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Content:
Anatomy
Physiology
Biochemistry
Pathology
Pharmacology
Microbiology
Public Health

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 Gastrointestinal System
Questions
Anatomy:
Lecture 1:
1) Vermilion is covered with:
A) specialized STRATIFIED SQUAMOUS EPITHELIUM
B) cuboidal epithelium
C) columnar epithelium
D) squamous epithelium
Answer: A

2) PALATINE APONEUROSIS is an expanded tendon of:

A) Levator veli palatine
B) Tensor veli palatine
C) Musculus uvulae
D) Geniohyoid.
Answer: B

3) The primary function of the tongue is:

A) speech production
B) push the bolus down
C) provide a mechanism for taste.
D) All of the following
Answer: C

4) palatoglossus muscle is supplied by the pharyngeal plexus ( from:

A) hypoglossal nerve
B) trigeminal nerve
C) Facial nerve
D) vagus nerve
Answer: D

5) the nerve that pass across parotid gland is :

A) hypoglossal nerve
B) trigeminal nerve
C) Facial nerve
D) vagus nerve
Answer: C

Lecture 2:
1. UPPER OESOPHAGEAL SPHINCTER Located at
A) C5-C6 level
B) T1-T2 level
C) C4-C5 level
D) L1 level
Answer: A

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2. Cervical part of esophagus is supplied by :
A) 4-6 aortic esophageal arteries
B) inferior thyroid arteries
C) left gastric artery
D) inferior phrenic artery
Answer: B

3. Pharynx begins at the:

A) C1
B) C2
C) base of the skull
D) T1
Answer: C

4. OROPHARYNX contains the following structures except:

A) Posterior 1/3 of the tongue.
B) Lingual tonsils
C) Palatine tonsils
D) ADENOID TONSILS
Answer :D

5. All the following founds between superior and middle constrictors except :
A) Stylohyoid ligament
B) Stylopharyngeus
C) Lingual nerve
D) Facial nerve
Answer: D

Lecture 3:
1. Which of the following found in Right hypochondriac region?
A) spleen
B) liver
C) cecum
D) kidney
Answer: B

2. iliac region innervation by?

A) T10_T11
B) T7_T12
C) L1
D) all of the following is correct
Answer: C

3. Below the perineum, it enters the wall of the scrotum and from there, it passes to be
attached on each side to the pubic arch where it is referred as:
A) camper’s facia
B) scrap's facia
C) colle's facia
D) two answers are correct
Answer: C

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4. Forms the inguinal ligament by?
A) external oblique folding, which extends from the anterior superior spine to the pubic crest
B) internal oblique folding, which extends from the anterior superior spine to the pubic crest
C) internal oblique folding, which extends from the anterior inferior spine to the pubic crest
D) external oblique folding, which extends from the anterior inferior spine to the pubic crest
Answer: A

5. Transversus Muscle Insertion:

A) Rectus sheath
B) Linea alba
C) Pubic crest
D) All of the following is correct
Answer: D

6. Where is the posterior wall found absent in rectus sheath?

A) Between the level of the anterior superior iliac spine and the pubis
B) Between the costal margin and the level of the anterior superior iliac spine.
C) Above the costal margin
D) All of the following is not correct
Answer: A

7. Which of the following muscle Origin: arises by its base from the anterior surface of the
pubis (pubic crest).
A) Rectus Abdominis
B) Pyramidalis
C) external oblique
D) Two answers are correct
Answer: B

8. how differentiate between ovary disease & Appendicitis

A) Blood analysis, If the number of WBCS is high, it is appendicitis in addition to the other
signs such as vomiting, McBurney's sign and pain.
B) Blood analysis, If the number of WBCS is high, it is ovary disease in addition to the other
signs such as vomiting, McBurney's sign and pain
C) Blood analysis, If the number of WBCS is high, it is appendicitis without other signs such as
vomiting, McBurney's sign and pain
D) Blood analysis, If the number of WBCS is high, it is ovary disease without other signs such
as vomiting, McBurney's sign and pain
Answer: A

9. Which of the following correct about suturing

A) the two fasciae (superficial and deep) from both sides are ligated separate each other
B) the two fasciae (superficial and deep) from both sides are ligated together
C) all of the following is not correct
D) all of the following is correct
Answer: B

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10. If the tendon of the muscle is not clear and come very close in appropriation to each other,
will be formed...... & which leads to:
A) calluses• Muscles break in any tension might occur.
B) calluses • Preventing the function of the muscles.
C) not of the following
D) all of the following is correct
Answer: D

Lecture 4:
1. Which of the following statements is incorrect about border of inguinal canal:
A) Floor upturned lower edge of inguinal ligament and lacunar ligament medially
B) Roof formed by arching over of the internal oblique and transversus abdominis muscle as
conjoint tendons.
C) Posterior wall laterally by the transversus abdominis muscle and medially by conjoint
tendon which enforces the medial by its backward reflection.
D) The anterior wall formed by the external oblique aponeurosis.
Answer: C

2. Which of the following mismatch about superficial ring:

A) External spermatic fascia........ comes from external oblique.
B) Cremaster muscle .... don't comes from the internal oblique.
C) Internal spermatic fascia .... comes from the transversalis fascia.
D) all of the following is correct
Answer: B

3. Which of the following is true:

A) The Deep inguinal ring an oval opening deficit in the facia transversalis
B) Superficial Inguinal Ring Is a oval-shaped deficit in the external oblique aponeurosis
C) the conjoint tendon A fixative tendon that fixes the 2 muscles into the pubic tubercle
D) all of the following is correct
Answer: A

4. Which of the following is not correct about hernia:

A) Reducible; if you put your finger at the pouch or the content of the hernia and push against
it, the contents of the hernia will go back into the abdomen
B) Incomplete means only a small part of the small intestine comes out of internal ring and
pops up into external ring
C) Inflamed: amount of blood supply from the inferior epigastric artery isn't sufficient and the
strangulation makes gangrene structure very dangerous
D) all of the following is correct
Answer: D

5. Which of the following the most common inguinal hernia

A) Direct
B) Reducible
C) Indirect
D) Inflamed
Answer: C

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6. Which of the following is correct about Direct hernia
A) Visible cough impulse present.
B) They do not protrude through any ring, but through an area of weakness in the posterior
wall of the inguinal canal; this area is likely to be Hesselbach's Triangle.
C) occur medial to the epigastric vessels.
D) all of the following are correct
Answer: D

7. Which of the following not correct about obstructed hernia:

A) Ischemia and necrosis of the hernial contents occur due to compromised vascular supply.
B) Strangulated
C) reducible
D) Edema will block both rings and cause obstruction.
Answer: C

8. Which of the following not correct about Umbilical hernia

A) Umbilical hernias usually occur in pregnancy due to decrease intraabdominal pressure.
B) caused by deficit in Linea alba muscle.
C) it's a direct hernia
D) it's Ventral hernias
Answer: A

9. About Groin hernias which of the following incorrect

A) There's a communication between the content of the pelvis especially the nerves and
arteries that come into the anterior aspect of the thigh
B) occurs at lumbar region.
C) occurs in femoral triangle
D) it's below the inguinal canal and ligament.
Answer: B

Lecture 5:
1. All of the following are true about peritoneum except:
A) peritoneum covers partially or totally the organs of both abdominal and pelvic cavities
B) it is closed in male and female
C) it is closed in male only
D) in female ectopic pregnancy may happen because of communication with uterine tube,
uterus and the vagina
Answer: B

2. Bare area of the liver has no peritoneal covering and located on the anterior surface of the
liver
A) true
B) false
Answer: B

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3. Which of the following sentences are false?
A) The Falciform Ligament a sickle-shaped fold of peritoneum
B) Mesentery of the small intestine Connects the loops of jejunum & ileum to the posterior
abdominal wall
C) flexures are often used to mark the distinction between different portions of the mesentry
D) Omenta Two layers of peritoneum that connect stomach to another viscus.
E) All are true
Answer: B

4. Due to the range of abdominal organs the mesentery envelopes, the root is long, narrow &
has a straight orientation, from the left side of the L2 vertebra to the right sacroiliac junction
roughly.
A) true
B) false
Answer: B

5. according to the innervation of the peritoneum which is not true:

A) Visceral peritoneum innervated by Autonomic afferent nerves
B) Parietal peritoneum innervated by Autonomic afferent nerves
C) Parietal peritoneum innervated by lower seventh thoracic nerves
D) 2 answers are false
Answer: D

