GI PRACTICE QUESTIONS & ANSWERS
Lipids are broken down where in the GI tract?
A. Esophagus
B. Stomach
C. Small intestine
D. Large intestine - Answer -B
Marvin, a known alcoholic with cirrhosis, is frequently admitted for coagulopathies and
occasionally receives blood transfusions. His wife asks why he has a bleeding problem.
You respond:
A. Occasionally he accumulates blood in the gut.
B. There is an interruption of normal clotting mechanisms.
C. Long term alcohol abuse has made his vessels very friable.
D. His bone marrow has been affected. - Answer -B
Jonas, age 34, had a Billroth II (hemigastrectomy and gastrojejunostomy) performed 1
week ago and just started eating a bland diet. What do you suspect when he complains
of epigastric fullness, distention, discomfort, abdominal cramping, nausea, and flatus
after eating?
A. Obstruction
B. Dumping syndrome
C. Metabolic acidosis
D. Infectious colitis - Answer -B
A common complication of viral gastroenteritis in children is:
A. Dehydration
B. GI bleeding
C. Peritonitis
D Bacterial sepsis - Answer -A
The most important diagnostic test for celiac disease is:
A. Confirming malabsorption by lab tests
B. Barium enema
C. A peroral biopsy of the duodenum
D. A gluten free diet trial with an accompanying improvement in mucosal histological
response - Answer -D
What is the most common cause of melena?
A. Colon cancer
,B. Upper GI bleeding
C. Drug abuse
D. Smoking - Answer -B
Which maneuver for diagnosing appendicitis is done by deep palpation over the LLQ
with resultant pain in the RLQ?
A. Rovsing's sign
B. Psoas sign
C. Obturator sign
D. McBurney's sign - Answer -A
Sam has UC and is on a low residue diet. Which foods do you recommend Sam avoid?
A. Potato skins, potato chips, and brown rice
B. Vegetable juices and cooked and canned vegetables
C. Ground beef, veal, pork, and lamb
D. White rice and pasta - Answer -A
Which of the following treatments for UC is contraindicated?
A. A high calorie, nonspicy, caffeine free diet that is low in high residue foods and milk
products
B. Corticosteroids in the acute phase
C. Antidiarrheal agents
D. Colectomy with permanent ileostomy in severe cases - Answer -C
Olive has an acute exacerbation of Crohn's disease. Which lab test values would you
expect to be decreased?
A. ESR
B. LFT
C. Vitamin A, B complex, and C levels
D. Bilirubin - Answer -C
You suspect Harry has a peptic ulcer and tell him that it has been found to be strongly
associated with:
A. anxiety and panic attacks
B. long term NSAID use
C. infection with H. pylori
D. a family history of peptic ulcer - Answer -C
You are doing routine teaching with a patient who has a family history of colorectal
cancer. You know she misunderstands the teaching when she tells you:
,A. decrease her fat intake
B. increase her fiber intake
C. continue her daily ASA use
D. increase her fluid intake - Answer -D
The proper order of assessment of the abdomen is:
A. palpation, percussion, auscultation, inspection
B. inspection, palpation, auscultation, percussion
C. inspection, auscultation, percussion, palpation
D. percussion, auscultation, inspection, palpation - Answer -C
Which of the following antibiotics causes more episodes of nausea and/or vomiting than
the others?
A. Azithromycin
B. Erythromycin
C. Penicillin
D. Tetracycline - Answer -B
Melva presents with an exacerbation of acute pancreatitis and you are going to admit
her to the hospital. Which is the most important factor in determining a negative long
term outcome for her?
A. age
B. infection
C. pain
D. length of time between exacerbations - Answer -B
One of the alarm signs and symptoms of IBS that requires prompt investigation is:
A. blood or pus in the stool
B. weight gain
C. hyperkalemia
D. first onset in the teen years - Answer -A
In a 2 month old infant with vomiting an diarrhea, the most effective way to determine a
fluid deficit is to check for:
A. decreased peripheral perfusion
B. hyperventilation
C. irritability
D. hyperthermia - Answer -A
The most common anal fissure location is: - Answer -posterior midline of anus
, Rectal bleeding associated with anal fissure is usually described by the patient as: -
Answer -drops of blood noticed when wiping
A 62 yo woman who reports frequent constipation is diagnosed with an anal fissure.
First line therapy includes all of the following except:
A. stool bulking supplements
B. high fiber diet
C. intraanal corticosteroids
D. periodic use of mineral oil - Answer -C
A 54 yo man with an anal fissure responds inadequately to dietary intervention and
standard therapy during the past 2 weeks. Additional treatment options include all of the
following except:
A. intraanal nitro ointment
B. botox to internal anal sphincter
C. surgical sphincterotomy
D. rubber band ligation of the lesion - Answer -D
In a patient who presents with a history consistent with anal fissure but with notation of
an atypical anal lesion, alternative diagnoses to consider include all of the following
except:
A. condylomata acuminate
B. Crohn's disease
C. anal squamous cell carcinoma
D. C. difficile colitis - Answer -D
Which of the following is the most likely patient report with anal fissure?
A. I have anal pain that is relieved with having a BM
B. Even after a BM, I feel like I still need to go more
C. I have anal pain for up to 1-2 hours after a BM
D. I itch down there almost all the time - Answer -C
Long term, recurrent high dose oral use of mineral oil can lead to deficiency in: -
Answer -vitamin A
Rectal bleeding associated with hemorrhoids is usually described as: - Answer -streaks
of bright red blood on stool
Therapy for hemorrhoids includes all of the following except:
A. weight control
B. low fat diet
C. topical corticosteroids
Lipids are broken down where in the GI tract?
