GI Medicine Practice Questions
A 25-year-old Jewish man presents with pain and watery diarrhea after meals. Examination shows fistulas
between the bowel and skin and nodular lesions on his tibias. - ANSWERCrohn's Disease
Extraintestinal manifestations of IBD. - ANSWERUveitis, ankylosing spondylitis, pyoderma gangrenosum,
erythema nodosum, 1° sclerosing cholangitis.
Difference between Mallory-Weiss and Boerhaave tears. - ANSWERMallory-Weiss—superficial tear in the
esophageal mucosa;
Boerhaave—full-thickness esophageal rupture.
A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the
back and is relieved by sitting forward. Management? - ANSWERConfirm the diagnosis of acute pancreatitis
with elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and "tincture of
time."
1. Patients with chronic gastroesophageal reflux disease (GERD) are at risk for
(A) candidal esophagitis
(B) Zenker diverticulum
(C) Barrett esophagus
(D) esophageal varices
(E) achalasia - ANSWER(C) Barrett esophagus
2. Hepatitis D infection requires coinfection with
(A) hepatitis A
(B) hepatitis B
(C) hepatitis C
, (D) hepatitis E
(E) hepatitis G - ANSWER(B) hepatitis B
3. Which of the following is a risk factor for non-healing of a duodenal ulcer?
(A) age greater than 50
(B) high-fat diet
(C) cigarette smoking
(D) chronic stress
(E) alcohol use - ANSWER(C) cigarette smoking
6. A middle-aged woman presents with elevated cholestatic liver enzyme levels. She is not taking
any medications, does not drink alcohol, and does not complain of abdominal pain. She has not
had any previous biliary tract surgery. Which of the following is the most likely diagnosis?
(A) primary biliary cirrhosis
(B) pancreatitis
(C) cholecystitis
(D) fatty liver
(E) primary sclerosing cholangitis - ANSWER(A) primary biliary cirrhosis
Primary biliary cirrhosis affects women typically between ages 40 and 60. It is often
discovered incidentally when the serum alkaline phosphatase level is found to be elevated. Many
patients do not have pain, which is more common in cholecystitis or pancreatitis. Primary
sclerosing cholangitis is more likely to occur in a patient with known inflammatory bowel
disease.
7. An adult patient presents with acute onset of watery, nonbloody, voluminous diarrhea accompanied by
nausea and vomiting. Which of the following organisms is the most likely cause?
(A) Clostridium difficile
(B) enterotoxigenic Escherichia coli
(C) Salmonella typhi
A 25-year-old Jewish man presents with pain and watery diarrhea after meals. Examination shows fistulas
between the bowel and skin and nodular lesions on his tibias. - ANSWERCrohn's Disease
Extraintestinal manifestations of IBD. - ANSWERUveitis, ankylosing spondylitis, pyoderma gangrenosum,
erythema nodosum, 1° sclerosing cholangitis.
Difference between Mallory-Weiss and Boerhaave tears. - ANSWERMallory-Weiss—superficial tear in the
esophageal mucosa;
Boerhaave—full-thickness esophageal rupture.
A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the
back and is relieved by sitting forward. Management? - ANSWERConfirm the diagnosis of acute pancreatitis
with elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and "tincture of
time."
1. Patients with chronic gastroesophageal reflux disease (GERD) are at risk for
(A) candidal esophagitis
(B) Zenker diverticulum
(C) Barrett esophagus
(D) esophageal varices
(E) achalasia - ANSWER(C) Barrett esophagus
2. Hepatitis D infection requires coinfection with
(A) hepatitis A
(B) hepatitis B
(C) hepatitis C
, (D) hepatitis E
(E) hepatitis G - ANSWER(B) hepatitis B
3. Which of the following is a risk factor for non-healing of a duodenal ulcer?
(A) age greater than 50
(B) high-fat diet
(C) cigarette smoking
(D) chronic stress
(E) alcohol use - ANSWER(C) cigarette smoking
6. A middle-aged woman presents with elevated cholestatic liver enzyme levels. She is not taking
any medications, does not drink alcohol, and does not complain of abdominal pain. She has not
had any previous biliary tract surgery. Which of the following is the most likely diagnosis?
(A) primary biliary cirrhosis
(B) pancreatitis
(C) cholecystitis
(D) fatty liver
(E) primary sclerosing cholangitis - ANSWER(A) primary biliary cirrhosis
Primary biliary cirrhosis affects women typically between ages 40 and 60. It is often
discovered incidentally when the serum alkaline phosphatase level is found to be elevated. Many
patients do not have pain, which is more common in cholecystitis or pancreatitis. Primary
sclerosing cholangitis is more likely to occur in a patient with known inflammatory bowel
disease.
7. An adult patient presents with acute onset of watery, nonbloody, voluminous diarrhea accompanied by
nausea and vomiting. Which of the following organisms is the most likely cause?
(A) Clostridium difficile
(B) enterotoxigenic Escherichia coli
(C) Salmonella typhi
