Gastrologie ENG 2018-2019

Gastroenterologie
1. Capitol: Esofag Mod de punctare: A1 Punctajul: 10In which cases odynophagia is NOT
characteristic?
a) [x] Carcinoma with periesophageal involvement
b) [ ] Caustic damage of the esophagus
c) [ ] Herpes esophagitis
d) [ ] Pill-induced esophagitis
e) [ ] Uncomplicated reflux esophagitis
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2. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What type of therapy for achalasia is effective
with clinical improvement in 60% of patients at 6 months?
a) [ ] Balloon dilatation for reducing the basal lower esophageal sphincter pressure by tearing muscle
fibers
b) [x] Endoscopic intrasphincteric injection of botulinum toxin
c) [ ] Heller's extramucosalmyotomy of the lower esophageal sphincter
d) [ ] Laparoscopic myotomy
e) [ ] Nitrates and calcium channel blockers
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3. Capitol: Esofag Mod de punctare: A1 Punctajul: 10In which case long-term (24-48 h)
esophageal pH recording is necessary?
a) [x] Only when the role of reflux in the symptom complex is unclear
b) [ ] Patients with no acid reflux
c) [ ] Patients with alkaline (bile) reflux
d) [ ] Peptic ulcer
e) [ ] Achalasia
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4. Capitol: Esofag Mod de punctare: A1 Punctajul: 10The goal of gastro esophageal reflux disease
treatment are NOT to provide:
a) [ ] Healing of erosive esophagitis
b) [ ] Prevention of complications
c) [ ] Prevention of Barett`sesofagus
d) [x] Eradication of Helicobacter pylori
e) [ ] Symptom relief
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5. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Which of the following is NOT among the
aggressive factors in the pathogenesis of reflux esophagitis?
a) [ ] Hydrochloricacid
b) [ ] Pepsin
c) [x] Mucus
d) [ ] Duodenal secretion
e) [ ] Pancreatic secretion
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6. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Which of the following is NOT an alarming
symptom in gastroesophageal reflux disease?
a) [ ] Weight loss
b) [ ] Anemia
c) [x] Sialorrhea
1
d) [ ] Odynophagia
e) [ ] Dysphagia
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7. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Nonoperative treatment of alkaline
esophagitis does NOT include:
a) [ ] General antireflux measures
b) [ ] Cholestyramine
c) [ ] Aluminum hydroxide
d) [ ] Sucralfate
e) [x] Antisecretory agents
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8. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Select the cause that NOT induces the
infectious esophagitis:
a) [ ] Viral organisms
b) [ ] Bacterial organisms
c) [ ] Fungal organisms
d) [ ] Parasitic organism
e) [x] Chron disease
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9. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Which is the most sensitive method for
diagnostic of Herpes simplex virus (HSV) esophagitis:
a) [ ] Barium swallow
b) [ ] Superior digestive endoscopy
c) [ ] Cytologic smear examination
d) [ ] Culture for HSV
e) [x] PCR assays for HSV
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10. Capitol: Esofag Mod de punctare: A1 Punctajul: 10The antireflux barrier of esophagus contain
all structures, EXCEPT:
a) [ ] Low esophageal sphincter
b) [ ] Angle of His
c) [x] Pylorus
d) [ ] Crural diaphragm
e) [ ] Peristalsis of esophagus
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11. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Which is the factor that CAN`T precipitate
or exacerbate gastro esophageal reflux disease symptoms:
a) [ ] Caffeine
b) [ ] Mineral water
c) [x] Weight loss
d) [ ] Eating prior to recumbency
e) [ ] Chewing gum with peppermint
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12. Capitol: Esofag Mod de punctare: A1 Punctajul: 10 Select the pathogenic factor which is
characteristic forgastro esophageal reflux disease:
a) [ ] Transient low esophageal sphincter relaxation
b) [ ] Increased intra-abdominal pressure
c) [ ] Delayed gastric emptying
d) [x] Decreasied intra-abdominal pressure
e) [ ] Decreasied gastric complaints
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13. Capitol: Esofag Mod de punctare: A1 Punctajul: 10In which case initial dysphagia to liquids (or
more pronounced to liquid than to solid foods) is typical:
a) [ ] Barrett's esophagus
b) [x] Achalasia
c) [ ] Esophageal diverticula
d) [ ] Gastroesophageal reflux disease
e) [ ] Tumors of the esophagus
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14. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What kind of clinical manifestation is NOT
specific for achalasia?
a) [ ] Regurgitation
b) [ ] Irritating cough
c) [ ] Weight loss
d) [ ] Chest pain
e) [x] Sialorrhea
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15. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Select disease in which heartburn is the
pathognomonic sign:
a) [ ] Gastric cancer
b) [ ] Achalasia
c) [x] Gastroesophageal Reflux Disease
d) [ ] Chronic gastritis type A
e) [ ] Gastric ulcer
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16. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Indicate the condition where is presented
metaplasia of malpighiene esophageal mucosa with intestinal columnar mucosa:
a) [ ] Esophageal ulcer
b) [ ] Peptic stenosis
c) [x] Barrett syndrome
d) [ ] Erosive esophagitis
e) [ ] Gastric ulcer
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17. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What is the most typical statement that
characterizes the gastroesophageal reflux disease?
a) [ ] The presence of gastroesophageal reflux
b) [x] The presence of pathologic gastroesophageal reflux (> 50 episode / 24 h; pH<4; more than 5 min
one episode)
c) [ ] Esophagitis
d) [ ] Intestinal metaplasia
e) [ ] Increased tone of lower esophageal sphincter
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18. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does dysphagia means?
a) [x] A sensation of "sticking" or obstruction of the passage of food through the mouth, pharynx, or
esophagus
b) [ ] Complete esophageal obstruction, which is usually due to bolus inpaction and represents a medical
emergency
c) [ ] Painful swallowing
d) [ ] Occurs in disorders of the voluntary phase of swallowing, once initiated, swallowing is completed
normally
e) [ ] The sensation of a lump lodged in the throat, no difficulty is encountered when swallowing is
performed
3
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19. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does aphagia means?
a) [x] Complete esophageal obstruction, which is usually due to bolus impaction and represents a medical
emergency
b) [ ] Painful swallowing
c) [ ] Occurs in disorders of the voluntary phase of swallowing, once initiated, swallowing is completed
normally
d) [ ] The sensation of a lump lodged in the throat, no difficulty is encountered when swallowing is
performed
e) [ ] Resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, being
characteristic of oropharyngeal dysphagia
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20. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What is the difficulty swallowing in
initiating?
a) [ ] Painful swallowing
b) [x] Occuring in disorders of the voluntary phase of swallowing, once initiated, swallowing is
completed normally
c) [ ] The sensation of a lump lodged in the throat, no difficulty is encountered when swallowing is
performed
d) [ ] Resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, is
characteristic for oropharyngeal dysphagia
e) [ ] Fear of swallowing
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21. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does Odynophagia means?
a) [ ] Occuring in disorders of the voluntary phase of swallowing, once initiated, swallowing is completed
normally
b) [ ] The sensation of a lump in the throat, no difficulty is encountered when swallowing is performed
c) [ ] Resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, is
d) [ ] Fear of swallowing
e) [x] Painful swallowing
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22. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does globus pharyngeus means?
normally
b) [x] The sensation of a lump lodged in the throat, no difficulty is encountered when swallowing is
performed
e) [ ] May occur in hysteria, rabies, tetanus, and pharyngeal paralysis due to fear of aspiration
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23. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does misdirection of food mean?
normally
b) [ ] The sensation of a lump lodged in the throat, no difficulty is encountered when swallowing is
performed
c) [x] Resulting in nasal regurgitation and laryngeal and pulmonary aspiration during swallowing, is
e) [ ] May occur in hysteria, rabies, tetanus, and pharyngeal paralysis due to fear of aspiration
4
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24. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does phagophobia means?
normally
performed
d) [x] Fear of swallowing
e) [ ] The subjective feeling of a need to vomit
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25. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does refusal to swallow means?
a) [ ] Occuring in disorders of the voluntary phase of swallowing, once initiated, swallowing is
completed normally
performed
d) [ ] Painful swallowing
e) [x] May occur in hysteria, rabies, tetanus, and pharyngeal paralysis due to fear of aspiration
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26. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does nausea means?
a) [x] Subjective feeling of a need to vomit
b) [ ] Effortless passage of gastric contents into the mouth
c) [ ] Repeated regurgitation of stomach contents, which may be rechewed and reswallowed
d) [ ] Oral expulsion of gastrointestinal contents resulting from contractions of gut and thoracoabdominal
wall musculature
e) [ ] Postprandial fullness and early satiety
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27. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does vomiting means?
a) [ ] Subjective feeling of a need to vomit
d) [x] Oral expulsion of gastrointestinal contents resulting from contractions of gut and thoracoabdominal
wall musculature
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28. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does regurgitation means?
b) [x] Effortless passage of gastric contents into the mouth
wall musculature
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29. Capitol: Esofag Mod de punctare: A1 Punctajul: 10What does rumination means?
c) [x] Repeated regurgitation of stomach contents, which may be rechewed and reswallowed
wall musculature
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30. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Select is the most common cause of upper
gastrointestinal bleeding:
a) [x] Peptic ulcers
b) [ ] Mallory-Weiss syndrome
c) [ ] Esophageal varices
d) [ ] Erosive gastropathy
e) [ ] Hemorrhagic gastropathy
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31. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Select the drug which is the most effective
and commonly used in GERD:
a) [x] PPIs
b) [ ] H2-blokers
c) [ ] Antacids
d) [ ] Prokinetiks
e) [ ] Calcium channel blockers
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32. Capitol: Esofag Mod de punctare: A1 Punctajul: 10Indicate the rate of cancer development in
long-segment Barrett's esophagus:
a) [x] 0.5% per year
b) [ ] 10% per year
c) [ ] 50% per year
d) [ ] 50% during 5 years
e) [ ] 85% during 10 years
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33. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the most common symptom of
Mallory-Weiss syndrome:
a) [x] Hemathemesis and melena
b) [ ] Vomiting
c) [ ] Regurgitation
d) [ ] Dysphagia
e) [ ] Odynophagia
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34. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate are the most important causes of
peptic ulcer disease?
a) [ ] Anticoagulants and glucocorticoids
b) [ ] Heart failure and chronic pancreatitis
c) [x] Helicobacter pylori infection and non-steroid antiinflammatory drugs
d) [ ] Non-steroid anti-inflammatory drugs and stress related mucosal damage
e) [ ] Smoking and alcohol drinking
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35. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the most common complication of
peptic ulcer disease:
a) [x] Gastrointestinal bleeding
b) [ ] Perforation
c) [ ] Penetration
d) [ ] Malignization
e) [ ] Gastric outlet obstruction
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36. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10What does nausea means?
6
a) [x] The subjective feeling of a need to vomit
b) [ ] The oral expulsion of gastrointestinal contents resulting from contractions of gut and
thoracoabdominal wall musculature
c) [ ] The effortless passage of gastric contents into the mouth
d) [ ] A nonspecific term that encompasses a variety of upper abdominal complaints including nausea,
vomiting, heartburn, regurgitation, and dyspepsia (the presence of symptoms thought to originate in the
gastroduodenal region)
e) [ ] Characterized by burning retrosternal discomfort that may move up and down the chest like a wave
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37. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the characteristic of heartburn or
pyrosis:
a) [ ] The subjective feeling of a need to vomit
e) [x] Characterized by burning retrosternal discomfort that may move up and down the chest like a wave
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38. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10What does indigestion means?
d) [x] A nonspecific term that encompasses a variety of upper abdominal complaints including nausea,
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39. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the characteristic of regurgitation:
c) [x] The effortless passage of gastric contents into the mouth
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40. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10 Select what does vomiting means?
b) [x] The oral expulsion of gastrointestinal contents resulting from contractions of gut and
d) [ ] A nonspecific term that encompasses a variety of upper abdominal complaints including
nausea,vomiting, heartburn, regurgitation, and dyspepsia (the presence of symptoms thought to originate
in the gastroduodenal region)
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41. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10What does rumination means?
7
a) [x] The repeated regurgitation of stomach contents, which may be rechewed and reswallowed
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42. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate in which case can be used the term
gastritis:
a) [x] Histologically documented inflammation of the gastric mucosa
b) [ ] Mucosal erythema seen during endoscopy
c) [ ] Dyspepsia
d) [ ] Epigastric pain
e) [ ] Nausea and vomiting
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43. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the symptom complex associated
with peptic duodenal ulcer disease:
a) [x] Burning epigastric pain exacerbated by fasting and improved with meals
b) [ ] Nausea and vomiting
c) [ ] Odynophagia
d) [ ] Heartburn
e) [ ] Flatulence
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44. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the mechanism of transmission of
H. pylori from person to person:
a) [x] Oral-oral or fecal-oral route
b) [ ] Parenteral route
c) [ ] Vertical transmission
d) [ ] Respiratory route
e) [ ] Direct contact
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45. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the specific chronic disorder that
have NOT been strong associated with Peptic Ulcer Disease:
a) [ ] Systemic mastocytosis
b) [x] Rheumatoid artritis
c) [ ] Chronic pulmonary disease and chronic renal failure
d) [ ] Cirrhosis and nephrolithiasis
e) [ ] Alfa1-antitrypsin deficiency
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46. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the scheme of a first-line
Helicobacter pylori eradication regimen (by V Maastriht Consensus) for patients who present allergy for
peniciline:
a) [ ] Pantoprazole 40 mg/day+ Metronidazole 1500 mg/day+ Furazolidone 400 mg/day, 5 days
b) [ ] Omeprazole 80 mg/day+ Ciprofluoxacine 1000 mg/day+ Amoxyciline 2000 mg/day, 7 days
c) [ ] Esomeprazole 40 mg/day+ Tetracycline 2000mg/day+ Metronidazole 1500 mg day, 7 day
d) [x] Esomeprazole 80 mg/day+ Bismuth subcitrate 480mg/day + Metronidazole 1000 mg/day +
Tetraciclin 1000 mg/day, 14 days
e) [ ] Omeprazole 40 mg/day+ Ofloxacin 400 mg/day, Metronidazole 1000 mg/day, 5 days
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47. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the most important causes of peptic
ulcer disease:
a) [ ] Anticoagulants and glucocorticoids
b) [ ] Heart failure and chronic pancreatitis
c) [x] Helicobacter pylori infection and non-steroid antiinflammatory drugs
d) [ ] Non-steroid anti-inflammatory drugs and stress related mucosal damage
e) [ ] Smoking and alcohol drinking
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48. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the most common complication of
a) [x] Gastrointestinal bleeding
b) [ ] Perforation
c) [ ] Gastric outlet obstruction
d) [ ] Penetration
e) [ ] Malignancy
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49. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Complications seen after surgery for peptic
ulcer disease does NOT include:
a) [ ] Afferent loop syndromes
b) [ ] Dumping syndrome
c) [ ] Postvagotomy diarrhea
d) [ ] Maldigestion and malabsorption
e) [x] Zollinger-Ellison syndrome
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50. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Which of the following conditions increase
the risk of gastric adenocarcinoma in patients with a gastric ulcer?
a) [ ] Smaller size (diameter<1.0 cm)
b) [x] Intestinal metaplasia
c) [ ] Nodular folds in the adjacent mucosa that radiate to the edge of the ulcer
d) [ ] Simultaneous occurrence of a duodenal ulcer
e) [ ] Pylorie localization
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51. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Treatment of Helicobacter pylori infection
should lead to improvement in all of the following conditions EXCEPT:
a) [ ] Gastric and duodenal ulcer
b) [ ] Gastric and duodenal inflammation
c) [ ] Gastric adenocarcinoma
d) [ ] Gastric B-cell lymphoma/mucosa-associated lymphoid tissue (MALT) lymphoma
e) [x] GERD
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52. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10The accuracy of C13 urea breath test for the
presence of H. Pylori can be compromised by all of the following EXCEPT:
a) [ ] Recent use of PPI
b) [ ] Recent use of antibiotics
c) [ ] Prior partial gastrectomy
d) [x] Recent use of H2-receptor antagonist
e) [ ] Small numbers of organisms in the stomach
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53. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Testing to confirm eradication of H. pylori
would include all of the following EXCEPT:
a) [x] Serological test
9
b) [ ] Endoscopy with biopsy for rapid urease testing
c) [ ] Endoscopy and biopsy for histologic examination
d) [ ] Stool antigen test
e) [ ] Urea breath test
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54. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Classification system of gastritis include all,
EXCEPT:
a) [ ] Sydnei Classifictaion (1990)
b) [ ] Baylor Classification
c) [ ] OLGA Classification
d) [x] Los Angelas Classification
e) [ ] Houston Update of Sydnei Classifictaion (1994)
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55. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Which of the methods can be done in
follow-up of gastric ulcer for the risk of developing gastric cancer?
a) [ ] Endoscopy without biopsy
b) [x] Endoscopy with biopsy
c) [ ] Manometry of low esophageal sphincter
d) [ ] Radiology examination of the stomach
e) [ ] 24 hour pH-metry
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56. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the type of gastritis that has an
increased risk for development of gastric cancer?
