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Clin Med GI

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GI practice
Diana Flores
Quiz by Diana Flores, updated more than 1 year ago
Diana Flores
Created by Diana Flores almost 9 years ago
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Resource summary

Question 1

Question
Which of the following is the MOST common cause of chronic dyspepsia?
Answer
  • Peptic Ulcer disease
  • GERD
  • Functional dyspepsia
  • Gastroparesis

Question 2

Question
Which of the following drugs causes Non-alcoholic fatty liver disease?
Answer
  • Amiodarone
  • Amlodipine
  • Methotrexate
  • Omeprazole

Question 3

Question
Which of the following is NOT a treatment for Alcoholic Fatty liver disease?
Answer
  • Folic acid and thiamine
  • Carbs and calories
  • Methylprednisone
  • Diuretics

Question 4

Question
Which of the following is an indication to a patient with alcoholic fatty liver?
Answer
  • Hepatic encephalopathy
  • INR <1.6
  • Total bilirubin < 10mg/dL
  • Decreased PTT

Question 5

Question
Which of the following symptoms is NOT an indication for upper endoscopy?
Answer
  • Weight loss
  • Dysphagia
  • Anemia
  • Hematochezia

Question 6

Question
If IgG serology or urea breath test is negative and patient is not using NSAIDS, peptic ulcer disease is excluded.
Answer
  • True
  • False

Question 7

Question
Which of the following is a scoring system to predict advanced fibrosis?
Answer
  • ROME III criteria
  • Duke's criteria
  • BARD criteria
  • Ranson's criteria

Question 8

Question
High consumption of tea and caffeine are cirrhosis protectant
Answer
  • True
  • False

Question 9

Question
Which of the following is a cause secondary constipation?
Answer
  • Dysynergic defecation
  • Hypercalcemia
  • Psychosocial problems
  • Weight gain

Question 10

Question
Which of the following characterizes acute diarrhea?
Answer
  • More than 3 BM/day
  • More than 200-300 mL in <48 hours
  • Persisting for more than 2 weeks
  • More than 5 BM/day

Question 11

Question
Which of the following is NOT true regarding inflammatory diarrhea?
Answer
  • Bloody diarrhea
  • Associated with LLQ cramping
  • Diarrhea is usually high in volume
  • Fecal leukocytes or lactoferrin are usually present in infections with invasive organisms

Question 12

Question
Which of the following do you use to screen for hepatocellular carcinoma?
Answer
  • CT scan
  • A-Fetoprotein
  • HBsAg levels
  • ERCP

Question 13

Question
Mikey is a 28 y/o male who presents to your clinic c/o 6 episodes of persistent, watery diarrhea that began today with associated periumbilical cramping, nausea, and multiple episodes of vomiting. He denies any fever, chills, weight loss, hematemesis, melena, hematochezia, or arthralgias. Pt states his symptoms began about 8 hours after going out to eat with his friend. He denies any recent traveling. Electrolytes were drawn and shows patient is hypokalemic. Stool culture is pending. Which of the following is the most common cause of his symptoms?
Answer
  • Non-inflammatory diarrhea
  • Inflammatory diarrhea
  • Crohn's
  • IBS

Question 14

Question
Which of the following is NOT a direct cause of pancreatitis?
Answer
  • Aging
  • Gallstones
  • Alcohol
  • Smoking

Question 15

Question
Which of the following diseases can also be seen to have concomitant pleural effusion and atelectasis?
Answer
  • GERD
  • Hepatitis
  • Pancreatitis
  • Cholecystitis

Question 16

Question
What does Ranson's Criteria measure?
Answer
  • The severity of acute alcoholic pancreatitis
  • The different treatment regimens depending on severity of pancreatitis
  • How to diagnose a patient with IBS
  • To predict advanced fibrosis

Question 17

Question
Crohn's disease has a high comorbidity in for gallstones
Answer
  • True
  • False

Question 18

Question
Choose ALL that apply: Which of the following can protect against gallstones?
Answer
  • Ceftriaxone
  • Octreotide
  • ASA
  • NSAIDS
  • Clofibrate

Question 19

Question
Which of the following is NOT associated with increase incidence of chronic pancreatitis?
Answer
  • Toxic metabolite
  • Genetic causes
  • Idiopathic
  • Hemochromatosis

Question 20

Question
An APACHE II score less than or equal to 8 correlates with mortality in acute pancreatitis?
Answer
  • True
  • False

Question 21

Question
Which of the following is the reason for development of chronic pancreatitis?
Answer
  • Acute pancreatitis causes an inflammatory process that results in injury and fibrosis
  • Edema or obstruction in the ampulla of Vater that causes reflux of bile into pancreatic ducts and causes direct and permanent injury of the pancreatic acinar cells by activated pancreatic enzymes
  • The development of chronic pancreatitis is unknown
  • None of the above

Question 22

Question
Which of the following pathogens are seen in inflammatory diarrhea? Choose ALL that apply.
Answer
  • E. coli
  • Staph aureus
  • Shigellosis
  • Salmonellosis
  • Campylobacter
  • STEC
  • Bacillus
  • Clostridium
  • Giardia
  • C. diff

Question 23

Question
Which of the following should be given to a post who requires severe rehydration due to multiple episodes of diarrhea and vomiting?
Answer
  • IV lactated ringer
  • Bisocodyl
  • Fluoroquinolones
  • Gatorade

Question 24

Question
Which of the following is NOT included in Charcot's triad?
Answer
  • Fever and chills
  • RUQ abdominal pain
  • Fever
  • Hypotension

