1. These statement are correct related with tuberculosis colitis, except : A.

Relation between high frequent of pulmonary tuberculosis and tuberculosis colon. B. Most case caused by mycobacterium tuberculosis. C. Can cause bleeding, obstruction, perforation. D. Drugs for treatment : rifamficin, INH. 2. Colon inflammation in pseudo-membrane colitis is caused by A. Antibiotic B. A toxin clostridium difficle C. Overgrowth normal flora colon. D. Clostridium difficle. 3. Extra-intestinal manifestation of inflammatory bowel disease, except : A. Uveitis B. Eritema nodosum C. Bursitis D. Pioderma 4. The important procedure to evaluated response of treatment and diagnostic in inflammatory bowel disease : A. Laboratory B. Radiology C. Colon in loop D. Colonoscopy 5. The most possibility of clinical manifestation of Enterobacteriaceae infection Instead of diarrheae is: A. Respiratory tract infection B. Urinary tract infection C. Meningoencephalitis D. Musculoskeletal infection 6. Antimicrobial therapy is crucial to the outcome in infections with members of the Enterobacteriaceace because of: A. Intrinsic resistance B. Plasmid & chromosomal resistance C. Metabolic resistance D. Narrow spectrum of antibiotics 7. The primary method of diagnosis of Enterobacteriaceae was conducted by: A. Serology B. PCR C. Culture D. Animal test 8. Acute diarrheae with feces non mucous and non bloody is usually caused by: A. E. coli B. S. typhi C. Rota virus D. C. albicans

9. Rotavirus infection usually is diagnosed by the presence of: A. Antigen in stool B. Virus in stool C. Antigen in blood D. Virus in blood MCQ/BLOK 13/2009 1

Questions 10-13 A man, 68 years old, presented with black and liquid stool, nausea, weakness. Knee joint pain history since 1 year ago. Dyspepsia history since 5 years ago. Two weeks before hospitalized, he presented to a doctor for joint pain. After been treated, he felt painless. Physical examination : pale, BP 90/70 mmHg, PR 116 /mnt, RR 28/mnt, pale conjungtiva, no epigastric pain. Laboratory results : hemoglobin 6.8 g%, normal ureum/creatinin, normal blood sugar, uric acid 9.2, normal albumin/globulin, negative HbsAg, negative Anti HCV. Questions : 10. A possibility diagnosis for the patient is : A. Melena ec erosive gastritis or peptic/duodenal ulcer B. Hematoschezia ec internal haemoroid C. Melena ec esophagus varices rupture D. Melena ec gastric carcinoma 11. To establish a definitive diagnosis, we require an exact diagnostic exam, such as : A. OMD B. Esophagogastrocopy C. Colonoscopy D. Colon in lope 12. Important initial management for the patient is : A. Doing a diagnostic examination to find bleeding causes (endoscopy) as soon as possible B. Stabilizing general state and then do diagnostic examinations C. Consulting to the digestive surgery D. Giving inotropic agents 13. Diagnostic exam result showed gastric ulcer. The patient had gout arthritis. If he had to consume rheumatic drugs (NSAID) so its better to : A. Prescribe antasid as a prophylactic drug B. Prescribe H2 blocker (eq. ranitidine) as a prophylactic drug C. Prescribe PPI (eq. lansoprazole) as a prophylactic drug D. Prescribe sucralfate as a prophylactic drug Questions 14-16 A 35 years old woman presented with sternal pain, heartburn, swallow pain, nausea, vomitus. Past illness history : she frequently presented to gyneacologists with leukorrhae complain and was treated with mefenamic acid and clindamysin. BP 120/80 mmHg, PR 72/mnt, RR 22/mnt, no pale conjungtiva, epigastric pain, normal cor-pulmo. Laboratory results showed normal routine blood count, normal liver and renal function tests. Question: 14. A possibility diagnosis of this patient is: A. Pleural effusion B. Angina pectoris C. Myalgia D. Esophagitis

15. We need an exact diagnosis examination to establish a definitife diagnosis such as: A. ECG B. Thorax photo C. Gastroscopy MCQ/BLOK 13/2009 2