6. According to mesenteries which of the following is not true:

A) mesosigmoid has a medial portion which is flattened against the posterior abdominal wall,
whereas the region of mesentery associated with the sigmoid colon itself is mobile.
B) Transvers mesocolon attached to the transverse colon of the large intestines, attaching it to
the posterior wall
C) Left & right mesocolon Flattened against the posterior abdominal wall (The ascending and
descending colon become secondarily retroperitoneal).
D) mesorectum Assists in anchoring the rectum through the pelvis
E) all are true
Answer: E
Lecture 6:
1. Choose the wrong statement:
A) stomach occupies epigastric, umbilical, left and right chondriac region
B) Rugae: The mucosa of the stomach thrown in longitudinal folds
C) stomach has 3 layers: Longitudinal(outer), circular and oblique (inner)
D) Most of the stomach is protected by anterior abdominal wall
E) 2 answers are wrong
Answer: E

2. According to greater curvature of the stomach which of the following is true:

A) it forms the long, convex, medial boarder of stomach
B) Arising at the cardiac orifice, it arches backwards and passes inferiorly to the left.
C) it supplied by the left gastric artery & right gastric branch of the hepatic artery.
D) all are true
E) 2 answers are correct
Answer: B

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3. Choose the true statement:
A) one of the anterior relation of the stomach is left costal margin
B) The inferior Esophageal sphincter Is a physiological sphincter
C) pyloric sphincter s is marked by an abrupt change from stratified squamous (esophagus) to
a simple columnar epithelium (stomach).
D) a and c
E) a and b
F) none of the following
Answer: D

4. Which of the following is false about arterial supply of stomach?

A) Left gastric artery Supply the cardia of the stomach & distal esophagus
B) proper hepatic artery branch of common hepatic artery
C) Right Gastroepiploic artery Supply greater curvature in conjunction with left gastroepiploic
artery
D) common hepatic artery gives left gastroepiploic artery and short gastric arteries
E) a and c
Answer: D

5. Which of the following is not true about parts of duodenum?

A) First part of duodenum It begins at the pylorus & runs upward & backward on the
transpyloric plane at the level of the 1st lumbar vertebra
B) The accessory pancreatic duct, if present, opens into the duodenum a little higher up on the
minor duodenal papilla.
C) Runs vertically downward in front of the hilum of the left kidney, on the right side of the
2nd & 3rd lumbar vertebrae.
D) a and b
E) all are true
Answer: C

6. Contraction of the suspensory ligament of treitz normally increase the angle of the
duodenojejunal flexure
A) true
B) false
Answer: A
Lecture 7:
1. The small intestine measures about ________ feet in length.
A) 8
B) 21
C) 30
Answer: B

2. The liver and pancreas, or accessory organs, produce material that either digests food or
helps in the process of digestion. Those products leave the liver and pancreas and enter into
the small intestine where the action is performed. The products from the liver and pancreas
enter into which part of the small intestine?
A) ileum
B) jejunum
C) duodenum
Answer: C

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3. The large intestine can be distinguished from the remaining segments of the
gastrointestinal tract by which anatomical feature:
A) omental appendices (epiploic appendages)
B) taenia coli
C) haustra coli.
D) all of the above
Answer: D

4. Which of the following structures is the retroperitoneal section of the colon that stretches
between the cecum and the liver?
A) Transverse Colon
B) Descending Colon
C) Ascending Colon
D) Sigmoid Colon
Answer: C

5. Which part of the large intestine (colon) is situated in the left iliac fossa?
A) Descending Colon
B) sigmoid colon
C) Transverse Colon
D) Appendix
Answer: B

Lecture 8:
1. Histologic specimen demonstrates an oral cavity organ with mucosa covered with
keratinized stratified squamous epithelium. Specify this organ or its part:
A) Labial mucosa
B) Gum
C) Inferior surface of tongue
D) Uvula
E) Soft palate
Answer: B

2. Which papilla on the tongue has the majority of the taste buds?
A) fungiform Papillae
B) circumvallate Papillae
C) foliate Papillae
D) Filiform Papillae
Answer: A

3. What percentage of the total mucosa is specialized mucosa?

A) 20%
B) 50%
C) 15%
D) 66%
Answer: C

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4. What percentage of the total mucosa is lining mucosa?
A) 20%
B) 50%
C) 15%
D) 60%
Answer: D

Lecture 9:
1) All of the following are correct regarding the gallbladder except:
A) Located underneath the left lobe of the liver.
B) Connected to the liver by the hepatic duct and to the duodenum by the common bile duct.
C) Function in concentrating and storing bile gallstones.
D) The anatomical subdivisions are fundus, body, and neck which terminates in the narrow
infundibulum.
E) The wall of the gallbladder is composed of three layers: Mucosa, Muscularis Externa and
Adventitia or Serosa.
Answer: A

2) All of the following are correct regarding the pancreas HEAD except:
A) The superior border: 1st part of duodenum / Superior pancreaticoduodenal artery
B) The inferior border: 3rd part of duodenum / Inferior pancreaticoduodenal artery.
C) The right lateral border: 2nd part of duodenum / Terminal part of bile duct
D) The Head of the pancreas: Enlarged, C-shaped part, lying within the concavity of
duodenum
E) The Anterior surface: IVC / Right renal veins / Right crus of diaphragm / Bile duct
Answer: E

3) All of the following are correct regarding the liver except:

A) Is the largest gland in the body, weighs about 1.5 kg.
B) Location: under the right kidney.
C) The best way to examine the liver, is by asking the patient to lie on a supine position and
palpate the liver whenever the patient takes a deep breath
D) Surfaces of the Liver - There are 3 superficial surfaces of the liver: Bare area /
Diaphragmatic surface / Intraperitoneal (visceral surface)
E) The liver contains 2 Functional lobes: Right and Left lobes
Answer: B

4) Which of the following ligament is largest hepatic ligament :

A) The ligamentum teres
B) right triangular ligament
C) left triangular ligament
D) Coronary ligaments
E) The Falciform ligament
Answer: D

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5) All of the following are correct regarding the endocrine pancreas except:
A) Is much smaller, but equally important portion of the pancreas.
B) Composed of pancreatic islets, which appear as islands of cells dispersed between the
pancreatic acini.
C) This consists of many serous pancreatic acini cells
D) These islet cells produce and secrete hormones (glucagon, insulin, somatostatin, and
pancreatic polypeptide) that regulate glucose, lipid, and protein metabolism.
E) All are correct
Answer: C

6) The common hepatic duct is usually less than 2.5 cm long and is formed by the union of the
right and left hepatic ducts.
A) True
B) False
Answer: A

Lecture 10:
1) Regarding the mucus cells, all of the following true except:
A) They are cuboidal in shape and has basal flattened nuclei.
B) Their cytoplasm foamy due to dissolved mucinogen secretory granules.
C) They have pale basophilic cytoplasm, so they appear dark in staining
D) Their secretions have many functions such as Lubrication and are effective barrier which
leads to aggregation of microorganisms.
Answer: C
2) Which of the following is true regarding serous cells?
A) The cells cuboidal in shape.
B) Have microvilli in their base.
C) Their nuclei are rounded and apical.
D) Their cytoplasm is deeply basophilic, so they appear dark in staining.
Answer: D

3) Seromucinous cells consists of serous cell capped with mucous cell.

A) True
B) False
Answer: B

4) Secretory end piece empties into:

A) Intercalated duct
B) Striated duct
C) Interlobular duct
D) Main duct
Answer: A
5) Which of the following is mismatched?
A) Intercalated Duct → Low Cuboidal Cells
B) Striated Ducts → Low or tall Columnar Cells
C) Interlobular Duct → Simple Columnar Cells.
D) Main Excretory Duct → Proximal → pseudostratified columnar
E) Middle → stratified columnar cells.
F) Distal → stratified squamous keratinized.
Answer: D

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6) All of the following are true except:
A) The septa between salivary gland lobules carry the nerves and blood vessels and small
excretory ducts.
B) The contraction of myoepithelial cells releases secretions into the duct system.
C) Von Ebner’s lingual gland is serous and Secretes digestive enzymes & proteins that play
role in taste process, also their secretion cleanses the tongue & prepare the taste receptors
for a new stimulus.
D) Labial and buccal glands are mixed glands.
E) All are true.
Answer: E

7) Regarding major salivary gland, choose the incorrect statement :

A) Parotid Gland has uniform, round and basal nuclei, small LN near or within the gland,
which arise from interstitial lymphocytes.
B) Submandibular gland has adipocytes and its secretions serous in nature.
C) Adenomeres are found within submandibular gland.
D) Sublingual salivary gland has adipocytes and mucous secretions
Answer: B

Lecture 11:
1) Tunica muscularis consists of:
A) epithelium, connective tissue, and muscle.
B) loose connective tissue, nerves, blood vessels, and glands in some organs.
C) MAXIMUM two layers, an inner circular and an outer longitudinal with parasympathetic
ganglia located between the layers
D) NONE OF THE ABOVE
Answer: D

2) Mismatched pair is?

