Medicine- Gastroenterology Exam Prep MCQ Test
- 1.A 41-year-old male with a history of chronic alcoholism has massive hematemesis following a bout of prolonged vomiting. This is most typical for:
- A.
Hiatal hernia
- B.
Mallory-Weiss tear
- C.
Esophageal variceal bleeding
- D.
Boerhaaeve’s syndrome
- 2.True statements regarding diverticulosis include all of the following EXCEPT:
- A.
The diverticula are most common in the right colon
- B.
It occurs more in elderly and middle-aged persons
- C.
A high-fiber diet contributes to their formation
- D.
The diverticula may become inflamed and rupture.
- 3.True in suspected acute variceal bleeding except
- A.
Vigorous saline resuscitation should generally be avoided
- B.
If necessary, transfuse up to hemoglobin of 8g/dl only
- C.
Tracheal intubation prior to EGD should be considered
- D.
Prophylactic antibiotics should be given only in cirrhotic patients with ascites
- 4.The most frequent cause of lower GI bleeding is:
- A.
Colonic malignancy
- B.
Hemorrhoids
- C.
Colonic diverticulosis
- D.
Vascular ectasia
- 5.Risk factors associated with diverticular bleeding except
- A.
Hypertension
- B.
Atherosclerosis
- C.
Frequent ingestion of nuts or seeds
- D.
Regular intake of NSAIDs
- 6.Institution of PPI therapy at presentation in all patients with UGIB
- A.
Downgrades high-risk ulcer characteristics
- B.
Decreases mortality
- C.
Decreases rebleeding
- D.
Increases survival
- E.
Option 5
- 7.Endotracheal intubation for airway protection in the management of acute Upper GI bleeding should be considered:
- A.
In all cirrhotic patients
- B.
In all patients with UGI bleeding
- C.
In patients with altered mental status and ongoing hematemesis
- D.
In patients with stable COPD
- 8.After initial stabilization and resuscitation of the patient, each of the following options should be considered in the management of UGI bleeding except:
- A.
Determine the source of bleeding
- B.
Stop acute bleeding
- C.
Prevent rebleeding
- D.
Emergency surgery
- 9.The two most common causes of severe hematochezia requiring hospitalization are:
- A.
Vascular ectasia and internal hemorrhoids
- B.
Diverticulosis and internal hemorrhoids
- C.
Colon cancer and colitis
- D.
Vascular ectasia and diverticulosis
- 10.A patient with an NSAID-related gastric ulcer complicated by UGI bleeding requires continued NSAID treatment. H. pylori test is positive. Which one of the following is the most effective approach once the index ulcer has healed?
- A.
Eradicate H. pylori, continue previous NSAID, maintenance PPI
- B.
Eradicate H. pylori, shift to a COX-2 selective NSAID
- C.
PPI maintenance therapy
- D.
Eradicate H. pylori, shift to a COX-2 selective NSAID, maintenance PPI
- 11.In a patient with severe hematochezia, hypotension, and anemia, both the upper gastroscopy and colonoscopy were not diagnostic. The patient continued to pass clots per rectum. Resuscitation has normalized her vital signs and maintained her Hct at 32%. What is the most effective management strategy?
- A.
Abdominal CT scan with contrast
- B.
Magnetic resonance imaging
- C.
Mesenteric angiography
- D.
Emergency surgery
- 12.Pharmacologic treatment for bleeding esophageal varices in a decompensated cirrhotic patient includes the following except:
- A.
Somatostatin infusion
- B.
PPI infusion
- C.
Antibiotics
- D.
Lactulose Enema
- 13.A 54 year-old man with a history of "alcoholic liver disease" presents with frank hemetemesis, a blood pressure of 80/40, pulse rate of 110, and a respiratory rate of 26. After assessing and managing the airway, which of the following is most likely to provide definitive treatment?
- A.
Somatostatin infusion
- B.
PPI infusion
- C.
Emergent endoscopy with variceal ligation
- D.
Sengtaken-Blakemore tube insertion
- 14.Risk factors associated with poor outcome in acute upper gi bleeding except:
- A.
Increasing age
- B.
Comorbidities
- C.
Hematemesis
- D.
Outpatient bleeds
- 15.Which of the following findings at endoscopy is most reassuring that the patient will not have a significant rebleeding episode within the next 3 days?
- A.
Adherent clot on ulcer
- B.
Ulcer crater with a flat pigmented spot
- C.
Dieulafoy lesion
- D.
Esophageal varices with red color sign
- 16.The most common cause of clinically apparent chronic pancreatitis
- A.
Diabetes Mellitus
- B.
Gall stone Disease
- C.
Hypertriglyceridemia
- D.
Alcoholism
- 17.Diagnostic Test with the best sensitivity and specificity for chronic pancreatitis
- A.
MRCP
- B.
Endoscopic Ultrasound
- C.
Secretin Stimulation Test
- D.
Lipase
- 18.For Patients with Acute pancreatitis, it is a faint blue discoloration around the umbilicus which may occur as a sign of hemoperitoneum
- A.
Turner’s Sign
- B.
Cullen’s Sign
- C.
Boas’ Sign
- D.
Fox’s Sign
- 19.Indication for prophylactic cholecystectomy
- A.
Stone >1.5 CM
- B.
Diabetic Patient
- C.
Multiple stones
- D.
Congenitally anomalous GB
- 20.A 94 y/o diabetic, female suffering from congestive heart failure admitted in the CCU suddenly developed right upper quadrant pain and fever. UTZ showed dilated GB with multiple lithiases and pericholecystic fluid. What is the ideal management?
- A.
Laparoscopic cholecystectomy
- B.
ERCP
- C.
Open cholecystectomy
- D.
Cholecystostomy and tube drainage
- 21.This occurs when the gallstone impacted in the cystic duct or neck of the gallbladder causing compression of the CBD
- A.
Bouveret Syndrome
- B.
Mirizzi’s Syndrome
- C.
Boerhaave Syndrome
- D.
Double Duct Syndrome
- 22.The treatment of choice for patients with uncomplicated acute cholecystitis
- A.
Antibiotic Therapy
- B.
Laparascopic Cholecystectomy within 72 hrs
- C.
Emergency Laporoscopic Cholecystectomy
- D.
Elective Laparoscopic cholecystectomy 1 week after discharge
- 23.This type of chronic gastritis has predominantly antral involvement and correlated with H pylori Infection.
- A.
Type A
- B.
Type B
- C.
Type C
- D.
Type D
- 24.A 75 years old male came in due to severe abdominal pain accompanied by nausea and vomiting. History revealed that patient also had episodes of bloody stools. On PE Bp 100/60 HR 110 Bpm Irreglarly irregular. Abdomen was soft with slight tenderness on all quadrants. What would be the best imaging modality for the patient
- A.
Scout film of the abdomen
- B.
Ultrasound of whole abdomen
- C.
MRI of the whole abdomen
- D.
Angiography
- 25.Most common location of mesenteric ischemia
- A.
Ascending colon
- B.
Transverse Colon
- C.
Descending colon
- D.
Rectosigmoid Colon
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