D. Colonoscopy 16. The drug of choice is: A. Antacid B. Sucralfate C. PPI D. Prokinetik Questions 17-19 A man, 55 years old presented with weakness. The physical examination showed general state: weak, pale conjungtiva, with icterus and ascites. Laboratory result showed hemoglobin 6,8 g%. Past illness history: yellow illness 30 years ago. Three years ago he was hospitalized with hematemesis melena and treated weell with esophagus varices ligation. Question: 17. A possibility cause of anemia of this patient is: A. Esofagus varises rupture B. Gastropathy portal hypertension C. Gastritis erosive D. Gastric ulcer 18. This patient did not complain hematemesis or melena. The simple test to ensure melena is: A. Sigmoidoscopy B. Rectal toucher C. Benzidine test D. Colon in loop 19. One of alarm signal to do endoscopy for the patient with dyspepsia is: A. Haematemesis B. Dyspepsia more than 2 weeks C. Flatulens D. Haematoschezia 20. Pancreatic islets consist of alpha, beta, and delta cells, which secrete glucagons, insulin, and somatostatin , respectively. These cells are derived from A. Mesoderm B. Endoderm C. Ectoderm D. Neuroectoderm 21. A 2-month-old baby with severe jaundice also has dark-colored urine (deep yellow) and white clay-colored stool. Which of following disorders might be suspected ? A. Esophageal stenosis B. Annular pancreas C. Hypertrophic pyloric strenosis D. Extrahepatic biliary atresia 22. A 28-day-old baby is brought to the physician because of projectile vomiting after feeding. On examination, a small knot is palpated at the right costal margin. Which of the following disorders might be suspected? A. Esophageal stenosis B. Annular pancreas C. Hypertrophic pyloric strenosis D. Extrahepatic biliary atresia 23. Which of the following arteries supplies foregut derivatives of the digestive system? A. Celiac trunk B. Superior mesenteric artery C. Inferior mesenteric artery MCQ/BLOK 13/2009 3

D. Right umbilical artery 24. The simple columnar or cuboidal epithelium lining the extraphetic biliary ducts is derived from A. Mesoderm B. Endoderm C. Ectoderm D. Neuroectoderm Questions 25-30 Woman, 55 years old, admitted in the hospital with the chief complaint diarrhea more than 4 weeks, frequency more than 3 times/day, blood (+). She felt abdominal pain, mouth ulcer, joint pain and decrease of body weight. Physical exam : TD : 120/80 mmhg, N : 80x/m, RR 20x/m, T : 36 C, mouth ulcer (+), C palpebra anemis (+), JVP 5-2 cmH2O, cor and pulmo : normal, hepar and lien not palpable, abdominal mass palpable in inguinal dextra region, peristaltic (+) normal. Laboratory : Hb 8gr/dl, leucosit 7000/mm3, LED 20/hour, trombosit 200.000/mm3, CRP (+), uric acid 4,4 mg/dl, LDH 50U/l, feces : benzidine test (+).. Endoscopy pattern : cobblestone appearance (+). 25. Based on the data, the patient was suffering from : A. Colon Ca B. Chrons disease C. Ulserative Colitis D. Colon tuberculosis. 26. The most frequent location of the disease is A. Rectal B. Descenden Colon C. Ileocaecal D. Transversum Colon 27. What should you give for the treatment : A. Surgery B. Chemoterapy C. Corticosteroid + 5 ASA D. Metrotexate 28. Etiopathogenesis of the disease is A. Unclear, related with autoimmune disease. B. Interaction between genetic and environment factor. C. Chromosom instability. D. Poor nutrition. 29. Frequent complication of the disease, except : A. Perforation B. Intestinal obstruction. C. Toxic megacolon D. Malabsorbtion. 30. The correct statement related with the diagnosis is A. There is no skip are B. Rectal area is frequent involved. C. Inflamation is continues. D. Lesion is segmental and transmural. Questions 31-35 Woman, 20 years old, admitted in the hospital with the chief complaint recurrent abdominal pain since 3 month ago, pain relief after defecation or flatus, diarrhea (+), blood (-), no fever, nausea (+). Physical exam : TD 120/80 mmhg, N 80x/m, RR 20x/m, T 36 C. C palpebrae : anemis (-), icteric (-), JVP 5-2 cmH2O, cor and pulmo normal, hepar and lien not palpable, peristaltic (+) increase, extremitas normal. Laboratory : Hb 10gr/dl, leucosit 7000/mm3, trombosit 235.000/mm3, LED 10mm/hour, uric acid 3,0 LDH 10 U/l, CEA (-), History taking antibiotic (+). 31. What kind of procedure should you perfomed to established the diagnosis ? A. Ultrasonografi. B. Colonoscopy C. Radiology E. Endoscopy. MCQ/BLOK 13/2009 4

