| Post Name | Assistant Professor in Medical Gastroentrology |
|---|---|
| Department | Medical Education |
| Question Paper Code | 062/2025/OL |
| Category Code | 764/2024 |
| Date of Test | 26 June 2025 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Choose the correct match with regard to hereditary gastrointestinal gastrointestinal cancer syndromes (i) Lynch syndrome 1. STK11 gene (ii) Cowden's disease 2. EPCAM gene (iii) Peutz-Jegher's sydrome 3. APC gene (iv) Gardner syndrome 4. PTEN gene
Answer
B. i-2, ii-4, iii-1, iv-3
2
Gut microbiota are involved in the synthesis of the following vitamins : i. Folate ii. Vitamin K iii. Thiamine iv. Biotin Choose the correct option
Answer
D. Only (i, ii and iv)
3
Which of the following statements regarding gut microbiota is/are true? i. Breast feeding has been shown to enrich vaginally acquired, lactic acid- producing bacteria in the baby's intestine ii. The jejunum is typically colonized only by relatively simple, rapidly growing, facultative anaerobes iii. The number and diversity of gut microbiota are least in the colon compared to the small intestine
Answer
A. Only (i and ii)
4
Which of the following statements regarding gut mucosal immunity is/are true? i. Epithelial barrier function is provided by goblet cells and Paneth cells ii. T regulatory cells represent a critical component of the gut's anti-inļ¬ammatory repertoire iii. Mutations in FOXP3 gene cause IPEX syndrome
Answer
B. all of the above (i, ii and iii)
5
Which of the following statements regarding gut neuropeptides is/are true? i. Cholecystokinin is a peptide transmitter produced primarily by enteroendocrine cells of the large intestine. ii. Leptin is secreted by the adipocytes. iii. Gastric fundus is the most abundant source of Ghrelin
Answer
A. only (ii and iii)
6
All are indicators of protein-calorie status except
Answer
D. Ferritin
7
Which of the following statements regarding nutritional management of acute pancreatitis is/are true? i. Oral feeding shall be oļ¬ered as soon as clinically tolerated and independent of serum lipase concentrations in patients with predicted mild acute pancreatitis ii. In patients with acute pancreatitis an elemental diet shall be used iii. Enteral nutrition should be started early, within 24 to 72 hour of admission, in case of intolerance to oral feeding
Answer
C. only (i and iii)
8
All the following are gastric endoscopic bariatric interventions in the management of obesity except
Answer
C. endobarrier
9
Which of the following statements regarding Avoidant Restrictive Food Intake Disorder (ARFID) is/are true? i. ARFID is an eating disorder characterized by the persistent failure to meet appropriate nutritional and/or energy needs ii. ARFID can be comorbid with neurodevelopmental disorders, such as intellectual disability and autism spectrum disorder iii. ARFID is a diagnosis that can occur only in children
Answer
A. only (i and ii)
10
Which of the following statements regarding food protein induced enterocolitis syndrome (FPIES) is/are true? i. FPIES may present with either acute or chronic symptoms characterized by protracted vomiting and diarrhea ii. Cow's milk and soy are the most common triggers of FPIES iii. About one-third of infants with severe diarrhea develop acidosis and transient methemoglobinemia
Answer
B. all of the above (i, ii and iii)
11
Identify the drug 1. Originally developed to treat hyperphosphatemia in CKD 2. FDA approved for treatment of IBS-Constipation 3. Sodium Hydrogen Exchanger Isoform 3(NHE 3) inhibitor
Answer
A. TENAPANOR
12
Identify the wrong statement about Recurrent Aphthous Ulcers (RAU)
Answer
B. Herpetiform aphthae usually exceed 6 mm and require months to heal, leaving scars
13
"PPP syndrome" described in Pancreatic Acinar Cell Carcinoma involves all except
Answer
B. Polyserositis
14
'Cow boy gun belt and holster' pattern refers to erythematous pruritic plaques that are seen after use of
Answer
C. Vitamin K
15
ALVARADO Score for acute appendicitis includes all except
Answer
D. High CRP
16
In a case of factitious constipation. Patient was given the message that the doctors are wise to the deception and that "if the next treatment fails to work, we are going to be forced to conclude that you are the source of your own illness". After this, the patient reported improvement of his symptoms. This is an example of :
Answer
C. Face saving technique
17
Identify the wrong statement about Gastric NETs (carcinoid tumors)
Answer
D. Fasting serum gastrin levels are usually high in Type 3
18
All are risk factors for Post ERCP pancreatitis except
Answer
C. Older age
19
IPSID is associated with
Answer
C. Campylobacter jejunii
20
Prophylactic antibiotics are recommended in all except
Answer
D. EUS guided FNA of solid lesions of upper GI tract
21
Which of the following is not included in the VACTERL developmental abnormality of esophagus? i. Vertebral ii. Liver iii. Cardiac iv. Renal
Answer
B. ii and iv
22
Schatski ring is
Answer
B. Mucosal and called B ring
23
Timed barium swallow is
Answer
A. Done at 1, 2, 5 minutes and measure height, width and area
24
Surgical treatment of GERD includes all except
Answer
C. Hellers
25
What is the clinical triad of Boerhaave's syndrome called
Answer
B. Mackler triad
26
GIST in EUS appears in which layers?
