Anatomy Past Paper PDF

Anatomy: 1) The root of the mesentery is approximately 15cm long. It passes inferiorly and to the right, from the duodenojejunal junction to the ileocecal junction, crossing the all following which one is the exception? A) ascending and horizontal parts of the duodenum B) abdominal...

Anatomy: 1) The root of the mesentery is approximately 15cm long. It passes inferiorly and to the right, from the duodenojejunal junction to the ileocecal junction, crossing the all following which one is the exception? A) ascending and horizontal parts of the duodenum B) abdominal aorta C) inferior vena cava D) right ureter E) left testicular or ovarian vessels 2) Which of the following is/are correct? I. Parotid duct opens to the sublingual caruncle II. Facial nerve and external carotid artery are observed in the parotid gland III. Parasympathetic innervation to the sublingual gland is provided via the chorda tympani IV. Superficial part of the submandibular gland is located in side the oral cavity A) only I B) Only I and II C) only II and III D) I, II, and III E) II, III and IV 3) Which of the following structures prevents the anterior dislocation of the temporomandibular joint? A) lateral ligament B) articular disc C) articular tubercle D) mandibular fossa E) pterygoid fossa 4) Mucus gland are located in which part of anal canal? A) anal columns B) rectal column C) anal sinuses D) anactenous line E) transverse pica 5)two days after an appendectomy in a 45 yrd old male patient the patient has developed an elevated temperature Is hydrossive? and complains of abdominal pain. An explanatory laptoratmy reveals large amount of blood in the peritoneal cavity due to an injury to a vessel that occurred during the appendectomy. Which of the following vessels must be ligated to stop bleeding? A) right colic artery B) right colic artery and superior rectal artery C) superior mesenteric artery D) ileocolic artery E) ileocolic artery and middle colic artery 6) Which structure passes through deep inguinal ring? A) iliohypogastric nerve B) inferior epigastric artery C) medial inguinal ligament D) round ligament E) epididymis 7) The fundus of the stomach receives its blood supply from which artery? A)left gastric B) right gastroduodenal C) artery of fundus d) splenic E anterior inferior pancreaticoduodenal 8) Through which vessels is the blood from hepatic sinusoidal cells delivered into the inferior vena cava? A) Hepatic artery B) Hepatic vv C) Hepatic portal vein D) Splenic vein E) Superior mesenteric vein 9) Which part of esophagus composed of voluntary striated muscle type? A) Superior third B) Middle third C) Inferior third D) Abdominal 10) Which of the following pair of veins of this patient may also enlarge due to portal hypertension? A) Superior and inferior phrenic veins B) Lumber and renal vein C) Superior rectal and inferior rectal vein D) Right gastric and azygos vein E) Superior and inferior epigastric vein 11) Which of the following structure is not innervated by the pelvic splanchnic ( erigendues nerves) A) Descending colon B) Duodenum C) Sigmoid colon D) Anal canal E) Rectum 12) Which is not boundary? Of the epiploic omental foramen? A) Hepatoduodenal ligament B) Inferior vena cava C) Splenorenal_ ligament D) Caudate process of liver E) First part of duodenum 13) A patient was diagnosed with bleeding ulcer of the lesser curvature of the stomach. Which artery is most likely involved ? A) Gastroduodenal B) Left gastric C) Left gastroomental (epiploic) D) Right gastroomental epiploic E) Short gastric 14) Which nerve marked posterior surface of the esophagus A) Right vagus B) Right C) Left recurrent laryngeal nerve D) Right phrenic nerve E) Left phrenic nerve 15) Which of the following below is correct the oral cavity? A) anterior 2/3 of the tongue general sensation is provided by the glossopharyngeal nerve B) anterior 2/3 of the tongue general sensation is provided by the chorda tympani C) Lingual nerve provides motor innervation is the intrinsic tongue muscles D) Mylohyoid muscle ___ the roof of the oral cavity E) Genioglossus muscle tracts tongue 16) which of the following muscles of mastication is chiefly? Responsible for the protraction and depression movement of the mandible? A) Superficial part of the masseter  B) Deep part of the masseter C) Lateral pterygoid D) Medial pterygoid E) Temporalis 17) Which of the following muscles of the tongue is innervated by the pharyngeal plexus A) styloglossus B) genioglossus C) hyoglossus D) palatoglossus E) inferior longitudinal muscle 18) the superficial inguinal ring is an opening in which of the structures? A) The transversals fascia B) Scarpa’s fascia C) External abdominal oblique aponeurom? D) Falx inguinal E) Internal oblique abdominal muscle BIOPHYSICS: 19) Which of the following is not a physical method of producing heat in the body? A) Conductive heating B) IR radiant heating C) Long wave diathermy D) Microwave diathermy E) Ultrasound 20) Choose correct statement I. Heat and transfer through radiation does not require material medium II. Heat conduction depends upon the number of colla? III. All heat transfer types require the presence of __? IV. Thermal conductivity of air is quite small A) Only I B) I and II C) II and IV D) I, III, and IV E) I, II, and IV 21) Which of the following is false? A) The body regulates its temperature mainly by controlling the