A. Oropharynx → stratified squamous non-keratinized epithelium
B. ESOPHAGUS → stratified squamous epithelium
C. Junction of the body and antrum → epithelial transition takes place, in which there is a shift
from the stratified squamous epithelium to simple columnar epithelium
D. Rugae of the stomach → longitudinally oriented folds.
Answer: C

3) The function of crypt cells is:

A) secrete intestinal juice which contains enzymes that break down proteins, carbohydrates,
fats.
B) secrete hormones.
C) produce pepsinogen, the inactive form of the protein-digesting enzyme pepsin.
D) secrete HCl and intrinsic factor.
Answer: A

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4) 1. The jejunum and ileum do not have Brunner's glands.
2. The jejunum has Peyer's patches in the mucosa (lamina propria) extending into the
submucosa, but the duodenum and ILEUM do not.
A) 1&2 are true
B) 1 is true & 2 is false
C) 1 is false & 2 is true
D) 1&2 are false
Answer: B

5) In descending colon, Presence of Paneth cells indicates chronic injury.

A) TRUE
B) FALSE
Answer: A

6) Esophagus, oropharynx, colorectal zone, gastroesophageal junction, pectinate line, stomach,

ileum respectively have:
A) All are consisting of stratified squamous epithelium
B) All are consisting of simple columnar epithelium
C) Stratified squamous epithelium, stratified squamous epithelium, simple columnar,
transitional epithelium, stratified squamous epithelium, simple columnar, simple columnar
D) Stratified squamous epithelium, simple columnar, transitional epithelium, stratified
squamous epithelium, simple columnar, simple columnar, pseudostratified columnar
epithelium.
Answer: C

Physiology:
Lecture 1:
1) Salivary secretion:
A) hypertonic
B) hypotonic
C) Isotonic
Answer: B

2) Which of the following is incorrect about saliva?

A) A. Saliva production is controlled by salivary center in medulla
B) pH of the saliva is acidic (+)
C) Proline-rich proteins prevents dental caries
D) Na+ absorption and K+ secretion is increased by aldosterone
E) E. Saliva entering the mouth is hypotonic
Answer: B

3) Which of the following isn’t true about salivary secretion?

A) Na: 135-145
B) Cl: 96-106
C) K+: 3.5-5
D) HCO3: 32-38
Answer: D

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4) About salivary amylase, which of the following is correct?
A) ↓ osmosis
B) ↑k
C) ↓Hco3
D) ↑Na
E) ↓cl
Answer: D

5) Which of the following isn’t true about salivary secretion?

A) The HCO3 concentration stays the same regardless of the rate of secretion
B) The level of modification depends on the rate of flow
C) saliva is produced from cells with the same composition of plasma
D) salivary ducts selective absorption of Na+ and Cl– from the saliva
Answer: A

6) The salivary glands, one of the following is correct:

A) selective secretion of Na+ and Cl– from the saliva
B) Bicarbonate is added to the saliva mainly in the striated ducts.
C) selective absorption of K+ and HCO3
Answer: B

7) If the rate of salivary secretion is increased, which of the following changes in ionic
composition results?
A) Bicarbonate concentration increases
B) Potassium concentration increases
C) Sodium concentration increases
D) Chlorine concentration decreases
Answer: C

8) Salivary glands:
A) All are encapsulated.
B) All have serous secretions
Answer: B

9) one of the following about salivary amylase is true?

A) salivary amylase digest starch to glucose
B) salivary amylase digest glycogen to glucose
C) gastric acid aid in digestion of carbohydrates
D) none of the above
Answer: D

10) Which gland is associated with secretion 60% of salivary secretion and open?
A) Submandibular gland beside sublingual papillary (frenulum)
B) Submandibular gland into a duct called rivinis
Answer: A

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11) Regarding salivary secretions all are wrong except:
A) Salivary secretions are purely under neural control
B) normally it’s about 1-3 L/day
C) in minimum flow majority of saliva comes from Parotid
D) in Maximum flow majority of saliva comes from Submandibular
Answer: A?

12) Which of the following is false?

A) in sleeping state, parotid gland secrets huge amount of saliva
B) flow in the unstimulated state comes from Submandibular
C) during eating majority of saliva comes from Parotid
Answer: A

13) Which of the following is wrong about saliva secretion?

A) normally it’s about 1-1.5 L/day
B) It is highly concentrated with Na at slow flow rate.
C) oral touch receptors stimulate Salivary secretion
Answer: B

14) The process of swallowing (deglutition):

A) Voluntary Stage when the bolus reaches posterior part of the mouth
B) Esophageal Stage when pushing the bolus posteriorly and upward against the palate.
C) esophageal secondary peristalsis is initiated by distention of esophagus by retained food.
Answer: C

15) Which one of the following is correct about swallowing (deglutination):

A) apnea occur in esophagus
B) Primary esophageal phase doesn’t cause receptive relaxation of LES
C) secondary esophageal phase doesn’t cause receptive relaxation of LES
Answer: A

16) Which one of the following is correct about swallowing (deglutination)?

A) Apnea occurs in the esophageal phase
B) The first stage is the voluntary stage which is the initiation stage (+)
C) The motor orders from the swallowing center to pharynx and esophagus are through the
5th cranial nerve only
Answer: B

17) Secondary strong peristalsis waves are generated:

A) When a bolus of food is stuck in the esophagus
B) during normal swallowing
C) by Voluntary control
Answer: A

18) vomiting which of the following statements is FALSE?

A) sudden and forceful expulsion of gastric and upper intestinal contents.
B) Destruction of chemoreceptor trigger zone abolishes vomiting in response to GI irritation.
C) triggered by Noxious substances in stomach
Answer: B

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19) which of the following is incorrect about vomiting?
A) respiration is stopped during vomiting
B) Prolonged vomiting leads to respiratory alkalosis
C) Vomiting Center Is found in the reticular formation of medulla and pons.
Answer: B

20) Which of the following statements is INCORRECT regarding vomiting?

A) respiration is stopped during vomiting
B) Vomiting Center Is found in the reticular formation of medulla and pons.
C) stimulation of chemoreceptor trigger zone inhibits vomiting.
Answer: C

21) Concerning vomiting, all are true except:

Answer: Vomiting may lead to respiratory alkalosis (if prolonged)

Lecture 2:
1) which of the following is mismatched?
A) Mucus neck cells --- secrete thin watery mucus
B) Surface epithelium --- secrete viscid thick mucus
C) Chief cells --- secrete pepsinogen
D) D cells --- acts like stem cells
E) G cells --- located in the pyloric antrum
Answer: D

2) the intrinsic factor that is responsible for the absorption of vit B12 is secreted by which
cells?
A) ECL cells
B) G cells
C) Goblet cells
D) Parietal cells
E) Surface epithelial cells
Answer: D

3) which of the following is wrong regarding the production process of gastric juice?
A) H+ ions are formed inside parietal cells from the dissociation of carbonic acid under the
influence of carbonic anhydrase enzyme.
B) Cl− is pumped inside parietal cell in exchange of HCO3− (via a counter-transporter).
C) H+ ions are pumped into interstitial fluid by K+ /H+ pump.
D) Cl− moves out (by diffusion) of parietal cell into the lumen through electrical gradients.
E) None of the above
Answer: C

4) one of the following is also called “glucose-dependent insulinotropic polypeptide” because

of its effect on insulin secretion:
A) Somatostatin
B) Secretin
C) gastric-inhibitory-polypeptide
D) vasoactive intestinal polypeptide
E) histamine
Answer: C

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5) regarding the following substances, one of the following is wrong regarding their effects on
Brunner’s glands secretions in the duodenum?
A) Tactile or irritating stimuli on duodenal mucosa --- increase secretion of mucus
B) Vagal stimulation --- increase secretion of mucus
C) Secretin hormone --- decrease secretion of mucus
D) Sympathetic stimulation --- decrease secretion of mucus
E) None of the above
Answer: C

Lecture 3:
1) all of the following is activated by trypsin except:
A) Colipase
B) Cholesterol esterase
C) Phospholipase
D) trypsinogen
Answer: B

2) which of the following sentences is not correct?

