April 2014 JPGN Quiz
1 - In pediatrics, the most common indications for anorectal manometry are all of the following, EXCEPT:
A   - Anal fissures
B   - Suspicion of Hirschsprung disease
C   - Suspicion of fecal outlet obstruction
D   - Chronic incontinence of stool
2 - In pediatrics, the parameter most commonly measured during anorectal manometry is:
A   - Rectal compliance and maximal rectal volume
B   - Pelvic floor descent and puborectalis muscle relaxation
C   - Anal sphincter baseline pressure and recto?anal inhibitory reflex
D   - First sensation and urgency volumes
E   - Rectal pressure increase and anal canal decrease during beardown
3 - Propofol during Anorectal Manometry testing was associated with:
A   - Increased anal sphincter pressure initially, then a decreased pressure
B   - Blunting of the recto?anal inhibitory reflex
C   - Decreased anal sphincter pressure
D   - No change of tone
E   - Increased external sphincter pressure and decreased internal sphincter pressure
4 - Common treatments for fecal outlet obstruction may include, EXCEPT:
A   - Instillation of anal Botulinum toxin for anal achalasia
B   - Behavior modification to relax canal pressures
C   - Use of stool softeners/stimulants
D   - Dietary modification
E   - Surgical Internal sphincter myomectomy
5 - In a patient with suspected Hirschsprung disease and an absent RAIR on anorectal manometry, what is the most appropriate next step?
A   - Barium enema
B   - Re?test without the use of anesthesia to avoid confounding results
C   - Anal pull?through surgery with transoperative biopsies for mapping
D   - Intranal Botulinum toxin
E   - Rectal suction/punch biopsy
6 - Autoantibodies diagnostic of autoimmune hepatitis type 1 are:
7 - Autoantibodies diagnostic of autoimmune hepatitis type 2:
A   - anti?smooth muscle antibody
B   - anti?liver kidney microsomal antibody
C   - anti?mitochondrial antibody
8 - In the family history of children with autoimmune liver disease:
A   - extra?hepatic autoimmune disorders are present in 40?50% of relatives (including first, second and third degree relatives)
B   - there is a high prevalence of ankylosing spondylitis
C   - there is frequent familial clustering of autoimmune liver disease
D   - autoimmune disorders are rarely observed
9 - Characteristic features of autoimmune sclerosing cholangitis are:
A   - lack of interface hepatitis on liver biopsy
B   - positivity for anti?liver kidney microsomal antibody
C   - bile duct abnormalities on cholangiography
10 - In the study which antibodies were found most commonly in first degree relatives of patients with autoimmune liver disease?
B   - ANA/anti?SLA
C   - SMA/anti?LC?1
D   - Anti?SLA/anti?LC?1