Anatomy 1. The following are the anterior relation of abdominal aorta EXCEPT: A. Celiac ganglia and plexus B.

Body of pancreas C. Splenic and left renal veins D. Anterior longitudinal ligament

2. Epiploic foramen of Winslow is: A. Connection of greater sac with the thorax cavity B. Connection of greater sac with the pelvic cavity C. Connection of greater sac with the lesser sac D. Connection of abdominal cavity to the pelvic cavity 3. The following are true regarding the Oesophagus, EXCEPT: A. it length is about 20 inches B. it is divided to 3 parts C. it end at the cardiac end of the stomach D. one of its blood supply is anterior thyroid artery

4. .All are true about the posterior relation of the abdominal aorta except : A. celiac ganglia B. lumbar vertebrae C. 3rd n 4th lumbar vein D. intervertebral disc E. anterior longitudinal ligament 5 .Anterior wall of lesser sac is formed of : A. lesser omentum B. peritomeum C. anterior 2 layer of greater omentum D. all above are true 6.Which artery branches arise from splenic artery that supply the stomach ? A. right gastric artery B. right gastroepiploic artery C. left gastric artery D. left gastroepiploic artery

7. Right relations of abdominal aorta is/are A. B. C. D. Azygos vein. Inferior vena cava. Cisterna chyle. All of the above.

8. The superior boundaries of epiploic foramen is A. B. C. D. Inferior vena cava. 1st part of duodenum. The caudate process of inferior surface of the liver. Free edge of lesser omentum

9.Which one is the anterior relation of the stomach? A. B. C. D. Spleen Hepatic area (liver) Pancreas Left kidney

10.Which one is a FALSE statement : A. The stomach is located at the left hypochondriac, epigastric, and umbilical regions of the abdomen. B. Pyloric orifice is inch to the left of the median plane at level of L1. C. Greater curvature forms the left border of the stomach and extends from the cardiac orifice to the pylorus. D. Stomach is J-shaped organ and has two orifices, the cardiac and pyloric orifices.

11.The following are true about the abdominal aorta except A. B. C. D. It enter the abdomen opposite to the T12 It is related posteriorly to all lumbar vertebrae and intervetebral disc It is on the left side of azygous vein It gives the renal arteries at the level of L2

12. Following is the tributaries of IVC exp: A. First part of duodenum B. second part of duodenum C. Third part of duodenum D. Peritoneum

13.Which part of stomach is full of gas? A B C HISTOLOGY body fundus pyoloric

14. The correct description of oesophagus is: A. it is muscular organ about 10cm long B. upper 3rd of the oesophagusis formed of both smooth and striated muscle C. the submucosal glands are compound tubulo-alveolar mucous gland type D. upper 3rd consist of abundant smooth muscle 15. All the following are true regarding the stomach, EXCEPT: A. is divided into 3 regions B. there is no pit present in the stomach C. the mucosa and submucosa forming the rugae in empty stomach D. simple columnar epithelium covers the surface of the stomach 16. The following are the functions of the stomach, EXCEPT: A. secretes mucin, protecting the mucosa B. excretes iodide and mercury C. release of intrinsic factor for vitamin B12 absorption D. mixes food with gastric secretions

17. The gastric glands are made of A. B. C. D. Simple unbranced tubular glands Simple branched tubular glands Complex unbranched tubular glands Complex branched tubular glands

18.Which of the following are TRUE regarding oesophagus? A B C D It is lined by keratinized stratified squamous epithelium submucosal oesophageal glands secrete acidic mucous muscularis mucosa mainly formed of striated muscles none of the above

19.Which of the followings pair are false? A B C D mucous neck cells production of intrinsic factor enteroendocrine cells secrete peptide hormone zymogen cells secretion of pepsin oxyntic cells HCl formation and secretion

20.All of the below are related to submucosal oesophageal gland except: A B C D Lined by tall columnar cell found along the entire oesophageal length secrete neutral mucus all of the above

21.Gastric pit in mucosa of fundus are I II III IV A B C D short deep wide narrow I & II II & IV III I & IV