Answer
B. Layer 2 and 4
27
Allgrove's syndrome includes all except
Answer
C. Ageusia
28
Which ablation treatment is not used in Barrett's esophagus
Answer
D. Laser
29
Number of eosinophils needed per high power ļ¬eld to diagnose eosinophilic esophagitis is
Answer
B. >15/HPF
30
Which foreign body should not be removed from the esophagus?
Answer
D. Body stuļ¬ng
31
A full-term newborn presents on the ļ¬rst day of life with bilious vomiting and mild abdominal distension. An abdominal radiograph reveals the classic "double bubble" sign. Which of the following ļ¬ndings is least likely to be associated with this clinical scenario
Answer
C. Presence of a hypoechoic "donut sign" on ultrasound
32
A 40-year-old woman with previously treated helicobacter pylori infection returns for follow-up two months after completing a standard triple therapy regimen. She is asymptomatic and has been oļ¬ PPIs and antibiotics for more than three weeks. Which of the following tests is not appropriate to conļ¬rm H. pylori eradication?
Answer
D. Serologic IgG antibody test
33
Which of the following is not true about gastric lipase?
Answer
C. Its activity is lesser than that of pancreatic lipase
34
Regarding microscopic anatomy of duodenum, which of the followings is true?
Answer
D. The villi in proximal duodenum are tall, slender and regular
35
Which of the following best describes the role of prostaglandins in the gastric mucosa?
Answer
C. Promote mucosal blood ļ¬ow
36
Which of the following factors accelerates gastric emptying rate?
Answer
A. Hypoglycemia
37
Which is true about multifocal atrophic gastritis?
Answer
D. Potentially reversible
38
Which of the following has lowest risk for nonsteroidal anti- inļ¬ammatory drug-induced gastro-duodenal ulcer?
Answer
B. Concomitant use of a glucocorticoid
39
A 50-year-old woman presents with fatigue and paresthesia. She was found to have macrocytic anemia and her endoscopic examination revealed atrophic gastritis. Which of the following ļ¬ndings are not consistent with the most likely diagnosis?
Answer
B. Hyposegmented Neutrophils
40
Which of the following is the main somatostatin containing cells in stomach?
Answer
B. D cells
41
Which was the ļ¬rst hormone to be discovered in the history of medicine?
Answer
C. Secretin
42
Which statement/statements is correct regarding pancreatic function tests? i. Pancreatic enzyme estimation in the stool is an example direct pancreatic function tests ii. Maldigestion do not occur until functional capacity of pancreas is reduced to 5 to 10% of the normal capacity of pancreas iii. Stimulation of pancreas with secretin and CCK is an example of direct pancreatic function test iv. Measurement of stool fat - 10% of ingested fat appear in the stool of a normal person
Answer
B. ii and iii
43
Which syndrome is characterized by Exocrine pancreatic insuļ¬ciency, hematologic abnormalities, skeletal defects and short stature?
