WEEK 5 CONTENT
Multiple Choice Questions (1–25)
1. GERD most commonly occurs due to which underlying
mechanism?
A. Increased gastric mucus secretion
B. Incompetent lower esophageal sphincter
C. Hypersecretion of gastrin
D. Delayed gastric emptying unrelated to sphincter function
2. Which symptom is most characteristic of a duodenal ulcer?
A. Pain immediately worsens after eating
B. Weight loss due to food avoidance
C. Pain relieved temporarily by eating
D. Vomiting immediately after meals
3. A 23-year-old woman presents with periumbilical pain migrating
to the right lower quadrant. Which pathophysiology best explains
her condition?
A. Autoimmune inflammation of colon crypts
B. Obstruction of the appendiceal lumen
C. Transmural lesions of the small intestine
D. Increased gastric acid secretion
4. Long-standing GERD increases the risk for which complication?
A. Celiac disease
B. Barrett’s esophagus
C. Diverticulosis
D. Pancreatitis
,5. A patient with continuous colonic lesions beginning at the rectum
most likely has:
A. Crohn’s disease
B. Ulcerative colitis
C. Irritable bowel syndrome
D. Celiac disease
6. Which laboratory finding best supports appendicitis?
A. Elevated alkaline phosphatase
B. Low neutrophil count
C. Elevated white blood cell count
D. Prolonged PT/INR
7. Ascites formation in cirrhosis primarily results from:
A. Increased serum albumin
B. Portal hypertension and low oncotic pressure
C. Excess aldosterone excretion
D. Decreased lymphatic circulation only
8. The hallmark structural change of alcoholic cirrhosis is:
A. Fatty infiltration without fibrosis
B. Portal vein thrombosis
C. Fibrosis and regenerative nodules
D. Chronic bile duct obstruction
9. Which mechanism drives hepatocyte injury in non-alcoholic fatty
liver disease (NAFLD)?
A. Autoimmune antibody destruction
B. Oxidative stress due to fat accumulation
C. Viral infection of hepatocytes
D. Excessive alcohol metabolites
,10. A patient with cirrhosis becomes confused and has asterixis.
Which abnormal lab value is expected?
A. Elevated ammonia
B. Low bilirubin
C. Elevated sodium
D. Low potassium
11. Which feature distinguishes Crohn’s disease from ulcerative
colitis?
A. Continuous mucosal inflammation
B. Skip lesions and transmural involvement
C. Disease limited to the rectum
D. High risk of toxic megacolon
12. First-line pharmacologic therapy for GERD is:
A. Antacids
B. Proton pump inhibitors
C. Opioid analgesics
D. Anticholinergics
13. A patient with epigastric pain relieved by eating most likely has:
A. Gastric ulcer
B. Duodenal ulcer
C. GERD
D. Cholecystitis
14. The most common cause of gastric ulcers is:
A. NSAID use
B. Viral infection
C. Gluten sensitivity
D. Hyperthyroidism
, 15. Ulcerative colitis pathophysiology involves:
A. Transmural granulomatous inflammation
B. Patchy lesions throughout the GI tract
C. Continuous mucosal inflammation of the colon
D. Involvement of the small intestine only
16. Which of the following is a major risk factor for Crohn’s disease?
A. Smoking
B. Low fiber intake
C. Appendectomy
D. Prior cholecystectomy
17. A patient with hepatic encephalopathy is most likely to have
which finding?
A. Elevated glucose
B. Reduced serum ammonia
C. Elevated serum ammonia
D. Low RBC count only
18. A patient describes sudden episodes of intense fear with
palpitations and shortness of breath. This best describes:
A. Generalized anxiety disorder
B. Panic disorder
C. Major depressive disorder
D. PTSD
19. Major depressive disorder is most strongly associated with
decreased levels of:
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
Multiple Choice Questions (1–25)
1. GERD most commonly occurs due to which underlying
mechanism?
A. Increased gastric mucus secretion
B. Incompetent lower esophageal sphincter
C. Hypersecretion of gastrin
D. Delayed gastric emptying unrelated to sphincter function
2. Which symptom is most characteristic of a duodenal ulcer?
A. Pain immediately worsens after eating
B. Weight loss due to food avoidance
C. Pain relieved temporarily by eating
D. Vomiting immediately after meals
3. A 23-year-old woman presents with periumbilical pain migrating
to the right lower quadrant. Which pathophysiology best explains
her condition?
A. Autoimmune inflammation of colon crypts
B. Obstruction of the appendiceal lumen
C. Transmural lesions of the small intestine
D. Increased gastric acid secretion
4. Long-standing GERD increases the risk for which complication?
A. Celiac disease
B. Barrett’s esophagus
C. Diverticulosis
D. Pancreatitis
,5. A patient with continuous colonic lesions beginning at the rectum
most likely has:
A. Crohn’s disease
B. Ulcerative colitis
C. Irritable bowel syndrome
D. Celiac disease
6. Which laboratory finding best supports appendicitis?
A. Elevated alkaline phosphatase
B. Low neutrophil count
C. Elevated white blood cell count
D. Prolonged PT/INR
7. Ascites formation in cirrhosis primarily results from:
A. Increased serum albumin
B. Portal hypertension and low oncotic pressure
C. Excess aldosterone excretion
D. Decreased lymphatic circulation only
8. The hallmark structural change of alcoholic cirrhosis is:
A. Fatty infiltration without fibrosis
B. Portal vein thrombosis
C. Fibrosis and regenerative nodules
D. Chronic bile duct obstruction
9. Which mechanism drives hepatocyte injury in non-alcoholic fatty
liver disease (NAFLD)?
A. Autoimmune antibody destruction
B. Oxidative stress due to fat accumulation
C. Viral infection of hepatocytes
D. Excessive alcohol metabolites
,10. A patient with cirrhosis becomes confused and has asterixis.
Which abnormal lab value is expected?
A. Elevated ammonia
B. Low bilirubin
C. Elevated sodium
D. Low potassium
11. Which feature distinguishes Crohn’s disease from ulcerative
colitis?
A. Continuous mucosal inflammation
B. Skip lesions and transmural involvement
C. Disease limited to the rectum
D. High risk of toxic megacolon
12. First-line pharmacologic therapy for GERD is:
A. Antacids
B. Proton pump inhibitors
C. Opioid analgesics
D. Anticholinergics
13. A patient with epigastric pain relieved by eating most likely has:
A. Gastric ulcer
B. Duodenal ulcer
C. GERD
D. Cholecystitis
14. The most common cause of gastric ulcers is:
A. NSAID use
B. Viral infection
C. Gluten sensitivity
D. Hyperthyroidism
, 15. Ulcerative colitis pathophysiology involves:
A. Transmural granulomatous inflammation
B. Patchy lesions throughout the GI tract
C. Continuous mucosal inflammation of the colon
D. Involvement of the small intestine only
16. Which of the following is a major risk factor for Crohn’s disease?
A. Smoking
B. Low fiber intake
C. Appendectomy
D. Prior cholecystectomy
17. A patient with hepatic encephalopathy is most likely to have
which finding?
A. Elevated glucose
B. Reduced serum ammonia
C. Elevated serum ammonia
D. Low RBC count only
18. A patient describes sudden episodes of intense fear with
palpitations and shortness of breath. This best describes:
A. Generalized anxiety disorder
B. Panic disorder
C. Major depressive disorder
D. PTSD
19. Major depressive disorder is most strongly associated with
decreased levels of:
A. Dopamine
B. Serotonin
C. GABA
D. Acetylcholine
