1) Malabsorption due to a mucosal intestinal defect occurs in:

a) Chronic pancreatitis
b) Cystic fibrosis
c) Coeliac disease
d) Ulcerative colitis

2) Which seromarker is specific for ulcerative colitis:

a) ASCA
b) ANCA
c) Serum albumin
d) ESR

3) In Caeliac disease, the best non invasive serological test is:

a) Anti endomysial IgA antibody
b) Positive C-reactive protein
c) Jejunal biopsy
d) D-xylose test

4) In ulcerative colitis the diagnosis is confirmed by:

a) Ileal involvement
b) Crypt abscesses
c) Skip lesion
d) Granulomas

5) 22year old man with inflammatory bowel disease is noted to haveA

string sign in the ileal area on barium enema which is seen in the
following conditions:
a) In the stenotic and nonstenotic phase of the
disease.
b) In the stenotic phase only.
c) With gastric involvement.
d) With rectal involvement

6) In ulcerative colitis only one statement is true:

a) Is more common in smokers than in non
smokers.
b) The first line of treatment is infliximab.
c) Commonly involves the ileum.
d) Is associated with HLA B27.
7) Lower GIT bleeding (heamatochezia) occurs in:
a) Diverticular disease.
b) Diabetes mellitus.
c) Helicobacter Pylori infection.
d) Mallory Weiss syndrome.

8) Gastric atony can occur in:

a) Motor neuron disease.
b) Marfan’s syndrome.
c) Diabetes mellitus.
d) Diabetes insipid us

9) Osmotic diarrhea may be caused by:

a) Zollinger Ellison syndrome.
b) Lactase deficiency.
c) Motility disorders.
d) Hyperthyroidism.

10) The best non invasive serological test in COELIAC disease is:
a) Antiendomysial IgA antibody.
b) Positive
C-reactive protein.
c) Jejunal biopsy.
d) Colonoscopy

11) A patient with lower abdominal pain,no weight loss and normal
colonoscopy.The most likely diagnosis is:
a) Colonic carcinoma.
b) Crohn’s colitis.
c) Ulcerative colitis.
d) Irritable bowel syndrome.

12) Which seromarker is specific for Crohn’s disease

a) ASCA
b) p-ANCA
c) Anti-pancreatic Ab
d) Anti-Flagellin Ab
13) Patient with lower abdominal pain, no weight loss and normal
colonoscsopy. The most likely diagnosis is
a) Colonic Carcinoma
b) Crohn’s disease
c) Ulcerative colitis
d) IBS

14) Which of the following features best distinguishes Crohn’s disease

from Ulcerative colitis
a) Oral ulcers
b) Crypt abscess
c) Non-caseating granuloma
d) continuous colonic involvement on endoscopy

15) Ulcerative colitis

a) Is more common in smokers than in non smokers
b) is treated as a first line with corticosteroids
c) commonly involves the ileum
d) Is associated withHLA B27

16) Malabsorption syndrome with normal D-Xylose test :

a) Celiac disease
b) Chronic pancreatitis
c) Blind loop syndrome
d) Chronic renal failure

17) In coeliac disease:

a) Is associated with increased risk of gastrointestinal lymphoma
b) Patients benefit from a diet high in complex carbohydrates such as
bread
c) CT abdomen is diagnostic
d) Bleeding per rectum is always present

18) A 55year old man with rectal bleeding and freckles on the lips.he has
positive family history of bowel surgery.The most likely diagnosis is:
a) Crohn’s disease
b) Peutz Jegher syndrome
c) Hereditary haemorrhagic te;angiectasia
d) Familial adenomatous polyposis

19) A50year old woman presents with watery diarrhea and right iliac
fossa pain.
On examination she has rumbling mid-diastolic murmur in the lower left
sternal border and the liver is enlarged.ECG shows tall P waves in lead
II.The most useful investigation would be:
a) Serum gastrin
b) Urine 5 hydoxy-indole acetic acid(5HIAA)
c) Serum vasoactive intestinal peptide(VIP)
d) Urine vanilyl mandelic acid

20) A 60 year old man presents with fever watery diarrhea and crampy
abdominal pain since one week.He has just completed treatment for
osteomyelitis.Proctosigmoidoscopy reveals erythematous ulcerations and
yellowish white plaques.The most likely diagnosis is:
a) Crohn’s disease
b) pseudomembranous colitis
c) Viral gastroenteritis
d) Clostridium perfringens enterocolitis

21 A 40 year old woman presents with abdominal bloating,diarrhea,and

weight loss for 9month.She has felt really well on holiday in Tunisia over
ayear ago.
Blood picture shows aneamia,micro and macrocytes.Howell-Jolly
bodies.The most likely diagnosis is:
a) Crohn’s disease
b) Tropical sprue
c) Coeliac disease
d) Whipple’s disease

22) Dysphagia with frequent chocking and nasal regurgitation occurs in:
a)Achalasia
b)Shatzki’s ring.
c)Pharyngeal paralysis.
d)Diffuse esophageal spasm.

23) Mouth ulcers are caused by the following EXCEPT:

a) Crohn’s disease
b) Behcet’s disease
c) Coeliac disease.
d) Rheumatic fever.

24) GERD occurs in the following conditions EXCEPT:

a) Hiatus hernia (sliding).
 b) Hiatus hernia (para-oesophageal).
c) Progressive systemic sclerosis
d) Intake of calcium channel blocker

In ACHALASIA the most appropriate long term therapy (25

:is
a) Nifedipine
b) Domperidone
c) metoclopropamide.
d) Balloon dilatation.