A. Esophagus
B. Stomach
C. Small intestine
D. Large intestine - Answer -B
Marvin, a known alcoholic with cirrhosis, is frequently admitted for coagulopathies and
occasionally receives blood transfusions. His wife asks why he has a bleeding problem.
You respond:
A. Occasionally he accumulates blood in the gut.
B. There is an interruption of normal clotting mechanisms.
C. Long term alcohol abuse has made his vessels very friable.
D. His bone marrow has been affected. - Answer -B
Jonas, age 34, had a Billroth II (hemigastrectomy and gastrojejunostomy) performed 1
week ago and just started eating a bland diet. What do you suspect when he complains
of epigastric fullness, distention, discomfort, abdominal cramping, nausea, and flatus
after eating?
A. Obstruction
B. Dumping syndrome
C. Metabolic acidosis
D. Infectious colitis - Answer -B
A common complication of viral gastroenteritis in children is:
A. Dehydration
B. GI bleeding
C. Peritonitis
D Bacterial sepsis - Answer -A
The most important diagnostic test for celiac disease is:
A. Confirming malabsorption by lab tests
B. Barium enema
C. A peroral biopsy of the duodenum
D. A gluten free diet trial with an accompanying improvement in mucosal histological
response - Answer -D
What is the most common cause of melena?
A. Colon cancer
,B. Upper GI bleeding
C. Drug abuse
D. Smoking - Answer -B
Which maneuver for diagnosing appendicitis is done by deep palpation over the LLQ
with resultant pain in the RLQ?
A. Rovsing's sign
B. Psoas sign
C. Obturator sign
D. McBurney's sign - Answer -A
Sam has UC and is on a low residue diet. Which foods do you recommend Sam avoid?
A. Potato skins, potato chips, and brown rice
B. Vegetable juices and cooked and canned vegetables
C. Ground beef, veal, pork, and lamb
D. White rice and pasta - Answer -A
Which of the following treatments for UC is contraindicated?
A. A high calorie, nonspicy, caffeine free diet that is low in high residue foods and milk
products
B. Corticosteroids in the acute phase
C. Antidiarrheal agents
D. Colectomy with permanent ileostomy in severe cases - Answer -C
Olive has an acute exacerbation of Crohn's disease. Which lab test values would you
expect to be decreased?
A. ESR
B. LFT
C. Vitamin A, B complex, and C levels
D. Bilirubin - Answer -C
You suspect Harry has a peptic ulcer and tell him that it has been found to be strongly
associated with:
A. anxiety and panic attacks
B. long term NSAID use
C. infection with H. pylori
D. a family history of peptic ulcer - Answer -C
You are doing routine teaching with a patient who has a family history of colorectal
cancer. You know she misunderstands the teaching when she tells you:
,A. decrease her fat intake
B. increase her fiber intake
C. continue her daily ASA use
D. increase her fluid intake - Answer -D
The proper order of assessment of the abdomen is:
A. palpation, percussion, auscultation, inspection
B. inspection, palpation, auscultation, percussion
C. inspection, auscultation, percussion, palpation
D. percussion, auscultation, inspection, palpation - Answer -C
Which of the following antibiotics causes more episodes of nausea and/or vomiting than
the others?
A. Azithromycin
B. Erythromycin
C. Penicillin
D. Tetracycline - Answer -B
Melva presents with an exacerbation of acute pancreatitis and you are going to admit
her to the hospital. Which is the most important factor in determining a negative long
term outcome for her?
A. age
B. infection
C. pain
D. length of time between exacerbations - Answer -B
One of the alarm signs and symptoms of IBS that requires prompt investigation is:
A. blood or pus in the stool
B. weight gain
C. hyperkalemia
D. first onset in the teen years - Answer -A
In a 2 month old infant with vomiting an diarrhea, the most effective way to determine a
fluid deficit is to check for:
A. decreased peripheral perfusion
B. hyperventilation
C. irritability
D. hyperthermia - Answer -A
The most common anal fissure location is: - Answer -posterior midline of anus
, Rectal bleeding associated with anal fissure is usually described by the patient as: -
Answer -drops of blood noticed when wiping
A 62 yo woman who reports frequent constipation is diagnosed with an anal fissure.
First line therapy includes all of the following except:
A. stool bulking supplements
B. high fiber diet
C. intraanal corticosteroids
D. periodic use of mineral oil - Answer -C
A 54 yo man with an anal fissure responds inadequately to dietary intervention and
standard therapy during the past 2 weeks. Additional treatment options include all of the
following except:
A. intraanal nitro ointment
B. botox to internal anal sphincter
C. surgical sphincterotomy
D. rubber band ligation of the lesion - Answer -D
In a patient who presents with a history consistent with anal fissure but with notation of
an atypical anal lesion, alternative diagnoses to consider include all of the following
except:
A. condylomata acuminate
B. Crohn's disease
C. anal squamous cell carcinoma
D. C. difficile colitis - Answer -D
Which of the following is the most likely patient report with anal fissure?
A. I have anal pain that is relieved with having a BM
B. Even after a BM, I feel like I still need to go more
C. I have anal pain for up to 1-2 hours after a BM
D. I itch down there almost all the time - Answer -C
Long term, recurrent high dose oral use of mineral oil can lead to deficiency in: -
Answer -vitamin A
Rectal bleeding associated with hemorrhoids is usually described as: - Answer -streaks
of bright red blood on stool
Therapy for hemorrhoids includes all of the following except:
A. weight control
B. low fat diet
C. topical corticosteroids