flow of blood to the skin B) Metabolic rate human body is 120w C) Evaporation cooling is not controllable  D) Black body absorbs all radiation incident on it E) Under heavy ____ noticeable perspiration is the major mechanism by which the body loses heat CHILD HEALTH AND DISEASES: 22. which of the following statement are correct regarding malabsorptive syndromes? I. presence of reducing sugar in stool indicated carbohydrate malabsorption II. iron mainly absorbed from ___ III. fat malabsorption may be seen in patients chronic liver de___ IV protein malabsorption or produce V. deficiency of vitamins A, D, E, K, its usually associated with protein malabsorption a) I-II-III b) I-III-V c) II-III-IV d) I-III-IV e) II-III-V 23. which of the following is not complication of acute severe gastroenteritis ? a) hypernatremia b) hypoadrema C) metabolic acidosis D) failure to thrive E) dehydration 24) which of the following is not true regarding malnutrition? A) Malnutrition results in impaired growth and development B) Malnutrition is one the most common causes of secondary immune deficiency in children C) Malnutrition is associated with poor wound healing and increased morbidity D) Marasmus( wasting( is the result of ___ and is a malabsorption response to __ E) Increased susceptibility to infection is an inevitable consequence of malnutrition. FAMILY MEDICINE: 25) 56 year old female patient ___ to the family physicians office with the complaint of epigastric discomfort and sometimes pain in the epigastric area since a year and she feels deeply tired. She describes dark defecation in the last week. Which of the following diagnostic method is the first choice for this patient? A) Urea breath test for helicobacter pylori B) Upper gastrointestinal endoscopy (MEMORIZE) C) Direct antibiotics use for helicobacter pylori D) Empiric use of antiacids  E) Empiric use of proton pump inhibitors 26) 35 year old female patient complaints of postprandial fullness, early sabiety and epigastric pain. Her complaints have begin last year but frequent for the last 3 months. There is no evidence of structural disease and alarming symptoms that is likely to explain the symptoms. Which of following is the most probable diagnosis ? A) Gastroesophageal reflux disease B) Peptic ulcer disease C) Functional dyspepsia D) Gastric cancer E) Irritable bowel syndrome GASTORINTEROLOGY/INTERNAL MEDICINE 27) 55 year old male admitted to gastroenterology outpatient classic with a complain of progressive dysphagia since 2 month. What should be initial diagnostic treat? A) Colenscopy B) Upper GI endoscopy C) Masometry D) pH meter E) CT scan 28) 43 year female present to the office with swelling of lower legs and feet for the last two month. Her blood work shows low serum total protein and low albumin. Urinalysis shows no pro__. There are no signs and symptoms of chronic liver disease. She js normal appetite and there is no recent weight loss. BMI is normal at 24__. Examination she appears self nourish. Pitting edema is present in lower extremities. She is referred to a clinical workup of protein - losing enteropathy. Which of following is the next best step in the management of this patient? A) )-xylase test B) Tachntium 99 lableled serum albumin C) Lactose tolerance test D) fecal alpha-1 antitrypsin A1AT clearance test E) Capsule endoscopy 29) 65 year old man presented with dysphagia which describes hard swallowing and progressed to liquids what is your probable diagnosis in first order for this patient? A) Reflux esophagus B) Achalasia C) Esophageal spasm D) ___ hernia E) Esophageal cancer 30) which of the following is not a factor accused in the pathogenesis of inflammatory bowel disease? A) genetics factors B) factors related to host immune system C) microbiota of the host D) triggering environmental factors E) psychological factors 31) which of the following cells are primarily responsible for the formation of fibrosis in the course of chronic liver inflammation? A) Hepatocells B) Biliary epithelial cells C) Hepatic stellate cells D) Monocytes E) Stem cells 32) which one of the following is not alarm symptoms for a patient with dyspepsia ? A) Weight loss more than 10% of body weight in 6month ) B) Enlarged lymph nodes C) Hematemesis D) Post prandial fullness E) Family history of gastric adenocarcinoma 33) which of the following is not a diagnose for chronic abdominal pain of inflammatory bowel origin? A) Eosinophilic gastroenteritis B) Mesenteric pancolitis C) Inflammatory bowel disease D) Pelvic inflammatory disease E) Mesenteric ischemia 34) 36yrs old male complains of intense mid abdominal pain that radiates to his back. The pain started 5hrs ago after he came home from work. His friend states that he found him groaning of pain on his bed in the fetal position. He says that curling himself in the fetal position sightly relieves the pain. He also reports nausea, and he committed 2 time since the pain started. He denies alcohol use. He has no significant past medical history. Vital signs etc A) Plain xray B) Ultrasound C) ERCP D) MRCP  E) CT 35) which one of the following causes isolated GGT elevation? A) Chronic pancreatitis B) Alcoholism C) Diabetes mellitus D) Renal failure E) All of above 36) which of the following is not cause upper gastrointestinal tract bleeding? A) Portal hypermassive gastropathy ? B) Esophagus C) Duodenal ulcer D) Adenocarcinoma of