A) Cholesterol esterase: hydrolyses cholesterol esters and releasing cholesterol.
B) Secretin (produced by S cells of upper part of duodenum and jejunum)
C) Cholecystokinin (CCK)Produced by I cell
D) Phospholipase: split fatty acids from phospholipids. It is activated inside small intestine by
trypsin.
E) Secretin (produced by S cells of duodenum and jejunum)
Answer: B

3) Secretion of CCK is triggered by stimulation of chemoreceptors in duodenum when they are

stimulated by acidic chyme coming from the stomach.
A) true
B) false
Answer: B

4) which of the following provide the fluid medium to wash out the enzymes that are secreted
into the acini:
A) Secretin
B) CCK
C) Pancreatic lipase
D) Cholesterol esterase
Answer: A

5) Intestinal Phase occurs Before chyme leaves the stomach and enters the small intestine,
pancreatic secretion becomes copious (containing HCO3-, Na+ and small amount of Cl-),
mainly in response to the hormone secretin
A) false
B) true
Answer: A

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6) which of the following sentences about bile is correct ?
A) watery secretion is stimulated by secretin hormone When bile flows through bile canaliculi.
B) Bile is continuously formed and secreted by hepatocytes. When sphincter of Oddi is opened
C) Bile is concentrated in duodenum
D) Bile can be concentrated in GB 15- 20 times.
Answer: A

7) All of the following is functions of liver except:

A) Synthesis of plasma proteins
B) Interconversions of the various amino acids and synthesis of other compound from amino
acids.
C) Formation of many chemical compounds from intermediate products of carbohydrate
metabolis
D) Oxidation of fatty acids to supply energy for other body function
E) all of the above is correct
Answer: E

Lecture 4:
1) Starch can be broken down by the act of a-amylase in which part of the GIT:
A) the mouth
B) large intestine
C) stomach
D) small intestine
E) all except B
Answer: E

2) Nitroglycerin is absorbed in:

A) mouth
B) stomach
C) duodenum
D) can't be absorbed by our bodies
E) large intestine
Answer: A

3) Which of the following is transported by facilitated diffusion?

A) fructose
B) Na+ from enterocytes to interstitial fluid
C) glucose from intestinal lumen to enterocytes
D) galactose from enterocytes to interstitial fluid
E) A&D
Answer: E

4) Which of the following sentence is right?

A) carboxypolypeptidase is endopeptidase
B) chemotrypsin acts on the ends of polypeptide chain
C) trypsin produces dipeptides
D) single free amino acids result from the action of trypsin & chymotrypsin
Answer: C

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5) Which sentence is false:
A) tripeptides are absorbed by co-transportation
B) pinocytosis is used by adult human to absorb large peptides
C) dipeptidase is transported from enterocytes to interstitial fluid by facilitated diffusion
D) neonates can absorb short & large peptides
Answer: B

6) All are true regarding pancreatic lipase, except:

A) it can freely enter fat globules
B) its action assisted by bile salts & collapse
C) it is water-soluble protein
D) active in alkaline media
Answer: A

7) Which is wrong about fat absorption:

A) triglycerides formed by small endoplasmic reticulum
B) butter fat is example of small chain fatty acids
C) chylomicrons are transported to interstitial fluid by facilitated diffusion
D) some cholesterols are esterified in small endoplasmic reticulum
E) tow answers are wrong
Answer: C

Lecture 5:
1) All of the following regarding Electrical activity of GIT are true EXCEPT:
A) Slow waves don't cause muscle contraction
B) Cajal cells are the pacemakers for smooth muscles in GIT
C) Muscles of GIT becomes more negative of resting membrane potential by Acetylcholine
D) The spikes potentials are true action potentials
Answer: C

2) Select the FALSE match from the sentences below:

A) Tonic contractions  Sphincters
B) Motilin hormone  Migrating motor complex
C) Secretin  contraction of pyloric sphincter
D) CCK  promotes stomach emptying
Answer: D

3) Regarding Stomach, Choose the incorrect statement:

A) Relaxation of stomach when the food enters it through vagovagal reflex
B) Emptying is faster after a fat-rich meal
C) Gastric inhibitory peptide is secreted by upper small intestine
D) Cutting the vagus nerves slows the emptying of stomach
E) Pyloric pump happens by antral peristaltic waves
Answer: B

4) Hunger contractions are greatly increased by the person’s having Higher than normal levels
of blood sugar.
A) TRUE
B) FALSE
Answer: B

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5) All of the following enzymes enhance intestinal peristalsis EXCEPT:
A) Secretin
B) Gastrin
C) CCK
D) Motilin
Answer: A

6) In an experiment on monkey, Scientists tend to study the physiology of GIT motility and
they don't hurt the monkey, one of the parasitical scientists hit a group of myenteric
plexuses, what do you expect to happen?
A) The monkey will experience severe constipation due to absence of peristalsis
B) Nothing will happen
C) Peristaltic activity will increase
D) Peristaltic activity will decrease
E) The monkey will experience severe diarrhea
Answer: A

7) Which of the following is a physiological reflex due to mass movements?

A) Gastro-ileal reflex
B) Gastro-colic reflex
C) Entro-gastric reflex
D) Colono-ileal reflex
Answer: B

8) Haustration is due to contraction of circular layer of smooth muscle in many spots and
relaxation in others ONLY
A) TRUE
B) FALSE
Answer: B

Biochemistry:
Lecture 1:
1) Which of the following are correct about the hepatic jaundice:
A) Are autosomal recessive.
B) Normal liver function
C) Accumulation in conjugated bilirubin only
D) Crigler-Najjar syndrome------- Absent enzyme
E) Two answers are correct
Answer: E

2) All of the following are correct about liver function test except:
A) Help identify the presence of liver disease.
B) Help make a specific diagnosis.
C) High levels of liver cell enzyme reflect severity
D) Help assess the severity of liver dysfunction or damage.
E) Monitor the progression of the disease and any response to therapeutic intervention.
Answer: C

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3) Which of the following is the main pathway in metabolizing the ethanol?
A) Microsomal ethanol oxidizing system (MEOS)
B) Alcohol dehydrogenase
C) Non-oxidative pathway
D) Oxidative phosphorylation
E) None of the following are correct.
Answer: B

4) Which of the following liver protein if its increase that mean hepatocellular carcinoma:
A) Albumin
B) Transferrin
C) Ceruloplasmin
D) Alpha fetoprotein
E) Alpha antitrypsin.
Answer: D

5) Identify the CORRECT statement

A) Numerous taste buds are found in the epithelium lining the lateral surfaces of filiform
papillae.
B) Cells of the gall bladder epithelium secrete the organic and inorganic components of the
bile.
C) The taenia coli form three bundles of longitudinal muscle on the outside of the appendix.
D) Insulin-secreting beta cells and glucagon-secreting alpha cells form the majority of
endocrine cells in the islands of Langerhans.
Answer: D

6) Which of the following enzyme indicate liver cell damage:

A) Alanine aminotransferase (ALT)
B) Biliverdin reductase
C) Alkaline phosphatase (ALP)
D) Gamma glutamyltransferase (GGT)
E) 5-nucleotidase.
Answer: A
Lecture 2:
1) Which of the following is mismatched?
A) histamine>amine> produce by ECL
B) gastrin>nuropeptide>produce by G cells
C) VIP>nuropeptide>>produce by enteric nerve
D) gunylin>peptide>produce by goblet cells.
Answer: B

2) proelastase become activated by:

A) autoactivation
B) pepsin
C) trypsinogen
D) trypsin.
Answer: D

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3) one of these enzymes is endopeptidase:
A) Zinc peptidases
B) Serine peptidases
C) Carboxyl peptidase
D) two answers are correct.
Answer: D

4) trypsin has specificity for which R group:

A) Arg, Lys, Ala
B) Arg, Ala, lys
C) Arg, lys
D) Ala, Gly, Ser.
Answer: C

5) which of the following is matched?

