Pregunta 1
Pregunta
a 39 year old man is having a routine physical examination because of history of colon cancer in his family , his stool is postive for occult blood . colonoscopy reveals multiple polyps in the ascending colon , including small 5 cm pendunculated tubular adenomas and 1cm tubulovillous adenomas , also few 2 cm sessile villous adenoma was found in the cecum , containing a focus of well differentiated adenocarcinoma . which of the following is the most likely diagnosis ?
Pregunta 2
Pregunta
a 54 year old man has complained for 5 months of upper abdominal pain accompanied by nausea , microscopic examination of gastric biopsies reveals acute and chronic mucosal inflammation aling with the presence of H.pylori organisms , the presence of there organisms is most likely to be associated with which of the following ?
Respuesta
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gastric mucosal invasion with septicemia
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doudenal peptic ulceration
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developnebt of pernicious anemia
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hypochlorhydria with atropic gastritis
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development of large B cell lymphoma
Pregunta 3
Pregunta
a 39 year old woman has experienced substernal burning pain following meals for the past 15 years , upper GI endoscopy revealed erythematous mucosa extending from the gastro oseophageal junction upward into the lower esophagus , microscopic examination shows areas of gastric cardiac typer mucosa and intestinalized mucosa . which of the following interpretation is most appropriate for this woman finding ?
Respuesta
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she has a congenital anomaly
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her risk for squamous cell carcinoma is increased
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she has chronic gastro oesophageal reflux
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her consumption of alcohol is high
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she has iron deficiency anemia
Pregunta 4
Pregunta
a 70 year old previously healthy man notes blood streaked stool , a clonoscopy is performed and ther is an area of obstruction from an encircling mass with superficial ulcerationn that is located at 20 cm above the anal verge . which of the following factors was most liekly to have been present for development of this lesion ?
Pregunta 5
Pregunta
a 23 year old primigravida gives birth at term following an uncomplicated pregnancy to a male infant with no apparent congenital anomalies , at 4 weeks of age , the infant begins to exhibit forceful vomition after each meal . the infant had been fine previously and gaining weight normally , which of the following condition is the probable cause for hos vomiting ?
Pregunta 6
Pregunta
a 61 year old woman presents with nausea , vomiting and the sudden onset of left sided abdominal pain , physical examinaton find a low grade fever , and lab evalutaion finds increased number of neutrophols in her peripheral blood , which of the following is most liekly diagnosis
Respuesta
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appendicitis
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cholecystitis
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colitis
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diverticulitis
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pancreatitis
Pregunta 7
Pregunta
a 49 year old woman taking profenid for increasing joint pain in he hands , presents with increasing pain in her midsternal arena , gastroscopy reveals multiple , scattered , punctuate haemprrhagic areas in her gastric mucosa , biopsies for one of there lesion reveals mucosal erosion with edema and haemorrhage , no mucosal ulceration is seen , which of the following is the most likely diagnosis ?
Respuesta
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active chronic gastritis
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acute gastritis
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autoimmune gastritis
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chronic gastritis
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peptic ulcer
Pregunta 8
Pregunta
a 56 year old woman presents with supraclavicular solitary enlarged lymphnode . she states that she has lost about 15 pounds over the last few months and has had severe heartburn, histopathological examination of the lymph node reveals infiltration by malignant epithelial neoplasm , made up of mucin postive cells , which of the following abnormalities is most likely to be present in the individual ?
Respuesta
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adenocarcinoma of the oesophagus
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clear cell carcinoma of kidney
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colloid carcinoma of breast
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musoepidermoid carcinoma of parotid
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signet cell carcinoma of the stomach
Pregunta 9
Pregunta
a 62 year old man present with increasing left side abdominal pain for the past days , with bright blood in his stool , physical examination reveals low grade fever and fresh blood on retcal examination , colonoscopy reveals hundreds of inflamed mucosal holes , with flask like mucosal herniations through the muscular layers of distal colon , which of the following is the most likely causing of his GIT bleeding
Respuesta
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appendicitis
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diverticulosis
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hemorrhoids
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intussusception
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amoebic dysentery
Pregunta 10
Pregunta
endoscopic biopsy performed in a patient with gastric hypochlorhydria reveals chronic atrophic gastritis , involving the findis and sparing the antral region , which of the following pathogenetic mechanisms is involved in this form of gastritis ?
Respuesta
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alcohol abuse
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autoimmune
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doudenal reflux
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h plori infection
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tabacco use