In ACHALASIA there (26

: is
a) High resting pressure of the lower
oesophageal sphincter.
b) Marked loss of weigh.
c) Haematemesis.
d) Increased peristalsis in the body of the
oesophagus.

:The most effective treatment of GERD is (27

a) Proton pump inhibitors.
b) H2 blocker.
c) Anticholinergic drug
d) Proton pump inhibitors+Prokinetic drug
28) Which drug can aggravate GERD symptoms
A) Ranitidine.
B) Domperid one
C) Omeprazole
D) Nifedipine

Dysphagia with loss of weight and occasional (29

:meleana
A) Barium study is indicated
B) Peptic ulcer disease is the cause
.C) Achalasia is the cause
D) Cancer colon is the cause

30) In a patient with progressive dysphagia, weight loss and occasional

melena
a) EGD is indicated
b) Peptic ulcer disease is the cause
c) Achalasia is the cause
 d) Ulcerative colitis is the cause

31) In a patient swith long standing GERD who starts to complain of

intermittent dysphagia for solids and weight loss. The most appropriate
test would be
a) Manometry
b) Endoscopy
c) Barium meal
d) pH metry

32) In Achalasia the most appropriate long term therapy is:

a) Nifedipine
b) Domperidone
c) Metoclopramide
d) Balloon dilatation

33) In 32 y old female with dysphagia for both solid & liquids with no
loss of weight or anemia the diagnosis is:
a) Adenocarcinoma of esophagus
b) Squamous carcinoma of esophagus
c) Achalasia
d) Schatzki ring
e) Epiphrenic Diverticulum

34) Chronic duodenal ulcer may be complicated by the following

conditions EXCEPT:
a)Hemorrhage
b) Perforation
c)Malignancy
d) Pyloric obstruction

35) All of the following are causes of upper gastrointestinal hemorrhage

EXCEPT:
a) Bleeding chronic duodenal ulcer
b) Bleeding oesophageal varices
c) Acute hemorrhagic pancreatitis
d) Gastric erosions
e) Mallory weiss syndrome

36) A 59 year old man presents with abdominal pain,anorexia and

nausea .
 He has lost weight and started to develop pedal edema.Endoscopy
reveals large gastric mucosal folds.This may be due to:
.a) hypoproteinemia due to malnutrition
b) hypoproteinemia due to protein loss
.c) Impaired hepatic synthesis of albumin
.d) Congestive heart failure

A 54 year old man suffering from chronic duodenal ulcer which of (37
the following is true
.a) The condition occurs in older people than gastric ulcers
.b) Gastric ulcers are more common than duodenal ulcers
.c) Duodenal ulcers can frequently be malignant
d) Infection can cause both types of ulcers

38) Successful Helicobacter Pylori eradication is determined by all of

the
following EXCEPT:
A) Helicobacter Pylori
.serology
B) Endoscopy and biopsy for
histology
C) Endoscopy and biopsy urease test
D) C13 urea breath test

39) Heliccobacter Pylori is associated with all the following

EXCEPT:
.A) Chronic atrophic gastritis
.B) Gastric carcinoma
.C) Gastric lymphoma
.D) Chronic duodenal ulcers

40) The most useful test in a patient with recurrent duodenal ulcer
with
Diarrhea
.A) Colonoscopy
B)
.Gastroscopy
.C) ERCP
D) Serum gastrin and CT of the
abdomen
 41) Which one of the following disorders is likely associated
with Helicobater Pylori infection:
.A) GERD
B) Coeliac disease
C) Gastric lymphoma
D) Achalasia of the cardia

42) In a patient with duodenal ulcer and positive Helicobacter Pylori

infection.The treatment of choice is:
.A) Omeprazole for 6 weeks
.B) Ranitidine for 6 weeks
.C) Omeprazole+amoxicillin+clarithromycin
D) Antacids+metronidazole

43) The most useful test in a patient with recurrent duodenal ulcer with
diarrhea
a) Colonoscopy.
b) Gastroscopy
c) ERCP
d) Serum Gastrin level
e) Serum gastrin & CT of abdomen

44) A 45 female with long standing history of peptic ulcer complain of

repeated bouts of projectile vomiting. The most likely the cause of her
symptoms
a) Psychogenic
b) Gastric outlet obstruction
c) Gastro-colic fistula
d) Pregnancy
e) Intestinal Obstruction

45) H.pylori is associated with all the following EXCEPT

a) Chronic atrophic gastritis
b) Gastric carcinoma
c) Gastric lymphoma
d) Autoimmune gastritis

46) Successful Hp eradication is determined by all EXCEPT

a) H pylori antibodies
b) Urea breath test
c) Endoscopy & biopsy for histopathologic examination
d) Rapid urease test
 e) Hp Ag in stool

47) Helicobacter pylori is

a) Gram negative cocci
b) Gram positive spiral bacilli
c) Gram negative spiral bacilli
d) Gram positive cocci

48) The mechanism through which H.pylori cause duoedenal ulcer is

a) Reduction of D cells via inflammation
b) Increase in somatostatin
c) Reduction in gastrin
d) Inflammation of parietal cells
e) Decrease in somatostatin by inflammation of ECL
cells

49) Acute pancreatitis may be caused by :

a) Rheumatoid Arthritis
b) IBD
c) Hyperlipidemia
d) Hypoparathyrodism
e) Diabetes Mellitus

50) Celiac disease is associated with

a) Ulcerative colitis
b) Smoking
c) Diabetes insipidus
d) Autoimmune hepatitis
e) Type II diabetes mellitus

51) In a patient with progressive dysphagia, weight loss and occasional

melena
a) EGD is indicated
b) Peptic ulcer disease is the cause
c) Achalasia is the cause
d) Ulcerative colitis is the cause