A) chymotrypsin> Tyr, Trp, Phe, Mer, Lue
B) Carboxypeptidase A> Val, Leu, Ile, Ala
C) pepsin A> Tyr, Phe, Trp, Leu
D) all of the above are correct.
Answer: D

Pathology:
Lecture 1:
1) Which of the following is possible causes of recurrent aphthous stomatitis?
A) Allergies
B) Smoking
C) Stress
D) All
Answer: D

2) Minor Aphthous Ulcerations is almost exclusively on:

A) Nonkeratinized mucosa
B) Keratinized mucosa
C) Non
Answer: A

3) Which of the following is considered as an immune-mediated diseases?

A) Pemphigus vulgaris
B) Mucous membrane pemphigoid
C) Aphthous
D) A+B
Answer: D

4) Homogenous Leukoplakia Characterized by a thickened, leathery, distinctly white plaque

with deepened fissures and more prone to be associated with carcinoma
A) True
B) False
Answer: B

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5) Which of the following is the most common salivary gland tumor?
A) Pleomorphic adenoma
B) Warthin tumor
C) Adenoid cystic carcinoma
Answer: A

Lecture 2:
1) What is the most common cause of esophageal varices?
A) Alcoholic cirrhosis
B) Schistosomiasis
C) Candida
D) Crohn's disease
Answer: A

2) Which of the following is an important association of Esophagitis?

A) Hiatal hernia
B) GERD
C) Esophageal varices
D) Adenocarcinoma
Answer: B

3) Which of the following condition is characterized by Longitudinal tear at GE junction after

forceful vomit?
A) Achalasia
B) Esophageal Hernia
C) Mallory Weiss Syndrome
D) Esophagitis
Answer: C

4) The most common cause for esophageal adenocarcinoma?

A) GERD
B) Barrett esophagus
C) Esophagitis
D) Esophageal varices
Answer: B

5) Ulceration, bleeding, and rupture are possible complications of

A) Achalasia
B) Esophageal Hernia
C) Mallory Weiss Syndrom
D) Esophagitis
Answer: C

6) The Mallory – Weiss syndrome refers to occurrence of gastrointestinal hemorrhage as a

result of:
A) varices
B) Mucosal tear at esophagogastric junction
C) Crohn's disease
D) Ectopia
Answer: B

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7) Replacement of the lower esophageal squamous mucosa by intestinal type (glandular)
mucosa is characteristic of:
A. Esophagitis
B. GERD
C. Ectopia
D. Barrett esophagus
Answer: D

Lecture 3:
1) All of the following are true about the clinical features of autoimmune gastritis, except:
A) Atrophy and intestinal metaplasia.
B) Hyperchlorhydria.
C) Hypergastrinemia.
D) Achlorhydria.
Answer: B
2) The differences between peptic ulcers are:
A) Gastric ulcers: more common and are associated with epigastric pain that improves with
meals leading to weight gain, but duodenal ulcers: are associated with epigastric pain that
worsens with meals leading to weight loss.
B) Gastric ulcers: more common and are associated with epigastric pain that worsens with
meals leading to weight loss, but duodenal ulcers: are associated with epigastric pain that
improves with meals leading to weight gain.
C) Duodenal ulcers: more common and are associated with epigastric pain that improves with
meals leading to weight gain, but gastric ulcers: are associated with epigastric pain that
worsens with meals leading to weight loss.
Answer: C

3) All of the following are from the graded variables of Sydney system grading of chronic
gastritis, except:
A) Polymorphonuclear neutrophil activity.
B) Glandular atrophy.
C) Intestinal metaplasia.
D) Acute inflammation.
Answer: D

4) Stress ulcers effect on which patients:

A) Who are associated with severe burns or trauma.
B) Who are with intracranial disease.
C) Who are with shock, sepsis or severe trauma.
Answer: C

5) One of the following isn't from the causes of peptic ulcer:

A) Hypocalcemia.
B) Excess stress.
C) Family history.
D) Smoking.
E) NSAIDs.
Answer: A

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Lecture 4:
1) Which of the following categories will be relieved by fasting?
A) Secretory diarrhea
B) Osmotic diarrhea
C) Malabsorptive diarrhea
D) Exudative diarrhea
E) Two answers are correct
Answer: E

2) Which of the following is mismatched?

A) Zollinger-Ellison syndrome & defective intraluminal digestion
B) Abetalipoproteinemia & decreased fat absorption
C) Crohn disease & decreased small intestine surface area
D) Cystic fibrosis & Defective terminal digestion
Answer: D
3) 55 years old male came to your clinic suffering from chronic diarrhea and flatulence, he
always feels tired with no physical effort. In physical examination you found a small red
rash with blisters on his skin which he thought it was just from the hot weather. Doing
endoscopy, the proximal part of his small intestine appears so flat and after taking a biopsy
you saw a villous atrophy and elongation in the crypts. One of the following isn't true about
his condition.
A) He has a tropical sprue
B) He will have HLA-DQ2 Antigen
C) His symptoms will relieve with antibiotics
D) C + A
E) He could develop T cell lymphoma
Answer: D

4) All of the following are false about Whipple disease except:

A) This disease infects mainly the small intestine
B) The causative agent is the gram-negative Tropheryma Whippelii bacteria
C) The hallmark in this disease is Macrophages being in epithelial cells
D) The patient will respond to antibiotics with possibility to relapse
Answer: D

5) Herniation/extrusion of abdominal contents without being covered by peritoneum is known

as:
A) Gastroschisis
B) Omphalocele
C) Atresia
D) Two answers are correct
Answer: A

6) All the following are true regarding Meckel's diverticulum except:

A) It's a failure of involution of distal portion of Vitelline duct
B) It's located 80 cm proximal to the ileocecal valve
C) Appendicitis is considered as a differential diagnosis
D) It may contain gastric or pancreatic mucosa
Answer: A

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7) You have a patient suffering from Hirschsprung disease (congenital ganglionic megacolon).
what is the true statement about the condition?
A) The affected segment of the intestine is not distended while the proximal one is distended
B) The proximal segment is not distended while the affected one is distended
C) It happened because of inactivation mutation in HLA gene
D) Peristalsis will be defective because adventitia layer is lacking ganglia
Answer: A

Lecture 5:
1) Diverticula in the colon may be associated with all of the following complications except?
A) lower GI Bleeding
B) Diverticulitis
C) Stricture formation
D) Crohn’s disease
Answer: D

2) Skip mucosal ulcerating lesions are most typically found in patients with?
A) Crohn's disease
B) Ulcerative colitis
C) Ischemic colitis
D) Mural infarction
Answer: A

3) Which of the following is a result from failure of coiling of the proximal portion of the
omphalomesenteric duct?
A) Zenker diverticulum
B) Traction diverticulum
C) Epiphrenic diverticulum
D) Merkel diverticulum
Answer: D

4) Ulcerative colitis favors Involvement of which part of the GI tract over Crohn disease?
A) Rectum
B) Cecum
C) Appendix
Answer: A

5) Extra-intestinal manifestations which are associated with crohn’s disease:

A) Uveitis
B) Obstructive uropathy
C) Sacroiliitis
D) primary sclerosing cholangitis
E) All of the above
Answer: E

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6) Which of the following is more common in ulcerative colitis rather than Crohn’s disease?
A) Erythema nodosum
B) Risk of colon cancer
C) Toxic megacolon
D) Crypt abscesses
Answer: A

7) Which of the following is false regarding Crohn disease?