32. If the result of any procedure that you have already done was normal, what is the possible diagnosis? A. Colitis infection B. Inflamatory bowel disease C. Irritable bowel syndrome D. Pseudomembran colitis 33. What kind of drugs should you give, A. Antidiarrhea, analgetic, antibiotic B. Transquilizer, antispasmodic, antidiarrhea C. Corticosteroid + 5ASA D. Antispasmodic, antibiotic 34. The most frequent location of colon ca : A. Sigmoid B. Descenden colon C. Rectal D. Caecum 35. Epithelial polyp that can lead to be malignant is A. Adenoma B. Inflamatory polyp C. Hyperplastic polyp D. Hamartoma. 36. The following are bacteria which have late lactose fermenters: A. E. coli B. Salmonella typhi C. Shigella sonnei D. Klebsiella sp 37. Strain of E. coli carrying K antigen are very virulence, because: A. Responsible for pyelonephritis B. Liable to cause cystitis C. Known to cause diarrhea D. Capable of causing meningitis 38. Stool culture can be used in the diagnosis of typhoid fever during: A. 1st week B. 2nd week C. 3rd week D. 4th week 39. The most probable organism causing food poisoning in a child who has eaten ice Cream 16-18 hrs earlier: A. Salmonella typhimurium B. Clostridium botulinum C. Clostridium perfringes D. Staphylococcus aureues 40. The following is true about Enterobacteriaceae : A. Oxidase negative B. Polar flagella C. Resistant to antibiotics D. Urease positive 41. Which one of the following structures is derived from the midgut? A. Appendix B. Stomach C. Liver MCQ/BLOK 13/2009 5

D. Pancreas 42. A 3-month-old baby girl presents with a swollen umbilicus that has failed to heal normally. The umbilicus drains secretions, and there is passage of fecal material through the umbilicus at times. What is the most likely diagnosis? A. Omphalocele B. Gasthroschisis C. Anal agenesis D. Ileal diverticulum 43. Kupffer cells npresent in the adult liver are derived from A. Mesoderm B. Endoderm C. Ectoderm D. Neuroectoderm 44. The simple columnar and stratified columnar epithelia lining the lower part of the anal canal is derived from A. Mesoderm B. Endoderm C. Ectoderm D. Neuroectoderm 45. A baby born to a young woman whose pregnancy was complicated by polyhydramnios was placed in the intensive care unit because of repeated vomiting containing bile. The stomach was markedly distended, and only small amounts of meconium had passed through the anus. What is the most likely diagnosis? A. Esophageal stenosis B. Annular pancreas C. Hypertrophic pyloric strenosis D. Duodenal atresia 46. Likely adsorben can absorb toxin and gas: A. Mg Hidroksida B. Al. Hidroksida C. Na Bikarbonat D. Bismut koloidal 47. This H2 Antihistamin can disturb metabolism of diazepam : A. Ranitidin B. Simetidin C. Pirenzepin D. Famotidin 48. Be carefully prescribe anti muscarinic in patient with hypertrophy prostate: A. Omeperazole B. Bismuth coloidal C. Pirenzepin D. Metoclopropamide 49. This drug can increase carcinoid incident if used in long time in animal : A. Sukralfat B. Natrium bikarbonat C. Omeperazol D. Misoprostol 50. The mechanism of this cytoprotectif is increasing PG endogen: A. Setraksat B. Misoprostol C. Domeperidone MCQ/BLOK 13/2009 6