jejunum E) Mallory veins 37) which one of the following is wrong about crohns disease? A) Crohns disease is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from out to anus B) Three categories of disease presenta____ penetrating and inflammation C) Crohns disease may affect only gastrointestinal system D) Crohns disease has genetic component E) The etiology of crohns disease is unknown 38) which of the following is/are true for chronic viral hepatitis B, C or D? i. Hepatitis C is mostly presented with acute hepatitis presentation ii. Chronic viral hepatis b has low viral replication and high liver enzymes in immune tolerance phase iii. Chronical of hepatitis B is highly possible in infants iv. Chronic hepatitis c treatment is mostly with interferons v. Hepatitis D infection has high chronical rates when coinfection with hepatitis B happens A) Only III 39) which one of the following disease may mimic esophageal adenocarcinoma clinically? A) Herpetic esophagitis B) Achalasia  C) Timomsa D) Reflux disease E) Nutcracker esophagus 40) which of the following wrong regarding autoimmune hepatitis? A) It causes chronic hepatocellular injury B) Its etiology is unclear C) Predominately cholestatic enzyme __ is detected D) Lymphocytic or lymphoplasmacytic infiltrate with interface hepatitis can be seen as pathologic finding E) autoantibodies and hypogammaglobinemia are important for diagnostic criteria 41) which of the following is not a diagnose for chronic abdominal pain of inflammatory origin? A) Eosinophilic gastroenteritis B) Mesenteric pancolitis C) Inflammatory bowel disease D) Pelvic inflammatory bowel disease E) Mesenteric ischemia 42) 30 year old woman has no prior liver disease presented with jaundice and confusion which started 4 days ago. Her liver enzyme ALT, AST are between 4000-5000__. Prothrombin time, __. Your physical examination showed tender hepatomegaly, discoloration and flapping tremor. She has no alchol and no drug history. Hbs Ag, anti-Hbc Jg M are positive, anti HCV is negative what is your diagnosis? A) Acute hepatitis C B) Chronic hepatitis B C) Acute fulminant hepatis B D) Acute autoimmune hepatitis E) Acute drug induced hepatitis 43) which of the following symptoms is suggestive of esophageal carcinoma? A) Heartburn B) Belching C) Regurartion D) Progressive dysphagia E) Abdominal pain 44) which of the following are true for adulthood metabolic liver disease? I. All first degree family members should be screened if an index diagnosis has been done  II. For screening genetic testing and consolation is the gold standard method III. Hepicdn is the key protein which regulates copper absorption in the intestine IV. For all metabolic liver diseases early diagnosis saves the patients lifes by preventing the advanced liver disease E)I, II and IV 45) what is the utility of noninavasive laboratory aids FIB-4 ( fibrosis-4) and NAFLD fibrosis score( NF5) in the management of patients with liver disease? A) To diagnose with NASH B) To grade the degree of fibrosis in patient with NAFLD C) To rule out advanced fibrosis in a patient with NAFLD D) To confirm hepatic inflammation E) To grade haptic inflammation to grade steatosis 46) which one of the followings are true for acute biliary colic? i. A stone stack in cystic duct which causes increase in intra gallbladder pressure ii. Pain usually starts at night iii. Pain located at upper quadrant or epigastrium__ iv. Patients usually have one attack B) Only I and III 47) which of the following statement is true regarding upper GI bleeding? A) Prophylactic antibodies are recommend for cirrhotic patients B) Patients with active upper GI bleeding are candidate for early discharge and outpatient follow up C) Blood pressure should be checked only in supine position D) Regarding the patients with history of dysphagia and weight loss suspected source of bleeding can be the mollary veins E) Most common cause is esophagitis 48) jaundice is caused due to ___ C) Excess of bilirubin in the blood 49) hepatiis C virus___ E)can be ___ in most of the patients by direct antiviral drugs 50) 67 yr old man who was healing before presented with jaundice and ascites after a period of urinary tract infection his past medical history reveal that patient had been diagnosed chronic hepatitis B. 20 yrs ago and has been on anti-viral treatment since then. Two days after admission patient developed a grade 3 hepatic encephalopathy and transferred to liver transplation unite. His last biochemical tests were as follows: ALT 50, AST 80, PT-INR 2.5, creatinine 2.7, T.Bilirubin 9.8. Hb 10, platelets 60000/mm3. HBV DNA negative, anti-HCV negative. Which one of the following are true for this situation? i. This patient has acute liver failure due to activation of hepatitis B infection ii. This patient has acute on chronic liver failure induced by urinary infection iii. This patient has to be started diuretic as soon as possible iv. For grade 3 encephalopathy, treatment should be in intensive care unit and oral feeding should be stopped v. This patient has already hepatorenal syndrome and hemodialysis is needed C) II and IV 51) 45 year old female present with one day of epigastric abdominal pain that radiates to her back. It is associated with nausea and vomiting. She has no any history of alcohol consumption. On examination she appears uncomfortable and is sitting up in bed. She is extremely tender