Answer
D. Schwachman-Diamond Syndrome
44
Which of the following is true regarding gallstone pancreatitis?
Answer
B. Most cases are due to stones less than 5 mm in size
45
Which of the following statements is correct regarding SPINK 1?
Answer
D. It inhibits trypsin auto activation
46
Which one of the following cystic neoplasms of pancreas have least malignant potential?
Answer
C. Serous cystadenomas
47
Which of the following has highest risk of developing pancreatic cancer by 70 years of age?
Answer
C. Peutz Jeghers syndrome
48
45 year old male came to casualty after a road traļ¬c accident. He had no signiļ¬cant symptoms initially and discharged from hospital after a period of observation. After 2 days he started to have abdominal pain associated with nausea and vomiting. CT scan of abdomen revealed pancreatic interstitial edema. Which part of pancreas is more vulnerable to injury?
Answer
D. Body of pancreas
49
A 63 year old man undergoes surgery (distal pancreatectomy) for IPMN localized to tail to pancreas. Histology of resected specimen reveals high grade dysplasia without invasion. Resected margins are not involved. What is the most appropriate follow up for this patient?
Answer
A. Indeļ¬nite post operative surveillance with MRI every two years
50
Which of the pancreatic cell type is responsible for bulk of pancreatic secretion?
Answer
C. Ductal cells
51
Which of the following regarding the embryology of the liver is true except?
Answer
C. Ductal plates can be detected by about 2 to 3 weeks of gestation
52
According to the modiļ¬ed Milwaukee classiļ¬cation system, type II Sphincter of Oddi dysfunction (SOD) is diagnosed in patients with
Answer
D. None of the above
53
Which of the following is a cause for Bile acid diarrhea?
Answer
D. All of the above
54
The following are true regarding Coļ¬ee and gallstones, except
Answer
C. Drinking decaļ¬einated coļ¬ee is as eļ¬ective as regular coļ¬ee in gallstone disease
55
The following are true regarding Primary Sclerosing Cholangitis (PSC) and Inļ¬ammatory Bowel Disease (IBD) except
Answer
B. PSC is present in about 7% of all patients with ulcerative colitis
56
Risk factors for the development of Cholangiocarcinoma in patients with Primary Sclerosing Cholangitis (PSC) are
Answer
B. Male sex
57
The following staging systems are used in Perihilar Cholangiocarcinoma.
Answer
D. All of the above
58
The following are true about Acalculous Cholecystitis
Answer
D. All of the above
59
The following are "Deļ¬nite" risk factors for Cholangiocarcinoma, except
Answer
A. Clonorchis sinensis infection
60
Regarding the natural history of gallstones and their complications, the following are true except
Answer
A. Gallstones remain asymptomatic in more than 90% of patients
61
Which is false about hepatitis C virus infection?
Answer
B. B cell immune response in liver result in direct lysis of infected cells and inhibition of replication
62
Which is false regarding HBV-HDV coinfection?
Answer
C. sustained response occurs in 50-60% pts after 1 year of treatment
63
Disease associations of Primary Biliary Cholangitis are all except
Answer
D. Intrahepatic Cholangiocarcinoma
64
All are true regarding ectopic varices except
Answer
A. Ectopic varices account for 10-15% of all varix related bleeding episodes
65
All the following neurotransmitter systems implicated in Hepatic encephalopathy are correctly matched with their normal actions except
Answer
A. Glutamate - Neuro-inhibition
66
Which of the following statements is TRUE regarding the AUDIT-C screeing tool for alcohol use?
Answer
B. In women, a score ā„ 3 is considered a positive screen for risky drinking
67
According to EASL guidelines, what is the gold standard for establishing a deļ¬nitive diagnosis of hepatic cyst infection?
Answer
D. Neutrophil debris and/or microorganisms in cyst aspirate
68
Which is false regarding Caroli's disease?
Answer
C. Starry sky pattern is a very typical imaging ļ¬nding in Caroli's disease
69
A 50-year-old lady diagnosed with chronic idiopathic constipation fails to respond to increased ļ¬ber supplements. It is decided to add another agent. Which of the following acts on the intestinal chloride channels to relieve constipation?