a) [x] Chronic atrophic gastritis with intestinal metaplasia
b) [ ] Lymphocytic gastritis
c) [ ] Granulomatous gastritis
d) [ ] Hemorrhagic gastritis
e) [ ] Stress-induced gastritis
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57. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Which of the following statements
concerning portal- hypertensive gastropathy is FALSE:
a) [ ] It occurs in patients with cirrhosis and portal hypertension
b) [ ] It can manifest as severe digestive bleeding
c) [x] Always requires biopsy for diagnosis
d) [ ] The lesions are caused by nitric oxide
e) [ ] Itrequire streatment by propranolol
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58. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the part of the world where has
been more commonly reported the Lymphocytic gastritis:
a) [ ] North America
b) [ ] South America
c) [ ] Africa
d) [x] Europe
e) [ ] Asia
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59. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Select the most frequent complication of H
pylori gastritis:
a) [x] MALT lymphoma
b) [ ] Pernicious anemia
c) [ ] Sarcoidosis
d) [ ] Autoimmune gastritis
10
e) [ ] Eosinophilic gastroenteritis
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60. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the diagnostic method that can
confirmed the chronic gastritis:
a) [x] By endoscopy and histology
b) [ ] By endoscopy and in clinical context
c) [ ] By endoscopy only
d) [ ] By clinical context only
e) [ ] It is a diagnosis of exclusion in patients with dyspepsia
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61. Capitol: Gastrita Mod de punctare: A1 Punctajul: 10Indicate the scheme of a first-line
Helicobacter pylori eradication regimen (by V Maastriht Consensus) for patients who were exposed for
macrolides:
a) [ ] Pantoprazole 40 mg/day+ Metronidazole 1500 mg/day+ Furazolidone 400 mg/day, 5 days
b) [ ] Omeprazole 80 mg/day+ Ciprofluoxacine 1000 mg/day+ Amoxyciline 2000 mg/day, 7 days
c) [ ] Esomeprazole 80 mg/day+ Tetracycline 2000mg/day+ Metronidazole 1500 mg day, 7 day
d) [ ] Esomeprazole 80 mg/day+ Claritromicyne 1000 mg/day+ Amoxyciline 2000 mg/day, 10 days
e) [x] Omeprazole 40 mg/day+ Bismuth subcitrate 480mg/day + Metronidazole 1000 mg/day +
Tetraciclin 1000 mg/day, 14 days
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62. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the correct statement about irritable
bowel syndrome:
a) [ ] Affects up to 50% of adults
b) [ ] Prevalence is equally in men and women
c) [ ] Is of viral etiology
d) [x] Is characterized by abdominal pain and altered bowel habits
e) [ ] Is characterized by fever
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63. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the feature which is NOT
caracteristic for diagnosis of irritable bowel syndrome:
a) [ ] Abdominal discomfort witch relieved by defecation
b) [ ] Bloating
c) [ ] Passage of mucus with the motion
d) [ ] Onset of symptoms following an episode of psychological stress
e) [x] Nocturnal diarrhea
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64. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the method which is NOT
recommended in diagnosis of irritable bowel syndrome:
a) [ ] Occult blood test
b) [ ] ROME IV criteria
c) [ ] CBC
d) [x] Capsule enteroscopy
e) [ ] Sigmoscopy
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65. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the marker of celiac disease:
a) [ ] Antinuclear antibodies (ANA)
b) [ ] Anti mitochondrial antibodies (AMA)
c) [ ] Perinuclear anti neutrophil cells antibodies (pANCA)
d) [x] Antiendomysial antibodies (EMA)
e) [ ] Anti smooth mussel antibodies (ASMA)
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66. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the UNCORRECT statement about
the mechanism of diarrhea in celiac disease:
a) [ ] May be secondary to fat malabsorption
b) [x] May be secondary to colitis
c) [ ] May be secondary to lactase deficiency
d) [ ] May be secondary to bile-acid malabsorption
e) [ ] May be secondary to endogenous fluid secretion resulting from crypt hyperplasia
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67. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the hallmark of diagnosis of celiac
disease:
a) [ ] Abnormal small intestinal biopsy
b) [ ] Severe malabsorption syndrome
c) [x] Reverts of histological changes following a gluten-free diet
d) [ ] Presence of antimitocondrial antibody
e) [ ] Presence of antigliadin antibody
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68. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the complication NOT characteristic
for celiac disease:
a) [ ] Intestinal cancer
b) [ ] Intestinal ulceration
c) [x] Collagenous colitis
d) [ ] Perforation
e) [ ] Gastrointestinal hemorrhage
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69. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the affirmation about Crohn's
disease which is NOT correct:
a) [ ] Is a transmural inflammation
b) [ ] Can affect any part of the gastrointestinal tract
c) [ ] Is characteristic "cobblestone" sign
d) [ ] Is characteristic fistula formation
e) [x] Is a superficial inflammation
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70. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the correct answer about the volume
of gastrointestinal tract affectation in Crohn's disease:
a) [ ] Only colon
b) [ ] Only esophagus
c) [x] Any part of the gastrointestinal tract
d) [ ] Only small intestine
e) [ ] Only stomach
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71. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the endoscopic lesions NOT
characteristic for Crohn's disease:
a) [ ] Deep longitudinal ulcers
b) [ ] "Cobblestone" pattern
c) [ ] Aphtous ulcers
d) [ ] Skip lesions with areas of healthy mucosa between
e) [x] Superficial transversal ulcers
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72. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the sign of easy degree of
malabsorption:
a) [ ] Weight loss >15%
12
b) [ ] Muscle weakness
c) [ ] Edema
d) [ ] Dermatitis
e) [x] Anemia
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73. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the most common localization of
Crohn's disease:
a) [ ] Colon alone
b) [x] Ileocolonic
c) [ ] Upper segment of gastrointestinal tract
d) [ ] Lower segment of gastrointestinal tract
e) [ ] Gastric
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74. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the primary function of the small
intestine:
a) [x] The digestion and assimilation of nutrients from the food
b) [ ] Regulation of water and electrolytes secretion
c) [ ] The storage of intraluminal contents
d) [ ] The salvage of some nutrients after bacterial metabolism of carbohydrate
e) [ ] Regulation the absorption of water and electrolytes
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75. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select correct statement. Irritable bowel
syndrome is:
a) [x] Functional bowel disorder
b) [ ] Dystrophic bowel disorder
c) [ ] Inflammatory bowel disorder
d) [ ] Bowel disorders caused by bacterial overgrowth
e) [ ] Bowel disorders caused by infection
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76. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the mainstay of therapy for mild to
moderate ulcerative colitis:
a) [x] Sulfasalazine and 5-ASA agents
b) [ ] Corticosteroids
c) [ ] Azathioprine
d) [ ] Methotrexate
e) [ ] Infliximab
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77. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the main sign of ulcerative colitis:
a) [ ] Transmural inflammation
b) [x] Continuous inflammation of colon
c) [ ] "Cobblestone" pattern
d) [ ] Granuloma on biopsy
e) [ ] Skip inflammation of colon
---------------------------------------------------------------------
78. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the endoscopic lesions characteristic
for ulcerative colitis:
a) [ ] Deep transversal ulcers
b) [ ] Stenosis
c) [ ] Deep longitudinal ulcers
d) [x] Continuous lesions of mucosa
e) [ ] Fistulas
13
---------------------------------------------------------------------
79. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the etiology of inflammatory bowel
diseases:
a) [ ] Viral
b) [ ] Bacterial
c) [ ] Toxic
d) [x] Unknown
e) [ ] Parasitic
---------------------------------------------------------------------
80. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the most often pattern of ulcerative
colitis evolution:
a) [ ] Continuous progressive
b) [ ] With acute severe onset
c) [x] With rare relapses
d) [ ] Without spontaneous relapses
e) [ ] With severe general complication
---------------------------------------------------------------------
81. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the antibodies characteristic for
ulcerative colitis:
a) [ ] Antimitochondrial antibodies ( AMA)
b) [ ] Antinuclear antibodies (ANA)
c) [ ] Anti-smooth mussel antibodies (ASMA)
d) [x] Perinuclear antineutrophil cells antibodies (pANCA)
e) [ ] Anti liver-kidney microsome antibodies (LKM)
---------------------------------------------------------------------
82. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the basic medicine for maintenance
of remission in mild-moderate ulcerative colitis:
a) [x] Mesalasine
b) [ ] Azathioprine
c) [ ] 6-mercaptopurine
d) [ ] Infliximab
e) [ ] Corticosteroids
---------------------------------------------------------------------
83. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the medicine for maintenance of
remission in severe ulcerative colitis:
a) [ ] Mesalasine
b) [x] Azathioprine
c) [ ] Systemic corticosteroids
d) [ ] Antibiotics
e) [ ] Probiotics
---------------------------------------------------------------------
84. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the most common gastrointestinal
disorders in the general practice:
a) [ ] Gastric and duodenal ulcers
b) [ ] Liver diseases
c) [ ] Pancreatitis
d) [x] Functional gastrointestinal disorders
e) [ ] Inflammatory bowel diseases
---------------------------------------------------------------------
85. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the organic or metabolic cause of
functional dyspepsia:
14
a) [ ] Pancreatic disease
b) [ ] Liver disease
c) [ ] Medication use
d) [x] No one
e) [ ] Diabetes mellitus
---------------------------------------------------------------------
86. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Chose the classes of drugs NOT used in
inflammatory bowel disease:
a) [ ] Local corticosteroids
b) [ ] Systemic corticosteroids
c) [ ] Immunosuppressive agents
d) [ ] Biologic agents
e) [x] Nonsteroidal antiinflammatory drugs
---------------------------------------------------------------------
87. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select NON correct statement about normal
stool in developed countries:
a) [ ] Weight of stool of an adult human is less than 200 g/d
b) [x] Weight of stool of an adult human is more than 300 g/d
c) [ ] Stool water accounts for 60 to 85% of the weight
d) [ ] Normal bowel frequency may be three times a week
e) [ ] Normal bowel frequency may be three times a day
---------------------------------------------------------------------
88. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the correct definition of
pseudodiarrhea:
a) [x] Is an increased frequency of defecation without an increase in stool weight above normal
b) [ ] Is an increased weight of stool without an increase frequency of defecation
c) [ ] Is formally defined as an increase in daily stool weight above 200 g
d) [ ] Is formally defined as an abnormal increase in stool liquidity and frequency (>3 daily)
e) [ ] Is the involuntary release of rectal contents
---------------------------------------------------------------------
89. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the correct definition of fecal
incontinence:
a) [ ] Is an increased frequency of defecation
b) [ ] Is an increased weight of stool
c) [ ] Is an increased rectal elimination of mucus
d) [ ] Is an increased stool liquidity and frequency
e) [x] Is the involuntary release of rectal contents
---------------------------------------------------------------------
90. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the correct duration for definition of
chronic diarrhea:
a) [ ] More than 7 days
b) [ ] 2-4 weeks
c) [x] More than 4 weeks
d) [ ] More than 3 months
e) [ ] More than 6 months
---------------------------------------------------------------------
91. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the most often etiology of acute
diarrhea:
a) [x] Infectious agents
b) [ ] Toxins ingestions
c) [ ] Nonsteroidal antiinflammatory drugs
15
d) [ ] Antibiotics
e) [ ] Laxatives
---------------------------------------------------------------------
92. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the most often disease, which
evaluated with chronic diarrhea:
a) [ ] Ulcerative colitis
b) [ ] Inflammatory bowel disease
c) [ ] Crohn's disease
d) [ ] Bacterial overgrowth syndrome
e) [x] Irritable bowel syndrome
---------------------------------------------------------------------
93. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the mainstay treatment in acute
diarrhea:
a) [x] Fluid and electrolyte replacement
b) [ ] Strong diet recommendations
c) [ ] Antidiarrheal agents
d) [ ] Antibiotics
e) [ ] Antiinflammatory drugs
---------------------------------------------------------------------
94. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the classical examples of disease
with osmotic diarrhea:
a) [ ] Ulcerative colitis
b) [ ] Crohn's disease
c) [ ] Radiation enterocolitis
d) [ ] Microscopic colitis
e) [x] Celiac disease
---------------------------------------------------------------------
95. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the classical examples of disease
with secretory diarrhea:
a) [ ] Celiac disease
b) [ ] Lactase deficiency
c) [ ] Short bowel syndrome
d) [ ] Ulcerative colitis
e) [x] Cholera
---------------------------------------------------------------------
96. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the classical examples of disease with
inflammatory diarrhea:
a) [ ] Celiac disease
b) [ ] Short bowel syndrome
c) [ ] Cholera
d) [ ] Chronic pancreatitis with pancreatic insufficiency
e) [x] Crohn's disease
---------------------------------------------------------------------
97. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the typical skin / mucosal
manifestation in celiac disease:
a) [ ] Erythema nodosum
b) [ ] Aphthous ulcerative stomatitis
c) [ ] Pyoderma gangrenosum
d) [ ] Livedo reticularis
e) [x] Dermatitis herpetiformis
---------------------------------------------------------------------
16
98. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Choose the hallmark of Whipple's disease
diagnosis:
a) [ ] Triad of symptoms: abdominal pain, fever, weight loss
b) [ ] Triad of symptoms: diarrhea, abdominal pain, weight loss
c) [ ] Triad of symptoms: abdominal pain, weight loss, arthritis
d) [ ] Granuloma on light microscopy (intestinal tissue)
e) [x] PAS-positive inclusions on light microscopy (duodenal, jejunal tissue)
---------------------------------------------------------------------
99. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Indicate the drugs recommended in
refractory celiac sprue:
a) [ ] 5-aminosalicylates
b) [ ] Selective smooth-muscle antispasmodics
d) [ ] Ursodeoxycholic and choledeoxycholic acids
e) [x] Corticosteroids
---------------------------------------------------------------------
100. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the duration of antibacterial
treatment in Whipple's disease:
a) [ ] During the relapse
b) [ ] Life-long maintenance treatment
c) [ ] Not less than 3 months
d) [ ] 3-4 weeks
e) [x] One to two years
---------------------------------------------------------------------
101. Capitol: Intestin Mod de punctare: A1 Punctajul: 10Select the most often cause of dyspepsia:
a) [ ] Chronic gastritis
b) [ ] Duodenal ulcer
c) [ ] Gastric ulcer
d) [ ] Gastric cancer
e) [x] Functional dyspepsia
---------------------------------------------------------------------
102. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10The following biological and clinical
parameters are prognostic indicators in acute alcoholic hepatitis, EXCEPT:
a) [ ] Encephalopathy
b) [ ] Ascites
c) [ ] Severe jaundice
d) [x] Age
e) [ ] Hepatorenal syndrome
---------------------------------------------------------------------
103. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What type of autoantibody is characteristic
for patients with primary biliary colangitis?
a) [ ] Anti liver-kidney microsomes antibodies
b) [x] Antimitochondrial antibodies
c) [ ] Antinuclear antibodies
d) [ ] Anti-smooth-muscle antibodies
e) [ ] Soluble liver antigen
---------------------------------------------------------------------
104. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following is the most
common cause of liver cirrhosis?
a) [x] Alcohol
b) [ ] Drugs
17
c) [ ] Autoimmune hepatitis
d) [ ] 1-antitrypsin deficiency
e) [ ] Nonalcoholic steatohepatitis
---------------------------------------------------------------------
105. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10High (>1.1 g/dL) serum-ascites albumin
gradient is consistent with all of the following diagnoses, EXCEPT:
a) [ ] Cirrhosis
b) [ ] Congestive heart failure
c) [ ] Constrictive pericarditis
d) [ ] Hepatic vein thrombosis
e) [x] Nephrotic syndrome
---------------------------------------------------------------------
106. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the most common cause of cirrhosis:
a) [ ] Autoimmune hepatitis
b) [ ] Primary biliary cirrhosis
c) [x] Chronic viral hepatitis
d) [ ] Suprahepatic vein thrombosis
e) [ ] Secondary biliary cirrhosis
---------------------------------------------------------------------
107. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the upper endoscopy sign that is
characteristic for cirrhosis:
a) [ ] Expansion of the portal vein
b) [ ] Splenomegaly
c) [ ] Portal thrombosis
d) [x] Esophageal varices
e) [ ] Reversal of portal flow
---------------------------------------------------------------------
108. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following clinical signs of
cirrhosis is caused by portal hypertension?
a) [ ] Spider angiomata
b) [ ] Clubbing
c) [ ] Jaundice
d) [ ] Palmar erythema
e) [x] Ascites
---------------------------------------------------------------------
109. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is TRUE about Child-Pugh score:
a) [x] It is used to assess the severity of cirrhosis
b) [ ] The severity of cirrhosis increases inversely proportional to the amount of lead
c) [ ] it is used to assess the severity of pancreatitis
d) [ ] Diameter of the portal vein is one of the parameters used to calculate the score
e) [ ] Small esophageal varices increased score value by 3 points
---------------------------------------------------------------------
110. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select FALSE statement about spontaneous
bacterial peritonitis:
a) [ ] It has a risk of hepatorenal syndrome
b) [ ] Carry albumin infusion on days one and three
c) [x] It has a mortality of 10% in the short and medium term
d) [ ] The diagnosis is based on neutrophil counts in the ascitic liquid
e) [ ] Cefotaxime is the first choice of treatment
---------------------------------------------------------------------
111. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Selected manifestation of portal
18
hypertension in cirrhosis.
a) [ ] Asterixis
b) [ ] Clubbing
c) [x] Wedged hepatic venous pressure (WHVP)is >/= 6mmHg
d) [ ] Palmar erythema
e) [ ] Stellar angiomas
---------------------------------------------------------------------
112. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Treatment of ascites in alcoholic liver
cirrhosis NOT include:
a) [x] Acetaminophen
b) [ ] Cessation of alcohol
c) [ ] Furosemide in progressive dose
d) [ ] Low-salt diet
e) [ ] Albumin infusion on day 1 and 3
---------------------------------------------------------------------
113. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Unfavorable prognosis of alcoholic
hepatitis is associated with the following changes EXCEPT:
a) [ ] Increased prothrombin time ≥ 5 sec
b) [ ] Marked hyperbilirubinemia (>137 mmol/l)
c) [x] Serum albumin more than 3.5 g/dl
d) [ ] Discriminant function (Madrey) > 32
e) [ ] Ascites and encephalopathy
---------------------------------------------------------------------
114. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following statements supports
a favorable prognosis in liver cirrhosis?
a) [ ] Presence of ascites
b) [ ] Presence of encephalopathy
c) [x] Serum albumin more than 3.5 g / dl
d) [ ] Serum bilirubin more than 3 mg / dL
e) [ ] Prothrombin activity below 40%
---------------------------------------------------------------------
115. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the factor that can precipitate hepatic
encephalopathy:
a) [ ] Low protein diet
b) [ ] High carbohydrate diet
c) [x] High protein diet
d) [ ] Fruits diet
e) [ ] High lipid diet
---------------------------------------------------------------------
116. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following antibiotics will be
most usefull in hepatic encephalopathy:
a) [ ] Imipenem (500mg) 2 x lflac/day for 1 week
b) [ ] Claritromycine 2 x 500mg/day for 1 week
c) [ ] Doxicilline 500mg/day 72hours
d) [x] Rifaximine (200mg) 3x2 tb/day for 1 week
e) [ ] Cefuroxyme (500mg) 2 x 1 tb/day for 1 week
---------------------------------------------------------------------
117. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10In the treatment of hepatic encephalopathy
are used the following drugs, EXCEPT:
a) [ ] Neomycin
b) [ ] Lactulose
19
c) [ ] Metronidazole
d) [ ] Rifaximin
e) [x] Benzodiazepine
---------------------------------------------------------------------
118. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is the minimum amount of daily
alcohol intake for women, that is associated with the development of chronic liver disease?
a) [ ] 1 drink
b) [x] 2 drinks
c) [ ] 3 drinks
d) [ ] 6 drinks
e) [ ] 12 drinks
---------------------------------------------------------------------
119. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10A 42-year-old man with cirrhosis related to
hepatitis C and alcohol abuse has ascites requiring frequent large-volume paracentesis. All of the
following therapies would be indicated for this patient EXCEPT:
a) [x] Fluid restriction to less than 2 L daily
b) [ ] Furosemide 40 mg daily
c) [ ] Sodium restriction to less than 2 g daily
d) [ ] Spironolactone 200 mg daily
e) [ ] Transjugular intrahepatic portosystemic shunt if medical therapy fails
---------------------------------------------------------------------
120. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following statements about
cardiac cirrhosis is TRUE?
a) [x] AST and ALT levels may mimic the very high levels seen in acute viral hepatitis
b) [ ] Budd-Chiari syndrome cannot be distinguished clinically from cardiac cirrhosis
c) [ ] Echocardiography is the gold standard for diagnosing constrictive pericarditis as a cause of
cirrhosis
d) [ ] Prolonged passive congestion from right-sided heart failure results first in congestion and necrosis
of portal triads, resulting in subsequent fibrosis
e) [ ] Venoocclusive disease can be confused with cardiac cirrhosis and is a major cause of morbidity and
mortality in patients undergoing liver transplantation
---------------------------------------------------------------------
121. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following statements
regarding liver transplantation is TRUE?
