GASTROENTEROLOGY PAST PAPER (UoN) PRACTICE
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
1. A 45-year-old man presents with epigastric pain relieved by meals. Which is the most
likely diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Gastroesophageal reflux disease
D. Acute pancreatitis
Correct Answer: B
Rationale: Duodenal ulcer pain is typically relieved by meals, whereas gastric ulcer
pain worsens with food. GERD causes heartburn, and pancreatitis causes severe
persistent pain radiating to the back.
2. Which organism is most commonly associated with peptic ulcer disease?
A. Escherichia coli
B. Helicobacter pylori
C. Staphylococcus aureus
D. Clostridium difficile
Correct Answer: B
Rationale: Helicobacter pylori is the primary cause of peptic ulcer disease. The
others are not commonly linked to ulcers.
3. A patient with liver cirrhosis develops ascites. What is the most appropriate initial
management?
A. Immediate paracentesis
B. Fluid restriction only
C. Sodium restriction and diuretics
D. Liver transplantation
Correct Answer: C
Rationale: First-line management includes sodium restriction and diuretics
(spironolactone ± furosemide). Paracentesis is for large or refractory ascites.
4. Which marker is most specific for acute pancreatitis?
A. Serum amylase
B. Serum lipase
, C. ALT
D. AST
Correct Answer: B
Rationale: Serum lipase is more specific and remains elevated longer than amylase in
acute pancreatitis.
5. A patient presents with dysphagia for solids and liquids. What is the most likely
diagnosis?
A. Esophageal carcinoma
B. Achalasia
C. GERD
D. Peptic stricture
Correct Answer: B
Rationale: Dysphagia to both solids and liquids suggests a motility disorder like
achalasia. Mechanical obstruction initially affects solids only.
6. Which of the following is a complication of chronic hepatitis B infection?
A. Acute renal failure
B. Hepatocellular carcinoma
C. Pancreatic cancer
D. Peptic ulcer
Correct Answer: B
Rationale: Chronic hepatitis B significantly increases the risk of hepatocellular
carcinoma.
7. A 60-year-old presents with painless jaundice and weight loss. What is the most likely
diagnosis?
A. Gallstones
B. Acute hepatitis
C. Pancreatic head tumor
D. Hemolysis
Correct Answer: C
Rationale: Painless jaundice with weight loss is classic for carcinoma of the
pancreatic head causing bile duct obstruction.
8. Which of the following is the best initial test for suspected upper GI bleeding?
A. Abdominal CT
B. Endoscopy
C. Barium swallow
D. Ultrasound
Correct Answer: B
Rationale: Upper GI endoscopy allows diagnosis and therapeutic intervention.
,9. Which vitamin deficiency is most associated with chronic alcohol use?
A. Vitamin C
B. Vitamin B1 (Thiamine)
C. Vitamin D
D. Vitamin K
Correct Answer: B
Rationale: Chronic alcohol use commonly leads to thiamine deficiency, causing
Wernicke’s encephalopathy.
10. Which condition is characterized by transmural inflammation of the GI tract?
A. Ulcerative colitis
B. Crohn’s disease
C. IBS
D. Celiac disease
Correct Answer: B
Rationale: Crohn’s disease involves full-thickness (transmural) inflammation, unlike
ulcerative colitis which is mucosal.
11. A positive Murphy’s sign indicates:
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Hepatitis
Correct Answer: C
Rationale: Murphy’s sign (pain on inspiration during RUQ palpation) is indicative of
acute cholecystitis.
12. Which test confirms celiac disease?
A. Anti-HAV IgM
B. Anti-tTG antibodies
C. AFP
D. CA 19-9
Correct Answer: B
Rationale: Anti-tissue transglutaminase antibodies are highly sensitive and specific
for celiac disease.
13. Which is the most common cause of acute pancreatitis?
A. Alcohol
B. Gallstones
C. Trauma
, D. Infection
Correct Answer: B
Rationale: Gallstones are the most common cause globally; alcohol is second.
14. A patient with cirrhosis develops confusion and asterixis. Diagnosis?
A. Stroke
B. Hepatic encephalopathy
C. Sepsis
D. Meningitis
Correct Answer: B
Rationale: Confusion and asterixis are hallmark signs of hepatic encephalopathy due
to ammonia accumulation.
15. Which is a risk factor for colorectal cancer?
A. High fiber diet
B. Ulcerative colitis
C. Regular exercise
D. Low-fat diet
Correct Answer: B
Rationale: Chronic inflammation in ulcerative colitis increases colorectal cancer risk.
16. Which enzyme is elevated in cholestasis?
A. ALT
B. AST
C. ALP
D. Lipase
Correct Answer: C
Rationale: Alkaline phosphatase rises significantly in biliary obstruction and
cholestasis.
17. A “string sign” on imaging is associated with:
A. Ulcerative colitis
B. Crohn’s disease
C. IBS
D. Appendicitis
Correct Answer: B
Rationale: The string sign indicates narrowed bowel lumen in Crohn’s disease.