D. Metronidazol 51. The role of prokinetic drug is working in D receptor in the GIT: A. Domperidone B. Bismut koloidal C. Hiosiamin D. Klaritromisin. 52. This prokinetic drug is contraindicated in patient with mechanic obstruction : A. Metoklopropamid B. Pirenzepin C. Sukralfat D. Kisaprid 53. The second line antibiotic combinations to treat peptic ulcer is : A. Tetrasiklin B. Kuinolon C. Bismut koloidal D. Klaritromisin 54. The definition of digestion is: A. chemical breakdown of big particles of food into chyme B. mechanical breakdown of food by teeth in mouth C. chemical and mechanical breakdown of food into absorbable units D. A process of metabolism which involves secretion of enzymes 55. 50 year old male without a significant past medical history or recent exposure to alcohol presents with mid-epigastric abdominal pain, nausea and vomiting. The physical examination is remarkable for the absence of jaundice and any other specific physical findings. Which of the following is the best strategy for screening for acute pancreatitis? A. Abdominal Ultrasound B. Abdominal CT scan C. Measurement of both serum amylase and serum lipase D. Magnetic Resonance imaging 56. At presentation of acute pancreatitis, all the following predict a poor prognosis except: A. Hematocrit above 44 % B. Albumin < 3,0 g/dl C. Body mass index above 30 D. Lipase > 600 U/L 57. Risk factor of acute pancreatitis are, except: A. Obesity B. Alcoholic C. Billiary obstruction D. Chronic hepatitis

58. A 35-year old female complains of RUQ pain that occurs after she eats a large meal. Occasionally the episodes are accompanied by nausea and vomiting. A plain x-ray of abdomen discloses gallstones. USG reveals gallstones and a normal size common bile duct. The patients MCQ/BLOK 13/2009 7

blood chemistry and complete blood count are normal. The most therapeutic manuver at this time would be: A. observation B. laparoscopic cholecystectomy C. ursodeoxycholic acid D. shock wave lithotripsy
59. Commonly overlooked as a cause of dyspepsia is lactose mal-absorption, which may cause A. A. bloating, B. B. cramps, C. flatulence, D. Al of the above

60. Crohn's disease frequently is associated with malnutrition. Deficiencies of nutrients below are common: A. Magnesium B. Potassium C. Zinc D. all of the above 61. Small-bowel mucosal injury and consequent mal-absorption in celiac sprue occurs when a susceptible patient ingests gluten-containing foods, that is A. Barley B. Wheat C. Rye D. all of the above 62. The most tightly cell to cell junction of GIT epithelial cell is found in: A. Esophagus B. Stomach C. small intestine D. large intestine 63. Gut- associated lymphoid tissue (GALT) mostly is found in: A. peritoneum B. muscularis externa C. sub-mucosa D. mucosa 64. Gastritis is a group of conditions characterized by inflammation of the stomach lining that caused by irritation by, at least, food and corrosive substances. Below are food assuming as irritant: A. spicy food, B. alcoholic beverage, C. highly seasoned food, D. all of the above. 65. GERD is a condition in which gastric contents move backward into the esophagus. Dietary can lead to GERD are as follow:
A. B. C. D. high-fat diet, or increased intake of chocolate, or excessively large meals, or all of the above.

66. There are two main classes of ulcer medications. The first group belong to H-2 Blockers. Studies have reported that H-2 receptor antagonists deplete vitamin B12, folic acid, vitamin D and the minerals such as . A. calcium, or B. iron, or MCQ/BLOK 13/2009 8

C. zinc, or D. all of the above 67. The slow wave potentials of GIT is: A. spontaneous cycles of depolarization and re-polarization of smooth muscles B. slow peristaltic waves when obstruction occurs C. mixing movement in stomach to move food into small intestine D. defecation reflex in infants 68. The physiological purpose of motility of GIT is: A. to keep GIT lumen free of pathogenic agents B. to maximize exposure of food particles to digestive enzymes by increasing their surface area C. to expose food particles to contact with lymphoid tissue D. to balance the equilibrium between secretion and absorption 69. The example of tonic contraction is the contraction of: A. segmental contraction in ileum B. mixing contraction in duodenum C. mass movement in colon D. muscle sphincter in pylorus 70. The digestion of protein begins in: A. mouth B. stomach C. small intestine D. large intestine 71. The digestion of triglyceride needs: A. bile B. pepsin C. hydro chloride acid D. lipase 72. The content of ORALIT usually includes sugar and salt, because: A. glucose and Na+ can decrease the motility of GIT B. glucose must be co-transported with Na+ C. secretion of GIT depends on glucose and Na+ D. absorption in colon is influenced by glucose and Na+ Questions 73-75 A woman, 60 years old, admitted to the hospital with the chief complaint mass in epigastrium quadrant and jaundice. In abdominal ultrasonography found mass in pancreas caput and obstruction in choledocus duct. 73. The exact diagnosis examination to establish a definitife diagnosis such as: A. CEA B. CA-125 C. CA 19-9 D. AFP