Answer
C. Lubiprostone
70
The uniļ¬ed deļ¬nition of ACLF was proposed in which consensus
Answer
B. Kyoto consensus
71
Upper GI endoscopy in an elderly man evaluated for epigastric pain and early satiety reveals a submucosal mass in the gastric antrum. EUS shows a 3 Ć2 cm hypoechoic mass masscontiguous with the fourth layer (muscularis propria). On the basis of the endosonographic appearance, which tumor is most likely?
Answer
D. GIST
72
All are immune checkpoint inhibitors used in metastatic colorectal carcinoma except
Answer
D. Panitumumab
73
All are true about Solid pseudopapillary tumours of pancreas except
Answer
C. Common mutated genes in SPT are K-ras and TP53
74
Deļ¬nite risk factors for Gastric adenocarcinoma are all except
Answer
B. Menetriers's disease
75
The mechanisms of action of advanced therapies for Inļ¬ammatory bowel disease are correctly matched below except
Answer
C. IL12/23p40 antagonist-Vendolizumab
76
Which of the following statements regarding small intestinal villi are correct? i. They are absent in the duodenum and progressively increase in height towards the ileum ii. They are primarily responsible for increasing the surface area for absorption iii. Crypts of LieberkĆ¼hn are located at their base iv. Enteroendocrine cells are predominantly found within the villous core
Answer
D. only ii and iii
77
A 45-year-old male presents with chronic diarrhea, abdominal pain and signiļ¬cant weight loss. Endoscopic biopsies reveal ļ¬attened villi, crypt hyperplasia and increased intraepithelial lymphocytes. Which of the following statements are true regarding his likely diagnosis? i. The condition is associated with an increased risk of T-cell lymphoma. ii. Serological markers like anti-tissue transglutaminase (tTG) IgA antibodies are typically elevated iii. A gluten-free diet is the cornerstone of treatment iv. Patients often present with isolated iron deļ¬ciency anemia without signiļ¬cant gastrointestinal symptoms
Answer
A. All of the above (i, ii, iii and iv)
78
A patient with severe Crohn's disease undergoes an ileocolic resection, leaving only 75 cm of jejunum and a defunctionalized colon. Which of the following are potential long-term complications or management considerations for this patient? i. Increased risk of kidney stones due to hyperoxaluria ii. Mandatory parenteral nutrition for long-term survival iii. Reduced bile acid reabsorption leading to steatorrhea iv. Increased incidence of D-lactic acidosis if signiļ¬cant carbohydrate malabsorption occurs
Answer
C. Only (ii and iv)
79
A 60-year-old female presents with recurrent episodes of bloating, abdominal discomfort and alternating diarrhea and constipation. Her symptoms improve temporarily with antibiotic courses. Which of the following investigations would be most helpful in conļ¬rming the suspected diagnosis? i. Colonoscopy with random biopsies ii. Hydrogen breath test after lactulose ingestion iii. Stool ova and parasite examination iv. Abdominal CT scan with contrast
Answer
B. Only (ii)
80
Regarding the pathophysiology of Inļ¬ammatory Bowel Disease (IBD), which of the following statements are correct? i. Genetic susceptibility plays a minor role compared to environmental factors. ii. An exaggerated immune response to commensal gut microbiota is a key feature. iii. NOD2/CARD15 gene mutations are exclusively associated with ulcerative colitis iv. Defects in epithelial barrier function contribute to chronic inļ¬ammation
Answer
B. Only ii and iv
81
A 35-year-old male with a history of recurrent abdominal pain and altered bowel habits, but no alarm features, is diagnosed with Irritable Bowel Syndrome (IBS). Which of the following management strategies are appropriate for this patient? i. Prescription of corticosteroids for symptom relief ii. Dietary modiļ¬cation, including a low FODMAP diet trial iii. Antispasmodics for acute pain episodes iv. Regular colonoscopy for surveillance of malignancy
Answer
B. Only ii and iii
82
Which of the following describe mechanism of water and electrolyte absorption in the large intestine in normal cases? i. Active transport of sodium via epithelial sodium channels (ENaC) ii. Passive diļ¬usion of water driven by osmotic gradients iii. Chloride secretion via CFTR channels iv. Short-chain fatty acid absorption contributing to water absorption