a) [ ] Individuals with cholangiocarcinoma should be referred early for consideration of liver
transplantation
b) [ ] Living donor transplantation is only performed in children
c) [x] Reinfection with hepatitis B typically occurs in 35% or more of patients with liver transplantation
d) [ ] The 5-year survival rate for orthotopic liver transplantation is about 50%
e) [ ] The most common indication for liver transplantation is chronic hepatitis B infection
---------------------------------------------------------------------
122. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following affirmation about
Wilson's disease is NOT correct?
a) [ ] It is an inherited disorder of copper homeostasis
b) [ ] Presence of Kayser-Fleischer rings in the cornea of the eyes
c) [x] In patients with mutations in ATP7B, copper is decreased in the liver
d) [ ] Serum ceruloplasmin level is reduced
e) [ ] Urinary excretion of copper is increased
---------------------------------------------------------------------
123. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Treatment of Wilson's disease NOT
include:
20
a) [ ] D-penicillamine
b) [x] Prednisone
c) [ ] Trientine
d) [ ] Copper chelating medications
e) [ ] Zinc
---------------------------------------------------------------------
124. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is the mainstay of therapy for
hemochromatosis?
a) [ ] Glucocorticoids
b) [ ] Azathioprine and 6-mercaptopurine
c) [x] Phlebotomy
d) [ ] Methotrexate
e) [ ] Infliximab
---------------------------------------------------------------------
125. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following statements is NOT
true about spontaneous bacterial peritonitis (SBP)?
a) [ ] Is characterized by spontaneous infection of the ascetic fluid
b) [ ] Bacterial translocation is the presumed mechanism for development of SBP
c) [ ] The most common organisms are Escherichia coli
d) [x] The diagnosis of SBP is made when the fluid sample has an absolute neutrophil count < 250/mm3
e) [ ] Treatment is with a second-generation cephalosporin
---------------------------------------------------------------------
126. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following statements is NOT
true about spontaneous bacterial peritonitis (SBP)?
a) [ ] Bacterial translocation is the presumed mechanism for development of SBP
b) [ ] If more than two organisms are identified, secondary bacterial peritonitis should be considered
c) [x] The most common organisms are Staphilococcus aureus
d) [ ] The diagnosis of SBP is made when the fluid sample has an absolute neutrophil count >250/mm3
e) [ ] Treatment is with a second-generation cephalosporin
---------------------------------------------------------------------
127. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10How do you define sustained viral respond
of hepatitis C?
a) [ ] The normalization of transaminases
b) [ ] The disappearance of anti-HCV
c) [x] Undetectable HCV RNA 6 months after the end of treatment
d) [ ] HCV RNA undetectable at end of treatment
e) [ ] Normalization of liver histology
---------------------------------------------------------------------
128. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10About hepatitis D (delta) virus is TRUE,
EXCEPT:
a) [ ] Is an RNA virus
b) [ ] Defective - depends on hepatitis B virus (HBV) virus for its replication
c) [ ] Causes a severe infection with accelerated evolution towards cirrhosis
d) [ ] Lacks effective treatment
e) [x] Is on DNA virus
---------------------------------------------------------------------
129. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Treatment of chronic hepatitis B virus
infection is indicated in case of, EXCEPT:
a) [ ] HBV DNA > 2000 Ul/ml
b) [ ] ALT > 1.5-2 x ULN (upper limit of normal)
c) [ ] At least moderate inflammatory activity
21
d) [ ] Liver fibrosis F3
e) [x] Occult infection phase
---------------------------------------------------------------------
130. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is the most frequent mode of
transmission HBV:
a) [ ] Parenteral
b) [x] Sexual
c) [ ] Perinatal
d) [ ] Permucosa
e) [ ] Habitual
---------------------------------------------------------------------
131. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10How many genotypes from HBV do now
exist?
a) [ ] 8
b) [x] 9
c) [ ] 7
d) [ ] 6
e) [ ] 5
---------------------------------------------------------------------
132. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Selectthe most efficient transmission route
of hepatitis C virus is:
a) [ ] Perinatal
b) [ ] Sexual exposure
c) [x] Intravenous drug use
d) [ ] Accidental exposure
e) [ ] Permucosal
---------------------------------------------------------------------
133. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10How many genotypes from HCV do exist
now?
a) [ ] 5
b) [ ] 6
c) [x] 7
d) [ ] 8
e) [ ] 9
---------------------------------------------------------------------
134. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the most commonrisk population
forHDV infection:
a) [ ] In children
b) [x] In adults
c) [ ] In pregnancy
d) [ ] In men
e) [ ] In female
---------------------------------------------------------------------
135. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select with what conditions is
associatedBEA - score = 2 points in hepatitis D:
a) [ ] Severe course of liver disease
b) [x] Excellent 5-10 year course
c) [ ] Developed liver-related complications within 5-7 years of follow-up
d) [ ] Hepatocellular carcinoma
e) [ ] Hepatic failure
---------------------------------------------------------------------
22
136. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select with what condition is associated
BEA- score > 5 points in hepatitis delta:
a) [ ] Mild course of liver disease
b) [ ] Excellent 5-10 year course
c) [ ] Not developed liver cirrhosis within 10 years
d) [x] Developed liver-related complications within 5-7 years of follow-up
e) [ ] Minimal liver fibrosis
---------------------------------------------------------------------
137. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What type of investigation is often used as
an initial investigation for patients with jaundice:
a) [x] Ultrasound
b) [ ] Computed tomography
c) [ ] Endoscopic retrograde cholangiopancreatography
d) [ ] Endoscopic ultrasound
e) [ ] Magnetic resonance cholangiopancreatography
---------------------------------------------------------------------
138. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What type of antibodies is possible to find
in hepatitis delta:
a) [ ] Anti liver-kidney microsomes 1 antibodies
b) [x] Anti liver-kidney microsomes 3 antibodies (LKM3)
c) [ ] Antinuclear antibodies
d) [ ] Anti-smooth-muscle antibodies
e) [ ] Soluble liver antigen
---------------------------------------------------------------------
139. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the most common symptom for
chronic hepatitis C:
a) [x] Fatigue
b) [ ] Jaundice
c) [ ] Sjogren's syndrome
d) [ ] Lichen planus
e) [ ] Porphyria cutanea tarda
---------------------------------------------------------------------
140. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10The direct antivirals drugs (so-called
specifically targeted antiviral therapy) in hepatitis C, is NOT including:
a) [ ] Polymerase inhibitors
b) [ ] Protease inhibitors
c) [ ] Nucleoside analogues
d) [ ] Guanosine analogue
e) [x] Interferon
---------------------------------------------------------------------
141. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is the weight of the liver in adult
person:
a) [ ] 2.0 to 2.5 kg
b) [x] 1.0 to 1.5 kg
c) [ ] 1.6 to 1.8 kg
d) [ ] 1.8 to 2.0 kg
e) [ ] 0.5 to 1.0 kg
---------------------------------------------------------------------
142. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Hepatocytes perform following functions,
EXCEPT:
a) [ ] Synthesis of most essential protein
23
b) [ ] Production of bile and its carriers
c) [ ] Regulation of nutrients (glucose, lipids, cholesterol)
d) [x] White blood synthesis
e) [ ] Metabolism end conjugation of lipophylic compounds
---------------------------------------------------------------------
143. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Liver diseases include, EXCEPT:
a) [ ] Wilson disease
b) [ ] Caroli disease
c) [ ] Jilbert syndrome
d) [ ] Budd-Chiari syndrome
e) [x] Reiter's syndrome
---------------------------------------------------------------------
144. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following liver disease can
NOT be prevented?
a) [ ] Hepatitis A
b) [ ] Hepatitis B
c) [ ] Alcoholic cirrhosis
d) [ ] Steatosis
e) [x] Wilson disease
---------------------------------------------------------------------
145. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Symptoms of liver diseases NOT include:
a) [ ] Pale itchy skin
b) [ ] Dark urine
c) [ ] Abdominal pain and swelling
d) [ ] Yellow eyes
e) [x] Periorbital edema
---------------------------------------------------------------------
146. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What symptoms are caracterisc for liver
disease?
a) [ ] Reddened skin, bloodshot eyes, frothy urine and weight gain
b) [x] Yellowed skin, yellowed whites of the eyes, dark urine and weight loss
c) [ ] Easily bruised skin, itchy eyes, scant urine and muscle wastage
d) [ ] Diarrhea or constipatition with abdominal pain
e) [ ] Heartbearn recurgitation with chest pain
---------------------------------------------------------------------
147. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What type of the cells is majority in the
liver?
a) [x] Hepatocytes
b) [ ] Kupffer cells (members of the reticuloendothelial system)
c) [ ] Stellate (Ito or fat-storing) cells
d) [ ] Endothelial cells
e) [ ] Bile ductular cells
---------------------------------------------------------------------
148. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Functions of hepatocytes include, EXEPT:
a) [ ] The synthesis of serum albumin
b) [ ] The production of bile and its carriers (bile acids, cholesterol, lecithin, phospholipids)
c) [ ] The regulation of nutrients (glucose, glycogen, lipids)
d) [ ] Metabolism and conjugation of bilirubin
e) [x] The synthesis of amylase
---------------------------------------------------------------------
149. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10 Select the characteristic of the HBeAg-
24
negative chronic hepatitis B:
a) [x] Chronic HBV infection with active virus replication, readily detectable HBV DNA but without
HBe Ag
b) [ ] Chronic HBV infection with nonactive virus replication, without HBe Ag
c) [ ] Chronic HBV infection in nonreplicative phase without HBe Ag
d) [ ] Chronic hepatitis B with high levels of HBV DNA and with HBe Ag and without antibody by HBe
Ag
e) [ ] Chronic HBV infection with HBsAg, antiHB core IgG, antiHBeAg and HBV DNA negative
---------------------------------------------------------------------
150. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which tests are including initial evaluation
for suspected hepatitis C?
a) [ ] Glucose, urea, prothrombin
b) [x] ARN HCV, ALT, AST
c) [ ] ALT, urea, creatinine
d) [ ] Total bilirubine, direct bilirubine, INR
e) [ ] Alkaline phosphatase, LDH, albumine
---------------------------------------------------------------------
151. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Choose the direct-acting antiviral agent
(DAA) for chronic HCV:
a) [ ] Entecavir
b) [x] Sofosbuvir
c) [ ] Lamivudina
d) [ ] Adefovir
e) [ ] Interferon
---------------------------------------------------------------------
152. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the most pronounced side effect of
ribavirin therapy in patients with chronic hepatitis C:
a) [x] Hemolysis
b) [ ] Ischemic event
c) [ ] Fever
d) [ ] Pneumonia
e) [ ] Toxic hepatitis
---------------------------------------------------------------------
153. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which of the following viral causes of
acute hepatitis is most likely to cause fulminant hepatitis in a pregnant woman?
a) [ ] Hepatitis A
b) [ ] Hepatitis B
c) [ ] Hepatitis C
d) [ ] Hepatitis D
e) [x] Hepatitis E
---------------------------------------------------------------------
154. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Indicate drug that has a direct toxic effect
on hepatocytes?
a) [x] Acetaminophen
b) [ ] Chlorpromazine
c) [ ] Halothane
d) [ ] Isoniazid
e) [ ] Rosuvastatin
---------------------------------------------------------------------
155. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which fluid can content the highest amount
of hepatitis virus B?
25
a) [x] Blood
b) [ ] Brest milk
c) [ ] Urine
d) [ ] Sweat
e) [ ] Tears
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156. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which fluids can content in moderate
amount hepatitis virus B?
a) [ ] Blood
b) [ ] Wound exudate
c) [x] Vaginal fluids
d) [ ] Sweat
e) [ ] Tears
---------------------------------------------------------------------
important goal of treating chronic viral hepatitis C?
a) [ ] Normalize AST and ALT
b) [ ] Improve symptoms
c) [ ] Reverse cirrhosis
d) [x] Eliminate the HCV RNA from the serum
e) [ ] Normalize prothrombin time
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158. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Select the factor associated with an
accelerated progression of hepatic fibrosis in 32-year old man with chronic hepatitis C?
a) [ ] Drinking 2 beers per week
b) [ ] Drinking 3 cups of coffee per day
c) [ ] Young age at hepatitis C acquisition
d) [x] Smoking marijuana 3 times per day
e) [ ] Body mass index of 22.5
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159. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Choose the most appropriate therapeutic
option for chronic hepatitis D:
a) [ ] Lamivudine once per day for 1 year
b) [ ] Ribavirin 100 mg per day for 1 year
c) [x] PegIntrferon for > 48 weeks
d) [ ] PegInterferon < 24 weeks
e) [ ] Sofosbuvir for 12 weeks
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160. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10All the following statements about viral
hepatitis are true, EXCEPT:
a) [ ] Hepatitis A and hepatitis E are transmitted primarily via the fecal-oral route
b) [x] An effective, killed vaccine is available for hepatitis C
c) [ ] Hepatitis A virus produces acute but not chronic hepatitis
d) [ ] Hepatitis D can only affect persons co-infected with hepatitis B
e) [ ] Hepatitis B can be prevented with vaccine
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161. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10What is the probability of an adult with
acute hepatitis B progressing to chronic hepattitis B?
a) [x] 3-5%
b) [ ] 90%
c) [ ] 50%
26
d) [ ] 70-80%
e) [ ] 100%
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162. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Elevations in all of the following laboratory
studies would be indicative of liver disease EXCEPT:
a) [ ] 5′-nucleotidase
b) [ ] Aspartate aminotransferase
c) [ ] Conjugated bilirubin
d) [x] D-xylose Test
e) [ ] Urine bilirubin
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common symptom of liver disease?
a) [x] Fatigue
b) [ ] Itching
c) [ ] Jaundice
d) [ ] Nausea
e) [ ] Right upper quadrant pain
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164. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10The hepatitis B virus can spread by all of
following mode, EXCEPT:
a) [ ] Having unprotected sex with an infected person
b) [x] Kissing, hugging, or sharing a toilet
c) [ ] Piercing or tattooing
d) [ ] From mother to baby during birth
e) [ ] Unsafe injection administration in healthcare settings
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165. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Who is not at-risk of hepatitis B?
a) [ ] Household contacts of infected persons
b) [ ] Injection and non-injection drug users
c) [ ] Health care workers
d) [x] Chemotherapy patients
e) [ ] Children born to HBV- mothers
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166. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Which treatment is the best to treat
hepatitis B in a 39-year-old woman with HBeAg-negative chronic hepatitis B (with diabetes and severe
depression in the past) and ALT levels > 3 times the upper limit normal?
a) [ ] Lamivudine
b) [ ] Pegylated Interferon
c) [x] Entecavir
d) [ ] Adefovir
e) [ ] Telbivudine
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167. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Indicate uncorrect statement regarding
management targets of NAFLD:
a) [ ] Lifestyle modification
b) [ ] Weight loos
c) [ ] Treatment of modifying the comorbid cardiovascular risk factors
d) [ ] Bariatric surgery indicate for morbid obesity
e) [x] Antioxidant do not have direct benefit for NAFLD
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27
168. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10How do you define sustained viral respond
of hepatitis C:
a) [ ] The normalization of transaminases
b) [ ] The disappearance of anti-HCV
c) [x] Undetectable HCV RNA 6 months after the end of treatment
d) [ ] HCV RNA undetectable at end of treatment
e) [ ] Normalization of liver histology
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169. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Treatment of chronic hepatitis B virus
infection is indicated in case of, EXCEPT:
a) [ ] HBV DNA > 2000 Ul/ml
b) [ ] ALT > 1.5-2 x ULN (upper limit of normal)
c) [ ] At least moderate inflammatory activity
d) [ ] Liver fibrosis F3
e) [x] Occult infection phase
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170. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10BEA- score in hepatitis D less than 2 points
is associated with:
a) [ ] Severe course of liver disease
b) [x] Excellent 5-10 year course
c) [ ] Developed liver-related complications within 5-7 years of follow-up
d) [ ] Hepatocellular carcinoma
e) [ ] Hepatic failure
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171. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10BEA- score in HDV more than 5 points
associated with:
a) [ ] Mild course of liver disease
b) [ ] Excellent 5-10 year course
c) [ ] Not developed liver cirrhosis within 10 years
d) [x] Developed liver-related complications within 5-7 years of follow-up
e) [ ] Minimal liver fibrosis
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172. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10The direct-acting antiviral agent (DAA) for
chronic HCV is:
a) [ ] Entecavir
b) [x] Sofosbuvir
c) [ ] Lamivudina
d) [ ] Adefovir
e) [ ] Interferon
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173. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10Indicate the set of results that most likely
can describe chronic hepatitis C in reactivation phase:
a) [ ] Increased level of amilase and bilirubine
b) [x] Presence of the antiHCV IgM and ARN HCV positive
c) [ ] Incresed value of bilirubine and prothrombine time
d) [ ] Trombocitopenia and anemia
e) [ ] Ascites and hepatic encephalopaty
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174. Capitol: Ficatul Mod de punctare: A1 Punctajul: 10The most appropriate therapeutic option for
chronic hepatitis D are:
a) [ ] Lamivudine once per day for 1 year
28
b) [ ] Ribavirin 100 mg per day for 1 year
c) [x] PegIntrferon for > 48 weeks
d) [ ] PegInterferon < 24 weeks
e) [ ] Sofosbuvir for 12 weeks
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175. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select correct symptoms for patient
with acute pancreatitis:
a) [ ] Has abdominal pain, pancreatic pain and serum lipids less than 3 times the normal value
b) [ ] Has back pain, history of chronic pancreatitis and serum lipopolysaccharides more than 3 times the
normal value
c) [ ] Has abdominal pain, serum lipase more than 3 times the normal value and normal pancreas on
abdominal CT scan
d) [x] Has abdominal pain, serum lipase more than 3 times the normal value and an enlarged and
edematous pancreas on CT scan
e) [ ] Has abdominal pain, salivary lipase increased more than 3 times the normal value and multiorgan
failure
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176. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Choose right manipulations from
biliary acute pancreatitis:
a) [ ] Requires corticosteroids
b) [ ] Occurs mainly after drinking
c) [ ] Occurs more frequently in overweight men
d) [x] May require endoscopic biliary drainage in case of associated angiocholitis
e) [ ] Occurs mostly in people with a history of cholecystectomy
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177. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select the best enzyme to measure for
the diagnosis of acute pancreatitis is:
a) [x] Value greater than three times normal of serum amylase and/or lipase
b) [ ] Urinary amylase
c) [ ] Amylase/creatinine clearance ratio
d) [ ] Serum trypsinogen
e) [ ] Serum elastase
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178. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate the right situation after
treatment of exocrine pancreatic insufficiency:
a) [ ] Involves the administration of liposoluble pancreatic enzymes
b) [ ] Involves the administration of enteric coated secretin
c) [ ] Sometimesinvolvesadministrationofglucagon
d) [ ] May lead to prolonged protrombin time
e) [x] May result in restores absorbtion of fat to an acceptable level and correctes steatorrea
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179. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select the most common cause of
clinically apparent chronic pancreatitis in adults:
a) [x] Alcoholism
b) [ ] Cystic fibrosis
c) [ ] Hereditary pancreatitis
d) [ ] Hypercalcemia
e) [ ] Pancreas divisum
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180. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate the most frequent cause of
clinically apparent chronic pancreatitis in children:
29
a) [ ] Alcoholism
b) [x] Cystic fibrosis
c) [ ] Hereditary pancreatitis
e) [ ] Pancreas divisum
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181. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicated the most widely used serum
marker in pancreatic cancer:
a) [x] Cancer-associated antigen 19-9 (CA 19-9)
b) [ ] Alfa-Fetoprotein (AFP)
c) [ ] Antinuclear antibody (ANA)
d) [ ] Anti liver-kidney microsom antibody (LKM)
e) [ ] Cancer-associated antigen 15-3
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182. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Selected the standard operation for
cancers of the head or uncinate process of the pancreas:
a) [ ] Billroth I procedure
b) [ ] Billroth II procedure
c) [x] Whipple procedure
d) [ ] Csende's procedure
e) [ ] Kelling-Madlener procedure
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183. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate the other vital hormone
secreted by the pancreas then insulin:
a) [x] Glucagon
b) [ ] Glycogen
c) [ ] Fructose
d) [ ] Sucrose
e) [ ] Amylase
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184. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Selected what cells produced insulin:
a) [ ] Bowman's capsule
b) [x] Islets of Langerhans
c) [ ] Nephrons
d) [ ] Glomeruli
e) [ ] Enterocromophine cells
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185. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate into what organ is secreted
pancreatic juice:
a) [ ] Esophagus
b) [ ] Stomach
c) [x] Duodenum
d) [ ] Ileum
e) [ ] None of the above
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186. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select the disease that may be provoked
by gallstones or alcohol abuse:
a) [ ] Cystitis
b) [ ] Pancreatic cancer
c) [x] Pancreatitis
d) [ ] Crohn disease
30
e) [ ] Caroli's disease
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187. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select a clinical form of chronic
pancreatitis with joudice, weight loss and hight level of IG G4:
a) [x] Chronic autoimmune pancreatitis type I
b) [ ] Chronic autoimmune pancreatitis type II
c) [ ] Tropical chronic pancreatitis
d) [ ] Heriditary pancreatitis
e) [ ] Alcoholic chronic pancreatitis
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188. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate the method to determine
steatorheea:
a) [x] Color of stool with Sudan III
b) [ ] Nitrogen(N) determination in stool
c) [ ] Pancreatography
d) [ ] With radioizotope investigation
e) [ ] Abdominal X-ray
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189. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Indicate which treatment can be
associated with pancreatic enzymes in correction of pancreatic insufficiecy:
a) [ ] Hypotesive drugs
b) [x] Antisecretion drugs
c) [ ] Antibiotics
d) [ ] Probiotics
e) [ ] Analgetics
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190. Capitol: Pancreasul Mod de punctare: A1 Punctajul: 10Select etiopathogenetic treatment in
chronic autoimmune pancreatitis:
a) [x] Chorticosteroidal treatment
b) [ ] Antibiotics
c) [ ] Prokinetics
d) [ ] Spasmolytics
e) [ ] Antidepressant treatment
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191. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate what investigation can be
used to measure the gallbladder ejection fraction:
a) [ ] Upper endoscopy
b) [x] Infusion of an octapeptide of CCK during cholescintigraphy
c) [ ] Barium swallow X-ray
d) [ ] Ultrasound examination of gallbladder
e) [ ] Selectiveangiography
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192. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Select what of the the following does
NOT present the risk for the development of acalculous cholecystitis:
a) [ ] Vasculitis
b) [x] GERD
c) [ ] Torsion of the gallbladder
d) [ ] "Unusual"bacterial infections of the gallbladder (e.g., Leptospira, Streptococcus, Salmonella)
e) [ ] Parasitic infestation of the gallbladder
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193. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate which is the therapy of
31
choice in patients with large-duct disease usually from alcohol-induced chronic pancreatitis?
