GI Pance Questions (Khai) and Answers rated A
18. An otherwise healthy 22-year-old presents right upper quadrant pain that radiates to the right
with mild jaundice. Which of the following scapula. This type of pain is associated with
additional historical factors best supports a disorders of which of the following?
diagnosis of Gilbert's disease? A. spleen
A. family history of recurrent jaundice B. gallbladder
B. family history of sickle cell trait C. esophagus
C. history of fatty food intolerance D. ascending colon- b
D. recent fever, malaise, and myalgias- a
75. A patient complains of difficulty seeing at
19. A 3-week-old male is brought to the clinic due night. Exam reveals dry conjunctivae with white
to nonbilious vomiting that has continued for 1 patches. These findings are consistent with a
week. Emesis has become more frequent and is deficiency of what vitamin?
now projectile. The infant is observed being A. A
bottle fed during the interview and appears B. B12
hungry with a good suck. What physical finding C. D
will most likely be found in this patient? D. niacin- a
A. abdominal distention
B. abdominal wall muscle rigidity 77. A 68-year-old male presents with recurring
C. olive-shaped abdominal mass right upper quadrant abdominal pain that radiates
D. sausage-shaped abdominal mass- c to the right scapula. He also complains of fever.
Physical exam reveals icteric sclerae, jaundice,
21. A 38-year-old patient has an older brother and tenderness in the right upper quadrant and
who was diagnosed with colon cancer at age 43 epigastrium. Labs show increased ALT, AST,
years. What is the recommended schedule for alkaline phosphatase, serum bilirubin, and WBC.
colorectal screening for this patient? Ultrasonography shows dilated bile ducts. What
A. screening colonoscopy at 40 years of age is the most likely diagnosis?
B. screening colonoscopy at 50 years of age A. cholangitis
C. screening flexible sigmoidoscopy at 40 years B. choledocolithiasis
of age C. hepatitis
D. screening flexible sigmoidoscopy at 50 years D. pancreatic carcinoma- a
of age- a
86. Which of the following is associated with the
23. Which of the following is an important greatest increased incidence of malignant
concern with the continued administration of transformation?
proton pump inhibitors (PPIs) or H2 receptor A. colonic strictures
blockers? B. regional enteritis
A. antacids should not be used within 30 minutes C. toxic megacolon
of administration of PPI or H2 receptor blockers D. ulcerative colitis- d
B. poor compliance occurs because they need to
be taken four times a day with food 98. A 65-year-old is brought in by his daughter
C. they alter the absorption of pH-dependent because she is worried that he seems
drugs depressed, fatigued, and has lost some weight.
D. they potentiate CNS depression with alcohol The patient describes vague diffuse epigastric
use- c pain for 2 months, which started after a couple of
weeks of mild diarrhea.
41. A 42-year-old complains of steady, severe He has a 15-lb unintentional weight loss and no
1/5
, GI Pance Questions (Khai) and Answers rated A
appetite. He is not interested in his usual 9 months. She has noted a nocturnal cough and
activities. Social history is positive for heavy also complains of substernal chest pain unrelated
tobacco and alcohol use. What is the most likely to meals. She has had a 10-lb unintentional
diagnosis? weight loss. Physical examination is normal. A
A. anemia barium swallow study reveals esophageal dilation
B. depression with
C. diabetes mellitus peristalsis appearing diminished or absent in the
D. pancreatic carcinoma- d distal two-thirds. Which of the following is used to
confirm the diagnosis?