A) transmural involvement
B) Skip lesions leading to cobble stone appearance.
C) Non-caseating granulomas are seen
D) Affect only proximal to distal portions
Answer: D

8) All of the following are Clues of diagnosis of chronic bowel ischemia except:
A) Preserved or minimal distortion of architecture
B) Hyalinization of lamina propria.
C) lack of Hemorrhage
Answer: C

9) Clinical Features of transmural infarction include:

A) Sudden onset of severe abdominal pain.
B) Bloody diarrhea.
C) May lead to shock and vascular collapse within hours.
D) all of the above
Answer: D

10) Not a usual site of herniations:

A) The inguinal canal
B) The umbilicus
C) Surgical scars
D) Diaphragmatic region
Answer: D

11) Causes of intra-abdominal adhesions include:

A) Surgical procedures
B) Infection (localized or generalized peritonitis)
C) Endometriosis
D) all of the above
Answer: D

12) Why Twisting of a loop of bowel about its mesenteric base of attachment always starts in
the venous flow?
A) Veins don’t have valves
B) Arteries dont have valves
C) Blood viscosity and nature
Answer: A

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13) Mural infarction is an Infarction of the mucosa and submucosa sparing the muscular wall.
A) True
B) False
Answer: A
14) Mural infarction: Infarction of the mucosa no deeper than the muscularis mucosae.
A) True
B) False
Answer: B

15) Mural and mucosal infarctions result from acute or chronic hypoperfusion or more localized
anatomic defects.
A) True
B) False
Answer: A
Lecture 6:
1) Which type of gastric polyps is an exuberant response to chronic gastritis?
A) Fundic gland polyps
B) hyperplastic polyps
C) adenomatous polyps
D) Hamartomatous polyps
Answer: B

2) Glandular hyperplasia driven by gastrin may occur due to the excessive use of _____ and it
causes ______.
A) NSAIDs, Fundic gland polyps
B) PPIs, Adenomatous glands polyps
C) PPIs, Fundic gland polyps
D) Aspirin, Adenomatous gland polyps
Answer: C

3) Which of the following is not a reason why there is a steady decline in the overall incidence
and mortality of gastric adenocarcinomas?
A) Treatment of H.pylori
B) The use of refrigerators
C) Treatment of shigella
D) Consuming healthier foods
Answer: C

4) All of the following are characteristics of the intestinal-type gastric adenocarcinoma

EXCEPT:
A) Usually forms a bulky mass
B) Associated with chronic gastritis
C) Arises de novo
D) Malignant cells form glands and tubules that resemble colonic adenocarcinoma
E) Has a better prognosis than the diffuse-type
Answer: C

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5) A mutation that can show in the diffuse-type adenocarcinoma:
A) RET
B) CDH1
C) NOD2
D) HLA-DQ8
Answer: B

6) The earliest lymph node that gastric carcinomas metastasize to is:

A) Supraclavicular LN
B) Celiac LN
C) Left gastric LN
D) Cervical LN
Answer: A

7) One of the following mutations is not associated with gastrointestinal stromal tumors:
A) SDH
B) Tyrosine kinase mutations
C) CDH1
D) c-KIT
E) PDGFRA
Answer: C

8) The most common type of gut lymphomas in Western countries is:

A) Burkitt lymphoma
B) Mantle cell lymphoma
C) Diffuse large B cell lymphoma
D) Marginal zone lymphoma of MALT type
Answer: D

9) Marginal zone lymphoma of MALT type usually arises in the background of:
A) Celiac disease
B) t(11;18) translocation
C) Hereditary diffuse gastric cancer
D) H.pylori- associated chronic gastritis
E) Two answers are correct
Answer: E

10) Lymphomatoid polyposis resembles which of the following:

A) Mantle cell lymphoma
B) Burkitt lymphoma
C) Marginal zone lymphoma
D) Carcinoids
Answer: A

11) The most common site for carcinoids to appear is:

A) Pancreas
B) Stomach
C) Appendix
D) Liver
Answer: C

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12) True or false: carcinoids in the appendix usually metastasize:
A) True
B) False
Answer: B

13) Secretions of carcinoids may produce all of the following EXCEPT:

A) Diarrhea
B) Hematemesis
C) Right-sided cardiac valvular fibrosis
D) Bronchospasm
Answer: B

14) Which tumor has cigar-shaped cells?

A) Intestinal-type adenocarcinoma
B) Leiomyoma
C) Lipoma
D) Diffuse-type adenocarcinoma
Answer: B

15) Which blood group has a slightly increased risk for gastric carcinoma?
A) A
B) B
C) AB
D) O
Answer: A

Lecture 7:
1) One of the following sentences is true:
A) Hyperplastic polyps occur only in rectosigmoid region
B) When hyperplastic polyps occur in adults, we call them retention polyps
C) Hyperplastic polyps have no malignant potential while juvenile polyps have
D) Hyperplastic polyps are mostly multiple ones, while juvenile polyps are usually single in
the rectum
Answer: D

2) Peutz jeghers polyps have dilated cystic appearance under microscope while juvenile ones
have arborizing network appearance
A) True
B) False
Answer: B

3) High potential of malignancy is associated with :

A) Tubular adenomas which are usually multiple ,small and pedunculated
B) Villous adenomas which are small and pedunculated
C) Villous adenomas which are large and sessile with cauliflower appearance
D) Lymphoid ployps
Answer: C

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4) Familial adenomatous polyposis is an AD syndrome that occurs as a result of a mutation in
the:
A) APC gene
B) SMAD4
C) STK11
D) BAX
Answer: A

5) One of the following sentences is true:

A) Both juvenile polyposis syndrome and peutz jeghers syndrome are AR syndromes
B) Juvenile polyposis syndrome is characterized by melanotic cutaneous pigmentation
C) Juvenile polyposis syndrome results from LKB1 gene mutation
D) Peutz jeghers syndrome increases risk for uterine cancer
Answer: D

6) If we found colorectal cancer in the distal colon ,we expect it to grow as annular encircling
lesion (napkin-ring constrictions )
A) True
B) False
Answer: A

7) The most common tumor of appendix is :

A) Squamous cell carcinoma
B) Neuroendocrine tumor
C) Adenocarcinoma
Answer: B
Lecture 8:
1) Which of the following is the consequence of portal hypertension?
A) Ascites
B) Portosystemic venous shunts
C) Congestive splenomegaly
D) Hepatic encephalopathy
E) All of the following
Answer: E

2) Which match is correct??

A) Lower esophagus - systemic inferior vena cave
B) Umbilical - portal veins of ligmentum teres
C) Upper anal canal - systemic superior rectal vein
Answer: B

3) _____: Irreversible end-stage of chronic liver disease, which leads to parenchymal injury and
fibrosis
A) Ascites
B) Cirrhosis
C) Caput medusae abdominal skin
Answer: B

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4) What is the cause of hepatorenal syndrome?
A) Vasoconstriction
B) Vasodilation
C) Increase Bilirubin
D) Increase renal blood flow
Answer: A

5) Dead hepatocytes is________

A) Basophilic
B) Acidophilic
C) Neutral
Answer: B

6) Unconjugated bilirubin =_______

A) Total bilirubin
B) Direct bilirubin
C) A-B
D) B-A
Answer: C

7) Which is the cause stenosis liver? Accumulation of ___

A) Water
B) Carbohydrates
C) Fat
D) Other
Answer: C

8) What is zone the first affect by disease?

A) Zone 1
B) Zone 2
C) Zone 3
D) All
Answer: A

Lecture 9:
1) all of the following are risk factors that cause cholesterol stones except
A) Age :40 & above
B) Gender: females
C) Demography: eastern World
D) Inborn disorders of bile acid metabolism
E) Obesity (fat)
Answer: C

2) Related to pigment stones of gallbladder which one is false

A) Contain calcium salts of unconjugated bilirubin
B) Black, small, numerous and friable
C) 70-80% are asymptomatic
D) Red in infected intra- or extra-hepatic ducts
Answer: D

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3) These are complications of pigment stones of the gallbladder except
A) Empyema
B) Perforation
C) Atresia
D) Inflammation of biliary tree
Answer: C

4) All of these are correct regarding Acute calculous except

A) caused by obstruction of GB neck or cystic duct
B) Symptoms may be mild or sudden & severe
C) It is the least frequent indication for emergency cholecystectomy
Answer: C

5) Chronic Cholecystitis can be described by all of these except

A) history of acute cholecystitis presence
B) stones & obstruction play a major role in initiation of inflammation
C) Supersaturation of bile predisposes to chronic inflammation- Bacteria are isolated in 1/3 of
cases
D) lymphocytic infiltration and fibrosis under microscope
Answer: B

6) Symptoms due to choledocholithiasis

A) Biliary obstruction
B) Pancreatitis
C) Cholangitis
D) Hepatic abscess
E) Acute calculous cholecystitis
Answer: E

7) Primary Biliary Cirrhosis features include all of these except

A) Pruritis because of accumulation of bile under the skin
B) Jaundice develops early
C) Hepatic failure over two or more decades
D) LAB tests: Serum alkaline phosphatase and cholesterol levels
Answer: B

8) Morphology of Primary Sclerosing Cholangitis include all of these except

A) Affected portal tracts show concentric periductal onion-
B) skin fibrosis & lymphocytic infiltrate.
C) Progressive atrophy of the bile duct epithelium leads to obliteration of the lumen
D) No Cholestasis & biliary cirrhosis occur
Answer: D