a) [ ] Prokineticagents
b) [x] Ductal decompression
c) [ ] Large doses of pancreatic enzymes
d) [ ] Proton pump inhibitors
e) [ ] Antacids
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194. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Choose what investigation does the
definitive diagnosis of Primary sclerosing cholangitis require:
a) [x] Cholangiographic imaging (MRI with magnetic resonance cholangiopancreatography or
endoscopic retrograde cholangiopancreatography (ERCP)
b) [ ] Liver biopsy
c) [ ] Hepatic fubctional tests
d) [ ] Abdominal ultrasound
e) [ ] Cholestaticenzymes
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195. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Select the drug that may help control
symptoms of pruritus in primary sclerosing cholangitis
a) [ ] Vitamin D and calcium
b) [x] Cholestyramine
c) [ ] Glucocorticoids
d) [ ] Methotrexate
e) [ ] Cyclosporine
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196. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate what symptom is specific for
billiary stones?
a) [ ] Vague epigastric fullness
b) [ ] Dyspepsia
c) [ ] Eructation
d) [ ] Flatulence, especially following a fatty meal
e) [x] Severe, steady ache or fullness in the epigastrium or right upper quadrant of the abdomen
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197. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Select in what situation prophylactic
cholecystectomy is NOT necessary:
a) [ ] Patients with very large gallstones (>3 cm in diameter)
b) [ ] Patients having gallstones in a congenitally anomalous gallbladder
c) [ ] Diabetic patients with silent gallstones
d) [x] All young patients with silent stones
e) [ ] Patients with prior complication of gallstone disease (acute cholecystitis, pancreatitis)
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198. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate how many criteria have
been used to define papillary stenosis:
a) [ ] One
b) [ ] Two
c) [ ] Tree
d) [ ] Four
e) [x] Five
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199. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Choose what is the most common
type of cholangitis:
a) [ ] Suppurative acute cholangitis
32
b) [x] Nonsuppurative acute cholangitis
c) [ ] Caroli's disease
d) [ ] Biliary Atresia and Hypoplasia
e) [ ] Chronic, recurrent cholangitis
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200. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Select what pathological conditions is
NOT specific from primary stones in the common bile duct:
a) [ ] Hepatobiliary parasitism or chronic, recurrent cholangitis
b) [ ] Congenital anomalies of the bile ducts (especially Caroli's disease)
c) [ ] Dilated, sclerosed, or strictured ducts
d) [ ] MDR3 gene defect leading to impaired biliary phospholipids secretion
e) [x] Calculi which migrate into the extrahepatic biliary tree from the gallbladder
---------------------------------------------------------------------
201. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate serum bilirubin level that is
characteristic in case of suspected common bile duct stones:
a) [ ] Less than 20 μmol/L
b) [ ] Less than 85,5 μmol/L
c) [x] More than 85,5 μmol/L
d) [ ] 260- 342 μmol/L
e) [ ] More than 342 μmol/L
---------------------------------------------------------------------
202. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Selected which of the following is the
most important determinant of crystal formation in the human gallbladder?
a) [x] Bile supersaturation with cholesterol
b) [ ] Gallbladder motility
c) [ ] Degree of bile acid synthesis
d) [ ] Degree of bilirubin synthesis
e) [ ] Degree of aminoacides synthesis
---------------------------------------------------------------------
203. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicated which of the following tests
should be performed first when biliary colic is suspected?
a) [ ] CT
b) [ ] MRI
c) [ ] Endoscopic ultrasound
d) [ ] Endoscopic retrograde cholangiopancreatography (ERCP)
e) [x] Transabdominal ultrasonography
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204. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate what is the gallbladder?
a) [ ] A small sac that stores waste products from the liver
b) [x] A small sac that stores bile
c) [ ] A small sac that stores dietary fats
d) [ ] An endocrine organ
e) [ ] An exocrine organ
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205. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate deficiency of what enzyme is
setting up more quickly in chronic pancreatitis:
a) [ ] Amylase
b) [x] Lipase
c) [ ] Trypsin
d) [ ] Ellastase
e) [ ] Chymotrypsin
33
---------------------------------------------------------------------
206. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Select the characteristic of pain in
chronic pancreatitis that is NOT right:
a) [ ] The pain is intermittent with a duration 24 hours, days or weeks
b) [ ] The pain is in epygastrium or left hypocondrium with irradiation in spine
c) [x] The pain disappearing after dinner
d) [ ] The pain is improving in the sitting position
e) [ ] The pain is persistent with light times
---------------------------------------------------------------------
207. Capitol: Caile biliare Mod de punctare: A1 Punctajul: 10Indicate condition when test with
secretin- pancreozimin is used in diagnostic of chronic pancreatitis:
a) [ ] In praesens of pancreatic calcifications
b) [ ] In praesens of steatorrea
c) [ ] In praesens of diabetes
d) [x] Without of calcifications, steatorrea and diabetes
e) [ ] In praesens of calcifications, steatorrea and diabetes
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208. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the sign that characterized
hematemesis:
a) [x] Vomitus of red blood
b) [x] Vomitus of "coffee-grounds" material
c) [ ] Black, tarry, foul-smelling stool
d) [ ] Passage of bright red or maroon blood from the rectum
e) [ ] Nasal bleeding
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209. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate sign that characterized
dysphagia:
a) [x] Sensation of "sticking" or obstruction of the passage of food through the mouth
b) [x] Sensation of "sticking" or obstruction of the passage of food through the pharynx
c) [x] Sensation of "sticking" or obstruction of the passage of food through the esophagus
d) [ ] Painful swallowing
e) [ ] Sensation of a lump lodged in the throat
---------------------------------------------------------------------
210. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the cause that provoke
noncardiac chest pain:
a) [x] Gastroesophageal reflux disease
b) [x] Diffuse esophageal spasm
c) [x] Esophageal ulcers
d) [ ] Functional dyspepsia
e) [ ] Portal gastropathy
---------------------------------------------------------------------
211. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the sign of achalasia:
a) [x] A motor disorder of the esophageal smooth muscle
b) [x] A disorder when the esophageal body loses peristaltic contractions
c) [ ] A disorder when the lower esophageal sfincter does not relax normally in response to swallowing
d) [x] An organic disorder of the esophagus
e) [ ] A functional disorder of the esophagus
---------------------------------------------------------------------
212. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the recommended methods
to treat achalasia:
a) [x] Nitrates
34
b) [x] Calcium channel blockers
c) [x] Injection of botulinum toxin
d) [x] Balloon dilatation
e) [ ] Prokinetics
---------------------------------------------------------------------
213. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the extraesophageal
manifestations of GERD:
a) [x] Chronic cough
b) [x] Laryngitis
c) [x] Pharyngitis
d) [x] Morning hoarseness
e) [ ] Angular cheilitis
---------------------------------------------------------------------
214. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10What may cause or be aggravated
by GERD?
a) [x] Chronic bronchitis
b) [x] Chronic obstructive pulmonary disease
c) [x] Pneumonia
d) [ ] MALT lymphoma
e) [ ] Sarcoidosis
---------------------------------------------------------------------
215. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the diagnostic methods
that documented and quantitated the GERD:
a) [x] Long-term (24-48 h)esophageal pH recording
b) [x] Impedance test
c) [ ] The Bernstein test
d) [ ] The Shilling test
e) [ ] Barium swallow
---------------------------------------------------------------------
216. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the condition that Barrett's
esophagus can lead:
a) [x] Adenocarcinoma
b) [x] Low-grade epithelium dysplasia
c) [x] High-grade epithelium dysplasia
d) [x] Chronic peptic ulcer of the esophagus
e) [ ] Metaplasia of esophageal squamous epithelium to columnar epithelium
---------------------------------------------------------------------
217. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the pathological state in
which H. pylori plays a role in the development:
a) [x] Gastric mucosal-associated lymphoid tissue (MALT) lymphoma
b) [x] Gastric adenocarcinoma
c) [x] Peptic gastric ulcers
d) [x] Peptic duodenal ulcers
e) [ ] Hypertrophic gastritis
---------------------------------------------------------------------
218. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the clinical manifestations
of Zollinger-Ellison syndrome:
a) [x] Peptic ulcers refractory to standard medical therapy
b) [x] Reflux esophagitis
c) [x] Diarrhea
d) [ ] Constipation
35
e) [ ] Pernicious anemia
---------------------------------------------------------------------
219. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the factors that may
contribute to GERD:
a) [x] Impaired lower esophageal sphincter function
b) [x] Hiatal hernia
c) [ ] Normal esophageal clearance
d) [x] Delayed gastric emptying
e) [x] Irritant effects of refluxate
---------------------------------------------------------------------
220. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Choose the main symptoms of
achalasia:
a) [x] Dysphagia
b) [x] Chest pain
c) [x] Regurgitation
d) [ ] Rumination
e) [ ] Heartburn
---------------------------------------------------------------------
221. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the signs of achalasia at the
barium swallow:
a) [x] Esophageal dilation
b) [ ] Esophageal ulcer
c) [ ] Proximal esophageal stricture
d) [x] Adnormal peristalsis in the lower two-thirds of the esophagus
e) [x] Terminal part of the esophagus with a persistent beaklike narrowing
---------------------------------------------------------------------
222. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Find the characteristic symptoms
of GERD:
a) [x] Heartburn
b) [x] Regurgitation of sour material into the mouth
c) [ ] Vomiting
d) [ ] Epigastric pain
e) [x] Angina-like or atypical chest pain
---------------------------------------------------------------------
223. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the extraesophageal
a) [x] Chronic cough, laryngitis, pharyngitis
b) [x] Morning hoarseness
c) [ ] Noncardiac chest pain
d) [x] Chronic bronchitis, asthma, pulmonary fibrosis
e) [x] Chronic sinusitis and dental decay
---------------------------------------------------------------------
224. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Choose the diagnostic methods
that documented mucosal damage in GERD:
a) [ ] Barium swallow
b) [x] Esophagoscopy
c) [x] Mucosal biopsy
d) [ ] History alone
e) [ ] Clinical features
---------------------------------------------------------------------
225. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate what recommendations
36
include the management of mild GERD:
a) [x] Weight reduction
b) [x] Sleeping with the head of the bed elevated by about 15 - 20
c) [ ] Elimination of factors that decrease abdominal pressure
d) [x] Should avoid smoking and consuming fatty foods, coffee, chocolate, alcohol, mint, orange juice
e) [x] Should avoid medications, such as anticholinergic drugs, calcium channel blockers, and other
smooth-muscle relaxants)
---------------------------------------------------------------------
226. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the factors which are
related with squamous cell esophageal cancer:
a) [x] Excess alcohol consumption and/or cigarette smoking
b) [x] Ingestion of nitrites, smoked opiates, and fungal toxins in pickled vegetables
c) [x] Damage caused by such harmful physical factors as long-term exposure to extremely hot tea
d) [ ] Dietary excess of molybdenum, zinc, and vitamin A
e) [x] Chronic gastric reflux (i.e., Barrett's esophagus)
---------------------------------------------------------------------
227. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Mark the initial symptoms in the
vast majority of patients with esophageal cancers:
a) [x] Progressive dysphagia initially occurs with solid foods
b) [x] Weight loss of short duration
c) [ ] Regurgitation
d) [ ] Vomiting
e) [ ] Aspiration pneumonia
---------------------------------------------------------------------
228. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate what include the
palliative approach in patients with esophageal cancers:
a) [x] Repeated endoscopic dilatation
b) [x] Surgical placement of a gastrostomy or jejunostomy for hydration and feeding
c) [ ] Total surgical resection of all tumor
d) [x] Endoscopic placement of an expansive metal stent to bypass the tumor
e) [x] Endoscopic fulguration of the obstructing tumor with lasers
---------------------------------------------------------------------
229. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the extraesophageal
a) [x] Asthma
b) [x] Chronic cough
c) [x] Halitosis
d) [x] Aspiration pneumonia
e) [ ] Heartburn
---------------------------------------------------------------------
230. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Select the diagnostic tests of
GERD:
a) [x] Barium esophagogram
b) [x] Gastro esophageal endoscopy
c) [x] 24 hour ambulatory pH testing
d) [ ] Endoscopic retrograde colangio-pancreatography
e) [x] Impedance monitoring
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231. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Mark the therapy goals in GERD:
a) [x] Alleviate or eliminate symptoms
b) [x] Diminish the frequency of recurrence and duration of esophageal reflux
37
c) [x] Promote healing - if mucosa is injured
d) [ ] Eradicatie helicobacter pylori infection
e) [x] Prevent complications
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232. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Mention the indications and
mechanism of action of Baclofen in GERD:
a) [x] Non-acid reflux
b) [ ] Acid reflux
c) [x] GABA agonist
d) [ ] GABA antogonist
e) [x] Adjuvant to PPI in refractory GERD
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233. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Choose the surgical therapy for
GERD:
a) [x] Nissen fundiplication
b) [x] Endoscopical "EsophyX" technic
c) [ ] Esophageal capsule endoscopy
d) [ ] Eradication of Helicobacter pylori infection
e) [x] Reconstruction of esophageal hiatus
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234. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Indicate the main symptoms
characteristic for achalasia:
a) [x] Backflow (regurgitation) of food
b) [x] Chest pain
c) [x] Cough
d) [x] Difficulty swallowing liquids and solids
e) [ ] Anorexia
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235. Capitol: Esofag multiplu Mod de punctare: A3 Punctajul: 10Choose the complications of
GERD:
a) [x] Esophagitis and esophageal strictures and ulcers, hemorrhage, perforation
b) [x] Bronhopulmonary aspiration
c) [x] Hemorrhage, perforation
d) [x] Development of Barrett's esophagus
e) [ ] Diverticulitis
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236. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mark the signs what is associated
with type A gastritis:
a) [x] Pernicious anemia
b) [x] Circulating antibodies against parietal cells
c) [x] Circulating antibodies against intrinsic factor
d) [x] Atrophic gastritis
e) [ ] H. pylori infection
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237. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mention the sign that associated
with type B gastritis:
a) [x] Antral- predominant gastritis
b) [ ] Autoimmune gastritis
c) [x] H. pylori infection
d) [x] Incidence increases with age
e) [x] Gastric atrophy with subsequent metaplasia, which may lead to development of gastric
38
adenocarcinoma
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238. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Which of the following
statements are correct for peptic ulcer?
a) [x] An ulcer is defined as disruption of the mucosal integrity of the stomach and/or duodenum leading
to a local defect or excavation due to active inflammation
b) [x] Ulcers occur within the stomach and/or duodenum and are often chronic in nature
c) [ ] Acid peptic disorders are uncommon
d) [x] Epigastric pain improved with meals
e) [x] Gastric ulcer tend to occur later in life than duodenal
---------------------------------------------------------------------
endogenous noxious agents tend constantly to affect the gastroduodenal mucosa?
a) [x] Acid and pepsin
b) [x] Bile acids
c) [x] Pancreatic enzymes
d) [ ] Drugs
e) [ ] Bacteria
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240. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate the composition of
mucosal barrier defense system:
a) [x] Preepithelial elements
b) [x] Epithelial elements
c) [x] Subepithelial elements
d) [ ] Pepsinogen/pepsin
e) [ ] HCl
---------------------------------------------------------------------
241. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select how the prostaglandins
regulate gastric epithelial defense/repair system:
a) [x] Release of mucosal bicarbonate and mucus
b) [x] Inhibition parietal cell secretion
c) [x] Mucosal blood flow and epithelial cell restitution
d) [ ] Inhibition of synthesis of epidermal growth factor
e) [ ] Inhibition of secretion of bicarbonate
---------------------------------------------------------------------
242. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mark the types of
pathophysiology abnormalities that are characteristic for duodenal ulcer (DU)?
a) [x] Increased basal and nocturnal gastric acid secretion
b) [x] Accelerated gastric emptying of liquids
c) [x] Decreased bicarbonate secretion
d) [x] Increased acid productiondue to H. pylori
e) [ ] Increased duodenal mucosal bicarbonate production due to H. pylori
---------------------------------------------------------------------
243. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the sign that associated
with high risk of gastric cancer:
a) [x] Long-term ingestion of high concentrations of nitrates in dried, smoked, and salted foods
b) [x] Helicobacter pylori infection
c) [ ] Atherosclerosis
d) [x] Prior gastric surgery (antrectomy) (15- to 20-year latency period)
e) [x] Pernicious anemia and atrophic gastritis
---------------------------------------------------------------------
39
244. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate how occur frequently
metastases of gastric cancer:
a) [ ] Cerebral metastasis
b) [x] Metastatic nodules to the ovary (Krukenberg's tumor)
c) [x] Periumbilical region metastasis ("Sister Mary Joseph node")
d) [x] Peritoneal cul-de-sac (Blumer's shelf palpable on rectal or vaginal examination)
e) [x] Malignant ascites
---------------------------------------------------------------------
245. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the complains
characteristic for patients with gastric cancer:
a) [x] Insidious upper abdominal discomfort varying in intensity
b) [x] Nausea and vomiting
c) [x] Weight loss
d) [x] Dysphagia and early satiety
e) [ ] Odynofagia
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symptoms are characteristic for Early Dumping Syndrome?
a) [x] Takes place 15-30 min after meals
b) [x] Crampy abdominal discomfort, nausea, belching and diarrhea
c) [x] Vasomotor symptoms (light-headedness, diaphoresis, palpitations, tachycardia, and syncope)
d) [ ] Occurs 90 min to 3 h after meals
e) [x] Occurs after meals rich in simple carbohydrates (especially sucrose) and high osmolarity
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247. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mark the common causes of
upper gastrointestinal sources of bleeding:
a) [x] Peptic ulcers
b) [x] Mallory-Weiss tears
c) [ ] Esophageal varices
d) [ ] Hemorrhagic or erosive gastropathy
e) [x] Meckel's diverticulum
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248. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate the common causes of
lower gastrointestinal sources of bleeding:
a) [x] Crohn's disease
b) [x] Primarily adenocarcinoma
c) [ ] Solitary rectal ulcer syndrome
d) [ ] Aortocolic fistulas
e) [x] Diverticula
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249. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mention the definition of peptic
ulcer:
a) [ ] Inflammation of the gastric mucosa
b) [x] Depth disruption of the mucosal integrity of the stomach and/or duodenum leading to a local defect
or excavation due to active inflammation
c) [x] Breaks in the mucosal surface >5 mm in size, with depth to the submucosa
d) [ ] Inflammatory cell infiltrate with lymphocytes and plasma cells
e) [ ] Inflammatory infiltrate with progressive distortion and destruction of the glands
---------------------------------------------------------------------
250. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the true statement about
Helicobacter pylori?