105. Which of the following is most characteristic A. esophageal manometry
in the presentation of acute mesenteric arterial B. computed tomography
occlusion? C. upper endoscopy
A. absence of bowel sounds D. 24-hour pH probe- a
B. intense abdominal pain
C. bloody diarrhea 130. A patient presents with dull, aching
D. peritoneal signs- b epigastric pain. There is some relief after eating
or with antacids. Rapid urease test is
106. A 58-year-old complains of nausea, "coffee positive. Which of the following is a complete
grounds" emesis, and dark tarry stools. There is recommended treatment regime?
a history of heavy alcohol use A. amoxicillin, bismuth subsalicylate, and proton
and NSAID exposure secondary to a painful pump inhibitor
musculoskeletal condition. The patient denies B. amoxicillin, clarithromycin, and proton pump
melena. What is the diagnostic test of choice? inhibitor
A. abdominal computed tomography C. clarithromycin, tetracycline, bismuth
B. colonoscopy subsalicylate
C. upper endoscopy D. proton pump inhibitor alone- b
D. upper gastrointestinal series- c
153. A 54-year-old obese African American male
119. A patient complains of intermittent epigastric with a 40-packyear history of smoking and
and left upper quadrant pain, weight loss, regular alcohol use presents with a
gaseous abdominal distention, flatulence, and 3-month history of progressive solid food
large, greasy, foul-smelling stools. He has a dysphagia. He has a 10-lb unintentional weight
history of alcohol and tobacco abuse. Laboratory loss. He denies heartburn, melena, or change in
testing shows increased serum amylase and bowel habits. What is the most likely diagnosis?
lipase as well as glucosuria. What is the most A. achalasia
sensitive imaging technique to evaluate the B. esophageal adenocarcinoma
suspected diagnosis? C. esophageal squamous cell cancer
A. abdominal computed tomography D. esophageal stricture- c
B. abdominal ultrasonography
C. abdominal plain-film radiography 169. A 15-year-old female complains of
D. endoscopic retrograde abdominal pain that started 12 hours ago after
cholangiopancreatography- d her birthday party where she ate pizza, soda, and
birthday cake. The patient has no appetite this
128. A 31-year-old female complains of chest morning and she feels warm. LMP was 3 weeks
fullness after eating and progressive dysphagia ago. Abdominal exam reveals right lower
of solids and liquids over the last quadrant tenderness without rebound. In addition
2/5
18. An otherwise healthy 22-year-old presents right upper quadrant pain that radiates to the right
with mild jaundice. Which of the following scapula. This type of pain is associated with
additional historical factors best supports a disorders of which of the following?
diagnosis of Gilbert's disease? A. spleen
A. family history of recurrent jaundice B. gallbladder
B. family history of sickle cell trait C. esophagus
C. history of fatty food intolerance D. ascending colon- b
D. recent fever, malaise, and myalgias- a
75. A patient complains of difficulty seeing at
19. A 3-week-old male is brought to the clinic due night. Exam reveals dry conjunctivae with white
to nonbilious vomiting that has continued for 1 patches. These findings are consistent with a
week. Emesis has become more frequent and is deficiency of what vitamin?
now projectile. The infant is observed being A. A
bottle fed during the interview and appears B. B12
hungry with a good suck. What physical finding C. D
will most likely be found in this patient? D. niacin- a
A. abdominal distention
B. abdominal wall muscle rigidity 77. A 68-year-old male presents with recurring
C. olive-shaped abdominal mass right upper quadrant abdominal pain that radiates
D. sausage-shaped abdominal mass- c to the right scapula. He also complains of fever.
Physical exam reveals icteric sclerae, jaundice,
21. A 38-year-old patient has an older brother and tenderness in the right upper quadrant and
who was diagnosed with colon cancer at age 43 epigastrium. Labs show increased ALT, AST,
years. What is the recommended schedule for alkaline phosphatase, serum bilirubin, and WBC.
colorectal screening for this patient? Ultrasonography shows dilated bile ducts. What
A. screening colonoscopy at 40 years of age is the most likely diagnosis?
B. screening colonoscopy at 50 years of age A. cholangitis
C. screening flexible sigmoidoscopy at 40 years B. choledocolithiasis
of age C. hepatitis
D. screening flexible sigmoidoscopy at 50 years D. pancreatic carcinoma- a
of age- a
86. Which of the following is associated with the
23. Which of the following is an important greatest increased incidence of malignant
concern with the continued administration of transformation?