in palpitation of the epigastrium. Her labs are notable for WBC of 16,000, AST 175U/L, ALT150, total bilirubin 1 mg/dl and lipase 600 (normal result 24 to 151 U/L) What is the common cause of this patients condition? A) Alcohol B) Hypertriglyceral C) Viral hepatitis D) Hypercalcemia E) Gallstone GENERAL SURGERY 52) which one of the following is not characteristic of acute abdominal pain? A) Sudden onset B) Dullness C) Accompanied with mental? D) Vagueness E) May be referred HISTOLOGY AND EMBERYLOGY: 53) find false item concerning pancreas A) Pancreas develops as an outgrowth of esophagus  B) It develops as two pancreatic buds the dorsal pancreatic bad and the ventral pancreatic bud C) Two pancreatic bud fuse to form the pancreas D) The dorsal bud giving rise to the body and tail of pancreas E) The ventral pancreas giving rise to the head and unicate? process of the pancreas 54) which of the following is not characteristic of the parietal cells? A) Microvilli ___ cancaculus B) Abundant mitochondria C) Well developed granular endoplasmic reticulum D) Secretion of HCI E) Secretion of intrinsic factor 55) which glands are found in the papilla vallata of the tongue ? A) von elners gland B) brunners galnds C) goblet cells D) apocrine glands E) sebaceous glands 56) which item is incorrect considering esophagus? A) esophageal epithelium is trans___ epithelium B) esophageal lamina propria is less cellular (fewer lymphocyte ) than that in stomach and intestine C) esophageal muscularis mucosa is noticeable thicker than that in the stomach and intestine and includes only longitudinal muscle fibers D) muscularis edema of the esophagus consists of the standard inner circular and out longitude layers of smooth muscle E) auerback’s plexus is found in between inner circular and out longitudinal muscle layer 57) which structure develops from both foregut and midgut A) Esophagus B) Stomach C) Duodenum D) Liver E) Small intestine 58) in liver, both endorcine and exocrine function are carried out by which of the following cells? A) Hepatocyte  B) Kupffer cell C) Ito cell? D) Endotherlial cell E) Canalicular cell 59) which of the following cells constitute 20% of the islet of Langerhans located at the periphery of the islet and secrete glucagon? A) alpha cell B) beta cell C) delta cell D) G cell E) PP cell 60) which of the structure written below are found in duodenum? A) Villi, microvilli Lieberkühn’s cript, brunner glands, oblic smooth muscle layer B) ___, villi, microvilli, Lieberkühn’s cript C) Micro ___, villi microvilli, Lieberkühn’s cript, Brunner glands D) Villi, Lieberkühn’s cript, brunners gland, peyers patch E) Villi, microvilli, Lieberkühn’s cript, brunners gland, taneia coli Medical biochemistry: 61) select the incorrect items about the regulation of carbohydrate metabolism in liver tissue i. Above the normal blood glucose concentration, the enzyme activity for hexokinase is stable while it is increasing for glucokinase ii. Insulin dephosphorylates and activates pyruvate kinase while fructose 2,6 biphosphate is the positive allosteric modulator iii. Fructose 2,6 biphosphate (F-2,6 F2) activates PFK-1 by increasing its affinity for fructose -6phospate and descending the inhibitory effect of ATP iv. Citrate is the positive modulator for fructose 1,6 biphosphates while AMP is the negative allosteric regulator v. Ca2+ activates glycogen synthase enzyme by promoting phosphorylation while ATP inactive it E)II and V 62) which of the following statement about pancreatic function tests is incorrect? (MEMORIZE THOSE HE MAY CHANGE ONE OF THOSE A) plasma amylase measurement is not effect by ethnicity B) plasma trypsin measurement is 100% specific to the pancreas C) plasma enzyme measurement is a standard test in acute pancreatitis  D) measurement of fecal fat excretion is a useful in proving that pancreatic enzyme replacement therapy E) stool pancreatic elastase 1- measurement only detects severe pancreatic dysfunction 63) select incorrect items about the carbohydrate metabolism. A) In the well fed state high Km of glucokinase allow it to phosphorylate glucose B) During starvation muscle proteins are converted into amino acid for liver gluconeogenesis C) In well fed state excess glucose is converted to acetyl-CoA for fatty acid synthesis D) During trauma glucose uptake from circulation is reduced because of relase cytokines E) During starvation lipoprotein lipase is activated fro fatty acid degradation in adipose tissue 64) which of the following compounds can carry single carbon units from the carbon skeleton of amino acids? A) pyridoxal phosphate B) tetrahydrobiopterin C) tetrahydrofolate D) biotin E) niacin 65) the main principle of detoxification is to increase the solubility of the main compound. But there are in exceptions in this principle. Regarding this, which of the phase II reactions decreases the motibility? Of ___ and causes crystallization of kidney tubules? C)acetylation 66) which of the following statements regarding chylomicron is correct? A) Chylomicrons are synthesized and stored in gall bladder B) Chylomicron can transport triacylglycerol but not phospholipids or lipid soluble vitamins C) Chylomicron are considered the most dense lipoprotein in human plasma D) Chylomicron are the only liprotein that express apoprotein E E) Hypochylcarcinoma? Can be caused by a deficiency ___ 67 which of the following choices correctly completes the sentence below? Oxidative deamination is the conversion of an amino________ A) group from an amino acid to a keto acid B) acid to a carboxylic acid plus ammonia C) acid to a keto acid plus ammonia D) acid to a amine plus ammonia E) group from an amino acid to a carboxylic acid 68) which of the following molecules are the precursors of heme synthesis?  