Gastrointestinal Hardest Practice Exam! Trivia Quiz

44 Questions | Total Attempts: 1892

SettingsSettingsSettings
Please wait...
Gastrointestinal Hardest Practice Exam! Trivia Quiz

Do you know anything about the gastrointestinal system? Do you think you could pass this exam? Common gastrointestinal disorders include constipation, irritable bowel syndrome, hemorrhoids, fissures, infections, diverticular disease, colitis, colon polyps, and cancer. And this is to name a few. There is a wide array of gastrointestinal problems that are not as common but do exist. Take this exam and see how much you know about the gastrointestinal system.


Questions and Answers
  • 1. 
    In Barrett's esophagus, which of the following cell types are seen above the Z-line?
    • A. 

      Stratified squamous only

    • B. 

      Stratified squamous and simple columnar

    • C. 

      Simple columnar only

    • D. 

      Simple columnar and pseudostratified ciliated columnar

  • 2. 
    Which of the following is correct regarding the contents of the layers of the alimentary canal?
    • A. 

      The mucosal layer contains all of the smooth muscle

    • B. 

      Meissner's plexus is located in the muscularis externa

    • C. 

      Retroperitoneal organs are defined as having serosa

    • D. 

      Auerbach's plexus is located in the muscularis externa

    • E. 

      Auerbach's plexus is located in the mucosa

  • 3. 
    A 4 month old infant present with bilious vomiting and abdominal distention.  X-ray shows What is the mechanism behind this patient's disease?
    • A. 

      Exposure to teratogens results in the loss of contractile ability of the smooth muscle cells

    • B. 

      Gestational diabetes leads to a neuropathy causing the inability to relax the smooth muscle segement

    • C. 

      The absence of intramural ganglion cells causes uncoordinated movement of the bowel segment, leading to obstruction

    • D. 

      Release of excess neurotransmitters results in the dyskinetic movement of the bowel segment

  • 4. 
    Which of these is not part of the functional lower esophageal sphincter?
    • A. 

      Smooth muscle

    • B. 

      Skeletal muscle

    • C. 

      Diapraghm

    • D. 

      Costal cartilage

    • E. 

      None (all of the above are part of the LES)

  • 5. 
    Which of these statements is/are true regarding the enzyme lactase?
    • A. 

      It is found in the brush border

    • B. 

      Deficiency is common in the elderly (defined as older than the dean of your medical school)

    • C. 

      Many experts don't consider lactase deficiency to be a disease because it is so common in otherwise healthy adults

    • D. 

      All of the above

    • E. 

      None of the above

  • 6. 
    Which phase is the least common cause of dysphagia in the elderly?
    • A. 

      Preparatory

    • B. 

      Oral

    • C. 

      Pharyngeal

    • D. 

      Esophageal

  • 7. 
    A 20-year-old man presents with 1 episode of hematochezia. He is concerned because his mother died of colorectal cancer at 50 years of age. He has no further information about his family history. He undergoes colonoscopy and is found to have 20 adenomas ranging in size from 4 to 15 mm.  On further exam and testing, he is found to have with supernumerary teeth, osteomas, epidermoid cysts and lipomas.What is the most likely diagnosis?
    • A. 

      Turcot syndrome

    • B. 

      FAP

    • C. 

      HNPCC

    • D. 

      Gardner's syndrome

    • E. 

      Juvenile polyposis

  • 8. 
    Which of the following statements is true regarding the genetics of colon cancer?
    • A. 

      P53 inactivation is a critical early step in the APC pathway of colon cancer

    • B. 

      Mismatch repair genes play a key role in the APC pathway

    • C. 

      SMAD2 and SMAD4 loss on 18q21 is a late factor in the APC pathway

    • D. 

      The first hit in the HNPCC pathway consists of change in function of E-cadherin or B-catenin

    • E. 

      The HNPCC pathway is the most common pathway of colon cancer development

  • 9. 
    (MULTIPLE ANSWER QUESTION)In this adenocarcinoma biopsy, which of the following are seen?
    • A. 

      Hyperchromatism of nuclei

    • B. 

      Normal goblet cells

    • C. 

      Pleomorphism of nuclei

    • D. 

      Neoplastic glands

  • 10. 
    Which of the following are symptoms of diverticulitis?
    • A. 

      Nausea

    • B. 

      Diarrhea

    • C. 

      Pneumaturia

    • D. 

      Leukocytosis

    • E. 

      All of the above

  • 11. 
    A 55 year old man with a history of atrial fibrillation presents to your office 2 months post myocardial infarction.  He has had sudden-onset, diffuse abdominal pain that began 18 hours ago. He has not been vomiting, but he has had several episodes of diarrhea, the last of which was bloody. What is the most likely mechanism behind his current symptoms?
    • A. 

      Arterial embolism

    • B. 

      Venous thrombosis

    • C. 

      Arterial thrombosis

    • D. 

      Nonocclusive ischemia

    • E. 

      All of the above

  • 12. 
    A 40-year-old housewife complains of recurrent constipation. She has had problems since her 20s, but they are worse now. The constipation is accompanied by abdominal bloating and abdominal pain, and the discomfort is only better when she has a bowel movement. On her gynecologist's advice, she has tried more fiber in her diet, including fresh fruits and leafy vegetables, but that has only made the bloating worse. Her past history includes a cholecystectomy and a hysterectomy. Physical examination is entirely normal. Rectal examination reveals normal consistency stool. Stool samples test negative for occult blood.  She denies anorexia, malnutrition, weight loss, or waking up at night in pain.What is the most likely diagnosis?
    • A. 