22.The musculosa of fundus and body of the stomach consists of which layer of muscle? A B C D outer longitudinal inner oblique middle circular all of the above

23. Which of the following regarding histological section of oesophagus is false : A. Lined by human non-keratinized squamous epithelium and mucoid cell B. mucous secreting type glang secrete neutral mucous C. Smooth muscle is absent in the upper third D. The continous layer of the longitudinal smooth muscle fibers starts at the level of cricoid cartilage

24. which of the following is not found between the inner tightly packed circular and outer longitidunal layer of the musculosa of alimentary tract A.blood vassel B.lymph vassel C.nerve plexus D.thick layer of connective tissue

PHYSIOLOGY

25.Chewing center is present in A. B. C. D. Cerebral cortex Pons Midbrain Medulla oblongata

26.Which of the following is FALSE composition of gastric secretion? A. B. C. D. 3L/day Anion: Cl- , SO4HCl : 1.4% pH=1

27.Which of the following is NOT the enzymes of gastric juices? A. B. C. D. Mucin Rennin Glycerol kinase Intrinsic factors

28.Efferents of nervous pathway of vomiting reflex are the following EXCEPT A. B. C. D. Trigeminal nerve Glossopharyngeal nerve Accessory nerve Hypoglossal nerve

29.All of the deglutition phase are involuntary except A B C first phase second phase third phase

30.Deglutition center is situated in A B C D pons cerebral cortex medulla oblongata none of the above

31.Which of the following is false regarding hunger contractions? A B C D occur in the fundus of stomach caused by strong vagal stimulation appear 12-24 hours after last meal strong contractions

32.Which of the following statements are false regarding vomitting? A B C D sometimes vomitus may contain bile vomitting center situated in pons vomitting will cause elevation of soft palate preceded by sense of nausea

33.What is/are the efferents of the nervous pathway of reflex vomiting ? A. B. C. D. E. Phrenic nerves to the diaphragm Spinal nerves to the muscle of the posterior abdominal walls. 5th, 6th, 7th, 10th and 12th cranial nerves to the lower part of the gastrointestinal tract. 5th, 7th,9th, 10th and 12th cranial nerves to the upper part of the gastrointestinal tract. A and D.

34.Which one is not included in the gastric motility? A. B. C. D. E. Tonic contraction Migrating motor complex Hunger relaxation Peristaltic movements Receptive relaxation

35. Human gastric secretion is about A. B. C. D. 1 liter/day 2 liter/day 3 liter/day 4 liter/day

36. Deglutition (swallowing) is: A. transfer of food from stomach to the mouth B. is divided into 3 phases only C. semisolids take shorter times than fluids D. cough and swallowing is stimulated during anesthesia

37. Which of the following is NOT the efferent of nervous pathway of relexvomiting: A. 5th cranial nerve B. facial nerve C. phrenic nerve D. 8th cranial nerve

38. Which of the following is not the action of protective reflexes to prevent entry of food into respiratory opening

A. Elevation of the soft palate B. elevation of the pharynx C. Approximation of the vocal cord D. Stimulation of respiration by replex mechanism

39 The following is true regarding HCL except : A. Secreted by perietal cells B. stimulation by h2 receptors, m2 receptors and gastrin receptors C. It facilitate the absorptions of calcium and iron D. Activate the in active proteolytic enzyme, pepsinogen to the active form pepsin

40.Receptors of conditioned reflexes of cephalic phase is present mainly in buccal cavity

True / false 41.Primary peristaltic contranction: A. occur in response of the distension of the body of oesophagus B. have a role in clearing function C. start at the upper end of the oesophagus D. travel along the whole length of the oesophagus about 3 seconds 42.The parasymphathetic supply of the stomach has the function of : A. reduce blood flow B. increase the rate of emptying of the stomach C. produce alkaline mucous secretin D. inhibitory to the muscle wall

43.Enzyme of the gastric juice consist of : A. Pepsin B. Renin C. Lipase D. mucin 44.What are the hormonal factor that regulate stomach emptying ; A. cholecystokinin B. secretin C. vasoactive intestinal peptide D. somatostatin E. all above are true