A) Alainine + succinyl CoA B) Glycine+ succinyl-CoA C) Glycine +carbonyl phosphate D) Alanine + carbonyl phosphate E) Succinyl-CoA + carbonyl phosphate 69) which of the following choices lists the substituent groups on a protophyrin IX ring correctly A) acetate, methyl, vinyl B) acetate, vinyl, propionic acid C) methyl, vinyl, propionic acid D) acetate, methyl propionic acid E) acetate, methyl vinyl, propionic acid 70) which of the following molecules below are absorbed to neterohepatic circulation? A) chemodeoxycholic acid B) taurocholic acid C) lithocholic acid D) deoxycholic acid E) cholic acid 71)find the best matches between the following statement and the blood test result 30 year old female presents to clonic with fevers, vomiting, lethargy and myalgia for 1 week. There is a mild continis right upper quadrant ache. She takes no medications or alcohol. 2 of her family members have been similarly unwell. C)ALP=150/ AST=1883/ ALT=1976 / GGT=151/ T.bil=3.63/ T. pro_= 6.4 / Alb=3.7 72) which of the following tests is a diagnostic tests for helicobacter pyloric infection? A) Breath hydrogen test B) Lactose tolerance C) Urea breath test? D) D-xylose test E) Schilling test 73) which one of the following sentences about nucleotide metabolism is incorrect? A) PRPP synthetase and PRPP amino transferase are the regulated steps in the de novo purine nucleotide synthesis B) Purine ____ is regulated in the __ pathway where ATP and GTP inhibit their own synthesis  C) PRPP amino transferase enzyme activity is stimulated by PRPP in purine nucleotide synthesis D) Aspartate transcarboxylase is the regulated step is py__ synthesis which is inhibited by CTP and activated by ATP E) There is also regulation of CMP decarboxylase for pyrimidine synthesis which is competivetly inhibited by UMP. 74) find the best matches between the following statement and the blood test result. 51 year old male presents with tense abdominal dis___. He drinks 80 units alcohol per week. D) ALP=73/ AST=89?/ ALT=55 / GGT=175/ T.bil=1.99/ T. pro_= 4.5 / Alb=2.2 75) which of the following pancreatic enzymes can activate other molecules of its kind by autocatalyisis? A) Pepsin B) Enterpreptidase C) Trypsin D) Chymotrypsin E) carboxypeptidase 76) which of the following conditions is a rare, X-linked, recessive, inherited disorder associated with a virtually complete deficiency of Hypoxanthine- guanine phosphoribosyltransferase (HGPRT)? A) over activity of PRPP synthetase B) Lesch Nyhan Syndrome C) adenosine deaminase deficiency D) von gierkes disease E) gout 77) fumarate that exits urea synthesis is formed from which of the following molecules carbone backbone? A) Carbamoxyl phosphate B) __ C) Citroline? D) Aspar__ E) Arginine 78) which of the following structures shows Cu-dependent? Oxidase activity and induces binding of iron to transferrin? A) Heme B) Copper C) Vitamin C  D) Cerophlasmin E) ferrtin 79) select the incorrect items about the carbohydrates. i. Starch contains alpha 1-4 linkages which are digestible, but cellulose contains beta 1- 4linkages which correct be digested by human enzymes ii. Salivary amylase cleaves alpha 1-4 linkage forming alpha limit detrin mullstones, mall__ and glucose mo___ iii. Intestinal cells contain sucrose, alpha dendrinase, glucoamylase, lactose nd pepridase on their brush borders iv. Monosaccharides are taken into the intestinal mucosal cells by passive transport and then pass to the circulation by facilated diffusion C) II and IV 80) which of the following statements is true? A) Amino acids are transported via a Na depenedent active transport protein B) Glycerol passes to the blood capillaries from the space between intestinal epithelial cells C) Fatty acid transportr via ? epithelial cells need to be activated with co4? D) Glycerol absorbed into epithelail cell are used for ___ synthesis E) Glucose, galactose and fructose are actively transported with __ co transport 81) select incorrect item about the diseases of carbohydrate metabolism A) Glycogen storage disease type IIIb is the deficient of debranching enzyme which is manufactured by hyperglyconmia, hyperlipidemia and elevated? Liver transminases B) Glycogen storage disease type VI (hers disease) is the deficiency of liver glycogen phosphorylase enzyme there by following adminsatrion of glucagon there is no increase in blood glucose C) Pyruvate kinasedeficency leads to hemolyric aneamia, jaundice gallstone, splenomegaly, and skeletal deformities, due to marrow expansion D) Essential fructosira is the lack of fructokinase enzyme which is a bengin condition with the accumulation of fructose in the urine E) Glycogen storage disease type VII is the deficiency of muscle phosphofructosekinase which is manifested by inability to exercise Medical genetics: 82) mutations on CFTR genes causes several molecular defect for CFTR protein. The tissue samples were taken from patient and control and western blot was performed for protein expression of CFT, western blot result showed normal size of CFTR protein