Answer
C. only i, ii and iv
83
A patient develops severe pseudomembranous colitis following antibiotic use. Which of the following statements are accurate regarding this condition? i. Clostridiodes diļ¬cile toxin A and B are the primary virulence factors ii. Oral Metronidazole is generally preferred over Vancomycin for severe disease iii. Fecal microbiota transplantaion (FMT) is a recognized treatment for recurrent infections iv. Colonoscopy with characteristic pseudomembranes is diagnostic but not always necessary
Answer
D. Only i, iii and iv
84
In the context of intestinal obstruction, which of the following are true? i. A "transition zone" on imaging is pathognomonic for paralytic ileus ii. Distal obstructions are more likely to cause signiļ¬cant ļ¬uid and electrolyte imbalances than proximal obstructions. iii. Strangulation is a surgical emergency due to the risk of bowel ischemia and perforation. iv. Adhesions from previous surgery are the most common cause of small bowel obstruction
Answer
B. Only iii and iv
85
Regarding colonic polyps and their malignant potential, which of the following statements are correct? i. Hyperplastic polyps have no malignant potential and do not require any surveillance ii. Villous adenomas carry a higher risk of malignant transformation than tubular adenomas iii. Sessile serrated adenomas are characterized by a "sawtooth" architecture and are often diļ¬cult to detect endoscopically iv, Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by hundreds to thousands of adenomatous polyps and an almost 100% risk of colorectal canser if untreated
Answer
B. Only ii, iii and iv
86
A 50-year-old male presents with a 6-month history of watery diarrhea, abdominal pain, and weight loss. He has also developed arthralgia, lymphadenopathy and signiļ¬cant neurological symptoms including cognitive decline. Small bowel biopsy reveals periodic acid-Schiļ¬ (PAS)-positive macrophages in the lamina propria. Which of the following therapeutic approaches would be appropriate for this patient? i. Long-term broad-spectrum antibodies, typically including trimethoprim- sulfamethoxazole ii. Immunosuppressive therapy with corticosteroids iii. Surgical resection of aļ¬ected bowel segments iv. A gluten-free diet
Answer
A. only i
87
Which of the following statements about the digestion and absorption of macronutrients are accurate? i. Pancreatic lipase is primarily responsible for the hydrolysis of triglycerids into monoglycerides and free fatty acids ii. Glucose and galactose are absorbed into enterocytes via SGLT1, while fructose is absorbed via GLUT5. iii. Protein digestion begins in the small intestine wth the action of pepsin iv. Vitamin B12 absorption requires intrinsic factor, which is secreted by gastric parietal cells and occurs predominantly in the duodenum
Answer
A. only i and ii
88
A patient with a chronic history of constipation and abdominal distension undergoes a motility study that reveals delayed colonic transit. Which of the following statements are relevant to the understanding and management of colonic motor dysfunction? i. Biofeedback therapy can be eļ¬ective for managing pelvic ļ¬oor dyssynergia in some patients ii. Opioid-induced constipation primarily results from increased colonic motility. iii. The Migrating Motor complex (MMC) is responsible for propulsive movements in the colon during the fasting state iv. Chronic constipation can be a symptom of underlying systemic diseases like hypotheroidism or diabetes mellitus
Answer
C. only i and iv
89
Regarding parasitic infections of the intestine, which of the following are true? i. Giardia lamblia commonly causes steatorrhea due to its preference for the small intestine and interference with fat absorption ii. Entamoeba histolytica infection is typically characterized by watery diarrhea and can lead to liver abscesses. iii. Eosinophilia is a common ļ¬nding in many intestinal helminthic infections iv. Cryptospordium parvum infection is often self-limiting in immuno competent individuals but can cause chronic, severe diarrhea in immuno compromised patients
Answer