9) The end-stage of cholestatic liver disease is

A) Ascending Cholangitis
B) Biliary Cirrhosis
C) Choledocholithiasis
D) Cholelithiasis
Answer: B

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10) metastasis of carcinoma of the gallbladder may occur
A) Direct to urinary bladder usually
B) Lymphatic: LNs in porta hepatis
C) The peritoneum, gastrointestinal tract, and lungs are most common sites of seeding
Answer: B

11) Cholangiocarcinomas is described as

A) Chronic cholestasis, inflammation & continuous injuries
B) abundant fibrous stroma (desmoplasia) on microscopic view
C) May spread to regional LNs, lungs, bones, and adrenal glands.
D) Adenocarcinomas arising from cholangiocytes in ducts within and outside of the liver
E) All of the above
Answer: B

Lecture 10:
1) Regenerative nodules found to be diffused all over the liver but with no fibrosis, this triad
is best described as:
A) Nodular regenerative hyperplasia
B) Liver cirrhosis
C) Focal nodular hyperplasia
D) two answers are correct
Answer: A

2) All of the following are true except:

A) Cavernous Hemangioma is the most common Benign tumor of the liver
B) Hepatic Adenoma usually associated with OCPs usage
C) Hepatic Adenoma will never transform into cancer
D) Dysplasia of the small cells in the liver is much worse than that of the large cells
Answer: C

3) Which statement is true regarding Hepatocellular carcinoma?

A) In Asia, the major cause is alcoholism with background of cirrhosis
B) All hepatocellular carcinoma in Asia and Africa occurs without cirrhosis
C) One of the major microscopic findings is the loss of reticulin stain
D) In fibrolamellar variant, patient will always come with cirrhosis and has poor prognosis
Answer: C

4) An emergency case arrived to the hospital suffering from severe abdominal pain, after
doing some tests it was found to be an Acute pancreatitis. Which of the following is
contraindicated with the case?
A) As a doctor I suspect Gallstones as a cause
B) The patient could has increasing in lipase levels without difference in amylase levels
C) In genetic test there may be a mutation in CFTR gene
D) Two answers are not related to the case
Answer: D

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5) Statement 1: Mucinous Cystic neoplasm usually found at the (body, tail, main pancreatic
duct) of the pancreas with hypercellular stroma
Statement 2: Intraductal papillary Mucinous neoplasm occurs mostly in females with no
possibility to transform into cancer
A) Statement 1 is true, Statement 2 is false
B) Statement 2 is true, Statement 1 is false
C) Both are false
D) Both are true
Answer: C

6) In chronic pancreatitis:
A) The endocrine functions are lost firstly
B) pancreas divisum, alcohol abuse, mutation in (PRSS 1, SPINK 1, CFTR) genes are
considered as risk factors
C) Amylase levels will stay normal
D) None of the above is related to chronic pancreatitis
Answer: B

7) Which of the following is well-matched?

A) early Solid pancreatic carcinoma & obstructive jaundice
B) Hereditary nonpolyposis colorectal cancer (lynch II) & BRCA2 mutation
C) Hereditary pancreatitis & p16 mutation
D) none of the following
Answer: D

Pharmacology:
Lecture 1:
1) Regarding NSAIDs-induced ulcers, which of the following if false?
A) Chronic
B) Often symptomatic
C) Happens mainly in the duodenum
Answer: C

2) We should give an empirical therapy for H. pylori.

A) True
B) False
Answer: B

3) Regarding PPIs, which of the following is false?

A) Can be used all the time
B) Put in the same capsule with antibiotics
C) Given 30-60mins before meal
D) Irreversible inhibition of pump
Answer: B

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4) Which of the following isn't included in the triple therapy?
A) Bismuth subsalicylate
B) Clarithromycin
C) PPI
D) Amoxicillin
Answer: A

Lecture 2:
1) Which of the following is mismatched?
A) Acute vomiting: This type happens within the first 24 hours after taking chemotherapy.
B) Delayed vomiting: If vomiting happens after the first 24 hours of taking the drug.
C) Breakthrough: This type is rarely responded to medications, so we must use multiple drugs
to treat.
D) Refractory vomiting: This is the hardest type to treat.
E) None of the above
Answer: C

2) Gynecomastia and galactorrhea are among the side effects related to the use of D2
antagonists due to their effect in increasing prolactin levels.
A) True
B) False
Answer: A

3) Which of the following is mainly used for acute chemotherapy-induced vomiting?

A) Ondansetron
B) Metoclopramide
C) Dexamethasone
D) Aprepitant
E) Scopolamine
Answer: A

4) Which of the following is considered the DOC in delayed chemotherapy-induced nausea

and vomiting?
A) Promethazine
B) Dronabinol
C) Aprepitant
D) Domperidone.
E) Granisetron.
Answer: C

5) Which of the following anti-dopaminergic agents has the least CNS-related side effect (less
BBB crossing) ?
A) Metoclopramide
B) Domperidone.
C) Droperidol
D) Haloperidol
E) Chlorpromazine
Answer: B

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6) Which of the following is the 1st choice in morning sickness?
A) Fosaprepitant
B) Promethazine
C) Olanzapine.
D) Scopolamine
E) None of the above
Answer: B

7) Which of the following is the 1st choice to treat post-operative nausea and vomiting?
A) Cyclizine
B) Dexamethasone.
C) Rolapitant
D) Haloperidol
E) Ondansetron
Answer: A

8) All of the following are among the side effects related to the use of Dexamethasone, except:
A) Hyperglycemia and Hypertension.
B) Osteoporosis.
C) Increased intraocular pressure.
D) Susceptibility to infections, peptic ulcers.
E) Decreased appetite and weight loss
Answer: E

Lecture 3:
1) Which of the following is a Microtubule inhibitor?
A) Paclitaxel
B) Carboplatin
C) Cisplatin
D) Epirubicin
Answer: A

2) Which of the following is an anthracycline's antibiotic?

A) Paclitaxel
B) Carboplatin
C) Cisplatin
D) Epirubicin
Answer: D

3) Molecular targeted therapy is always used in localized gastric cancer.

A) True
B) False
Answer: B

4) Which of the following combinations is incorrect?

A) Paclitaxel + 5-FU
B) Cisplatin + capecitabine
C) 5-FU + capecitabine
D) Carboplatin + paclitaxel combined with radiation
Answer: C

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5) Irinotecan is specific to which phase?
A) S
B) G1
C) M
D) G0
Answer: A

Lecture 4:
1) One of the following has normal endoscopy:
A) collagenous colitis.
B) radiation colitis
C) laxative colitis
D) Crohn’s disease
Answer: A

2) Regarding Ab associated colitis, which of the following isn't true:

A) caused by side effects of oral Ab
B) there is destruction in the normal flora
C) caused by non-oral Ab which can be eliminated actively
D) has no relation with C. difficile
Answer: D

3) regarding radiation colitis, the true choice is:

A) more in male
B) associated with skin cancer
C) most common in the anterior wall of rectum
D) Antibiotics are involved in the treatment plan
Answer: C

4) Which of the following isn't matched?

A) Crohn’s disease & skip lesion
B) ulcerative colitis & surgical removal of whole colon
C) development of IBD & use of NSAID
D) Tacrolimus & targeting TNF-a
Answer: D

5) the last choice biologic agent in treatment of Crohn’s disease is:

A) infliximab
B) natalizumab
C) adalimumab
D) certolizumab
Answer: B

6) Which isn't involved in IBS management plan:

A) symptomatic treatment
B) specific diet plan commitment
C) psychological treatment
D) eloxadoline to reduce diarrhea
Answer: B

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Microbiology:
Lecture 1:
1) A 24-year-old woman was seen in a hospital emergency department with a history of
nausea, vomiting, and non-bloody diarrhea, which progressed to bloody diarrhea. Four days
earlier she had eaten a hamburger at a fast-food restaurant. Three days later the patient
awoke with vomiting and contacted her private physician. To replace fluid lost from
diarrhea, she was given 2 L of IV fluid. Her condition improved and she was sent home
with antinausea medication. Three days later the patient awoke with vomiting and
contacted her private physician. Laboratory tests were done with the following results:
blood urea nitrogen 67.0 mg/dL (ref. 7-19); white blood cells 13 100/mL; hemoglobin 7.0 g/dL
(ref. 11.5-15.5); platelet count 75 000/μL (ref. >150 000). All of the following sentences
regarding her case are true EXCEPT?
A) The stool culture taken earlier was positive for E coli O157:H7
B) Colonized restaurant worker was the cause of her case
C) The bacterial virulence factor that causes her case is Shiga toxin
D) It has a complication of Hemolytic uremic syndrome
E) If the meat in the burger cooked well, it may be not infected
Answer: B

2) About Shigella, all of following sentences are true EXCEPT?

