1
GI Case studies 2025 REAL EXAM QUESTIONS |MOST
TESTED QUESTIONS AND CORRECT ANSWERS |100%
ACCURATE|GET IT RIGHT!!
A 55-year-old salesman is noted to have a cancer of the lower third of the
esophagus. He is a nonsmoker and occasionally drinks alcohol. Which of the
following is the most likely cell type?
A Adenocarcinoma
B Melanoma
C Metastatic cancer
DSarcoma
ESquamous cell carcinoma - (ANSWER)A. Adenocarcinoma is the most common
malignancy of the lower third of the esophagus and is strongly associated with
Barrett esophagus. Squamous cell carcinoma is the most common type of cancer
of the esophagus worldwide and usually affects the upper or middle region of the
esophagus.
An 18-year-old man presents with difficulty swallowing over the last 3 days. He
denies ingestion of unusual substances and complains of pain even when
swallowing liquids. He is an intravenous (IV) drug user and has been taking several
medications to "help his immunity." Which of the following is the most likely
finding on esophageal endoscopy?
A
Brown blotches scattered throughout the esophagus
B
Normal-appearing esophagus
C
, 2
Red patches in the distal esophagus
D
Reddish streaks throughout the pharynx and upper esophagus
E
White patches adherent to the esophagus - (ANSWER)E. This patient probably
has HIV, and the clinical syndrome of painful and difficult swallowing is consistent
with Candida esophagitis. Endoscopy probably would reveal white plaques
adherent to the esophagus. Other causes of esophagitis include herpes simplex
infection, cytomegalovirus (CMV) infection, and chemical-induced conditions such
as those resulting from lye (suicide attempt).
A newborn male is noted to have difficulty feeding and "turns blue and chokes
when drinking formula." The prenatal records reveal that the amniotic fluid
appeared normal on ultrasound. A pediatric feeding tube is passed orally to 20 cm
without difficulty, with gastric secretions aspirated. Which of the following is the
most likely diagnosis?
A
Congenital heart disease
B
Floppy epiglottis
C
Respiratory distress syndrome
D
Tracheoesophageal fistula
E
, 3
Zenker diverticulum - (ANSWER)D. The vast majority newborns with TE fistulae
involve a nonpatent esophagus that is diagnosed by the inability to pass a feeding
tube. However, the baby in this case most likely has an unusual type of TE fistula
(H type) in which the esophagus is patent but there is a connection between the
esophagus and the trachea. When the baby feeds, the formula is aspirated into
the tracheobronchial tree, leading to choking and cyanosis. This condition may be
diagnosed with a radiologic contrast study and requires surgical correction.
A 30-year-old healthy woman recently attended a health fair, where she tested
positive for H. pylori on a blood test. She denies any recent abdominal discomfort,
nausea, vomiting, diarrhea, or melena. Occasionally, she uses over-the-counter
acid suppressive therapy after eating spicy foods or drinking alcohol when she
develops mild heartburn, and her symptoms typically resolve within a week.
Which of the following is the most appropriate advice to give this patient
regarding H. pylori?
A
Based on this test result, it is not possible to tell if she has an active infection.
B
She should undergo stool antigen testing to prove infection.
C
She should undergo upper endoscopy to prove infection.
D
She should be prescribed a PPI for 8 weeks.
E
She should be prescribed triple therapy to treat infection. - (ANSWER)A. H. pylori
serologic testing cannot distinguish active infections from old infections or
, 4
diagnose the presence of ulcers. Treating a positive serum test in an
asymptomatic person is not indicated, but rather education of the patient
regarding the need for further testing to confirm the diagnosis. Stool antigen
testing (answer B), upper endoscopy (answer C), daily PPI therapy (answer D), and
triple therapy (answer E) are not indicated in a patient without symptoms of
dyspepsia.
A 62-year-old man presents with increasing shortness of breath and fatigue over
the last several days. Cardiac examination reveals regular rate and rhythm, and
lungs are clear to auscultation bilaterally. No jaundice, jugular venous distention,
or peripheral edema is noted. Mucous membranes are pink with no evidence of
cyanosis, and capillary refill is brisk. CBC reveals a microcytic anemia, and a gastric
ulcer is diagnosed on upper GI endoscopy. Gastric mucosa biopsy confirms an H.
pylori infection. This patient's last colonoscopy was 10 years ago and was
unremarkable. Which of the following is the next most appropriate step in the
workup of this patient?