74. This patient also complaint fever, pain in right upper quadrant and leucocytosis. Complication of this patient probably are ,except: A. Cholelithiasis B. Sepsis C. Hepatitis MCQ/BLOK 13/2009 9

D.

Cholesistitis

75. Treatment of this patient is: A. Chemotheraphy B. ERCP with stent C. Pancreatectomy D. Embolization 76. A man, 48 years old, admitted to the hospital with the chief complain pain right upper quadrant, fever, no jaundice. With leukocyte 16000/mm3, In USG examination found thickening with sludge in gall bladder, The most propably diagnose in this case is: A. Cholesytitis B. Cholelytiasis C. Hepatitis D. Sepsis 77. Clinical patogenesis of acute cholesystitis except : A. Recovery completely B. Gall blader perforation C. Refluks empedu D. Gall blader abcess 78. Classic sign of A. B. C. D. acute cholesystitis is : Murphy sign Ludwig sign Psoas sign Curvosier law -> Pembesaran gallbladder

79. The malnutrition universal screening tool (MUST) is designed to detect protein-energy malnutrition as well as those individuals at risk of developing malnutrition by using criteria below: A. current weight status, B. unintentional weight loss C. acute disease effect D. all of the above. 80. The Subjective Global Assessment (SGA) is a tool used to recognize and document nutritional problems in patients. It includes A. a dietary and medical history, B. a functional assessment and C. a physical examination and D. all of the above. 81. The Mini Nutritional Assessment (MNA) is a rapid and reliable tool for evaluating the nutritional status of the elderly. It is composed of A. 15 items B. 16 items C. 17 items D. 18 items

82. The Nutrition Risk Score (NRS) was developed to assess a patients nutritional risk at hospital admission. The NRS contains variables of A. weight loss, B. food intake C. physiologic stress D. all of the above. MCQ/BLOK 13/2009 10

83. Minimum criteria for the diagnosis of kwashiorkor is A. decubitus ulcers, or B. skin breakdown, or C. edema, or D. all of the above 84. Decreased food intake is commonly encountered in IBD, especially in Crohns disease. This frequently occurs because of anorexia and association of food intake with A. Nausea and vomiting, or B. diarrhea or C. pain, or D. all of the above
85. Dyspepsia may be caused by a number of foods, medications, systemic disorders, and diseases

of the GI tract. Specific foods below are commonly implicated in dyspepsia: .. A. Coffee, but its relationship to dyspepsia is unproven. B. Spicy foods, particularly red peppers, may cause acute gastric mucosal injury. C. Spicy foods, particularly black peppers, may cause acute epigastric pain. D. All of the above. 86. Most patients those suffering from celiac sprue will improve with dietary management alone. Foodstuffs are allowed to consumed are as follow: A. corn, or B. rice, or C. buckwheat, or D. all of the above 87. The greatest impact of antacid usage is developing of depleting some nutrient, that is A. calcium, or B. iron, or C. zinc, or D. all of the above 88. Peptic ulcer disease (PUD) is an erosion of the lining of the stomach, pylorus, duodenum, or esophagus caused by exposure to hydrochloric acid, pepsin, etc. Unfortunately, treatment PUD using tagamet cause deficiency of A. protein, B. iron, C. calcium, D. all of the above. 89. Clients with hiatal hernia should be educated to manage the symptoms of heartburn and regurgitation by: A. eating a snack immediately before going to bed. B. allowing an hour to recline after a meal. C. sleeping lying flat without using a pillow. D. eating more frequent, smaller meals.

90. Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two: A. Names for the same disease. B. Degrees of severity of the same disease. C. Distinct types of disease, affecting different segments of the colon but with the same tissue pathology.