exists in the control sample, However CFTR protein was not found in patients sample. Also, immunostaining results showed that CFTR protein for the control was located at cell membrane but CFTR protein for the patient was not localized any place in cells such as Golgi cell membrane What do u think effect of this mutation on functional abnormality for CFTR protein? A) Folding defect B) Iron transport defect C) Decreased half of protein D) No protein synthesis E) Channel opening defect MEDICAL MICROBIOLOGY: 83) which of the following reflects the typical serological profile of an acute HIV infection that results in recovery? A) HBsAg- neg, HBeAg-pos, AntiHBc- pos B) HBsAg- Neg, AntiHBc-pos, AntiHBs-neg C) HBsAG- neg, ANtiHBc-pos, ANtiHBs-pos 84) which of the following bacteria causes food borne disease that has the shortest incubation period? A) Salmoenlla choleracius B) Staphylococcus aureus C) Clostirdum perfringens D) Clostridum botulinum E) Yersina pestis 85) which of the following is the least helpful direct examination method of stool for laboratory diagnosis of diarrhea? A) Wet mounth B) Ioden staining C) Trichrome staining D) Gram staining E) Methylene blue staining 86) ur patient is 28 yr old male who has fever and right upper quadrant pain. He reports that had bloody diarrhea 2 months ago. A CT scan reveals a radiolucent area in the liver that is interpreted to be an abscess. Aspiration of material from the abscess was performed. Microscopic examination revealed motile, ___ trophozoite with ameboid movement of the following which one is most likely cause of this infection. A) enterambea histolycia B) giardia lamia C) balantidum coli D) cryptosporidium parvan E) trichamonas vagilalis 87) which one of following is most accurate rotavirus? A) The diarrhea is caused by exotoxin that increases cyclic adenosine monophosphate cyclicAMO B) Rotavirus has a nonsegmented single stranded rna genome and there is no polymerase in the vir__ C) The diagnosis of rotavirus diarrhea is typically made by the detection of fourfold or greater rise in antibody __ to the virus D) The vaccine against rotavirus contains __ , __ virus as the immunogen E) Diarrhea cause by rotavirus is due to a viral protein that increases the release of IgA from many submucosal B lymphocytes 88) which of the following statement about vibrio cholera is true? A) Cause clinical disease by invasding the intestinal system and causing bloody diarrhae B) Is characterized by numerous leukocyte and erytherocyt in the stool C) Is transmitted from contaminated __ D) Is very contagious and even 10 to 100 bacteria may intellat the infection E) Should be treated with antibiotic 89) which of the following serological or virological markers reduces that hepatitis b infection has progessed to the chronic phase? A) Presence of HBeAG in the blood for more than six months B) Presence of ANtiHBc antibodies in the blood for more than six month C) Presens of ___ in the blood for more than six month D) Presence of anti-Hbe antibodies is the blood for more than six month E) Presenece of HBV-DNA in the blood for more than 6 month 90) which of the following is not true for intestinal helminths? A) There is no direct person to person transmission or infection from fresh feces and the eggs should develop into infective stage in the soil B) Enterobius vermicularis females laue eggs perianal. Regions at nights C) Trichurs trichura may be related with rectal prolapses D) Ascaris lumbricodes is the most widespread human gut __ E) Trichuella spiralis is transimitted by the bile of infected female __ and cause lymphatic obsurption? 91) which one of the following is correct for enteric fever? I. Enteric fever called typhoid fever if caused by salmonella typhi II. Enteric fever can also be caused by salmonella paratymphi A B C III. Slamenlla paratype speciea causes milder diseae than S.Typhi  IV. Salmonella typhi strains spread to liver and spleen inside macrophages V. Multidrug resistance is widespread for salmonella typhi E)All of the above 92) which of the following matches about E. coli and diarrheal diseases Is not correct? A) Travelers diarrhea (exterotogenic E. coli) B) Hemorrhagic colitis and hemolytic __ syndrome enterohemorrhagic e. coli C) Persistent diarrhea ( enteroaggregative e.coli) D) Watery diarrhea of infants ( enteropathogenic E.coli) E) Persistent, __ chronic diarrhea in the elderly( enter__e.coli) Pathology: 93) which of the following salivary gland tumor is the most common? A) Pleomorphic ademna ? B) Warthin tumor C) Adenoid cystic carcninoma D) Macropedermoid carcinoma E) Acinic cell carcinoma 94) which of the following causes mass lesion and mimics pancreatic carcinoma? A) Pancreas division B) Ectopic pancreas C) Pseudocyst D) Autoimmune pancreatitis E) Hereditary pancreatic 95) which of the following statments regarding cholangiocarcinoma is/are true? I. Cholangiocarcinoma takes its origin other from mature hepatocytes or from progenitor cells II. Because of the glandular formation and much production of the neuplatic cells, cholangiocarcinoma is a type of adenocarcinoma III. Patients with parasitic infection such as clorchs? And opthorchis? Carry high risk for cholangiocarcinoma IV. Primary biliary cholangitis cirrhosis there is an aincreased risk for cholangiocarcinoma C) Only II and III are true 96) which of the follwiing developmental biliary disease the __ of the liver is either normal or oddly enlarged without any large cyst and in microscopic examination the portal areas shows prominent fibrosis containing irregular shaped bile ducts that communicate with the reest of the bilary system? A) Cholefocal cyst B) Carolis disease C) Autosomal receptors _ __ kidney disease? D) Autosomal dominnat polycystic liver kidney disease E) Wilsons disease 97) which of the following statements concering epithelial polyps of the lower gastrointestinal GI tract are/is true? i. hyperplastic polyps account for 90% of all epithelial polyps in lower GI and rarlet can show neoplastic transformation ii. In hamartostatous polyps the epithelial cells that line the glandular component are always neoplastic iii. In adenomas, the long epithelium of the tubules and villous structure have at least low grade dysplasia iv. Serrated lesion polyp is a subtype of adenomatous polyp that shows fingerlike projections on the surface C)ONLy I and III are true 98) which of the following cysts is a sequel lesion due to acute pancreatitis? A) Mucous cystic neoplasm B) Serous cystadenoma C) Pseudocyst D) Intraductal papillary mucinous neoplasm E) Benign mucous cyst 99) a 42 yeard olf female patient with a history of autoimmune thyroiditis presented with fatigue and myalgia. Mild hepatomegaly was deducted in her physical examination. Screening of the liver tests revealed increased serum levels of aminotransferase, gamma globules and immunoglobin c. alkaline phosphate levels were normal viral serologic markers were negative. Smooth muscle antibodies (SMA) and antinuclear antibodies (ANA) were found to be positive. What would you expect to see in the liver biopsy of this patient? A) Ground glass hepatocytes B) Mallory denk bodies C) Ductal and ductular bilirubin stasis  D) Portal and periportal plasma cell infiltration E) Microsteatosis 100) male infant was brought by his parents at age 4 weeks because of yellow discoloration of the skin and sclera which started in the second week of life. The infant was born at term pregnancy was uneventful and has birthweight was 2.6kg. he was fully breastfed, his urine has deep yellow color and stool was of normal color. Liver function tests showed total serum bilirubin of 30mg/dl direct bilirubin 21mg/dl, aspiration aminotransferase AST 583, alanine aminotransferase ALT 350 , total protein 5.4 g/dl, albumin 3.9g/dl and alkaline phosphatase 450IU/L. Urine for reducing substances was negative as well as urine culture and sensitivity. Hepatitis B and C screening was negative, TOCH light screening was also negative. Abdominal ultrasound showed enlarge liver with normal texture and echogenicity, no focal lesion, normal gall bladder. A percutaneous liver biopsy was obtained which showed feathery degeneration of hepatocytes, giant cells transformation, extramedullary hepatoposis, prominent bile stasis in the caracul and mild inflammatory cellular infiltrate in the portal tract with focal piece __ necrosis. Bile ductule proliferation was mild and bile plugs within bile ducts or ductulus were not seen. What would be diagnosis of this case? A) Extraheptic biliary athresia B) Wilsons disease C) Primary scheming cholanigits D) ___ hepatitis E) Carolis disease 101_ which of the following associated with risk of developing ademocarcinoma pastric adeomasas? A) Size of input B) Patient age C) Sex of patient D) Lesion location E) Number of lesion 102) 32 year old male patient with a history of ulcerative colitis presented with fatigue and itching. Mild hepatomegaly was detected in his physical examination endoscopic retrograde cholangpancreatograpy (ERCF) reveal segmental narrowing in both intrahepatic and entraheptic biliary duct. Screening of liver tests showed increased serum levels of alkaline phosphatase and y-glutamyl transpeptidase What would you exoect to see in the liver of biopsyof this patient? A) Granulatious destruction of biliary ducts B) Bile ducts in the parenchyma of the liver C) Confluent necrosis in the parenchyma of the liver  D) Diffuse macrocytosis in the parenchyma of the liver E) Concerti fibrosis __. Screening surrounding biliary ducts 103) 52 year old female patient underwent gastrectomy because of her stomach mass lesion. She exposed to medication an anesthetic drug, at operation. After this surgery, her ALT?AST levels increased. Her clinician thought that midocl?__ affected her liver adversely. Which kind of drug reactions and mechanism could be underlying the situation, choose correct match? A) Predictabl durg reaction, the patient was slow to metabolize B) Unpredictable drug reaction the patterns had genetic disorder effecting her enzymes which eliminate the metabolites of __ C) Predictable drug reaction, m__ caused an allergic reaction at the patient D) Unpredictable drug reaction the anesthetist used excessive dose of ___ E) Predictable drug reaction the patient showed intense immune response to ___ 104)which of the following statements regarding liver fibrogenesis is false? A) In normal liver collagens comprises less than 2% of the liver volume and is located in the portal areas in the walls of the central veins B) Myofibroblast differentiation in specific cells I the key event in the mutation of fibrogenesis in chronic liver diseases C) Ability to show myofibroblast inflammation in the liver is limited to induce anti hepatocytes D) Besides the specific cells