      Ulcerative colitis

    • B. 

      Crohn's disease

    • C. 

      Celiac disease

    • D. 

      Irritable bowel syndrome

    • E. 

      Staph aureus infection

  • 13. 
    What is true about the mechanism of action of the IBS medications Alosetron and Tegaserod?
    • A. 

      Alosetron and Tegaserod are both 5HT agonists

    • B. 

      Alosetron and Tegaserod are both 5HT antagonists

    • C. 

      Alosetron is a 5HT3 agonist and Tegaserod is a 5HT4 antagonist

    • D. 

      Alosetron is a 5HT3 antagonist and Tegaserod is a 5HT4 agonist

  • 14. 
    Which of the following metal ions has primarily a structural (as opposed to catalytic) role within the body?
    • A. 

      Fe2+

    • B. 

      Co2+

    • C. 

      Mg2+

    • D. 

      Mn2+

    • E. 

      Ca2+

  • 15. 
    What is the role of Folic acid (B9) in amino acid metabolism and nucleotide synthesis?
    • A. 

      Coenzyme for redox reactions

    • B. 

      Catalyze aldehyde transfer rxns

    • C. 

      Source of 1-Carbon fragments

    • D. 

      Maintains activity of Fe2+-dependent hydroxylases

  • 16. 
    A 55-year-old male smoker is admitted with pneumonia. He lives alone and has been unemployed for several years, since being kicked out of medical school.  He is receiving unemployment benefit but no additional social support. He is unkempt and thin, with a BMI of 19 kg/m^2.  He shows signs of irritability, fatigue, headaches, and peripheral edema.  The following day it is noted that the man is increasingly confused and requiring full nursing support as he is too unsteady to stand unaided. The ward doctor notes that he has nystagmus. High alcohol intake is queried, but no independent social history is available. The patient gradually improves but has continuing problems with his memory and appears to invent events to compensate for this. He remains unsteady on his feet and is found to have poor sensation in his lower limbs. The patient is judged no longer able to care for himself, and is admitted to a nursing home for long-term care.What vitamin deficiency is most likely here?
    • A. 

      B1

    • B. 

      B3

    • C. 

      B6

    • D. 

      B12

    • E. 

      C

  • 17. 
    A medical student preparing to pull an all-nighter to prepare for the upcoming GI test decides to make the ultimate energy drink.  He takes a 6 pack of 5 hour energy drinks (each containing 40 mg of B6), combines them in a beer stein, and adds 4 ground-up 100 mg B6 supplements to the mixture, then drinks it all in one sitting.  Which of the following symptoms is he most likely to have as a result of his concoction?
    • A. 

      Photosensitivity

    • B. 

      Loss of position and vibratory sense (motor strength intact)

    • C. 

      Loss of vibratory but not position sense

    • D. 

      All of the above

    • E. 

      A and B only

  • 18. 
    Which of these laxatives is hyperosmolar laxative?
    • A. 

      Methylcellulose

    • B. 

      Polycarbophil

    • C. 

      Lactulose

    • D. 

      Psyllium hydrophilic mucilloid

  • 19. 
    What is the most common process that leads to anorectal suppuration?
    • A. 

      Carcinoma

    • B. 

      Trauma

    • C. 

      Radiation

    • D. 

      Surgery

    • E. 

      Cryptoglandular

  • 20. 
    Hematemesis is usually caused by a bleeding site that is proximal to which structure?
  • 21. 
    A 48-year-old man presents to the ER after several episodes of vomiting blood after periods of forceful retching and vomiting. He has been binge drinking alcohol over the preceding 2 days.  Endoscopic view is seen here:What is the diagnosis?
    • A. 

      Mallory-Weiss tear

    • B. 

      Neoplasm

    • C. 

      Acute esophagitis

    • D. 

      Cameron lesion

    • E. 

      Gastric varices

  • 22. 
    A 78 year old man presents to his PCP with a recent history of painless bloody stools of the past 2 days.  He has no hemorrhoids or other obvious source of bleeding.  A representative colonoscopic view is shown. What is true about the pathogenesis of this condition?
    • A. 

      Exact mechanism is clearly known

    • B. 

      Unrelated to age, because aging is not a disease!

    • C. 

      Dilitation and tortuosity of veins leads to small AV communication

    • D. 

      Usually occurs because of trauma

    • E. 

      This is a rare cause of lower GI bleeds

  • 23. 
    The above image is most representative of which polyposis?
    • A. 

      Juvenile polyposis

    • B. 

      Peutz-Jegher

    • C. 

      Adenomatous polyposis coli

    • D. 

      HNPCC

  • 24. 
    A 46-year-old woman presents with fatigue and is found to have iron deficiency with anemia. She has experienced intermittent episodes of mild diarrhea for many years, previously diagnosed as irritable bowel syndrome and lactose intolerance. She has no current significant gastrointestinal symptoms. Examination reveals 2 oral aphthous ulcers and pallor. Abdominal examination is normal and results of fecal testing for occult blood are negative.  Biopsy is shown above.  What is the diagnosis?
    • A. 

      Crohn's

    • B. 

      Ulcerative colitis

    • C. 

      Celiac sprue

    • D. 

      HNPCC

    • E. 

      Chronic gastritis

  • 25. 
    Which of the following is true about the condition depicted here?
    • A. 

      Caused by trauma

    • B. 

      Most common in elderly adults

    • C. 

      Most common site is the ileo-cecal valve

    • D. 

      Common in the colon

    • E. 

      Underlying cause is clearly understood

Back to Top Back to top