proton pump inhibitors (PPIs) or H2 receptor A. colonic strictures
blockers? B. regional enteritis
A. antacids should not be used within 30 minutes C. toxic megacolon
of administration of PPI or H2 receptor blockers D. ulcerative colitis- d
B. poor compliance occurs because they need to
be taken four times a day with food 98. A 65-year-old is brought in by his daughter
C. they alter the absorption of pH-dependent because she is worried that he seems
drugs depressed, fatigued, and has lost some weight.
D. they potentiate CNS depression with alcohol The patient describes vague diffuse epigastric
use- c pain for 2 months, which started after a couple of
weeks of mild diarrhea.
41. A 42-year-old complains of steady, severe He has a 15-lb unintentional weight loss and no
1/5
, GI Pance Questions (Khai) and Answers rated A
appetite. He is not interested in his usual 9 months. She has noted a nocturnal cough and
activities. Social history is positive for heavy also complains of substernal chest pain unrelated
tobacco and alcohol use. What is the most likely to meals. She has had a 10-lb unintentional
diagnosis? weight loss. Physical examination is normal. A
A. anemia barium swallow study reveals esophageal dilation
B. depression with
C. diabetes mellitus peristalsis appearing diminished or absent in the
D. pancreatic carcinoma- d distal two-thirds. Which of the following is used to
confirm the diagnosis?
105. Which of the following is most characteristic A. esophageal manometry
in the presentation of acute mesenteric arterial B. computed tomography
occlusion? C. upper endoscopy
A. absence of bowel sounds D. 24-hour pH probe- a
B. intense abdominal pain
C. bloody diarrhea 130. A patient presents with dull, aching
D. peritoneal signs- b epigastric pain. There is some relief after eating
or with antacids. Rapid urease test is
106. A 58-year-old complains of nausea, "coffee positive. Which of the following is a complete
grounds" emesis, and dark tarry stools. There is recommended treatment regime?
a history of heavy alcohol use A. amoxicillin, bismuth subsalicylate, and proton
and NSAID exposure secondary to a painful pump inhibitor
musculoskeletal condition. The patient denies B. amoxicillin, clarithromycin, and proton pump
melena. What is the diagnostic test of choice? inhibitor
A. abdominal computed tomography C. clarithromycin, tetracycline, bismuth
B. colonoscopy subsalicylate
C. upper endoscopy D. proton pump inhibitor alone- b
D. upper gastrointestinal series- c
153. A 54-year-old obese African American male
119. A patient complains of intermittent epigastric with a 40-packyear history of smoking and
and left upper quadrant pain, weight loss, regular alcohol use presents with a
gaseous abdominal distention, flatulence, and 3-month history of progressive solid food
large, greasy, foul-smelling stools. He has a dysphagia. He has a 10-lb unintentional weight
history of alcohol and tobacco abuse. Laboratory loss. He denies heartburn, melena, or change in
testing shows increased serum amylase and bowel habits. What is the most likely diagnosis?
lipase as well as glucosuria. What is the most A. achalasia
sensitive imaging technique to evaluate the B. esophageal adenocarcinoma
suspected diagnosis? C. esophageal squamous cell cancer
A. abdominal computed tomography D. esophageal stricture- c
B. abdominal ultrasonography
C. abdominal plain-film radiography 169. A 15-year-old female complains of
D. endoscopic retrograde abdominal pain that started 12 hours ago after
cholangiopancreatography- d her birthday party where she ate pizza, soda, and
birthday cake. The patient has no appetite this
128. A 31-year-old female complains of chest morning and she feels warm. LMP was 3 weeks
fullness after eating and progressive dysphagia ago. Abdominal exam reveals right lower
of solids and liquids over the last quadrant tenderness without rebound. In addition
2/5