40
a) [x] Plays a role in the development of gastric mucosa-associated lymphoid tissue (MALT) lymphoma
b) [x] Gastric infection with the bacterium H. pylori accounts for the majority of peptic ulcer disease
c) [x] Plays a role in the development of gastric adenocarcinoma
d) [x] H. pylori is able to facilitate gastric mucosal injury
e) [ ] Decreases the risk of gastric carcinoma
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251. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select two predominant causes of
a) [ ] Cigarette smoking
b) [x] Helicobacter Pylori
c) [x] NSAIDs
d) [ ] Cytomegalovirus
e) [ ] Ischemia
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252. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate the complications of
a) [x] Gastrointestinal Bleeding
b) [x] Autoimmune gastritis
c) [x] Perforation
d) [ ] Gastric outlet obstruction
e) [x] Penetration
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253. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Choose the invasive tests for
detection of H. Pylori infection:
a) [x] Rapid urease
b) [x] Histology
c) [ ] Urea breath test
d) [x] Culture
e) [ ] Stool antigen
---------------------------------------------------------------------
noninvasive tests can be used in detection of H. Pylori :
a) [x] Serology
b) [ ] Rapid urease
c) [ ] Histology
d) [x] Urea breath test
e) [x] Stool antigen
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255. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mention the conditions which is
usually associated with duodenal ulcer:
a) [ ] Gastric acid hyposecretion
b) [x] Elevated fasting serum gastrin levels
c) [ ] Delayed emptying of gastric acid into the duodenum
d) [ ] Increased duodenal bicarbonate production
e) [x] Decreased bicarbonate production
---------------------------------------------------------------------
256. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the drugs are used in the
treatment of peptic ulcer disease:
a) [x] H2 receptor antagonists
b) [ ] NSAID
c) [x] Proton pump inhibitors
41
d) [x] Sucralfate
e) [x] Bismuth-containing compounds
---------------------------------------------------------------------
257. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mark the optimal treatment
regiments for H. pylori infections:
a) [x] Amoxicillin, clarithromycin, bismuth subcitraste and a PPI for 14 days
b) [ ] Metronidazole and PPI for 14 days
c) [x] Metronidazole, tetracycline, bismuth and PPI for 14 days
d) [ ] Ciprofloxacinand amoxicillin for 14 days
e) [ ] Amoxicillin and a PPI for 14 days
---------------------------------------------------------------------
258. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the evenements which is
useful for prophylacsis of peptic ulcer induces by administration of NSAIDs:
a) [ ] H2 - receptor antagonists, Prokinetics
b) [ ] Misoprostol
c) [x] H. Pylori infection treatment
d) [ ] Antacids
e) [x] Proton pump inhibitors
---------------------------------------------------------------------
259. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10 Choose the forms of acute
gastritis:
a) [x] Erosive
b) [x] Nonerosive
c) [x] Phlegmonous
d) [ ] Autoimmune
e) [ ] Lymphocytic
---------------------------------------------------------------------
260. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate the cause of chronic
gastritis:
a) [x] Helicobacter pylori
b) [x] Bile reflux
c) [x] Nonsteroidal anti-inflammatory drugs
d) [ ] Clostridium dificile
e) [x] Autoimmune
---------------------------------------------------------------------
261. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10 Indicate the current gastritis
staging systems used for gastric atrophy?
a) [ ] Savary-Miller classification
b) [x] Baylor
c) [ ] Los Angela
d) [x] OLGA
e) [ ] Forrest classification
---------------------------------------------------------------------
262. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Select the etiological factors
which are associated with infectious granulomatous gastritis:
a) [x] Tuberculosis
b) [x] Syphilis
c) [x] Histoplasmosis
d) [ ] Helicobacter pylori
e) [x] Fungi
---------------------------------------------------------------------
42
263. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate with what kind of factors
associated with chronic noninfectious granulomatous gastritis:
a) [x] Crohn disease
b) [ ] Tuberculosis
c) [x] Sarcoidosis
d) [x] Isolated granulomatous gastritis
e) [ ] Lymphocytic gastritis
---------------------------------------------------------------------
264. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Mark the types of antibody which
is associated with autoimmune gastritis:
a) [x] Serum antiparietal cels
b) [ ] Antimitochondrial
c) [ ] Antinuclear
d) [x] Anti-intrinsic factor
e) [ ] Anti-liver kidney microsomal
---------------------------------------------------------------------
265. Capitol: Gastrita multiplu Mod de punctare: A3 Punctajul: 10Indicate the condition which is
associated with chronic reactive chemical gastropathy:
a) [x] Long-term intake of aspirin or NSAIDs
b) [ ] Helicobacter pylori infection
c) [ ] Sarcoidosis
d) [x] Bile-containing intestinal contents reflux into the stomach
e) [ ] Radiation
---------------------------------------------------------------------
266. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select common procedures used
in the diagnosis of irritable bowel syndrome:
a) [x] Occult blood test
b) [ ] Balloon endoscopy
c) [x] CBC
d) [ ] Capsule endoscopy
e) [x] Sigmoidoscopy
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267. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose sings more characteristic
for ulcerative colitis than for Crohn's disease:
a) [x] Superficial, mucosal affectation
b) [ ] Fistula formation
c) [ ] Cobblestone pattern of inflammation
d) [ ] Extension of inflammation below the intestinal mucosa
e) [x] Diffuse inflammation
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268. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose sings more characteristic
for Crohn's disease than for ulcerative colitis:
a) [x] Small bowel involvement
b) [ ] Uniform involvement in the colon from rectum to cecum
c) [x] Skip lesions of normal mucosa between areas of inflammation
d) [x] Granuloma on biopsy
e) [x] Fistula formation
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269. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select laboratory tests associated
with relapse in ulcerative colitis:
a) [x] Increased C-reactive protein
43
b) [x] Increased platelet count
c) [x] Increased erythrocyte sedimentation rate
d) [x] Decreased level of hemoglobin
e) [ ] Decreased platelet count
---------------------------------------------------------------------
270. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate side effects of
anticholinergic antispasmodics:
a) [x] Visual disturbances
b) [x] Urinary retention
c) [x] Dry mouth
d) [ ] Malabsorption syndrome
e) [ ] Orange colored urine
---------------------------------------------------------------------
271. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the indications for
corticosteroids in inflammatory bowel disease:
a) [ ] Mild distal colitis
b) [x] Severe distal colitis
c) [ ] Mild total colitis
d) [x] Severe total colitis
e) [ ] Maintenance therapy
---------------------------------------------------------------------
272. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the signs of bacterial
overgrowth syndrome:
a) [x] Vitamin B12 malabsorption
b) [ ] Increased folate levels
c) [x] Abnormal bile acid breath test
d) [x] Steatorrhea
e) [x] Positive jejunal cultures
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273. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the types of extensive
resection which may cause steatorrhea:
a) [x] Stomach resection
b) [x] Duodenum resection
c) [x] Jejunum resection
d) [x] Ileum resection
e) [ ] Transverse colon resection
---------------------------------------------------------------------
274. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose etiopathogenic factors of
celiac disease:
a) [x] Environmental (gliadin)
b) [x] Immunologic
c) [x] Genetic
d) [ ] Long-term ingestion of high concentrations of nitrates in dried, smoked, and salted foods
e) [ ] Smoking
---------------------------------------------------------------------
275. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate characteristic histological
changes in celiac disease:
a) [x] Atrophy of villi
b) [ ] Hypertrophy of villi
c) [ ] Atrophy of crypts
d) [x] Hypertrophy of crypts
44
e) [x] Increased lymphocytes and plasma cells in the lamina propria
---------------------------------------------------------------------
276. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the pathology associated
with celiac disease:
a) [x] Dermatitis herpetiformis
b) [x] Diabetes mellitus
c) [ ] Obesity
d) [ ] Helicobacter pylori infection
e) [ ] Atherosclerosis
---------------------------------------------------------------------
277. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the sings of bacterial
overgrowth syndrome:
a) [x] Diarrhea
b) [ ] Burning epigastric pain
c) [x] Steatorrhea
d) [x] Macrocytic anemia
e) [ ] Eritema nodosum
---------------------------------------------------------------------
278. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the etiopathogenetic factors
of bacterial overgrowth syndrome:
a) [x] Impaired peristalsis (functional stasis)
b) [ ] Circulating antibodies against intrinsic factor
c) [x] Changes in intestinal anatomy (anatomic stasis)
d) [ ] Inhibition of synthesis of epidermal growth factor
e) [x] Unfunctional ileocecal valve
---------------------------------------------------------------------
279. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the condition that can
cause bacterial overgrowth syndrome:
a) [x] Stagnant bowel syndrome
b) [x] Afferent loop syndromes
c) [ ] Dumping syndrome
d) [ ] Zollinger-Ellison syndrome
e) [x] Blind loop syndrome
---------------------------------------------------------------------
280. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the classical symptoms
of Whipple's disease:
a) [x] Diarrhea
b) [ ] Epigastric pain
c) [x] Fever
d) [x] Weight loss
e) [x] Arthralgia
---------------------------------------------------------------------
281. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the routine laboratory
tests that may suggest the presence of malabsorption:
a) [x] Complete blood count
b) [x] Prothrombin
c) [ ] Serum bilirubin
d) [x] Serum albumin
e) [ ] Alkaline phosphatase
---------------------------------------------------------------------
282. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the symptoms of lactose
45
intolerance:
a) [x] Diarrhea
b) [ ] Constipation
c) [x] Bloating
d) [ ] Heartburn
e) [ ] Fever
---------------------------------------------------------------------
283. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the possible clinical forms
of celiac disease:
a) [x] Atypical
b) [x] Silent
c) [ ] Mixed
d) [x] Classic
e) [x] Latent
---------------------------------------------------------------------
284. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the factors that determine
the type of symptoms in the short bowel syndrome:
a) [x] Segment of intestinal resection
b) [x] Integrity of the ileocecal valve
c) [x] Length of the resected segment
d) [x] Residual disease in the remaining intestine
e) [ ] Type of pouch anastomosis
---------------------------------------------------------------------
285. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the diagnostic criteria for
irritable bowel syndrome:
a) [x] Relation with defecation
b) [x] Change in frequency of stool
c) [ ] Weight loss
d) [x] Change in form of stool
e) [x] Abdominal pain or discomfort
---------------------------------------------------------------------
286. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the possible causes of
chronic diarrhea:
a) [x] Lactase deficiency
b) [ ] Hipothyroidism
c) [x] Pancreatic exocrine insufficiency
d) [x] Hyperthyroidism
e) [x] Microscopic colitis
---------------------------------------------------------------------
287. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the clinical
manifestations of Crohn's disease:
a) [x] Recurrent episodes of right lower quadrant pain
b) [ ] Recurrent episodes of epigastric pain
c) [x] Diarrhea
d) [x] Fever
e) [x] Weight loss
---------------------------------------------------------------------
288. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the tipical complications
ofCrohn's disease:
a) [x] Fistula formation
b) [ ] Toxic megacolon
46
c) [ ] Peritonitis
d) [x] Intraabdominal abscess
e) [x] Intestinal stenosis
---------------------------------------------------------------------
289. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the possible regions of
affectation in Crohn's disease:
a) [x] Ilion only
b) [x] Jejun only
c) [ ] Appendix only
d) [ ] Perianal area only
e) [x] Gastroduodenal area only
---------------------------------------------------------------------
290. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the major symptoms of
ulcerative colitis:
a) [x] Diarrhea
b) [x] Rectal bleeding
c) [x] Tenesmus
d) [x] Crampy abdominal pain
e) [ ] Recurrent episodes of right lower quadrant pain
---------------------------------------------------------------------
291. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the typical features of
ulcerative colitis:
a) [x] Gross blood in stool
b) [ ] Response to antibiotics
c) [x] Fever and weight loss
d) [ ] Recurrence after adequate surgery
e) [x] Response to corticosteroids
---------------------------------------------------------------------
292. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the drugs used in
treatment of ulcerative colitis:
a) [x] 5-ASA agents
b) [x] Corticosteroids
c) [ ] Antisecretory drugs
d) [x] Azathioprine
e) [ ] Nonsteroid antiinflammatory drugs
---------------------------------------------------------------------
293. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the risk factors for
colorectal cancer:
a) [x] Animal fat alimentary abuse
b) [x] Familial adenomatous polyposis
c) [ ] Zollinger-Ellison Syndrome
d) [x] Nonpolyposis syndrome (Lynch's syndrome)
e) [x] Long-time inflammatory bowel disease
---------------------------------------------------------------------
294. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select diseases that are included
in inflammatory bowel diseases:
a) [ ] Colitis pseudomembranous
b) [ ] Colitis caused by Yersinia enterocolitica
c) [ ] Colitis caused by Clostridium difficile
d) [x] Ulcerative colitis
e) [x] Crohn's disease
47
---------------------------------------------------------------------
295. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the characteristics of
inflammatory changes in ulcerative colitis:
a) [ ] Involving the mucosa and submucosa of any segment of the gastrointestinal tract
b) [x] Involving the colonic mucosa and submucosa
c) [ ] Involving the mucosa and submucosa of small intestine
d) [x] Continuous fashion of inflammation
e) [ ] Discontinuous fashion of inflammation
---------------------------------------------------------------------
296. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the characteristics of
Crohn's disease:
a) [x] Transmural inflammation
b) [ ] Just mucosal inflammation
c) [x] Inflammation of any segment of the gastrointestinal tract
d) [ ] Inflammation of continuous fashion
e) [x] Inflammation of discontinuous fashion (skip lesions)
---------------------------------------------------------------------
297. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the areas with the higher
prevalence of inflammatory bowel diseases:
a) [x] Urban
b) [ ] Rural
c) [x] High socioeconomic level
d) [ ] Low socioeconomic level
e) [ ] Low hygienic level
---------------------------------------------------------------------
298. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the major pathogenetic
factors in inflammatory bowel diseases:
a) [ ] Viral infection
b) [x] Intestinal misrobiota
c) [x] Genetic factors
d) [x] Environmental factors
e) [x] Immune factors
---------------------------------------------------------------------
299. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose skin extraintestinal
manifestations of inflammatory bowel diseases:
a) [x] Erythema nodosum
b) [x] Pyoderma gangrenosum
c) [ ] Dermatitis herpetiformis
d) [ ] Exema
e) [ ] Lichen planus
---------------------------------------------------------------------
300. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the main clinical features
of ulcerative colitis:
a) [ ] Constant dull abdominal pain
b) [x] Bloody diarrhea
c) [x] Rectal bleeding
d) [x] Urgency and frequent trips to the toilet
e) [x] Predefecational cramps
---------------------------------------------------------------------
301. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select common complications of
ulcerative colitis:
48
a) [x] Massive bleeding
b) [ ] Stenosis
c) [ ] Abdominal abscess
d) [x] Perforation with peritonitis
e) [x] Toxic dilatation of the colon (toxic megacolon)
---------------------------------------------------------------------
302. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select endoscopic features of
ulcerative colitis:
a) [x] Continuous lesions from rectum to proximal parts of colon
b) [ ] Fibrinous membrane
c) [ ] Discontinuous lesions
d) [x] Loss of mucosal vascularity
e) [x] Superficial ulcerations
---------------------------------------------------------------------
303. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the main clinical features
of Crohn's disease:
a) [x] Abdominal pain
b) [ ] Rectal bleeding
c) [x] Diarrhea
d) [x] Weight loss
e) [ ] Pruritus
---------------------------------------------------------------------
304. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the common
complications of Crohn's disease:
a) [x] Intestinal strictures and obstruction
b) [x] Fistulization
c) [x] Abdominal abscess
d) [ ] Paucitis
e) [ ] Toxic dilatation of the colon (toxic megacolon)
---------------------------------------------------------------------
305. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the endoscopic features of
Crohn's disease:
a) [ ] Diffuse mucosal friability
b) [x] Aphthoid ulcerations
c) [x] Deep linear ulcers
d) [x] "Cobblestone" pattern
e) [ ] Large superficial ulcerations
---------------------------------------------------------------------
306. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose pathogenetic treatment of
inflammatory bowel diseases:
a) [x] 5-ASA
b) [ ] Anticholinergics
c) [x] Corticosteroids
d) [x] Anti-TNF agents
e) [x] Thiopurins
---------------------------------------------------------------------
307. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the criteria for chronic
diarrhea:
a) [ ] Complain of excessive straining
b) [ ] Passage of abnormally liquid or unformed stools at an increased frequency
c) [x] Stool weight >200 g/day
49
d) [x] >4 weeks in duration
e) [x] >4 months in duration
---------------------------------------------------------------------
308. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the criteria for fecal
incontinence :
a) [ ] More then three bowel movements per day
b) [x] The involuntary discharge of rectal contents
c) [x] Most often caused by neuromuscular disorders
d) [ ] The passage of stool totaling <200 g/day
e) [ ] Stool weight >200 g/day
---------------------------------------------------------------------
309. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the functional esophageal
disorders:
a) [x] Functional heartburn
b) [ ] Gastro-esofagial reflux disease
c) [x] Functional dysphagia
d) [ ] Acalazia
e) [x] Globus
---------------------------------------------------------------------
310. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select criteria for functional
dyspepsia according to Rome IV:
a) [x] Bothersome postprandial fullness
b) [x] Early satiation
c) [x] Epigastric pain
d) [ ] Flatulence
e) [x] Epigastric burning
---------------------------------------------------------------------
311. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select alarm features that exclude
functional gastrointestinal disorders:
a) [x] Unexplained weight loss
b) [x] Fever
c) [x] Gastrointestinal blood loss
d) [ ] Diarrhea
e) [ ] Vomiting
---------------------------------------------------------------------
312. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the characteristics of
functional gallbladder disorders:
a) [x] Episodes of pain lasting 30 minutes or longer
b) [ ] Short-term spastic pain
c) [x] The pain builds up to a steady level, being moderate to severe enough to interrupt the patient's daily
activities or dream
d) [ ] Mild-moderate pain without nocturnal symptoms
e) [x] Pain is associated with nausea and vomiting
---------------------------------------------------------------------
313. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the clinical features of
a) [x] Diarrhea
b) [x] Constipation
c) [x] Abdominal pain
d) [ ] Malabsorbtion symptoms
e) [ ] Pain or diarrhea awakening the patient from sleep
50
---------------------------------------------------------------------
314. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the possible treatment of
a) [x] Selective smooth-muscle antispasmodics
b) [x] Anxiolytic agents and antidepressants
d) [x] Fiber supplements or lactulose
e) [ ] Surgery
---------------------------------------------------------------------
315. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the signs for
pseudodiarrhea:
a) [x] Increased frequency of defecation without increased stool weight
b) [x] Frequent elimination of mucus and pus, without feces
c) [ ] Normal frequency of defecation with increased stool weight
d) [ ] Frequent elimination of feces with mucus and pus
e) [ ] Increased frequency of defecation with increased stool weight
---------------------------------------------------------------------
316. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the pathophisiological
types of acute diarrhea:
a) [x] Secretory
b) [x] Osmotic
c) [x] Inflammatory
d) [ ] Dismetabolic
e) [x] Due to intestinal dysmotility
---------------------------------------------------------------------
317. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the clinical characteristics
of secretory diarrhea:
a) [x] Large volume watery diarrhea
b) [ ] Improvement with fasting
c) [x] No pus, no blood
d) [x] Little or no response to fasting
e) [x] Small stool osmotic gap (<50 mOsm)
---------------------------------------------------------------------
318. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the diseases which
evaluate with secretory diarrhea:
a) [x] Cholera
b) [x] VIP-tumor
c) [x] Carcinoid syndrome
d) [ ] Pancreatic insufficiency
e) [ ] Chron’s disease
---------------------------------------------------------------------
319. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the clinical characteristics
of osmotic diarrhea:
a) [x] Improvement with fasting
b) [ ] Little or no response to fasting
c) [x] No blood or pus
d) [x] Malabsorption syndrome
e) [x] Increased osmotic gap in fecal (>50 mOsm)
---------------------------------------------------------------------
evaluate with osmotic diarrhea:
51
a) [x] Pancreatic insufficiency
b) [x] Celiac disease
c) [x] Lactase deficiency
d) [x] Short bowel syndrome
e) [ ] Carcinoid syndrome
---------------------------------------------------------------------
321. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the clinical characteristics
of inflammatory diarrhea:
a) [ ] Large volume watery diarrhea
b) [x] Fever
c) [x] Abdominal pain
d) [x] Blood in stool
e) [x] Leucocytes in stool
---------------------------------------------------------------------
evaluate with inflammatory diarrhea:
a) [ ] Cholera
b) [ ] Carcinoid syndrom
c) [x] Ulcerative colitis
d) [x] Crohn's disease
e) [ ] Pancreatic insufficiency
---------------------------------------------------------------------
323. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the clinical characteristics
of diarrhea due to intestinal dysmotility:
a) [ ] Large volume watery diarrhea
b) [x] No large volume unformed stool
c) [x] Alternating diarrhea and constipation is possible
d) [x] Malabsorption syndrome is possible
e) [ ] Inflammatory syndrome is possible
---------------------------------------------------------------------
evaluate with diarrhea due to intestinal dysmotility:
a) [x] rritable bowel syndrome
b) [x] Hyperthyroidism
c) [x] Diabetic diarrhea
d) [ ] Pancreatic insufficiency
e) [ ] Celiac disease
---------------------------------------------------------------------
325. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the characteristics of
functional diarrhea:
a) [x] No inflammation signs
b) [x] No steatorrhea
c) [x] No "alarm" symptoms
d) [x] Mucus in stool
e) [ ] Leucocytes in stool
---------------------------------------------------------------------
326. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the correct definitions of
malabsorption in clinical practice (in large sense):
a) [x] All aspects of impaired assimilation of nutrients
b) [ ] Defective intraluminal hydrolysis of nutrients
c) [ ] Impaired mucosal absorption
52
d) [ ] Impaired digestion and mucosal absorption
e) [x] Impaired digestion and/or mucosal absorption and/or removing of nutrients to the vascular or
lymphatic circulation
---------------------------------------------------------------------
327. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the causes of
malabsorption according the pathophysiological classification:
a) [x] Luminal phase impairment
b) [x] Mucosal phase impairment
c) [x] Transport phase disorders
d) [ ] Arterial phase disorders
e) [x] Combined disorders
---------------------------------------------------------------------
328. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the condition that may
cause malabsorption by luminal phase disorders (maldigestion):
a) [x] Gastric diseases (stomach resection.)
b) [x] Pancreatic insufficiency
c) [x] Bile salt insufficiency
d) [x] Small bowel diseases
e) [ ] Colon diseases
---------------------------------------------------------------------
329. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the criteria for moderate
degree of malabsorption:
a) [x] Weight loss <15%
b) [x] Clinical manifestation of nutrients deficiency
c) [ ] No clinical manifestation of nutrients deficiency
d) [x] Clinical manifestation of vitamins deficiency
e) [ ] No clinical manifestation of vitamins deficiency
---------------------------------------------------------------------
330. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the clinical manifestation
of malabsorption syndrome:
a) [x] Tetany, paresthesias
b) [x] Muscle weakness
c) [x] Edema
d) [x] Night blindness, xerophthalmia
e) [ ] Eritema nodosum
---------------------------------------------------------------------
331. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the clinical manifestation
of malabsorption syndrome:
a) [x] Ecchymoses
b) [x] Hyperkeratosis
c) [x] Glossitis
d) [x] Peripheral neuropathy
e) [ ] Pioderma gangrenosum
---------------------------------------------------------------------
332. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the sings of steatorrhea in
stool examination:
a) [x] Neutral fat
b) [x] Fat acids
c) [ ] Undigested muscle fibers
d) [ ] Intracellular amidon
e) [ ] Extracellular amidon
53
---------------------------------------------------------------------
333. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the test for evaluation of
malabsorption syndrome:
a) [x] D-xylose test
b) [x] Schilling test
c) [x] Quantitative stool fat test
d) [ ] Test with antacids
e) [ ] Test with nitrates
---------------------------------------------------------------------
334. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose four cardinal clinical
manifestations of Whipple's disease:
a) [x] Diarrhea
b) [x] Abdominal pain
c) [x] Weight loss
d) [x] Arthralgia/Arthritis
e) [ ] Hepatitis
---------------------------------------------------------------------
335. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the risk factors for
neoplasia in ulcerative colitis:
a) [x] Extent of disease
b) [x] Duration of disease
c) [ ] Activity of disease
d) [x] Resistance to treatment
e) [ ] Biotherapy in history
---------------------------------------------------------------------
336. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the risk factors for
neoplasia in Crohn's disease:
a) [x] Extent of disease
b) [x] Duration of disease
c) [x] Colon strictures
d) [ ] Resistance to treatment
e) [ ] Biotherapy in history
---------------------------------------------------------------------
337. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the medical agents used
in biotherapy of ulcerative colitis:
a) [x] Infliximab
b) [x] Adalimumab
c) [ ] Vedolizumab
d) [ ] Tenofovir
e) [ ] Ribavirina
---------------------------------------------------------------------
338. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the medical agents used
in biotherapy of Crohn's disease:
a) [x] Infliximab
b) [x] Adalimumab
c) [x] Vedolizumab
d) [ ] Entecavir
e) [ ] Lamivudin
---------------------------------------------------------------------
339. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the medical agent for
maintenance treatment in severe ulcerative colitis:
54
a) [x] Infliximab
b) [x] Adalimumab
c) [x] Azatioprine
d) [ ] Corticosteroides
e) [ ] Mesalazine
---------------------------------------------------------------------
340. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the medical agent for
maintenance treatment in mild ulcerative colitis:
a) [x] Mesalazine
b) [x] Any drugs which contain 5-aminosalicylates
c) [ ] Corticosteroids
d) [ ] Infliximab
e) [ ] Azatioprina
---------------------------------------------------------------------
341. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the evolution forms of
Crohn's disease:
a) [x] Without stenosis or penetration
b) [x] With stenosis
c) [x] With penetration
d) [x] With perianal affectation
e) [ ] With perforation
---------------------------------------------------------------------
342. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the criteria for activity
evaluation in ulcerative colitis:
a) [x] Frequency of bloody stool
b) [x] Fever
c) [x] Puls
d) [x] C-reactive protein level
e) [ ] Albumin level
---------------------------------------------------------------------
343. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Choose the laboratory criteria for
activity evaluation in ulcerative colitis:
a) [x] C-reactive protein level
b) [x] ESR
c) [x] Hemoglobin
d) [ ] Albumin
e) [ ] Total proteins
---------------------------------------------------------------------
344. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Select the epidemiological
features of inflammatory bowel diseases:
a) [x] The peak age of onset is between 15 and 30 years
b) [ ] The peak age of onset is between 45 and 60 years
c) [x] Urban areas have a higher prevalence than rural areas
d) [ ] Rural areas have a higher prevalence than urban areas
e) [x] High socioeconomic classes have a higher prevalence than lower socioeconomic classes
---------------------------------------------------------------------
345. Capitol: Intestin multiplu Mod de punctare: A3 Punctajul: 10Indicate the regions with high
prevalence of inflammatory bowel diseases:
a) [x] North America
b) [x] North Europe
c) [x] Israel
55
d) [ ] Asia
e) [ ] Africa
---------------------------------------------------------------------
346. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What drugs include treatment of
severe alcoholic hepatitis:
a) [ ] Urosodeoxycholic acid
b) [ ] Anabolic steroids
c) [x] Prednisone
d) [x] Pentoxifylline
e) [ ] Propylthiouracil
---------------------------------------------------------------------
347. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the correct statements about
Mallory bodies:
a) [ ] Are specific for alcoholic hepatitis
b) [x] It appears as clusters of intensely eosinophilic perinuclear material in damaged hepatocytes
c) [ ] May occur in Wilson disease
d) [x] Can be identified in patients with morbid obesity and poorly controlled diabetes
e) [x] Are suggestive for alcoholic hepatitis
---------------------------------------------------------------------
348. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the liver biopsy findings
characteristic for alcoholic liver disease:
a) [x] Hepatocyte ballooning degeneration
b) [x] Fibrosis in the perivenular and perisinusoidal space of Disse
c) [x] Inflammatory infiltrate with polymorphonuclear neutrophils
d) [ ] Periportal infiltration with plasma cells
e) [x] Mallary bodies
---------------------------------------------------------------------
349. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the complication of advanced
cirrhosis:
a) [x] Gastroesophageal variceal hemorrhage
b) [x] Ascites
c) [ ] MALT lymphoma
d) [x] Hepatic encephalopathy
e) [x] Spontaneous bacterial peritonitis
---------------------------------------------------------------------
350. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What type of major complications of
cirrhosis are directly induced by portal hypertension?
a) [x] Variceal hemorrhage
b) [ ] Hepatorenal syndrome
c) [ ] Spider angioma
d) [ ] Spontaneous bacterial peritonitis
e) [x] Ascites
---------------------------------------------------------------------
351. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select thetreatment of hepatic
encephalopathy:
a) [x] Nonabsorbable disaccharide (lactulose)
b) [ ] Dietary sodium restriction
c) [x] Poorly absorbed antibiotics (rifaximin)
d) [ ] Transjugular intrahepatic portosystemic shunt
e) [x] Zinc supplementation
---------------------------------------------------------------------
56
352. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the characteristic features of
compensated cirrhosis associated with hepatitis C:
a) [x] The 10-year survival rate is close to 80%
b) [x] Mortality occurs at a rate of 2-6% per year
c) [ ] Mortality occurs at a rate of 10-1% per year
d) [x] Decompensation at a rate of 4-5% per year
e) [x] HCC at a rate of 1-4% per year
---------------------------------------------------------------------
353. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which of the following are the
causes of liver cirrhosis?
a) [x] Alcohol
b) [x] Drugs
c) [ ] Hypergastrinemia
e) [x] Chronic viral hepatitis
---------------------------------------------------------------------
354. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What kind of criteria does CHILD-
PUGH classification of cirrhosis include?
a) [x] Serum bilirubin
b) [x] Serum albumin
c) [x] Ascites
d) [ ] Serum ALT
e) [x] Hepatic encephalopathy
---------------------------------------------------------------------
355. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the complications of liver
cirrhosis:
a) [x] Ascites
b) [x] Portosystemic encephalopathy
c) [x] Gastroesophageal varices bleeding
d) [ ] Gallstones
e) [ ] Dumping syndrome
---------------------------------------------------------------------
356. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What type of the following criteria
are specific for hypersplenism?
a) [x] Anemia
b) [ ] Hepatopulmonary syndrome
c) [ ] Hemolysis
d) [x] Leukopenia
e) [x] Thrombocytopenia
---------------------------------------------------------------------
357. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select precipitating factors of
hepatic encephalopathy:
a) [x] Electrolyte disturbance
b) [ ] Administration of lactulose (nonabsorbable dissacharide)
c) [x] Increase dietary protein load
d) [x] Hypokalemia
e) [x] Infection
---------------------------------------------------------------------
358. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select histological characteristic of
liver cirrhosis:
a) [x] Formation of regenerative nodules
57
b) [ ] The presence of focal nodular hyperplasia
c) [ ] Normal architecture of the liver
d) [x] Architectural distortion
e) [x] Development of fibrosis
---------------------------------------------------------------------
359. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the complications of portal
hypertension:
a) [x] Gastroesophageal varices with hemorrhage
b) [x] Ascites
c) [x] Hypersplenism
d) [ ] Spider angiomata
e) [ ] Itchy skin
---------------------------------------------------------------------
360. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which hemodynamic factors
contribute to the development of ascites in liver cirrhosis?
a) [x] Vasodilatation of the splanchnic arterial system
b) [ ] Vasoconstriction of the splanchnic arterial system
c) [x] Increase intrahepatic resistance
d) [ ] Decrease intrahepatic resistance
e) [ ] Decrease level of aldosterone
---------------------------------------------------------------------
361. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the signs of hepatocellular
failure in liver cirrhosis:
a) [x] Spider angiomata
b) [x] Palmar erythema
c) [ ] Splenomegaly
d) [x] Clubbing
e) [x] Jaundice
---------------------------------------------------------------------
362. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What kind of therapeutic measures
are recommended in case of repeated short-term gastrointestinal bleeding in cirrhosis?
a) [x] Endoscopic variceal ligation
b) [x] Liver transplant if hemostasis fails
c) [ ] Linton tube for esophageal varices
d) [ ] Sengstaken-Blakemore tube for subcardiale varices
e) [x] Transjugular intrahepatic portosystemic shunt
---------------------------------------------------------------------
363. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the sing on Doppler
ultrasound specific for portal hypertension in cirrhosis:
a) [ ] Gallstone
b) [x] Slowing velocity of portal flow
c) [x] Splenomegaly
d) [x] Increasing of resistance in hepatic artery
e) [x] Dilation of portal trunk
---------------------------------------------------------------------
364. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What includes the treatment of
ascites under liver cirrhosis:
a) [x] Low sodium diet (<2 g sodium per day)
b) [x] Spironolactone 100-200 mg/day
c) [x] Furasemed 40-80 mg/day
d) [ ] NSAIDs
58
e) [x] Large-volume paracentesis in case of refractory ascites
---------------------------------------------------------------------
365. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the cause of skin
haemorrhagic syndrome in alcoholic cirrhosis?
a) [x] Thrombocytopenia due to hypersplenism
b) [x] Reduced hepatic synthesis of coagulation factors
c) [x] Malabsorption of vitamin K due to cholestasis
d) [ ] Bleeding from esophageal varices
e) [ ] Hemolytic anemia
---------------------------------------------------------------------
366. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the effects of Propranolol in
patients with liver cirrhosis:
a) [x] Reduces portal hypertension
b) [x] Vasodilatory effects on splanchnic arterial bed
c) [ ] Vasoconstrictor effects of portal venous system
d) [x] Decreases cardiac output
e) [ ] It is effective in doses which reduce the frequency of the rest of 10%
---------------------------------------------------------------------
367. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the cause of anemia in
alcoholic cirrhosis?
a) [x] Hemolysis
b) [x] Coexistent nutritional deficiencies (especially folic acid and vitamin B12)
c) [x] Hypersplenism
d) [x] Iron deficiency
e) [ ] Erythropoietin deficiency
---------------------------------------------------------------------
368. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the factors involved in the
pathogenesis of ascites in liver cirrhosis:
a) [ ] Secondary hypoaldosteronism
b) [x] Hypoalbuminemia
c) [x] Vasodilatation of splanchnic arterial system
d) [x] Sodium retention
e) [x] Activation of the renin-angiotensin-aldosterone system
---------------------------------------------------------------------
369. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the cause of anemia seen in
patients with alcoholic cirrhosis:
a) [ ] Deficiency of vitamine K
b) [x] Deficiency of folic acid
c) [x] Hemolysis
d) [x] Hypersplenism
e) [x] Direct suppressive effect of alcohol on bone marrow
---------------------------------------------------------------------
370. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the common risk factors
for hepatocellular carcinoma?