A
Barium esophagram
B
Abdominal ultrasound
C
Colonoscopy
D
Urea breath test
E
GI Case studies 2025 REAL EXAM QUESTIONS |MOST
TESTED QUESTIONS AND CORRECT ANSWERS |100%
ACCURATE|GET IT RIGHT!!
A 55-year-old salesman is noted to have a cancer of the lower third of the
esophagus. He is a nonsmoker and occasionally drinks alcohol. Which of the
following is the most likely cell type?
A Adenocarcinoma
B Melanoma
C Metastatic cancer
DSarcoma
ESquamous cell carcinoma - (ANSWER)A. Adenocarcinoma is the most common
malignancy of the lower third of the esophagus and is strongly associated with
Barrett esophagus. Squamous cell carcinoma is the most common type of cancer
of the esophagus worldwide and usually affects the upper or middle region of the
esophagus.
An 18-year-old man presents with difficulty swallowing over the last 3 days. He
denies ingestion of unusual substances and complains of pain even when
swallowing liquids. He is an intravenous (IV) drug user and has been taking several
medications to "help his immunity." Which of the following is the most likely
finding on esophageal endoscopy?
A
Brown blotches scattered throughout the esophagus
B
Normal-appearing esophagus
C
, 2
Red patches in the distal esophagus
D
Reddish streaks throughout the pharynx and upper esophagus
E
White patches adherent to the esophagus - (ANSWER)E. This patient probably
has HIV, and the clinical syndrome of painful and difficult swallowing is consistent
with Candida esophagitis. Endoscopy probably would reveal white plaques
adherent to the esophagus. Other causes of esophagitis include herpes simplex
infection, cytomegalovirus (CMV) infection, and chemical-induced conditions such
as those resulting from lye (suicide attempt).
A newborn male is noted to have difficulty feeding and "turns blue and chokes
when drinking formula." The prenatal records reveal that the amniotic fluid
appeared normal on ultrasound. A pediatric feeding tube is passed orally to 20 cm
without difficulty, with gastric secretions aspirated. Which of the following is the
most likely diagnosis?
A
Congenital heart disease
B
Floppy epiglottis
C
Respiratory distress syndrome
D
Tracheoesophageal fistula
E
, 3
Zenker diverticulum - (ANSWER)D. The vast majority newborns with TE fistulae
involve a nonpatent esophagus that is diagnosed by the inability to pass a feeding
tube. However, the baby in this case most likely has an unusual type of TE fistula
(H type) in which the esophagus is patent but there is a connection between the
esophagus and the trachea. When the baby feeds, the formula is aspirated into
the tracheobronchial tree, leading to choking and cyanosis. This condition may be
diagnosed with a radiologic contrast study and requires surgical correction.
A 30-year-old healthy woman recently attended a health fair, where she tested
positive for H. pylori on a blood test. She denies any recent abdominal discomfort,
nausea, vomiting, diarrhea, or melena. Occasionally, she uses over-the-counter
acid suppressive therapy after eating spicy foods or drinking alcohol when she
develops mild heartburn, and her symptoms typically resolve within a week.
Which of the following is the most appropriate advice to give this patient
regarding H. pylori?
A
Based on this test result, it is not possible to tell if she has an active infection.
B
She should undergo stool antigen testing to prove infection.
C
She should undergo upper endoscopy to prove infection.
D
She should be prescribed a PPI for 8 weeks.
E
She should be prescribed triple therapy to treat infection. - (ANSWER)A. H. pylori
serologic testing cannot distinguish active infections from old infections or
, 4
diagnose the presence of ulcers. Treating a positive serum test in an
asymptomatic person is not indicated, but rather education of the patient
regarding the need for further testing to confirm the diagnosis. Stool antigen
testing (answer B), upper endoscopy (answer C), daily PPI therapy (answer D), and
triple therapy (answer E) are not indicated in a patient without symptoms of
dyspepsia.
A 62-year-old man presents with increasing shortness of breath and fatigue over
the last several days. Cardiac examination reveals regular rate and rhythm, and
lungs are clear to auscultation bilaterally. No jaundice, jugular venous distention,
or peripheral edema is noted. Mucous membranes are pink with no evidence of
cyanosis, and capillary refill is brisk. CBC reveals a microcytic anemia, and a gastric
ulcer is diagnosed on upper GI endoscopy. Gastric mucosa biopsy confirms an H.
pylori infection. This patient's last colonoscopy was 10 years ago and was
unremarkable. Which of the following is the next most appropriate step in the
workup of this patient?
A
Barium esophagram
B
Abdominal ultrasound
C
Colonoscopy
D
Urea breath test
E
