e- Anemia.
Q4: Complications of upper GIT endoscope, all of the followings are true,
except:
a- Aspiration pneumonia.
b- Visceral perforation.
c- GIT bleeding.
d- Cardiopulmonary depression due to over sedation.
e- Very minor risk of infective endocarditis.
Q5: Dynamic tests are used in the diagnosis of many GIT diseases, all of the
followings are true, except:
a- Lactose hydrogen breath test is used for lactose intolerance and although being non
invasive and accurate but it may provoke abdominal pain diarrhea in sufferers.
b- 14C –triolein breath test is used for fat malabsorption, although being fast and non-
invasive but is non quantitative.
c- 75SeHCAT test is used in fat malabsorption and is accurate and specific but
requires 2 visits and involves radiation.
d- Pancreolauryl test is used as a test for pancreatic exocrine function and is accurate
and avoids duodenal intubation but needs accurate collection of urine.
e- 14C glycocholate breath test is a useful screening test for bacterial overgrowth.
Q6: Radio-isotope tests are still used in clinical gastroenterology, all of the
followings are true, except:
a- 13C and 14C urea breath test is used in H pylori detection.
b- 99mTc pertechnetate is used for the detection of Meckel's diverticulum.
c- 99mTc HMPAO labeled leukocytes is used for the detection of visceral abscesses.
d- 51Cr-albumin is used a test for epithelial permeability.
e- 99Tc-sulphur is used a test for protein losing enteropathy.
Q7: In Barrette's esophagus, all of the followings are true, except:
a- Is a pre-malignant condition increases the risk of esophageal adenocarcinoma by

90-150 folds.
b- Is always symptomatic with heartburn and regurgitation.
c- It is due to long standing gastric acid reflux.
d- The risk of malignancy is particularly very high when the metaplastic tissue is of
intestinal with goblet cells origin.
e- Long term acid suppression is not useful in reversing the histological abnormality.
Q8: Complications of long standing gastro-esophageal reflux disease (GERD), all
of the followings are true, except:
a- Iron deficiency anemia.
b- Benign stricture formation.
c- Barrette's esophagus.
d- Esophagitis.
d- Esophageal squamous cell carcinoma.
Q10: In Achalasia of the cardia, all of the followings are true, except:
a- A similar picture may be seen in Chaga's disease.
b- May result in esophageal squamous cell carcinoma even after treatment.
c- Hear burn is prominent.
d- Usually seen in middle age women, although no age is exempt.
e- Treatment with botulinum toxin is effective, yet the effect is transient.
Q11: Etiological factors in the development of esophageal carcinoma include all
of the followings, except:
a- Coeliac disease.
b- Tylosis.
c- Smoking and alcoholism.
d- Chewing tobacco.
e- Ulcerative colitis.
Q12: Causes of acute gastritis includes all of the followings, except:
a- Iron medications.
b- Bile reflux following gastric surgery.
c- CMV infection.

d- Acute infection with H. pylori.
e- Pernicious anemia.
Q13: The following diseases are associated with H pylori infection, except:
a- Gastric ulcer.
b- Duodenal ulcer.
c- Gastric MALTOMA.
d- Gastric adenocarcinoma.
e- Gastro-esophageal reflux disease.
Q14: Regarding methods to diagnose H pylori infection, all of the followings are
true, except:
a- H pylori serology although being rapid and useful for population studies but it can
not differentiate between acute and past infections and lacks sensitivity and
specificity.
b- Although urea breath test has a high sensitivity and specificity but 14C requires
radio-activity and 13C requires mass spectrometer.
c- Rapid urease test on an antral biopsy specimen has a high sensitivity and is cheap
and quick.
d- Microbiological culture of an antral biopsy specimen is the gold standard method
and defines antibiotic sensitivity but it is slow and lacks sensitivity.
e- Histopahtological examination of an antral biopsy specimen although sensitive and
specific yet false negative results are still seen and takes several days to process,
Q15: Risk factors for NSAIDs induced peptic ulceration, all of the followings are
true, except:
a- Past history of peptic ulcer.
b- High dose or multiple NSAIDs.
c- Concomitant steroid therapy.
d- Age blow 50 years.
e- Treatment with azapropazone.
Q16: Side effects encountered during treatment with anti H. pylori medications,
all are true, except:

a- Diarrhoa is uncommonly seen.
b- Metallic taste in the mouth is commonly seen with metronidazole.
c- Headache.
d- Skin rashes.
e- Abdominal cramps and vomiting.
Q17: Side effects of individual anti H. pylori medications, all are true, except:
a- Cimetidin can cause confusion.
b- Omprazole can cause hypergastrenemia.
c- Sucralfate can enhance the effect of digoxin and warfarin.
d- Misopristol causes diarrhea up to 20 % of cases.
e- Colloidal bismuth blackens teeth, tongue and stool.
Q18: In Zollinger Ellison syndrome, all of the followings are true, except:
a- Accounts for about 0.1 % of all cases of peptic ulceration.
b- Commonly seen between 30-50 years of age.
c- 90% are due to gastrin secreting pancreatic tumors.
d- 50-70% are malignant.
e- 20-60 % of cases are part of MEN type II.
Q19: In Zollinger Ellison syndrome, all of the followings are true, except:
a- Should be suspected whenever there is severe, multiple peptic ulceration.
b- Diarrhoea is common and may the presenting feature up to 30 % of cases.
c- Ulcer bleeding and perforations are common.
d- Barium meal may reveal thin mucosal folds.
e- The ulcers may occur at atypical sites like the jejunum and esophagus.
Q20: Regarding the management of Zollinger Ellison syndrome, all of the
followings are true, except:
a- Some patients present with metastatic disease and hence surgery is inappropriate.
b- Proton pump inhibitors should be given in large doses to be effective.
c- Octreotide has been shown to be of value in the treatment.
d- The overall 5 years survival is 10-15%.
e- All patients should be monitored for the future development or other features of

MEN type I.
Q21: Predisposing factors to gastric cancer includes all of the followings, except:
a- Previous partial gastrectomy.
b- Autoimmune gastritis.
c- Adenomatous gastric polyps.
d- Familial adenomatous polyposis.
e- Tylosis.
Q22: In gastric cancer, all are true, except:
a- The incidence of gastric cancer is rising in the western world like UK.
b- The overall prognosis remains very poor.
c- Almost all tumors are adenocarcinomas.
d- Clinical examination may reveal nothing.
e- Dyphagia is seen in tumors near the cardia.
Q23: In Celiac Disease, all of the followings are true, except:
a- The disease may occur at any age.
b- The presentation is highly variable depending on the severity and extent of the
small bowel involvement.
c- An association with HLA –B8, DR17, DQ2.
d- The earliest histological finding is an increase in the intra-epithelial lymphocyte.
e- The disease is seen world wide but is very rare in northern Europe.
Q24: In the treatment of celiac disease, all of the followings are true, except:
a- Gluten free diet should be taken infinitely.
b- Dietary restriction of wheat, rye, barely and possibly oats should be encouraged.
c- Rice, maize and potatoes should be restricted.
d- Minerals and vitamins may be given but in practice this is uncommon.
e- Poor compliance with dietary advices remains the commonest cause of treatment
failure.
Q25: Complications of celiac disease, all of the followings are true, except:
a- Ulcerative jejunitis.
b- Esophageal adenocarcinoma.