18. Which condition presents with “currant jelly stools”?
A. Appendicitis
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
1. A 45-year-old man presents with epigastric pain relieved by meals. Which is the most
likely diagnosis?
A. Gastric ulcer
B. Duodenal ulcer
C. Gastroesophageal reflux disease
D. Acute pancreatitis
Correct Answer: B
Rationale: Duodenal ulcer pain is typically relieved by meals, whereas gastric ulcer
pain worsens with food. GERD causes heartburn, and pancreatitis causes severe
persistent pain radiating to the back.
2. Which organism is most commonly associated with peptic ulcer disease?
A. Escherichia coli
B. Helicobacter pylori
C. Staphylococcus aureus
D. Clostridium difficile
Correct Answer: B
Rationale: Helicobacter pylori is the primary cause of peptic ulcer disease. The
others are not commonly linked to ulcers.
3. A patient with liver cirrhosis develops ascites. What is the most appropriate initial
management?
A. Immediate paracentesis
B. Fluid restriction only
C. Sodium restriction and diuretics
D. Liver transplantation
Correct Answer: C
Rationale: First-line management includes sodium restriction and diuretics
(spironolactone ± furosemide). Paracentesis is for large or refractory ascites.
4. Which marker is most specific for acute pancreatitis?
A. Serum amylase
B. Serum lipase
, C. ALT
D. AST
Correct Answer: B
Rationale: Serum lipase is more specific and remains elevated longer than amylase in
acute pancreatitis.
5. A patient presents with dysphagia for solids and liquids. What is the most likely
diagnosis?
A. Esophageal carcinoma
B. Achalasia
C. GERD
D. Peptic stricture
Correct Answer: B
Rationale: Dysphagia to both solids and liquids suggests a motility disorder like
achalasia. Mechanical obstruction initially affects solids only.
6. Which of the following is a complication of chronic hepatitis B infection?
A. Acute renal failure
B. Hepatocellular carcinoma
C. Pancreatic cancer
D. Peptic ulcer
Correct Answer: B
Rationale: Chronic hepatitis B significantly increases the risk of hepatocellular
carcinoma.
7. A 60-year-old presents with painless jaundice and weight loss. What is the most likely
diagnosis?
A. Gallstones
B. Acute hepatitis
C. Pancreatic head tumor
D. Hemolysis
Correct Answer: C
Rationale: Painless jaundice with weight loss is classic for carcinoma of the
pancreatic head causing bile duct obstruction.
8. Which of the following is the best initial test for suspected upper GI bleeding?
A. Abdominal CT
B. Endoscopy
C. Barium swallow
D. Ultrasound
Correct Answer: B
Rationale: Upper GI endoscopy allows diagnosis and therapeutic intervention.
,9. Which vitamin deficiency is most associated with chronic alcohol use?
A. Vitamin C
B. Vitamin B1 (Thiamine)
C. Vitamin D
D. Vitamin K
Correct Answer: B
Rationale: Chronic alcohol use commonly leads to thiamine deficiency, causing
Wernicke’s encephalopathy.
10. Which condition is characterized by transmural inflammation of the GI tract?
A. Ulcerative colitis
B. Crohn’s disease
C. IBS
D. Celiac disease
Correct Answer: B
Rationale: Crohn’s disease involves full-thickness (transmural) inflammation, unlike
ulcerative colitis which is mucosal.
11. A positive Murphy’s sign indicates:
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Hepatitis
Correct Answer: C
Rationale: Murphy’s sign (pain on inspiration during RUQ palpation) is indicative of
acute cholecystitis.
12. Which test confirms celiac disease?
A. Anti-HAV IgM
B. Anti-tTG antibodies
C. AFP
D. CA 19-9
Correct Answer: B
Rationale: Anti-tissue transglutaminase antibodies are highly sensitive and specific
for celiac disease.
13. Which is the most common cause of acute pancreatitis?
A. Alcohol
B. Gallstones
C. Trauma
, D. Infection
Correct Answer: B
Rationale: Gallstones are the most common cause globally; alcohol is second.
14. A patient with cirrhosis develops confusion and asterixis. Diagnosis?
A. Stroke
B. Hepatic encephalopathy
C. Sepsis
D. Meningitis
Correct Answer: B
Rationale: Confusion and asterixis are hallmark signs of hepatic encephalopathy due
to ammonia accumulation.
15. Which is a risk factor for colorectal cancer?
A. High fiber diet
B. Ulcerative colitis
C. Regular exercise
D. Low-fat diet
Correct Answer: B
Rationale: Chronic inflammation in ulcerative colitis increases colorectal cancer risk.
16. Which enzyme is elevated in cholestasis?
A. ALT
B. AST
C. ALP
D. Lipase
Correct Answer: C
Rationale: Alkaline phosphatase rises significantly in biliary obstruction and
cholestasis.
17. A “string sign” on imaging is associated with:
A. Ulcerative colitis
B. Crohn’s disease
C. IBS
D. Appendicitis
Correct Answer: B
Rationale: The string sign indicates narrowed bowel lumen in Crohn’s disease.
18. Which condition presents with “currant jelly stools”?
A. Appendicitis