45.which of the following is true about the lower oesophageal spincter A. B. C. D. Main mediator of the transfer function of the oesophagus Called the pyloric spincter Vulnerable to damaged and ulceration by irritant food Relaxed between meal

PATHOLOGY 46.Red velvety mucosa extending upward from GE junction is characteristics gross picture for A. B. C. D. Esophagitis Carcinoma of oesophagus Barret oesophagus Ulcer of esophagus

47.Which of the following condition is precancerous condition? A. B. C. D. Acute gastritis Pyloric stenosis Chronic gastritis Diaphragmatic hernia

48.Definiton of achalasia is A a sac-like dilatation of stomach with protrusion through the oesophageal hiatus of diaphragm B failure of receptive relaxation of LES C an outpouching of one or more layer of oesophageal wall D none of the above 49.All are related to traction diverticulum except A B C D occur distal in mid and lower esophagus occur in upper esophagus result from an outside pully effect of inflammatory adhesion none of the above

50.What will cause achlorhydria? A B C Reduction in pepsinogen I concentration loss of parietal cell for gastric acid and intrinsic factor secretion failure of vitamin B12 absorption

51. The causative agent for Ludwigs angina is A. B. C. D. Streptococcal infection of the tissue surrounding the submandibular gland. Treponema vicenti and fusiformis. Deficiency of B-complex vitamins. Total white count is low and polymorphs are reduced to 5% or less.

52. The effect of hiatal hernia is A. B. C. D. Development of squamous cell carcinoma Hepatic coma Bilharzial hepatic fibrosis (BHP) Peptic ulceration and hematemesis

53. Disease of the oesophagus: A. Sialadenitis B. Xerostomia C. Achlasia D. Leukoplakia

54. Benign tumours of oesophagus : A. Common in adults B. mostly in mesenchymal C. Common in men tha female

55. Peptic ulcer disease : A. 10% of ulcer in gastric antrum B. commonly in middle aged to older adults (20 - 40 years) C. Bleeding is common clinical presentation

56.Which of the following is NOT invasive method to diagnose H.Pylori? A. B. C. D. detect in stool by ELISA direct urease test histopathological examination culture

57.Helicobacter Pyolori is a A B C D motile with tuft polar flagella spiral shaped rods gram negative all of the above

58.Which of the following is true about H. Pyolori? A B C D gram positive urease negative immotile caused chronic gastritis

59.In lab diagnosis, the non invasive method is A B C D urea breath test direct urease test culture in Skirrows medium histopathological examination

60.The virulence factor of H. Pyolori is A B C D vacuolating cytotoxins urease enzyme protease enzyme all of the above

PHARMACOLOGY

61 .which of the following drugs is best indicated for erosive esophagitis A. B. C. D. cimetidine omeperazole pirenzepine nizatidine

62. which of the following drugs is paired with incorrect mechanism of action A. B. C. D. ranitidine:reversible competitive blocking of binding of histamine to H2 receptor lanzoprazole: irreversibly inhibit H+/K+ ATPase proton pump antacid: neutralization of gastric acidity omeperazole: reversibly inhibit H+/K+ ATPase proton pump

63.Which of the following drug is used to treat Zollinger-Ellison Syndrome? A. B. C. D. Pirenzepine Omeprazole Sodium bicarbonate Mg trisilicate

64.Which of the following statements is true? A B C D cimetidine only cause minor effects like headache sodium bicarbonate will not cause systemic alkalosis magnesium oxide will cause systemic alkalosis Pirenzipine is one of anti muscarinic drug

65. Which group of drug in treatment of peptic ulcer is falsely paired : A. Proton pump inhibitors - lanzoprazole B. h2 receptors anatagonist - cimetidine C. Anti muscarinic drugs ranitidine

ANSWERS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. D C A A D D D C A B B B B D B B B B A C D D A D B C C C A C A B E C C B B D B FALSE C B B E C

46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65.

B C B B B A D C B B A D D A D B D B D C