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D. Distinct types of disease, affecting different segments of the colon with different tissue pathology. 91. The treatment of GI diseases is based on: A. The client learning to live with the disease because there are no known cures. B. Stress management techniques because stress is the primary cause of most GI diseases. C. Multiple modalities for managing inflammation, controlling pain, preventing infection, improving diet and nutrition, and making lifestyle changes to avoid triggering factors. D. Managing one symptom at a time to ensure complete effectiveness. 92. When assessing a clients nutritional status, which is indicative of malnutrition? A. Dull hair. B. A body mass index (BMI) of 24. C. Moist mucous membranes. D. Soft abdomen. 93. A women age 40th years-old comes to the doctor with mass in sub-mandibular region without pain. In pathological examination the tumor involves parotid gland as a benign mixed tumor called : A. Sialadenitis B. Adenoid cystic carcinomas C. Pleomorphic adenomas D. Adamantinoma 94. A man age 35 years-old with the lession lies in his tongue, the clinical diagnosis conformed is leukoplakia. The tumor is A. Circumcribed lesion and grayish B. The lession is a malignant tumor associated with HIV C. A benign tumor with irregular white mucosal patches D. In microscopic finding the lession shows parakeratosis 95. A man age 50 years- old comes to the internist with acute epigastric pain. The biopsy of gastric mass suggests as an active chronic gastritis. The most common microbial associated with it is : A. Candida albicans B. Helicobacter pylori C. Salmonella sp D. Staphylococcus aureus 96. An intussuceptions best defined as: A. Bowel obstruction due to diverticulitis B. Telescoping of a bowel segment C. Perforation with peritonitis D. A twisting of a loop of bowel upon itself 97. A man age 50 years- old comes to the surgery with bleeding in his bowel habit. The surgery made a clinically diagnosis is an hemorrhoids. What do you know about this disease in pathological examination? A. A tortuous dilation of small vessels spanning the intestinal mucosa or sub-mucosa. B. A benign lession, polipoid and severe inflammation C. Dilated internal and external venous plexuses in the anal canal. D. Perforation of colon caused by toxic mega-colon 98. An acute appendicitis is emergency situation of acute abdomen cases. In pathological examination the lession are A. Caused by obstruction of the appendiceal lumen most often by fecalith, resulting in bacterial proliferation and invasion of the mucosa. B. Gross changes include a congested appendix with a swollen distal galf covered by purulent exudates, the lumen also contains a purulent exudates and often a fecalith. MCQ/BLOK 13/2009 12

C. Histologic characteristics include an acute inflammatory infiltrate extending from the mucosa through the full thickness of the appendiceal wall. D. All the statements above are correct. 99. Gross and microscopic features of adeno-carcinoma of the pancreas include A. Frequent haemorrhage and necrosis in tumor B. Usually well differentiated C. Most common location in body of pancreas D. Rarely obstruction in the common bile duct 100. A possibility diagnosis in patient with abdominal pain at right upper quadrant are. except : A. Cholelithiasis B. Hepatocelluler carsinoma C. Proctitis D. Liver Abcess 101. A possibility diagnosis in patient with mass at epigastric area are except : A. Pancreatic carcinoma B. Aneurysma aorta C. Hepatocelluler carcinoma D. Cholecystolithiasis 102. A possibility diagnosis in patient with abdominal pain at left upper quadrant are except : A. Acute pyielonephrithis B. Peptic ulcer C. Ileitis terminalis D. Kidney stone 103. This is clinical features of chronic pancreatitis, except : A. Steatorrhea B. Epigastric pain C. Malabsorption D. Pain can reduce by alcohol consumption 104. This condition can cause obstructive jaundice, except : A. Cholangiocarcinoma B. Cholelithiasis C. Primary billiary cirrhosis D. Hemolysis 105. This is clinical features of cirrhosis hepatic, except : A. Gynecomastia B. Spider nevi C. Erythema nodosum D. Splenomegaly 106. Which are this statement true, except : A. Acute pancreatitis is classically relieved by sitting forward while holding the abdomen B. Gallblader pain commonly radiates around the right side to the back C. Pancreatic pain radiates through to the middle of the back D. Duodenal ulcer tend to cause symptoms at night and worse by food 107. Which of the following statements concerning adeno-carcinoma of the large bowel is true? A. Is the most common carcinoma in men B. Most the tumors arise in the transverse colon C. These tumors often present with rectal bleeding D. Prognosis is best related hiistologic grade MCQ/BLOK 13/2009 13