a) [x] Hepatitis B or C chronic infection
b) [x] Ethanol chronic consumption
c) [ ] Hemochromatosis
d) [x] Nonalcoholic steatohepatitis
e) [x] Aflatoxin B1
---------------------------------------------------------------------
371. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the features of
59
decompensated liver cirrhosis with portal hypertension:
a) [x] Ascites
b) [x] "Medusa head" on the anterior abdominal wall
c) [ ] Astheno-neurotic syndrome
d) [ ] Encephalopathy
e) [x] Hidrothorax
---------------------------------------------------------------------
372. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the characteristic of
decompensated liver cirrhosis with portal hypertension:
a) [ ] Cardiovascular syndrom
b) [x] Portal gastropathy
c) [x] Splenomegaly
d) [ ] Endocrine/articulare symptoms, muscle pain
e) [x] Flatulence
---------------------------------------------------------------------
373. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the characteristic of
decompensated liver cirrhosis with metabolic disorders:
a) [ ] Cardiovascular Syndrom
b) [ ] Portal Gastropathy
c) [x] Encephalopathy
d) [x] Weight Loss
e) [x] Palmar eritema, spider angioma
---------------------------------------------------------------------
374. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the drugs used in treatment of
autoimmune liver cirrhosis:
a) [x] Corticosteroid Prednisone
b) [x] Azathioprine
c) [ ] Peginterferon
d) [x] Calcium And Vitamine D
e) [ ] Antibiotics
---------------------------------------------------------------------
375. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the drugs used in treatment of
primary biliary colangitis:
a) [x] Ursodeoxycholic acid
b) [x] Cholestyramine
c) [ ] Peginterferon,
d) [x] Calcium And Vitamine D
e) [x] Naloxone
---------------------------------------------------------------------
376. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the recommendations for
treatment of compensated cirrhosis due to Nonalcoholic Fatty Liver Disease:
a) [ ] Cholestyramine
b) [x] Weight Reduction Through Diet And Exercise
c) [ ] Proton Pump Inhibitors
d) [x] Diabetes Management
e) [x] Pioglitazone
---------------------------------------------------------------------
377. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What does the reatment of portal
hypertension in liver cirrhosis include?
a) [x] Nonselective beta-blockers
b) [ ] Ursodeoxycholic acid
60
c) [x] Endoscopic variceal ligation
d) [ ] Prednisone
e) [x] Transjugular intrahepatic portosystemic shunting
---------------------------------------------------------------------
378. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the ultrasound characteristics
of liver cirrhosis:
a) [x] Dilated portal vein
b) [x] Splenomegaly
c) [ ] Dilated bile canaliculi
d) [x] Micronodular appearance
e) [ ] Macrovesicular steatosis
---------------------------------------------------------------------
379. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which are manifestations of
hepatocellular failure in patients with liver cirrhosis:
a) [x] Jaundice
b) [x] Coagulation Disorders
c) [ ] Dilated Portal Vein
d) [x] Hypoalbuminemia
e) [x] ProlongedProthrombin Times
---------------------------------------------------------------------
380. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the enzyme systems account
for metabolism of alcohol in the liver:
a) [x] Cytosolic Alcoholdehydrogenesis
b) [ ] Cyclooxygenase (Cox)
c) [x] The Microsomal-Oxidizing System (Meos)
d) [x] Peroxisomal Catalase
e) [ ] Udp-Glucuronosyltransferases
---------------------------------------------------------------------
381. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the statements characteristic
for ethanol intake:
a) [x] Increases The Intracellular Accumulation Of Triglycerides
b) [x] Increases Fatty Acid Uptake
c) [ ] Increases Fatty Acid Oxidation
d) [x] Reduces Fatty Acid Oxidation
e) [ ] Increases Lipoprotein Secretion
---------------------------------------------------------------------
382. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the most important risk
factors involved in the development of alcoholic liver disease:
a) [x] Quantity of alcohol intake
b) [ ] Type of beverage
c) [x] Duration of alcohol intake
d) [ ] Pattern of drinking
e) [ ] Social factors
---------------------------------------------------------------------
383. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the risk factors for alcoholic
liver disease:
a) [x] Gender
b) [ ] Beverage type
c) [x] Chronic infection with hepatitis C
d) [x] Malnutrition
e) [x] Obesity
61
---------------------------------------------------------------------
384. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the typical laboratory
abnormalities seen in acute alcoholic hepatitis:
a) [x] AST/ALT ratio > 1,5
b) [x] Leukocytosis
c) [x] Elevated gama-glutamyltranspeptidase (GGTP)
d) [x] Increased Ig A
e) [ ] Hyperalbuminemia
---------------------------------------------------------------------
385. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the markers characteristics
for autoimmune cirrhosis:
a) [ ] Antimitochondrial antibody (AMA)
b) [x] Antinuclear antibody (ANA)
c) [x] Anti-smooth-muscle antibody (ASMA)
d) [ ] Elevated gama-glutamyltranspeptidase (GGTP)
e) [x] Increased Ig G
---------------------------------------------------------------------
386. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which complications can develop
Caroli's disease?
a) [x] Secondary biliary cirrhosis with portal hypertension
b) [x] Extrahepatic biliary obstruction
c) [x] Cholangiocarcinoma
d) [x] Recurrent episodes of sepsis with hepatic abscess formation
e) [ ] Congenital hepatic fibrosis
---------------------------------------------------------------------
387. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Find the correct afirmations which
are more characteristic for patients with HBeAg- positive chronic hepatitis B:
a) [x] HBeAg and HBV DNA levels well in excess of 105-106 virions/mL in the serum
b) [x] Detectable intrahepatocyte nucleocapsid antigens (HBcAg) in the liver
c) [x] High infectivity
d) [ ] Low infectivity
e) [x] Accompanying liver injury
---------------------------------------------------------------------
388. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Find the correct afirmations which
are more characteristic for HBeAg-negative chronic hepatitis B:
a) [ ] HBeAg positive
b) [x] Anti-HBe positive
c) [x] HBV DNA below a threshold of 103 virions/mL
d) [x] Anti-HB corr total positive
e) [x] Low infectivity
---------------------------------------------------------------------
389. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which conditions are more likely
lead to progression of liver disease in patients with chronic hepatitis C:
a) [x] Older age and longer duration of infection
b) [x] Advanced histologic stage and grade
c) [ ] Genotype 3
d) [ ] Decreased hepatic iron
e) [x] Concomitant other liver disorders (alcoholic liver disease and liver steatosis)
---------------------------------------------------------------------
390. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the indications for antiviral
therapy of chronic hepatitis C?
62
a) [x] Detectable HCV RNA (with or without elevated ALT)
b) [x] Portal/bridging fibrosis or moderate to severe hepatitis on liver biopsy
c) [ ] Decompensated cirrhosis
d) [ ] Age >60
e) [ ] Mild hepatitis on liver biopsy
---------------------------------------------------------------------
391. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What is the mainstay of treatment of
fatty liver disease?
a) [x] Weight loss
b) [x] Thiazolidinedione medications which improve insulin sensitivity within the adipocyte and skeletal
muscle
c) [x] Zinc supplementation
d) [x] Antioxidants
e) [ ] Ribaverin
---------------------------------------------------------------------
392. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which of the following can be
prevented?
a) [x] Hepatitis A
b) [x] Hepatitis B
c) [ ] Alcoholic cirrhosis
d) [ ] Hemocromatosis
e) [x] Steatosis
---------------------------------------------------------------------
393. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the symptoms of liver
diseases:
a) [x] Nausea
b) [x] Dark urine
c) [ ] Heartburn
d) [x] Yellow eyes
e) [x] Pale / dark colored stool
---------------------------------------------------------------------
394. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the main functions of the
liver?
a) [x] The elimination of toxins
b) [ ] The elimination of carbon dioxide and the manufacture of urine
c) [ ] The elimination of damaged blood cells
d) [ ] The regulation of blood pressure
e) [x] Processing of food nutrients
---------------------------------------------------------------------
395. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the most common causes
of liver disease?
a) [ ] Deficiency of α1-antitrypsine
b) [ ] Wilson disease
c) [x] Infections with B virus
d) [x] Excessive alcohol consumption
e) [x] Chronic infections with C virus
---------------------------------------------------------------------
396. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which of the following is the most
important goal of treating chronic viral hepatitis B infection?
a) [x] Lose HbsAg in the serum
b) [x] Normalize ALT and AST
63
c) [ ] Decreased bilirubin level
d) [x] HbeAg seroconversion to antiHBeAg
e) [ ] Decreased level of alkaline phospphatase
---------------------------------------------------------------------
397. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Indicate the set of results that most
likely indicate the most biochimical changes in chronic hepatitis D in reactivation phase.
a) [x] Increased value of ALT, AST, bilirubin
b) [ ] Incresed level of ureea, creatinin, glucosa
c) [ ] Incresed level of cholesterol, triglicedride
d) [ ] Reduced value of glucose, AST
e) [x] Reduced value of prothrombin, albumin
---------------------------------------------------------------------
398. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which of the folowing are false
regarding chronic hepatitis C?
a) [x] May be treated with lamivudine
b) [ ] May be lead to liver cancer
c) [ ] May be cause autoimmune tiroiditis
d) [x] Histologically can determine specifically "ground glass" hepatocytes
e) [ ] May be treated with sofosbuvir for 24 weeks
---------------------------------------------------------------------
399. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which symptoms are specifical for
chronic hepatitis C with extrahepatic manifestation:
a) [ ] Jaundice
b) [x] Arthralgia
c) [ ] Pain in right hypocondria
d) [x] Hyperglicemia
e) [x] Vasculitic rash
---------------------------------------------------------------------
400. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What laboratory tests would you
request in man known to be carrier of HbsAg who presents with jaundice, pain in right hypocondria and
reveal AST and ALT > 900 IU/ml?
a) [x] AND HBV quantitative
b) [x] AntiHDV IgM antibodies
c) [ ] AntiHBsAg antibodies
d) [ ] Level of urea
e) [ ] Level of alfa fetoprotein
---------------------------------------------------------------------
401. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What laboratory tests should be
obtained to determine if therapy is effective in patient with HBV infection who has treated for 12 weeks
with lamivudine?
a) [x] ALT
b) [x] HBV DNA
c) [ ] Genotype for HBV
d) [x] Anti HBe
e) [x] HbsAg
---------------------------------------------------------------------
402. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the cofactors for fibrosis
progression in chronic HCV?
a) [ ] Tabacco smoking
b) [x] Obesity
c) [x] Dayly cannalis use
64
d) [ ] Coffe consumtion
e) [x] Alcohol abus
---------------------------------------------------------------------
403. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the noninvasive markers
for assessment liver fibrosis in chronic HCV?
a) [ ] Liver biopsy
b) [x] Fibrotest
c) [x] Fibroscan
d) [x] APRI
e) [x] FIB - 4
---------------------------------------------------------------------
404. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the histological findings in
chronic HCV?
a) [x] Centrilobular cholestasis
b) [x] Steatosis
c) [x] Nodular lymphocytic aggregates
d) [ ] Ground glas hepatocytes
e) [ ] Mallory bodies
---------------------------------------------------------------------
405. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which extrahepatic sites can content
HBV?
a) [x] Lymp nodes
b) [x] Bone marrow
c) [x] Spleen
d) [ ] Gallblades
e) [ ] Pancreas
---------------------------------------------------------------------
406. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the first-line drugs
(nucleotide/ nucleoside analogues) for chronic HBV?
a) [ ] Lamivudine
b) [ ] Adefovire
c) [ ] Telbivudine
d) [x] Tenofovir
e) [x] Entecavir
---------------------------------------------------------------------
407. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the second - line drugs
(nucleotide/ nucleoside analogues) for chronic HBV?
a) [x] Lamivudine
b) [x] Adefovire
c) [x] Telbivudine
d) [ ] Tenofovir
e) [ ] Entecavir
---------------------------------------------------------------------
408. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the advantages for
nucleotide/nucleoside analogues therapy on HBV?
a) [ ] Finite duration
b) [x] Daily oral dosing
c) [x] Potent HBV DNA suppression
d) [ ] No antiviral resistance
e) [ ] Expensive
---------------------------------------------------------------------
65
409. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the antiviral therapy for
patients with chronic hepatitis C:
a) [ ] Interferon-based regimens
b) [x] Interferon- free regimens
c) [ ] Lamivudin associated with interferon
d) [ ] Amoxacilin with clarytromicin
e) [x] Sofosbuvir + Ledipasvir
---------------------------------------------------------------------
410. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What factors can influence the
treatment regimens in HCV?
a) [x] Genotypes of HCV
b) [x] Genetic barrier
c) [x] Potency
d) [x] Adverse profiles
e) [ ] Gender
---------------------------------------------------------------------
411. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the direct-acting antiviral
agents (DAA) for chronic HCV?
a) [ ] Entecavir
b) [x] Sofosbuvir
c) [x] Simeprevir
d) [x] Daclatasvir
e) [x] Ledipasvir
---------------------------------------------------------------------
412. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select the fluids which can content
HBV in high amount:
a) [x] Blood
b) [x] Wound exudate
c) [ ] Urine
d) [ ] Sweat
e) [ ] Tears
---------------------------------------------------------------------
HBV in moderate amount:
a) [ ] Blood
b) [ ] Semen
c) [x] Saliva
d) [x] Vaginal fluid
e) [ ] Breast milk
---------------------------------------------------------------------
HBV in low amount:
a) [x] Urine
b) [ ] Sweat
c) [ ] Blood
d) [x] Tears
e) [ ] Semen
---------------------------------------------------------------------
415. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the conditions due to HDV
co-infection?
a) [ ] Increase the severity of chronic hepatitis B
66
b) [x] Increase the severity of acute hepatitis B
c) [x] Does not increase the likelihood of progression to chronic hepatitis B
d) [ ] Decreased the severity of acute hepatitis B
e) [ ] Decreased the severity of chronic hepatitis B
---------------------------------------------------------------------
416. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which circumstances are useful for
testing anti-HDV antibodies in patients with hepatitis B?
a) [x] Patients with severe and fulminant disease
b) [x] Patients with chronic hepatitis B who have acute hepatitis-like exacerbations
c) [x] Persons with frequent percutaneous exposures
d) [x] Persons from areas where HDV infection is endemic
e) [ ] Patients with chronic hepatitis C
---------------------------------------------------------------------
417. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which conditions lead to
progression of liver disease in patients with chronic hepatitis C?
a) [x] Longer duration of infection
b) [x] Minimal histologic stage
c) [ ] Genotype 1
d) [ ] More complex quasispecies diversity
e) [x] Increased hepatic iron
---------------------------------------------------------------------
418. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which serological markers can
including in evaluation for patients with suspected HCV?
a) [ ] HBs Ag
b) [ ] HBcor Ag
c) [x] Anti HCV total
d) [x] ARN HCV quantitative
e) [x] ARN HCV qualitative
---------------------------------------------------------------------
419. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which conditions lead to
progression of liver disease in patients with chronic hepatitis C?
a) [x] In patients with older age
b) [ ] Shorter duration of infection
c) [ ] Genotype 2 or 3
d) [ ] Decreased hepatic iron
e) [x] Associated with chronic alcohol abuse
---------------------------------------------------------------------
420. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Select three correct statements about
NAFLD:
a) [x] NAFLD is the hepatic manifestation of metabolic syndrome
b) [x] NAFLD includes the clinical spectrum from hepatic steatosis, nonalcoholic steatohepatitis, which
can progress to cirrhosis
c) [ ] The prelevance of NAFLD in western countries is estimated at 5%
d) [x] NAFLD is likely to become the leading couse of liver transplantation in the future
e) [ ] There is only small association between NAFLD and polycystic ovarian syndrome
---------------------------------------------------------------------
421. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Indicate correct statement regarding
pathogenesis of NAFLD:
a) [x] The liver stores energy as triglycerides
b) [ ] Subcutoneous fat releases more free fatty acids
c) [ ] Adipose tissue is an inert depot of stored energy
67
d) [x] In obesity, the release of the insulin-sensing hormone adiponectin is reduced
e) [x] Tumor necrosis factor are predictive of progression to NAFLD
---------------------------------------------------------------------
422. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Standard indications for antiviral
therapy of chronic hepatitis C are:
a) [x] Detectable HCV RNA (with or without elevated ALT)
b) [x] Portal/bridging fibrosis or moderate to severe hepatitis on liver biopsy
c) [x] Liver cirrhosis
d) [ ] AntiHCV IgGpoz, ARN HCV neg
e) [ ] Mild hepatitis on liver biopsy
---------------------------------------------------------------------
a) [x] Increased value of ALT, AST, bilirubin
e) [x] Reduced value of prothrombin, albumin
---------------------------------------------------------------------
424. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Describe the signs wich characterise
the chronic hepatitis C with extrahepatic manifestation:
a) [ ] Jaundice
b) [x] Arthralgia
d) [x] Hyperglicemia
---------------------------------------------------------------------
425. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Cofactors for fibrosis progression in
chronic HCV are:
a) [ ] Protein intake
b) [x] Obesity
c) [x] Dayly cannalis use
d) [ ] Coffe consumtion
e) [x] Alcohol abus
---------------------------------------------------------------------
426. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Noninvasive markers for assessment
liver fibrosis in chronic HCV are:
a) [ ] Liver biopsy
b) [x] Fibrotest
c) [x] Fibroscan
d) [ ] Abdominal ultrasound
e) [ ] Digestive endoscopy
---------------------------------------------------------------------
427. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Selections of the treatment regimens
in HCV will be influenced by:
a) [x] Genotypes of HCV
b) [x] Genetic barrier
c) [x] Potency
d) [ ] Level of alcaline Phosphatase
e) [ ] Level of iron in serum
---------------------------------------------------------------------
68
428. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Antiviral therapy in patients with
chronic hepatitis C including:
a) [x] Interferon-based regimens
b) [x] Interferon- free regimens
c) [ ] Lamivudin associated with interferon
d) [ ] Amoxacilin with clarytromicin
e) [ ] Entecavir with interferon
---------------------------------------------------------------------
429. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10The direct-acting antiviral agents
(DAA) for chronic HCV are:
a) [ ] Entecavir
b) [x] Sofosbuvir
c) [x] Velpatasvir
d) [ ] Lamivudine
e) [x] Ledipasvir
---------------------------------------------------------------------
430. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10What are the main functions of the
liver?
a) [x] The elimination of toxins
b) [ ] The elimination of carbon dioxide and the manufacture of urine
c) [ ] The elimination of damaged blood cells
d) [ ] The regulation of blood pressure
e) [x] Processing of food nutrients
---------------------------------------------------------------------
431. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Which of the following is the most
important goal of treating chronic viral hepatitis B infection?