c- Small bowel T cell lymphoma.
d- Intensely itchy skin rash.
e- Small bowel carcinoma.
Q26: In diagnosis of celiac disease, all of the followings are true, except:
a- Of all detected antibodies, IgA anti-endomysium antibodies have the highest
sensitivity and specificity.
b- Small bowel biopsy is the gold standard.
c- Barium follow through will reveal non specific findings of dilated loops with
coarse folds and contrast clumping.
d- Dimorphic blood picture may be seen.
e- Co-existent IgA deficiency will not affect the serological tests.
Q27: The followings are associated with celiac disease, except:
a- Type II diabetes.
b- Splenic atrophy.
c- Hypothyroidism.
d- Primary biliary cirrhosis.
e- Inflammatory bowel disease.
Q28: In Tropical sprue, all of the followings are true, except:
a- The disease occasionally occurs in epidemics and hence an infective etiology has
been suggested.
b- Partial villous atrophy is much more common than total villous atrophy in small
bowel biopsy.
c- The most important differential diagnosis in endemic areas is an infective diarrhea.
d- Tetracycline for 28 days will produce cure or long term remission and is the
treatment of choice.
e- The disease is rare in Malaysia and Indonesia.
Q29: In Bacterial overgrowth syndrome, all of the followings are true, except:
a- May be caused by pernicious anemia.
b- 14C-glycocholate breath test is a good screening test.
c- Serum B12 and serum folates are low.

d- The treatment of choice in most patients is tetracycline for 1 week.
e- Patients usually present with watery diarrhea and or steatorrhoea.
Q30: Whipples disease, all of the followings are true, except:
a- Caused by a small gram negative bacilli.
b- Usually seen in middle aged men with clubbing, low grade fever and hyper
pigmentation.
c- Almost any organ can be involved.
d- Almost fatal if not treated.
e- Following successful therapy, follow up is very important as up 30% of cases will
relapse.
Q31: In short bowel syndrome, all of the followings are true, except:
a- May be caused by nectrotizing enterocolitis in children and by Crohn's disease in
adults.
b- Dehydrations and weight loss are common.
c- Some patients need treatment with octreotide to lessen the bowel secretions and
diarrhea volume.
d- Anti-diarrheal agents are contraindicated.
e- Some patients need total parenteral nutrition for survival.
Q32: Radiation enteritis, all of the followings are true, except:
a- Usually occurs in the context of radiotherapy for abdominal or pelvic malignancy.
b- The terminal ileum, sigmoid and rectum are the usual victims.
c- May produce malabsorption through different mechanisms.
d- Small bowel adhesions and fistulae may occur.
e- Cholestyramin is totally useless.
Q33: Protein losing enteropathy, all of the followings are true, except:
a- The usual picture is peripheral edema with hypoalbuminemia and normal liver
function test and normal 24 urinary protein excretion.
b- Treatment is that of the underlying disorder.
c- Nutritional support is important.
d- The diagnosis is confirmed by the rate of fecal clearance of intravenous

radiolabelled albumin.
e- Can be caused by very few GIT diseases.
Q34: Intestinal lymphangiectasia, all of the followings are true, except:
a- May be caused by Whipple's disease, filariasis, lymphoma and constrictive
pericarditis.
b- Prominent lymphocytosis is present.
c- Hypogammaglobulinemia is seen.
d- Small bowel biopsy reveals dilated lacteals.
e- Medium chain triglyceride supplements are given.
Q35: Eosinophilic gastroenteritis, all of the followings are true, except:
a- Any part of the GIT may be involved.
b- The inflammatory process may involve the mucosa, muscular and or serosal layer.
c- Peripheral blood eosinophilia is present in 80 % and up to 50 % have some form of
allergy.
d- Full thickness intestinal biopsy is usually used for the diagnosis although multiple
endoscopic biopsies are used in clinical practice.
e- The prognosis is unfortunately poor in the majority.
Q36: Inflammatory bowel disease, all of the followings are true, except:
a- It is more common in Jewish people.
b- HLA DR103 is seen in those with severe ulcerative colitis.
c- Associated with low residue and high refined sugar diet.
d- There is a possible and query association with measles and atypical mycobacterial
infection.
d- Crohn's disease is usually seen in ex-smokers.
Q37: Signs of severity in active Ulcerative colitis, all of the followings are true,
except:
a- Stool volume more than 400 gram / day.
b- Hemoglobin less than 10 g/ dl.