108. A 70-year-old man present with bowel bleeding. A complete blood count reveals anemia with hemoglobin of 10.0g/dl. In colonoscopy and colon biopsy reveal adeno-carcinoma. The morphological of this tumor are A. A polipoid mass, napkin ring structure, glandular pattern some with mucin production. B. The lession seem like Barret lession C. Ulcerative lession with caseose necrosis and granuloma. D. The lession is benign with severe inflammatory of leucocytes and hemorrhage. 109. A man 57 year-old with jaundice, loss of his weight, nausea, anemia, diagnosed reveal a hepatocellular carcinoma. The correct statement about his diseases is A. This hepatic malignancy almost always develops in associated with HAV infection. B. Neoplastic cell structure are pseudoglandular or trabecular with pleomorphic giant cells C. Also association with nitrosamine and cigarette. D. The level of serum concentration of alpha fetoprotein is decreased. 110. Your patient is a 70 year-old man who under-went bowel surgery for colon cancer 3 days ago. He now has a fever and abdominal pain. He now has a fever and abdominal pain. You are concerned that he may have peritonitis. Which one of the following pairs of organism is MOST likely to be cause? A. Bacteroides fragilis B. Bordetella pertussis C. Actinomyces israelli D. Clostridium botulinum 111. Escherichia coli can be classified by their characteristic virulence properties and different mechanisms that cause disease. To which group does the verotoxin producing E. coli 0157:H7 serotype belong? A. Enteroaggregative E. coli (EAEC) B. Enterohemorrhagic E. coli (EHEC) C. Enteroinvasive E. coli (EIEC) D. Enteropathogenic E. coli (EPEC) 112. A 45-year-old man presents to the hospital vomiting blood. He is diagnosed with a perforated peptic ulcer. The causative agent discovered by gastric biopsy is a spiral gram-negative bacillus. What other long-term complications could this organism cause if not treated? A. Skin ulcers B. Esophageal varices C. Gastric MALT lymphomas D. Colon cancer 113. Which one of the following organisms causes diarrhea by producing an enterotoxin that activates adenylate cyclase? A. Escherichia coli B. Bacteroides fragilis C. Staphylococcus aureus D. Enterococcus faecalis 114. A 25-year-old male tests postivie for a hepatitis C infection. Which of the following is the most likely method of transmission? A. Fecal oral B. Formite C. Intravenous drug ( needles ) D. Sexual transmission 115. A 33 year-old nurse sufferd a needle sticky injury. The patient used illicit intravenous drugs. One month later, the nurse develops jaundice. Which of the following findings would implicate hepatitis B as the etiology? A. Positive antihepatitis B surface antibody B. Positive antihepatitis B-core antibody C. Postive hepatitis B surface antigen MCQ/BLOK 13/2009 14

D.

Positive antihepatitis A antibody

116. Short incubation food poisoning, caused by ingestion of preformed enterotoxin, is caused by which bacteria listed below? A. Staphylococcus epidermidis. B. Enterococcus faecalis. C. Staphylococcus aureus. D. Streptococcus pneumoniae. 117. Microscopic examination of a patientss fecal culture shows comma-shapped bacteria. These bacteria 2-4% NaCl to grow. The bacteria probably belong to the genus A. Campylobacter. B. Vibrio. C. Salmonella. D. Shigella. 118. This virus is the most important cause of gastroenteritis in infants and young children. It causes infections that are often severe and may be life- threating, especially in infants. A. Echovirus B. Norwalk virus C. Rotavirus D. Orbivirus 119. A. B. C. D. The bacterium causing pseudomembranous colitis is Clostridium difficile. Streptococcus pyogenes. Mycobacterium avium- intracellulare. Corynebacterium diptheriae.

120. Predisposising factor of cutis candidosis : A. Heart disease B. Diabetes melitus C. Cushings syndrome D. Nephrotic syndrome

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