GI TEST 5

Question 1

What is the hallmark symptom of ulcerative colitis?

Answer 1

Bloody diarrhea

Question 2

What pattern of inflammation is seen in Crohn’s disease?

Answer 2

Transmural inflammation with skip lesions

Question 3

Which IBD is associated with fistulas?

Answer 3

Crohn’s disease

Question 4

Which IBD always involves the rectum?

Answer 4

Ulcerative colitis

Question 5

Which IBD shows cobblestoning on endoscopy?

Answer 5

Crohn’s disease

Question 6

What is the classic symptom of mesenteric ischemia?

Answer 6

Severe abdominal pain out of proportion to exam

Question 7

What is the best initial imaging for mesenteric ischemia?

Answer 7

CTA without oral contrast

Question 8

Most common cause of arterial embolic mesenteric ischemia?

Answer 8

Atrial fibrillation

Question 9

What imaging finding suggests SBO?

Answer 9

Air-fluid levels and dilated loops on abdominal x-ray

Question 10

What is the primary cause of ileus?

Answer 10

Postoperative state or electrolyte abnormalities

Question 11

What sign on CT suggests volvulus?

Answer 11

Whirl sign

Question 12

Primary treatment for severe C. difficile infection?

Answer 12

Oral vancomycin

Question 13

Most common cause of C. diff?

Answer 13

Antibiotic exposure, especially clindamycin

Question 14

What lab ratio suggests an upper GI bleed?

Answer 14

BUN:Cr > 20:1

Question 15

What medication is first-line for variceal bleeding?

Answer 15

Octreotide

Question 16

What is the classic presentation of lower GI bleed?

Answer 16

Hematochezia

Question 17

Major modifiable risk factor for colon cancer?

Answer 17

Diet high in red/processed meat

Question 18

Genetic syndrome strongly associated with colon cancer?

Answer 18

Lynch syndrome

Question 19

Most common cause of PUD?

Answer 19

H. pylori infection

Question 20

Most common complication of duodenal ulcer?

Answer 20

Bleeding

Question 21

Which ICU patients require stress ulcer prophylaxis?

Answer 21

Mechanical ventilation or coagulopathy

Question 22

Most commonly used stress ulcer prophylaxis agent?

Answer 22

IV proton pump inhibitor (pantoprazole)

Question 23

Classic physical exam finding in peritonitis?

Answer 23

Rebound tenderness

Question 24

What are the 3 diagnostic criteria for acute pancreatitis?

Answer 24

Typical epigastric pain, lipase >3x ULN, imaging

Question 25

Best initial imaging for suspected biliary pancreatitis?

Answer 25

Ultrasound

Question 26

Preferred fluid for pancreatitis resuscitation?

Answer 26

Lactated Ringer’s

Question 27

Indication for ERCP in pancreatitis?

Answer 27

Cholangitis or obstructing stone

Question 28

Most common complication of ERCP?

Answer 28

Post-ERCP pancreatitis

Question 29

First-line treatment for mild ulcerative colitis?

Answer 29

Mesalamine (5-ASA)

Question 30

First-line for moderate-severe Crohn’s flare?

Answer 30

Corticosteroids

Question 31

What electrolyte abnormality is commonly seen in acute pancreatitis?

Answer 31

Hypocalcemia

Question 32

What physical sign suggests retroperitoneal hemorrhage in pancreatitis?

Answer 32

Grey-Turner’s sign

Question 33

What physical sign suggests periumbilical hemorrhage?

Answer 33

Cullen’s sign

Question 34

What is the most common cause of acute cholecystitis?

Answer 34

Gallstones obstructing the cystic duct

Question 35

Best imaging for acute cholecystitis?

Answer 35

Ultrasound

Question 36

What is a positive HIDA scan in cholecystitis?

Answer 36

Non-visualization of the gallbladder

Question 37

What condition presents with RUQ pain radiating to the shoulder?

Answer 37

Cholecystitis

Question 38

What is the most common cause of large bowel obstruction?

Answer 38

Colon cancer

Question 39

What is the most common cause of small bowel obstruction?

Answer 39

Adhesions from prior surgery

Question 40

What is the first-line treatment for ischemic colitis?

Answer 40

Supportive care: fluids, bowel rest, antibiotics

Question 41

What finding on CTA suggests mesenteric ischemia?

Answer 41

Bowel wall thickening and decreased enhancement

Question 42

What organism is associated with toxic megacolon from colitis?

Answer 42

C. difficile

Question 43

What is the definitive treatment for severe toxic megacolon?

Answer 43

Subtotal colectomy

Question 44

What is first-line therapy for H. pylori?

Answer 44

PPI + clarithromycin + amoxicillin (triple therapy)

Question 45

What condition can cause bilious vomiting and air-fluid levels?

Answer 45

Small bowel obstruction

Question 46

Which GI cancer is strongly linked to H. pylori?

Answer 46

Gastric adenocarcinoma

Question 47

What tumor marker is elevated in pancreatic cancer?

Answer 47

CA 19-9

Question 48

What is the best diagnostic test for pancreatic cancer?

Answer 48

EUS-guided biopsy

Question 49

What is the most common cause of lower GI bleeding?

Answer 49

Diverticulosis