1- Which of the following does not lead to an ascitic fluid with serum-ascites albumin gradient of less than 1.1?

a) Peritoneal carcinomatosis b)Congestive heart failure c)Nephrotic syndrome d)Peritoneal tuberculosis e)Pancreatitis

2- Which is the clinical cut-off value for polymorphonuclear cell count in the diagnosis of spontaneous bacterial peritoniitis? a)50 b)100 c)250 d)500 e)1000

3- All of the following completions will be correct EXCEPT Inactive carrier stage of chronic Hepatitis B infection .... a)is a nonreplicative phase b)shows normal serum aminotransferase values c)ultimately may develop episodes of reactivated hepatitis

d)may progress to hepatocellular carcinoma e)is an indication for three shots of Hepatitis B vaccine (at 0,1 and 6th months)

4- All of the following completions will be correct EXCEPT Hepatitis C Virus.... a)is the leading indication for liver transplantation b)has ability to induce persistent infection in at least 85% of affected otherwise healthy persons c) presence is ensured by the serum anti-HCV positivity d)escapes the host's immune response because of quasispecies e) has a high mutational rate

5- Which one the followings are true? I-Heartburn is usually defined as a feeling of substernal burning that radiates towards the left arm. II.Gastrointestinal endoscopy is indicated for the patients with dyspepsia and iron deficiency anemia III-Severe right upper quadrant pain, jaundice and fever indicates cholangitis IV-Esophageal manometry is the gold standart diagnostic test for the diagnosis of gastroesophageal reflux disease a)2-3 b)2-4 c)3-4 d)1-2 e)1-4

6- Which one of the following statements are true for peptic ulcer disease? I.Peptic ulcer patients mostly suffer from post-prandial epigastric pain II.Upper Gastrointestinal bleeding is the major complication of peptic ulcer III. Helicobacter pylori infection should be treated to prevent the recurrence of peptic ulcer IV.Duodenal ulcers have the risk of malign potential a)IV+III

b)I+II c)III+IV d)I+III e)II+III

7- Which one of the followings are not the cause of intrahepatic cholestasis? a)Primary Biliary Cirrhosis b)Choledecolithiasis c)Drugs d)Autoimmune Cholangiopathy e)Sepsis

8- Which one of the followings is not the physical sign of chronic liver disease? a)Hepatosplenomegaly b)Dupuytran contracture c)Malar rash d)Temporal wasting e)Gyneocomastia

9- Which one of the followings are true in the case of patient with ascites? 1. Chronic liver failure and portal hypertension should be suspected if the ascites-serum albumin gradient is higher than 1.1 2. At least 500 mL of sample is necessary for the cytologic examination of the ascites. 3. Culture of the ascites should be done at bedside with blood culture bottles. 4. Cardiac Failure causes low serum-albumin gradient ascites a) 2-4 b) 1-2- 4 c)1-3 d)1-2-3 e)3

10- Which one of the followings are true for hemochromatosis? 1. 2. 3. 4. Transferin saturation is always above % 50 in hemochromatosis Liver biopsy is not necessary if the patient has HFE gene homozygote mutation Chelation with desferoxamine is the first line treatment for hemachromatosis Due to high risk of Hepatocellular carcinoma, screening & surveillance with USG and AFP should be performed for each

patient a) 1 b)1-2-4 c)1-3 d)3-4 e)All of above

11- Endotracheal intubation for airway protection in the manegement of UGI bleeding should be considered: a)in all cirrhotic patients b)in all patients with UGI bleeding c)in patients with altered mental status and ongoing hematemesis d)in patients with stable COPD e)unless it delays urgent endoscopy

12- The two most common causes of severe hematochezia requiring hospitalization requiring hospitalization are: a)Angiodysplasia and internal hemorrhoids b)Diverticulosis and internal hemorrhoids c)Colon cancer and colitis d)Angiodysplasia and internal hemorrhoids e)Colon polyps and internal hemorrhoids

13- Why cannot corticosteroids be used for the long-term maintenance treatment of the inflammatory bowel diseases? a)Because of side effects b)Because of high cost of treatment c)Because there are no maintenance treatment of IBD d)Because of possible addiction to corticosteroids e)Because of because of patient incompliance

ANSWERS 1. B 2. C 3. E 4. C 5. A 6. E 7. B 8. C 9. D 10. B 11. C 12. B 13. A