B. Only i, iii and iv
90
A 28-year-old female undergoes a total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for refractory ulcerative colitis. Which of the following are potential long-term complications of this procedure? i. Pouchitis, characterized by inļ¬ammation of the ileal pouch ii. Increased risk of colorectal cancer within the ileal pouch iii. Nutritional deļ¬ciencies, particularly of fat-soluble vitamins iv. Impaired fertility in females due to pelvic adhesions
Answer
B. only i, iii and iv
91
Which of the following statements is/are true regarding the applications of artiļ¬cial intelligence (AI) in various gastrointestinal endoscopic procedures? i. Detection of malignancy within polyps ii. Detection and delineation of early dysplasia in Barrett's oesophagus iii. Diļ¬erentiation of autoimmune pancreatitis from chronic pancreatitis iv. Gastric cancer detection and assessing depth of invasion
Answer
C. all of the above i, ii, iii and iv
92
Which one of the following is/are ileal bile acid transport inhibitor? i. Maralixibat ii. Elecaftor iii. Lumacaftor iv. Odevixibat Choose the correct option
Answer
D. Only (i and iv)
93
Non-cirrhotic portal ļ¬brosis (NCPF) should be suspected in the following situations. i. Unexplained splenomegaly ii. Variceal hemorrhage without any evidence of hepatocellular decompensation iii. Portal hypertension in the absence of cirrhosis/hepatocellular dysfunction iv. Unexplained chronic elevation in liver biochemistry
Answer
C. All of the above (i, ii, iii, iv)
94
Choose the correct match with regard to progressive familial intrahepatic cholestasis (PFIC)? i. PFIC type 1 1. ABCB11 gene ii. PFIC type 2 2. MDR3 gene iii. PFIC type 3 3. TJP2 gene iv. PFIC type 4 4. ATP8B1 gene
Answer
A. i-4, ii-1, iii-2, iv-3
95
Which of the following statements regarding management of Wilson Disease (WD) is/are true? i. A 'start low, go slow' treatment regimen is recommended for chelators, especially in patients with a neurological presentation. ii. Liver transplantation should be considered in patients with decompensated cirrhosis despite adequate medical treatment in WD iii. High-volume plasma exchange should be considered as a bridge to liver transplantation in WD iv. Liver transplantation should be contraindicated in patients witn WD and neurological symptoms who need to be transplanted for decompensated cirrhosis
Answer
A. Only (i, ii and iii)
96
Which of the following statements about intestinal ultrasound (IUS) parameters in inļ¬ammatory bowel disease is/are true? i. A threshold of 3 mm is the recommended cut-oļ¬ for presence of mural inļ¬ammation for both small and large bowel for deļ¬ning bowel wall thickness ii. Ulcers are deļ¬ned as depressions in the mucosal layer. iii. Stricture is deļ¬ned as wall thickening with a narrowed lumen with or without a dilatation of a proximal loop iv. Fistula is deļ¬ned as hypoechoic tract with or without hyperechoic content
Answer
B. All of the above (i, ii, iii and iv)
97
Which of the following statements regarding intelligent wireless capsule endoscopy robots is/are true? i. Intelligent lesion detection ii. Integrated diagnostic and therapeutic function iii. High-speed-bi-directional communication iv. Passive motion navigation
Answer
A. Only (i, ii and iii)
98
Which of the following statement about use of Artiļ¬cial Intelligence (AI) in colonoscopy is/are true? i. AI-assisted systems potentially increase adenoma detection rates by 8%-10%. ii. The main beneļ¬t of computer aided detection systems is in detecting small adenomas. iii. Aids in the diļ¬erentiation of neoplastic and nonneoplastic lesions
Answer
A. All of the above (i, ii and iii)
99
Endoscopic submucosal dissection (ESD) is preferred over endoscopic mucosal resection (EMR) in the management of all except
Answer
D. Early-stage gastric adenocarcinoma; well or moderately diļ¬erentiated, nonulcerated intestinal type cancer measuring < 20 mm
100
Which of the following is/are Ultrasound based liver fat quantiļ¬cation methods? i. Attenuation coeļ¬cient ii. Backscatter coeļ¬cient iii. Controlled attenuation parameter iv. Proton density fat fraction
Answer
C. Only (i, ii and iii)
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