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40. Endoscopy was done on the above patient. which of the For questions 46-52, refer to the ff case: a 45 year old
are typical endoscopic findings in patients with crohns salesman consulted you because of jaundice. No abdominal
disease? pain, fever noted. ultrasound showed a nodular and small
a. Rectal sparing liver.
b. Cobblestoning
c. Fistula formation 46. Your impression is:
d. AOTA a. Liver cirrhosis
b. Biliary obstruction
41. Biopsy was done on the lesions found in the colon. Which c. Liver abscess
of the ff Histopathologic findings are typical of crohns d. Fatty liver
disease?
a. Inflammation is limited to the submucosa 47. A few months later, he develops melena and
b. Granuloma formation is observed hematemesis. His abdomen is enlarged with shifting
dullness. No abdominal pain/tenderness or fever was
48. On upper GI endoscopy, esophageal varices were noted. 55. A few years later, the patient consulted you because of
the next procedure to be done would be to elevated ALTs, polyuria, polyphagia. FBS remains
a. Give beta blockers elevated. Ultrasound remains the same. Hepatitis profile
b. TIPS is non-reactive for A, B, & C. impression at this time is:
c. Variceal ligation a. Hepatitis
d. Surgery b. NASH
c. Hepatocellular carcinoma
49. As the medical resident in charge of the patient, you d. Hepatic abscess
want to prevent possibility of problems associated with
GI bleeding & ascites. You decide to start: 56. Treatment of the above patient may include:
a. Antibiotics a. Anti-diabetic medications
b. Lactulose b. Surgery
c. Low sodium diet c. Percutaneous drain
d. Branched chain amino acids d. Observe
50. Your patient was discharged with no more recurrence of For questions 57-59, refer to the ff case: a 53 y/o male,
GI bleeding. He was given furosemide, spironolactone diagnosed with NASH for the past 10 years, was noted to be
and propanolol as home medications. you advise follow jaundiced with enlarging abdomen. Blood tests showed
up after 2 weeks. On follow up, relatives told you of the slightly elevated ALT, deranged prothrombin time, low
changes in sensorium of the patient with no lateralizing albumin. PE showed (+) fluid wave.
signs. Your patient is experiencing:
a. Cerebral infarction 57. Your impression is:
b. Cerebral hemorrhage a. Acute viral hepatitis
c. Hepatic encephalopathy b. Drug induced hepatitis
d. Septicemia c. Liver cirrhosis
d. Ischemic hepatitis
51. The most probable precipitation factor on why the above
patient developed this problem is: 58. On further history, a CT scan was used to diagnose his
a. Electrolyte abnormality fatty liver. The following is the typical CT scan findings to
b. Infection a patient with fatty liver:
c. Recurrence of GI bleeding a. Hypodense liver compared to spleen
d. Hypertensive emergency b. Hyperdense liver compared to spleen
c. Same density as spleen and kidnyes
52. Treatment for the above patient will include: d. Presence of mass lesion
a. Discontinuing loop diuretics
b. Giving antibiotics 59. A liver biopsy was done on a patient suspected of NASH.
c. Control GI bleeding You would expect to see which of the ff findings which
d. Anti-hypertensive medication are the hallmarks for NASH:
a. Steatosis
For questions 53-56, refer to the ff case: a 40 year old b. Lobular inflammation
overweight businessman consulted you because of c. Fibrosis
ultrasound findings of hyperechoic liver. He is non-alcoholic d. Necrosis
and all blood tests are normal except for elevated fasting
blood sugar. 60. A 35 year old male consulted you because of findings on
ultrasound suggestive of fatty liver. Aside from NAFLD,
53. Your impression on the patient is: the ff may present with the same ultrasound picture:
a. Hepatitis a. Hemangiomas
b. NAFLD b. Alcoholic liver disease
c. Normal liver c. Lymphoma
d. Liver cyst d. Hepatocellular carcinoma
87. In which of the following cases would the prolonged 94. What is the most common cause of non-traumatic
prothrombin time be corrected by the administration of pneumoperitoneum?
parenteral vitamin K? a. Perforated PUD
a. Fulminant hepatitis A b. Bowel obstruction
b. Fulminant hepatitis B c. Necrotizing enterocolitis
c. Cholestatic hepatitis A d. Ruptured diverticulum
d. Decompensated cirrhosis due to hepatitis B