in the liver bone marrow cells that enter he liver by hepatic circulation have ability to show myofibroblast differentiation E) When myofibroblast differentiation scores the cells gain capacity to produce collagen 105) which of the following statement is/aretrue concerning the microvascular rearrangement that is mainly due in collagen deposition in __ space during hepatic fibrogenesis? I. It is responsible for the endothelial cell pure narrowing that __ the II. It leads to decrease in endothelial permeability III. It is a cause of increase sinusoidal pressure IV. It is responsible for the formation of porto-systemic shants E)I,II,III, and IV are true 106) which of the following is not a hetapathologic feature of acute self limited colitis? A) Fibrosa B) prominent neutrophil infibilatraion in the hemna propria 107) 46 yr old female patient with fatigue admitted to outpatine clinic. She had also history of diabeties mellitus. In her lab results, ALT and AST levels were 120 and 140IU/L respecitively, hepatomegaly and grade 1 hyperostosis were detected by abdominal ultrasound evaluation. Which of the following is correct for her most probably disease with this findings? A) Early fibrotic lesion is pericellular perinuclear fibrosis B) Ballooning degeneration is not a h___ in her liver biopsy C) Mallory-Denk body is a pathogen_ and characteristic lesion of this disease D) Microvascular 108) in 8 years old male patient with chronic diarrhea and weight loss, upper endoscopy is performed. Endoscopic biopsies of the bulbus and duodenum revealed normal villi and crypt architecture but in the surface epithelial cells there was cytoplasmic vacuolization. There was mild inflammation in the lamina propria but no increase in the intraepithelial lymphocytes. What would be diagnosis? A) Celiac disease B) Crohns disease C) Ab_____????? D) Whipple disease E) Tropical sprae 109) which of the following statement explains the mechanism underlying the granuloma formation in the gastrointestinal tract of patients with crohns disease? A) There is an abnormality in the suppression of T _ lymphocyte response which induces macrophages accompanied by _____ B) There is abnormality in the suppression in the Tx17 lymphcyte repsones that stimulates epithelioid histocytes by IL-23 C) Antigens presenting cells stimulate CD4+ lymphocytes which in __ release IL-2 leading to lymphocyte accumulation 110) which of the following stamtents concering hepatocarcingoesis is/are true? I. Heaptocellualr carcinoma can take its origin either from mature hepatocytes or from profemntar cells II. __ de mor carcinogenesis 111) 50 yr male patient underwent transplantation one yar ago. He admitted to had fever and flu like symptoms. On physical examination, he had right quadrant abdominal pain with palpation. Microscopically, focal necrotic areas of the parenchyma is present in his liver biopsy. Immunohistochemically, nucleus are seen in some of the hepatocytes of his liver biopsy. Which of the following microorganisms could be related to her disease? A) Salmonella typhi B) Nessmeria gonorrhoeae C) Cytomega_virus D) Candida albicans E) Strangyliods 112) 44 yr old man presented with nausea vomiting, upper abdominal discomfort, and pernicious anemia. Her blood tests revealed hypochlorhydria and elevation in gastrin level. Urease breath test was positive. Upper endoscopy was performed with multiple biopsy from gastric mucosa. What do u think__ biopsy of this patient A) Sever gastric trophy limited ti mystic mucosa B) Antral prominent pangastric with involvement in both antral and cystic mucosa C) Cardia type gastric with no involvement in antral mucosa D) Antral type gastritis with no involvement in oxytic mocusa E) Corpus type gastritis with no involvement in antral mucosa 113) which of the folllwong is NOT a clinicopathologic feature seen in Barrett esophagus A) Endoscopy shows one or several tongues or patches in the gastroesophageal junction B) Red, velvety mucosa is seen extending upward from the gastroesophageal junction C) Microscopy shows H.pylroic incubation D) Microscopy shows goblet cells E) There might be dysplasia in microscopic examination NUCLEAR MED: 114) which of following is NOT true regarding nuclear medicine application in the gastrointesetinal system? PHARMACOLOGY: 115) which of the following irreversibly inhibits the N+/K+/ATP are in the gastric parietal cells and therefore reduces intragestirc acid levels? A) Omeprazole? B) Randobine C) Sucroflate D) M E) Gastrin 116) which of the following drugs is the most suitable in the treatment of post-up vomiting? A) ondansetron 117) if mushroom is eaten with alcohol land disofram like reaction occurs, u sell corrinder which mycotoxin produces this syndrome? A) Coprine 118) which of the following agents is a cathartic locative? A) Senna glycosine 119) drug X whose clearing is know to be dependent on both hepatic metabolism and glomerular __ know to be 99%__. and subjected to endroheptic circulation one glucorinde metboltie of the drug secreted to intestic which of the following consequence of liver failure may cause a significant decrease in drug concentrations? A) Decresed bdining to albumin B) Decreased heaptic metabolism C) Decreased renal excretion D) Decreased enterohepatic circulation? E) Decreased production of factor VII PHYSIOLOGY: 125) IV.excess vomiting causes metabolic acidosis A) ONLY I, ii, III