a) [x] Lose HbsAg in the serum
b) [x] Normalize ALT and AST
c) [ ] Decreased bilirubin level
d) [x] HbeAg seroconversion to antiHBeAg
e) [ ] Decreased level of alkaline phospphatase
---------------------------------------------------------------------
a) [x] Increased value of ALT, AST
e) [x] Reduced value of Cholinesterase, albumin
---------------------------------------------------------------------
433. Capitol: Ficat multiplu Mod de punctare: A3 Punctajul: 10Describe the signs wich characterise
the chronic hepatitis C with extrahepatic manifestation:
a) [ ] Jaundice
b) [x] Arthralgia
d) [x] Hypotiroidia
---------------------------------------------------------------------
434. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected etiological factors of
chronic pancreatitis:
a) [x] Alcohool
69
b) [ ] Diabetes
c) [ ] Peptic ulser
d) [x] Disfunction of sf. Oddi
e) [ ] Autoimmune hepatitis
---------------------------------------------------------------------
435. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated clinical signs what is
presented in chronic pancreatitis (symptoms):
a) [x] Pain postprandial
b) [x] Steatorrhea
c) [ ] Pozitiv Herning symptom
d) [ ] Splenomegaly
e) [ ] Hepatomegaly
---------------------------------------------------------------------
436. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected grups of medicaments
what is used in treatment of chronic pancreatitis:
a) [ ] Glucocorticosteroides
b) [x] Antisecretory
c) [x] Antispasmodies
d) [ ] Fosfolipides
e) [x] Analgetiscs
---------------------------------------------------------------------
437. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated what investigations is
used in diagnostic of chronic pancreatitis:
a) [x] Coprological investigation
b) [x] Abdominal USG
c) [x] CT
d) [x] ERSP
e) [ ] Oral colecistography
---------------------------------------------------------------------
438. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Choose complications of
a) [x] Manonic jaundice
b) [x] Diabetes
c) [x] Defisiense of vitamins
d) [ ] Mallory-Weiss syndrome
e) [ ] Zollinger-Elison syndrome
---------------------------------------------------------------------
439. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected characteristic
symptoms from "pancreatic fecales:
a) [x] Polifecaly
b) [x] Content of blood
c) [x] Fetty aspect
d) [ ] Peresites
e) [ ] Black color
---------------------------------------------------------------------
440. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated proteolitic enzimes:
a) [x] Tripsine
b) [x] Chimotripsine
c) [x] Ellastase
d) [ ] Lipase
e) [ ] Α- amilase
70
---------------------------------------------------------------------
441. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated characteristic
processes from chronic pancreatitis:
a) [x] Irreversible damage of the pancreas
b) [ ] Reversible damage of the pancreas
c) [x] Chronic inflammation
d) [x] Progressive destruction of both exocrine and eventually endocrine tissue
e) [x] Fibrosis
---------------------------------------------------------------------
442. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected etiological factors of
a) [x] Alcohool
b) [ ] Diabetes
c) [ ] Peptic ulser
d) [x] Disfunction of sf. Oddi
e) [ ] Autoimmune hepatitis
---------------------------------------------------------------------
443. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated clinical signs what is
presented in chronic pancreatitis (symptoms):
a) [x] Pain postprandial
b) [x] Steatorrhea
c) [ ] Pozitiv Herning symptom
d) [ ] Splenomegaly
e) [ ] Hepatomegaly
---------------------------------------------------------------------
444. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected grups of medicaments
what is used in treatment of chronic pancreatitis:
a) [ ] Glucocorticosteroides
b) [x] Antisecretory
c) [x] Spasmolytics
d) [ ] Fosfolipides
e) [x] Analgetiscs
---------------------------------------------------------------------
445. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated what investigations is
used in diagnostic of chronic pancreatitis:
a) [x] Endoscopic ultrasonography
b) [x] Abdominal USG
c) [x] CT
d) [x]MRI/MRCP
e) [ ] Oral colecistography
---------------------------------------------------------------------
446. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Choose complications of
a) [x] Manonic jaundice
b) [x] Diabetes
c) [x] Defisiense of vitamins
d) [ ] Mallory-Weiss syndrome
e) [ ] Zollinger-Elison syndrome
---------------------------------------------------------------------
447. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected characteristic
symptoms from ”pancreatic fecales”:
71
a) [x] Polifecaly
b) [x] Content of blood
c) [x] Fetty aspect
d) [ ] Content of parasites
e) [ ] Black color
---------------------------------------------------------------------
448. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated proteolitic enzimes:
a) [x] Tripsine
b) [x] Chimotripsine
c) [x] Elastase
d) [ ] Lipase
e) [ ] Α- amilase
---------------------------------------------------------------------
449. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated characteristic
processes from chronic pancreatitis:
a) [x] Irreversible damage of the pancreas
b) [ ] Reversible damage of the pancreas
c) [x] Chronic inflammation
d) [x] Progressive destruction of both exocrine and eventually endocrine tissue
e) [x] Fibrosis
---------------------------------------------------------------------
450. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected the clinical features of
autoimmune pancreatitis:
a) [x] Mild abdominal pain
b) [x] Presentation with obstructive jaundice
c) [x] Diffuse swelling and enlargement of the pancreas, especially the head, the latter mimicking
carcinoma of the pancreas
d) [ ] Decrease levels of serum gamma globulins
e) [x] Presence of antinuclear antibodies, rheumatoid factor
---------------------------------------------------------------------
451. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated the pathogenesis,
diagnostic approach, clinical course, and treatment results for large-duct forms of chronic pancreatitis as
follows:
a) [x] Sex Predominance - male
b) [ ] Sex Predominance- female
c) [x] Fecal elastase - often abnormal
d) [ ] Therapy of pain with pancreatic enzymes-good to excellent response
e) [ ] Surgical procedures - not usually indicated
---------------------------------------------------------------------
452. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated while alcohol is by far
the most common cause of pancreatic calcification, such calcification may also be noted in:
a) [ ] Mild protein-calorie malnutrition
b) [x] Hereditary pancreatitis
c) [x] Posttraumatic pancreatitis
d) [x] Hypercalcemic pancreatitis
e) [x] Idiopathic chronic pancreatitis
---------------------------------------------------------------------
453. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected complications of
Chronic Pancreatitis:
a) [x]Pseudocysts
b) [ ] Obesity
72
c) [x] Vascular complications
d) [ ] Colonic stenosis
e) [x] Strictures of the pancreatic duct and/or the biliary ducts
---------------------------------------------------------------------
454. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated the management of
pain in patients with large-duct disease usually from alcohol-induced chronic pancreatitis:
a) [x] Ductal decompression (sphincterotomy, stenting, stone extraction, and drainage of a pancreatic
pseudocyst)
b) [x] Large doses of octreotide (200 μg given SC three times daily)
c) [ ] Nonenteric coated enzyme preparations containing high concentrations of serine proteases
d) [ ] Enteric-coated enzymes
e) [ ] Prochinetics
---------------------------------------------------------------------
455. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Choose the management of pain
in patients with small-duct type of chronic pancreatitis:
a) [x] Proton pump inhibitors
b) [ ] Large doses of octreotide (200 μg given SC three times daily)
c) [x] Ductal decompression (sphincterotomy)
d) [ ] Enteric-coated enzymes
e) [x] Prokinetic agents
---------------------------------------------------------------------
456. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated the clear risk factors
for the development of pancreatic cancer:
a) [x] Cigarette smoking
b) [x] Obesity
c) [x]Hereditary chronic pancreatitis
d) [ ] Barett Esophagus
e) [ ] Escherichia coli
---------------------------------------------------------------------
457. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selected the common presenting
features of pancreatic cancer:
a) [x] Pain in the upper abdomen that may radiate to the back
b) [x] Obstructive jaundice
c) [x] Weight loss and anorexia
d) [x] Pruritus, pale stools, and dark urine
e) [ ] Constipation
---------------------------------------------------------------------
458. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated which types of
abnormalities detectable on physical examination are characteristic for pancreatic cancer:
a) [x] Jaundice
b) [x] Courvoisier's sign
c) [x] Abdominal mass
d) [x] Virchow's node
e) [ ] Rheumatic nodules
---------------------------------------------------------------------
459. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated what changes in
diagnostic of pancreatic cancer are illustrated in CT:
a) [x] Pancreatic mass
b) [x] Dilatation of the biliary system or pancreatic duct
c) [x] Distal spread to the liver
d) [x] Regional lymph nodes, or peritoneum (and/or associated ascites)
73
e) [ ] Small lesions (<2-3 cm in diameter)
---------------------------------------------------------------------
460. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated the parameters of
pancreas:
a) [x] An endocrine organ
b) [x] An exocrine organ
c) [x] It secretes the hormones required for sugar metabolism
d) [x] It secretes the pancreatic juice required for digestion
e) [ ] Itraperitoneal organ
---------------------------------------------------------------------
461. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Choose the vital hormones
secreted by the pancreas:
a) [x] Glucagon
b) [ ] Glycogen
c) [ ] Fructose
d) [ ] Sucrose
e) [x] Insulin
---------------------------------------------------------------------
462. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Select pathogenetic factors in
a) [ ] Activation of protheolitic enzymes in duodenum
b) [x] Pancreatic stellate cell activation
c) [x] Cholangio-pancreatic reflux
d) [x] Activation of protheolitic enzymes in pancreatic ducts
e) [ ] Duodeno-gastral reflux
---------------------------------------------------------------------
463. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicated what answers are
included treatment of chronic pancreatitis with persistent pain.
a) [x] Dietary fat restriction and rich in proteins dinner
b) [x] Diet without using of alcohol
c) [x] Treatment with somatostatines
d) [ ] Treatment with immunstimulators
e) [x] Treatment with tramadol
---------------------------------------------------------------------
464. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Select correct affirmation of
chronic pancreatitis evolution:
a) [x] A long evolution lead to malabsorbtion
b) [ ] The decreasing of proteolitic enzymes secretion is predominant to lipasae decreasing
c) [x] The pain is increasing postdinner
d) [x] The evolution of disease have chronic- recidivant characteristic
e) [x] Diabetes may be as a complication of chronic pancreatitis
---------------------------------------------------------------------
465. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Select right assertions of pain
mechanisms in chronic pancreatitis:
a) [ ] The increasing of glucagon concentration
b) [x] Perineural inflammation and fibrosis of intrapancreatic nervusis
c) [ ] Hyperinsulinaemia
d) [x] Duct obstruction with increasing of intraductal pressure
e) [x] Affectation of peritoneum and /or/ duodenum
---------------------------------------------------------------------
74
466. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Select tests what are using in
investigation of pancreas.
a) [x] Pancreatic enzymes in blood a jeun
b) [x] Pancreatic enzymes in urine
c) [x] Pancreatic enzymes in fecales
d) [x] Quantitative stool fat determination
e) [ ] The activity of aminotransferases in blood
---------------------------------------------------------------------
467. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selecte blood tests for
nutritional assesstment in chronic pancreatitis:
a) [x] 25-OH cholecalciferol (vitamin D)
b) [ ] Creatinine
c) [x] Prealbumin
d) [x] Retinol-binding protein
e) [x] Serum iron, zinc and magnesium
---------------------------------------------------------------------
468. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicate the main
extrapancreatic diseases, associated with autoimmune pancreatitis:
a) [x] Sclerosing cholangitis Ig G 4 -pozitive
b) [x] Retroperitoneal fibrosis
c) [x] Siladenitis
d) [ ] Ulcerative colitis
e) [ ] Crohn's disease
---------------------------------------------------------------------
469. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicate what factors are
associated with nutritional deficiency in chronic pancreatitis:
a) [x] Increasing of mortality
b) [x] Cardiovascular events
c) [x] Traumatic risk
d) [x] Risk of infections
e) [ ] Decrease of pain episodes incidence
---------------------------------------------------------------------
470. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Selecte blood tests for
nutritional evaluation in chronic pancreatitis:
a) [x] Serum magnesium
b) [ ] Blood ureea
c) [x] Albumin, prealbumin
d) [ ] Prothrombin
e) [x] 25-OH cholecalciferol (vitamin D)
---------------------------------------------------------------------
471. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Select the treatment of pain in
chronic pancreatitis recommended by WOH:
a) [x] Paracetamol
b) [x] Tramadol
c) [x] Gabapentinoids and anxiolytics
d) [ ] Myotropic analgesics
e) [ ] M-colinolitics
---------------------------------------------------------------------
472. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicate effective prophylactic
actions in chronic pancreatic pain:
75
a) [x] Excludig alcohol
b) [x] Excludin smoking
c) [x] Compliance to the treatment
d) [ ] Decrease protein using less that 20 g/day
e) [ ] Decrease physical exercises
---------------------------------------------------------------------
473. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Choose parameters of abdominal
pain sydrom in chronic pacreatitis:
a) [x] The pain is beginning typical in dependence of food or alcohol use
b) [x] The pain is in epigastrium with irradiation in spine or " in girdle"
c) [x] The pain decrease in Bozeman position
d) [ ] The pain decrease in dorsal decubitus
e) [ ] The pain decrease after dinner
---------------------------------------------------------------------
474. Capitol: Pancreas multiplu Mod de punctare: A3 Punctajul: 10Indicate the clinical sydromes
in chronic pacreatitis:
a) [ ] Hemorrhagical
b) [x] Abdminal pain
c) [x] Endocrine
d) [x] Exocrine insufficiency of pancreas
e) [x] Dyspeptic
---------------------------------------------------------------------
475. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select Charcot triad ,the
characteristic presentation of acute cholangitis:
a) [x] Biliary pain
b) [x] Jaundice
c) [x] Spiking fevers with chills
d) [ ] Blood cultures are positive
e) [ ] Leukocytosis
---------------------------------------------------------------------
476. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicated what defective bile
acid conjugation can caused:
a) [ ] Fluide overload
b) [ ] Ascites
c) [x] Fat-soluble vitamin deficiency
d) [ ] Vitamine B12 deficiency
e) [x] Steatorrhea
---------------------------------------------------------------------
477. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Choose the functions of bile
acids:
a) [x] Induce bile flow and hepatic secretion of biliary lipids (phospholipid and cholesterol)
b) [x] Play an important role in the digestion of dietary fats
c) [x] Are essential for the intestinal absorption of cholesterol and fat-soluble vitamins
d) [ ] Decrease absorption of vitamins A,D,K,E
e) [x] Neutralization of HCl and pepsin
---------------------------------------------------------------------
478. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Selected the components of
bile:
a) [x] Bile salts
b) [x] Water
c) [x] Cholesterol
76
d) [x] Bilirubin
e) [ ] Pepsin
---------------------------------------------------------------------
479. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Choose the components of
bile:
a) [x] Cholic acid
b) [x] Dezoxicholic acid
c) [x] Glutation
d) [ ] Gastrine
e) [x] Immunoglobulin A
---------------------------------------------------------------------
480. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Selected the functions of
sphincter Oddi:
a) [x] Regulation of bile flow into the duodenum
b) [x] Regulation of pancreatic flow into the duodenum
c) [x] Evacuation of hepatic bile into the gallbladder
d) [x] Prevention of reflux of duodenal contents into the pancreaticobiliary tract
e) [ ] Secretion of bile acids
---------------------------------------------------------------------
481. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicated what vitamins are
absorb with helps of Bile?
a) [x] Vitamins A, D
b) [x] Vitamine E
c) [x] Vitamine K
d) [ ] Vitamin B complex
e) [ ] Vitamin C
---------------------------------------------------------------------
482. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select the mechanisms that
are important in regulating bile flow:
a) [x] Active transport of bile acids from hepatocytes into the bile canaliculi
b) [x] Active transport of other organic anions from hepatocytes into the bile canaliculi
c) [x] Cholangiocellular secretion
d) [ ] Hemolysis
e) [ ] Insufficiency of UDPglucuronosyltransferase
---------------------------------------------------------------------
483. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicated the primary bile
acids:
a) [x] Cholic acid
b) [x] Chenodeoxycholic acid (CDCA)
c) [ ] Deoxycholic acid
d) [ ] Lithocholic acid
e) [ ] Ursodeoxycholic acid(UDCA)
---------------------------------------------------------------------
484. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select the secondary bile
acids:
a) [ ] Cholic acid
b) [ ] Chenodeoxycholic acid (CDCA)
c) [x] Deoxycholic acid
d) [x] Lithocholic acid
e) [x] Ursodeoxycholicacid(UDCA)
---------------------------------------------------------------------
77
485. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicated what criteria can be
used to identify patients with acalculous cholecystopathy:
a) [x] Recurrent episodes of typical RUQ pain characteristic of biliary tract pain
b) [x] Abnormal CCK cholescintigraphy demonstrating a gallbladder ejection fraction of <40%
c) [ ] Mirizzi'ssyndrome
d) [x] Infusion of CCK reproduces the patient's pain
e) [x] A large gallbladder on ultrasound examination
---------------------------------------------------------------------
486. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select follwing signs what
increased risk for the development of acalculous cholecystitis:
a) [x] Serious trauma or burns
b) [x] The postpartum period following prolonged labor
c) [x] Orthopedic and other nonbiliary major surgical operations in the postoperative period
d) [ ] Increased gastric acidity
e) [x] Prolonged parenteral hyperalimentation
---------------------------------------------------------------------
487. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select precipitating factors
for acalculous cholecystitis:
a) [ ] Sindrom Mallory-Weiss
b) [x] Obstructing adenocarcinoma of the gallbladder
c) [x] Diabetes mellitus
d) [x] Torsion of the gallbladder
e) [x] Parasitic infestation of the gallbladder
---------------------------------------------------------------------
488. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicated forms of chronic
pancreatitis according TIGAR-O classification:
a) [ ] Interstitial pancreatitis
b) [x] Toxic-metabolic
c) [x] Autoimmune
d) [x] Recurrent and severe acute pancreatitis
e) [x] Obstructive
---------------------------------------------------------------------
489. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select the tests that suggests
pancreatic exocrine insufficiency:
a) [x] Decrease of serum trypsinogen level to <20 mg/mL
b) [ ] Increase of serum amylase level
c) [x] Fecal elastase of <100 μg per gram of stool
d) [ ] Increase of serum trypsinogen level
e) [ ] Increase of fecal elastase
---------------------------------------------------------------------
490. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select symptoms of
maldigestion in chronic pancreatitis:
a) [x] Chronic diarrhea
b) [x] Steatorrhea
c) [ ] Abdominal pain
d) [x] Weight loss
e) [x] Fatigue
---------------------------------------------------------------------
491. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicate what mechanisms
partisiped in formation of bile stouns:
a) [x] Bile stasis
78
b) [x] Chronic infection in bille ducts
c) [ ] Presens of duodenal ulser
d) [x] Lithogenetic changes of bila
e) [ ] Presens of stomac ulser
---------------------------------------------------------------------
492. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicate what investigations
is more useful to diagnostic chronic colecistites:
a) [x] MRI
b) [x] Abdominal use
c) [ ] Bilecultura
d) [ ] Duodenoscopy
e) [ ] Gastroscopy
---------------------------------------------------------------------
493. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select what medicaments
included treatment of chronic colecistites:
a) [ ] Coleretics
b) [ ] H2-blours
c) [x] Antibiotics
d) [x] Antispastics
e) [ ] Nonsteroidian antiinflamatores
---------------------------------------------------------------------
494. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicate what signs
characterized chronic cholestatic syndrome in primary sclerosing cholangitis:
a) [x] Diffuse inflammation and fibrosis involving the entire biliary tree
b) [x] Chronic cholestasis
c) [ x] Obliteration of both the intra- and extrahepatic biliary tree
d) [ ] Obliteration of only extrahepatic biliary tree
e) [ ] Obliteration of only intrahepatic biliary tree
---------------------------------------------------------------------
495. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Indicat the medicaments
what are using in treatment of chronic cholecistitis.
a) [x] Choleretics
b) [ ] H2-blocers
c) [x] Antibacterial treatment
d) [x] Antispasmodics
e) [ ] Nonsteroid antyinflamatory
---------------------------------------------------------------------
496. Capitol: Caile biliare multiplu Mod de punctare: A3 Punctajul: 10Select the drugs what have a
dissolve action in gallstones.
a) [x] Ursodeoxicholic acid
b) [ ] Himecromonum
c) [ ] Pancreatin
d) [ ] Antibiotics
e) [x] Chenodesoxicholic acid
---------------------------------------------------------------------
79

Gastrologie ENG 2018-2019

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