1. Which mechanism explains the development of Barrett esophagus in chronic GERD
patients?
a. A) Squamous cells undergo hypertrophy to resist acid.
b. B) Normal squamous epithelium is replaced by columnar tissue in the distal
esophagus.
c. C) Esophageal tissue undergoes fibrotic scarring and stricture formation.
d. D) The lower esophageal sphincter (LES) permanently loses its closure strength.
e. Answer: B
2. In Peptic Ulcer Disease, how does the timing of pain typically differentiate a gastric
ulcer from a duodenal ulcer?
a. A) Duodenal pain occurs immediately after eating; gastric pain occurs 3 hours
later.
b. B) Gastric ulcers cause pain on a full stomach; duodenal ulcers cause pain 2–
3 hours after a meal when the stomach is empty.
c. C) Both cause pain only at night regardless of food intake.
d. D) Gastric ulcers are relieved by spicy foods, while duodenal ulcers are worsened.
e. Answer: B
3. A patient with peritonitis presents with a "board-like" rigid abdomen. What is the
physiological cause of this finding?
a. A) Accumulation of gas and fluid in the small intestine.
b. B) Reflex muscle spasms of the abdominal wall due to peritoneal irritation
and inflammation.
c. C) Destruction of the normal flora leading to gas production.
d. D) Sepsis causing systemic hypotension.
e. Answer: B
4. How does Ulcerative Colitis differ from Crohn’s Disease in its anatomical
presentation?
a. A) Crohn's is limited to the rectum; Ulcerative Colitis involves skip lesions.
, b. B) Ulcerative Colitis begins in the rectum and extends continuously through
the colon; Crohn’s presents with "skip lesions" and involves the full
thickness of the wall.
c. C) Ulcerative Colitis only affects the small intestine; Crohn's affects the large
intestine.
d. D) Crohn's is caused by H. pylori, while Ulcerative Colitis is caused by
antibiotics.
e. Answer: B
5. Which of the following describes the pathophysiology of acute pancreatitis?
a. A) Chronic irritation from gallstones causing low-grade inflammation.
b. B) Autodigestion of the pancreas due to premature enzyme activation, often
triggered by gallstones or alcohol.
c. C) Hypoactive bowel sounds leading to mechanical obstruction.
d. D) Hypertriglyceridemia causing the destruction of the islets of Langerhans.
e. Answer: B
6. A patient presents with pain at McBurney’s point and systemic signs of
inflammation. Which condition is most likely?
a. A) Cholecystitis.
b. B) Diverticulitis.
c. C) Appendicitis.
d. D) Pseudomembranous colitis.
e. Answer: C
7. What is the defining characteristic of a functional bowel obstruction like paralytic
ileus?
a. A) A physical blockage such as a tumor or adhesion.
b. B) The intestine telescoping into itself (intussusception).
c. C) A loss of propulsive ability (peristalsis) due to medications, surgery, or low
fiber.
d. D) Twisting of the bowel causing ischemia (volvulus).
e. Answer: C
8. What is a significant risk factor for developing esophageal cancer?