Medical Council of Canada Qualifying Examination Quiz 06

Question 1 of 10

1. Question

Which statement best describes the esophagus?

Muscular tube 25 cm long with a diameter of 2 cm and extends from pharynx to the stomach.
Takes food to intestine for digestion and absorption, secretes acid, facilitates digestion of protein/iron/B1, and minor contribution to initial protein digestion via pepsin.
Regulates enteral pH via secretin, lowers gastric acid secretion, and increased bicarbonate secretion.

Question 2 of 10

2. Question

Treatment for gastroesophageal reflux disease includes:

The most effective treatment is proton pump inhibitors, which must normally be continued as maintenance therapy, antacids (Mg(OH)2, Al(OH)3, alginate), H2-blockers, or PPIs can be used for NERD, avoid alcohol, coffee, spices, tomatoes, and citrus juices in your diet to help with symptoms rather than cure the illness, weight loss (if obese) and elevating the head of the bed are useful lifestyle changes (nocturnal symptoms), and if you stop taking your medication, your symptoms may come back.
The most effective treatment is a mineral replacement, which must normally be continued as maintenance therapy, antacids (Mg(OH)2, Al(OH)3, alginate), H2-blockers, avoid alcohol, coffee, spices, tomatoes, and citrus juices in your diet to help with symptoms rather than cure the illness, weight loss (if obese) and elevating the head of the bed are useful lifestyle changes (nocturnal symptoms), and if you stop taking your medication, your symptoms may come back.
The most effective treatment is proton pump inhibitors, which must normally be continued as maintenance therapy, antacids (Mg(OH)2, Al(OH)3, alginate), H2-blockers, or PPIs can be used for NERD, increase intake of alcohol, coffee, spices, tomatoes, and citrus juices in your diet to help with symptoms rather than cure the illness, weight loss (if obese) and elevating the head of the bed are useful lifestyle changes (nocturnal symptoms), and if you stop taking your medication, your symptoms may come back.
The most effective treatment is proton pump inhibitors, which must normally be continued as maintenance therapy, antacids (Mg(OH)2, Al(OH)3, alginate), H2-blockers, or PPIs can be used for NERD, avoid alcohol, coffee, spices, tomatoes, and citrus juices in your diet to help with symptoms rather than cure the illness, Maintain a BMI of 34.9 and if you stop taking your medication, your symptoms may come back.

Question 3 of 10

3. Question

Which statement accurately describes Barrett’s esophagus?

Normal squamous esophageal epithelium metaplasia into abnormal columnar epithelium-containing-type intestinal mucosa (intestinal metaplasia).
The contents of the stomach (most commonly acid) move backward from the stomach into the esophagus in this condition (the tube from the mouth to the stomach).
Swallowing difficulties, globus sensation.
One or more layers of the esophageal tract outpouchings.

Question 4 of 10

4. Question

The treatment plan of Barrett’s esophagus includes:

Endoscopy every 3 years if no dysplasia, regular and periodic surveillance with intensive biopsy, endoscopic ablation/resection, or esophagectomy if dysplasia, evidence increasingly favors endoscopic ablation with mucosal resection or radiofrequency ablation if low-grade dysplasia, surveillance and endoscopic ablation/resection are satisfactory.
The most effective treatment is proton pump inhibitors, which must normally be continued as maintenance therapy, antacids (Mg(OH)2, Al(OH)3, alginate), H2-blockers, or PPIs can be used for NERD, avoid alcohol, coffee, spices, tomatoes, and citrus juices in your diet to help with symptoms rather than cure the illness, weight loss (if obese) and elevating the head of the bed are useful lifestyle changes (nocturnal symptoms), and if you stop taking your medication, your symptoms may come back.
Endoscopic dilatation and indefinite PPI, and anti-reflux surgery (fundoplication) if the above treatment is unsuccessful.
If candida, nystatin swish and swallow, ketoconazole, fluconazole. If herpes, often self-limiting; acyclovir, valacyclovir, famciclovir and if CMV, IV gancyclovir, famciclovir, or oral valganciclovir.

Question 5 of 10

5. Question

Causes of esophageal motor disorder includes:

Idiopathic, achalasia (painless), scleroderma (painless), diabetes mellitus, and DES: rare and can be difficult to diagnose due to intermittent presentation.
inappropriate transient relaxations of LES – most common cause, low basal LES tone (especially in scleroderma), contributing factors include: delayed esophageal clearance, delayed gastric emptying, obesity, pregnancy, acid hypersecretion (rare) from Zollinger-Ellison syndrome (gastrin-secreting tumour), and hiatus hernia worsens reflux, but does not cause it.
H. pylori, dietary, environmental factors (multi-focal), autoimmunity, NSAID, bile radiation injury celiac disease, drug-food allergies Crohn's disease, sarcoidosis, bacteria, viruses, fungi, parasite, TB, syphilis.
Alcohol, Aspirin/NSAID, shock/physiological stress.

Question 6 of 10

6. Question

Diabetes mellitus, chemotherapy, and immunocompromised patients are at risk for:

Infectious esophagus
Dyspepsia
Esophageal carcinoma
Peptic strictures

Question 7 of 10

7. Question

Which statement holds true?

The parietal cells of the stomach secretes hydrochloric acid which is an intrinsic factor and is stimulated by histamine, ACh, and gastrin.
Chief cells secrete gastrin which is stimulated by vagal input and local acid.
G-cells secretes pepsinogen which is stimulated by hydrogen+ production from parietal cells.
Superficial epithelial cells secrete gastric acid which is stimulated by histamine, ACh, and gastrin.

Question 8 of 10

8. Question

Which statement holds true?

Chief cells secrete pepsinogen which is stimulated by vagal input and local acid.
Parietal cells secrete pepsinogen which is stimulated by vagal input and local acid.
G-cells secrete pepsinogen which is stimulated by vagal input and local acid.
Superficial epithelial cells secrete pepsinogen which is stimulated by vagal input and local acid.

Question 9 of 10

9. Question

A thirty-year-old male has been diagnosed with anxiety disorder. He is prescribed lorazepam (Ativan). He presents at the A&E department after having two weeks’ supply in one day. What class of drug is lorazepam?

Lorazepam is a benzodiazepine.
Lorazepam is a betablocker.
Lorazepam is a antipsychotic.
Lorazepam is a sedative.

Question 10 of 10

10. Question

Which statement is true regarding the management of Crohn’s disease?

Antibiotics and Antivirals can be prescribed.
Antibiotics and corticosteroids are used for management.
Chron's disease only affects the lower digestive tract.
Prednisone: starting dose 300 mg OD for acute exacerbations.

Medical Council of Canada Qualifying Examination Quiz 06

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