A) Shigella serogroup A - Mortality is significant
B) Glucose fermenter-Lactose fermenter
C) Culture on Hektoen enteric agar
D) Shigella serogroup D -Dysentry not watery diarrhe
E) Lack of H antigen
Answer: B

3) Hemorrhagic colitis is caused by?

A) Salmonella
B) Shigella
C) E. coli
D) H.pylori
Answer: C

4) Choose the FALSE match regarding E. coli?

A) ETEC - Traveler's diarrhea
B) EIEC - Resembles Shigelle
C) EPEC - Diarrheal illness in bottle-fed infants
D) EHEC -Developing countries
E) EAEC -Linked to O104:H4
Answer: D

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Lecture 2:
1) All of the following bacteria inject their virulent factor into enterocytes by type III secretion
system EXCEPT?
A) E. coli
B) H. pylori
C) Yersinia
D) Vibrio
E) Shigella
Answer: B

2) Regarding Salmonella, all of the following are true EXCEPT?

A) Enteric fever slowly increasing fever pattern
B) Glucose fermenter, Lactose non-fermenter, H2S producer
C) It appears as much as early in the urine
D) Typhoid fever is treated by Ciprofloxacin
Answer: C

3) Guillain-Barré syndrome (GBS) is a rare, autoimmune disorder in which a person's own

immune system damages the nerves, which of the following is considered a causative
bacterial agent?
A) Salmonella
B) Yersinia
C) Vibrio
D) Campylobacter
E) Two of the above
Answer: E

4) All of the following regarding Yersinia Spp. Is true EXCEPT?

A) Secreted (Yops) disrupt cellular function
B) Yersinia are not routinely sought in stool
C) Acute mesenteric lymphadenitis mimics Acute appendicitis
D) Y.entercolitica can be treated by Ciprofloxacin
E) Polyarthritic syndrome caused by Y.entercolitica
Answer: D

5) Which of the following is FALSE regarding Vibrio cholera?

A) ToxR controls CT and TCP genes
B) Mucosa becomes altered with some hyperemia
C) Hypokalemia due to potassium loss
D) Metabolic acidosis due to bicarbonate loss
E) No fever
F) Two of the above
Answer: B

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6) Drug of choice for Vibrio cholera is?
A) Clarithromycin
B) Amoxicillin (Single dose)
C) Temocillin
D) Azithromycin (Single dose)
Answer: D

7) About Campylobacter, Choose the TRUE characteristic?

A) Amphitrichous bacteria
B) Cytolethal distending toxin (CDT) as a membrane-bound protein
C) Leading cause of gastrointestinal infection in developing countries
D) Facultative aerobic
Answer: B

8) Choose the WRONG match regarding H.pylori?

A) VagA - linked to gastric adenocarcinoma
B) CagA - Alter Cytoskeleton
C) CagA and VacA -delivered by injection type IV secretion system
D) H.pylori - The sole nondrug cause of gastritis and ulcers
E) Drug - bismuth salts
Answer: A

Lecture 3:
1) Needs high temperature for life cycle?
A) Entamoeba histolytica
B) Rotavirus
C) Adenovirus
D) Cryptosporidium parvum
E) E. norovirus
Answer: A

2) All of the following infectious agents can be transmitted to humans by oral-genital sex,
EXCEPT?
A) Entamoeba histolytica
B) Giardia lamblia
C) Cryptosporidium parvum
D) Hepatitis A virus
E) Ascaris lumbricoids
Answer: E

3) All of the following cause infantile diarrhea except?

A) norovirus
B) Rotavirus
C) Adenovirus
D) Cryptosporidium parvum
E) Entamoeba histolytica
Answer: A

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4) Pericarditis and cardiac tamponade are possible complications of infestation with?
A) Entamoeba histolytica
B) Giardia lamblia
C) Cryptosporidium parvum
D) Ancylesioma dudenale
E) Strongyloides stetcoralis
Answer: A

5) You sense the smell of Sulfur with a patient infected with?

A) American Tryponosomiasis .
B) Entamoeba Histolytica .
C) Cryptosporidium .
D) Giardia lamblia.
Answer: D

6) Which of the following is incorrect?

A) Asymptomatic intraluminal carriage may happen with any of the protozoan pathogens .
B) G. intestinalis mostly attacks the duodenum
C) String test is used for the diagnosis of Giardiasis
Answer: C

7) Sulfuric eructation is associated with?

A) Giardia lamblia
B) Trichuris trichuria
C) Cryptosporidium
D) Tenia solium
Answer: A

8) Giardia lamblia Treated by all of these drugs expect?

A) Tinidazole
B) Metronidazole
C) Quinacrine
D) Furazolidone
E) noon of the following
Answer: E

9) Infectious stage of Giardia lamblia is?

A) Trophozoite stage
B) Cyst stage
C) 2 Nuclei stage
D) motile phase
Answer: B

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Lecture 4:
1) Cyclospora is treated by?
A) Trimethoprim–sulfamethoxazole
B) Paromomycin
C) Mebendazole
D) Pyrantel pamoate
Answer: A

2) Which of the following penetrates the skin?

a) Hookworms
b) Ascaris lumbricoides
c) Trichuris trichura
d) Enterobius vermicularis
Answer: A

3) Which of the following is associated with hydatid cyst?

A) Hookworms
B) Ascaris lumbricoides
C) Echinococcus Granulosus
D) Taenia Solium
Answer: C

4) Humans act as intermediate host for T. saginata?

A) True
B) False
Answer: B

5) Schistosoma is treated by?

A) Mebendazole
B) Pyrantel pamoate
C) Metronidazole
D) Praziquantel
Answer: D

Lecture 5:
1) The most common cause of winter gastroenteritis in children less than 5 years of age is?
A) Rotaviruses
B) Astroviruses
C) Coronaviruses
D) Caliciviruses
Answer: A

2) Astroviruses gene is?

A) ssRNA
B) dsRNA
C) ssDNA
D) dsDNA
Answer: A
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3) Which one has the longest incubation period?
A) Adenovirus
B) Astrovirus
C) Calcivirus
D) Rotavirus
Answer: A

4) Which one has the shortest incubation period?

A) Adenovirus
B) Astrovirus
C) Calcivirus
D) Rotavirus
Answer: C

5) Which one destroys villous cells of jejunum and upper duodenum?

A) Adenovirus
B) Astrovirus
C) Calcivirus
D) Rotavirus
Answer: D

Public Health:
1) One of the following is true about the significance of CRC?
A) The 5th most common cause of cancer in men.
B) The 1st leading cause of cancer deaths in men and women.
C) It accounts for 20% of all cancer deaths in the USA.
D) The 3rd most common cause of cancer in women.
Answer: D

2) who of the those is the highest one at risk of developing CRC?

A) A white young woman.
B) A black old man.
C) A person with high SES.
D) A person without any family history of CRC.
Answer: B

3) Which of the following is from the modifiable risk factors of CRC?

A) High vegetable diet.
B) Low fat diet.
C) Vitamin D deficiency.
D) Age and gender.
Answer: C

4) The blood level of vitamin D that indicates a person with high protection against CRC:
A) Greater than 80 nmol/L.
B) Less than 20 nmol/L.
C) Less than 30 nmol/L.
D) Greater than 30 nmol/L.
Answer: A

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5) The mean age at diagnosis of CRC is:
A) 43 years.
B) 62 years.
C) 88 years.
D) 24 years.
Answer: B

6) The new cases in 2007 approximate ........... and the death cases are about ...............
(respectively) :
A) 2 million _ 861,000.
B) 400,000 _ 490, 000.
C) 1,200,000 _ 630,000.
D) 3 million _ 701,200.
Answer: C

7) Identify the CORRECT statement

A) 70%.
B) 91%.
C) 88%.
D) 63%.
Answer: D

8) According to population attributable risk percent, 25% - 35% of CRC may be related to:
A) High fat intake.
B) Low intake of fruits and vegetables.
C) Physical inactivity.
D) Low fiber intake.
Answer: B

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