Question 25

Question
How many stool samples are required to check for ova and parasites?
Answer
  • 1
  • 2
  • 3
  • 5

Question 26

Question
Which of the following is NOT indicated for antibiotic use in patients with acute diarrrhea?
Answer
  • Emperic use
  • Patient with fever, tenesmus
  • Bloody stools without STEC infection
  • Presence of fecal lactoferrin

Question 27

Question
Increased osmotic gap (>125) in indicative of what?
Answer
  • Malabsorption of osmotically active substances
  • Endocrine tumors
  • Bile malabsorption
  • Chronic infection

Question 28

Question
How is carb malabsorption diagnosed?
Answer
  • Elimination trial for 2-3 weeks
  • Hydrogen breath test
  • Osmotic gap greater than 125
  • Both A and B
  • Both B and C

Question 29

Question
Which of the followings the routine stool study for checking steatorrhea?
Answer
  • Sudan stain
  • Serologic testing
  • Endoscopy
  • Somalian test

Question 30

Question
Total weight and fat of 24 hour stool collection that shows <200-300g/24 hr indicates:
Answer
  • Osmotic diarrhea
  • Secretory diarrhea
  • Diarrhea caused by motility disorders (such as IBS)
  • Chronic infection

Question 31

Question
Large volume of bright red blood is typically due to a [blank_start]colonic[blank_end] source
Answer
  • colonic
  • Rectosigmoid
  • Anus
  • Lesion in the right colon

Question 32

Question
It's important to perform an NG tube aspiration in patients with acute lower GI bleeds
Answer
  • True
  • False

Question 33

Question
Patient presents to your clinic with fever, abdominal pain, and distention. He also states he has had decrease in urinary output and his mind has felt "fuzzy" and has been feeling forgetful for the past 2 days. Which of the following is necessary in order to make a dx and to treat the patient?
Answer
  • CBC with diff
  • Paracentesis
  • ERCP
  • Ultrasound to evaluate the liver size and amount of ascites that is present

Question 34

Question
Patient presents to your office c/o clay-colored stool and dark urine, as well as jaundice. You draw LFTs and and enzyme immunoassay and recombinant immunoblot assay since the patient has admitted to you that he has multiple sexual partners without using protection. You find that the patient is positive for Anti-HCV and HCV RNA genotype type 1. Which of the following treatments is indicated for this patient?
Answer
  • Simeprevir (Olysio) (NS3/4A protease inhibitors)
  • Peginterferon followed by ribavirin
  • Dasabuvir alone (NS5B NNPIs)
  • Daclatasvir (NS5A inhibitors)

Question 35

Question
Which of the following drugs are not indicated for treatment of spontaneous bacterial peritonitis?
Answer
  • Norfloxacin
  • Bactrim
  • Cefotaxime
  • Metronidazole

Question 36

Question
Which of the following is MOST associated with Barrett's esophagitis?
Answer
  • Hiatal hernias
  • Gastroparesis
  • Delayed gastric emptying
  • Strictures

Question 37

Question
Which of the following is NOT a symptom of GERD?
Answer
  • Pain 30-60 min after eating
  • Epigastric pain relieved with eating
  • Relief of pain with antacids
  • Heartburn with asthma symptoms

Question 38

Question
Which of the following is not an indication for upper endoscopy in patient who presents with GERD?
Answer
  • Patient's with dysphagia or odyophagia
  • Patient with iron deficiency anemia
  • Patients who are 55 years of age or older
  • Patients with an acid taste in their mouth, which would represent abnormal esophageal acid exposure

Question 39

Question
Typical GERD patient does not require initial studies
Answer
  • True
  • False

Question 40

Question
Which of the following esophageal abnormalities is worse?
Answer
  • A
  • B
  • C
  • D

Question 41

Question
When is it NOT indicated to perform a barium esophagography?
Answer
  • To identify stricture
  • To visualize esophageal webs and rings
  • Zenker diverticulum
  • These are all indicated

Question 42

Question
Which of the following is NOT an indication for fundoplication?
Answer
  • Barrett's
  • Patients with poorly controlled symptoms
  • Patients with extraesophageal symptoms and recurrence of symptoms
  • Patient that does not respond to PPI bid

Question 43

Question
Which of the following is true regarding Barrett's?
Answer
  • Columnar cells are replaced by metaplastic squamous epithelium
  • It occurs more in females than in males
  • It is an orange-gastric type epithelium
  • None of the above

Question 44

Question
Which of the following CANNOT be used to treat acute nausea and vomiting?
Answer
  • Serotonin 5-HT3 receptor antagonists
  • Neurokinin receptor antagonists with steroids and serotonin antagonists
  • Dopamine antagonist
  • All can be used to treat acute N/V

Question 45

Question
Three week old child is brought in to the ER by his parents after they report he has been having projectile vomiting. Your physical exam shows signs of dehydration as well as an "olive-shaped" mass. Which of the following imaging studies will you want to obtain first to confirm your diagnosis?
Answer
  • CT of the abdomen/pelvis
  • Abdominal Ultrasound
  • Barium X-ray to show stenosis
  • EGD

Question 46

Question
Which of the following treatments is indicated for pyloric stenosis?
Answer
  • Pyloromyotomy
  • Dilation with flexible bougies
  • Anticholinergics to relax the sphincter
  • Fundoplication

Question 47

Question
Which of the following gastric neoplasms have the worst prognosis?
Answer
  • Ulcerative carcinoma
  • Superficial
  • Polypoid carcinoma
  • Linitis plastic

Question 48

Question
Which of the following is not true regarding gastric neoplasms?
Answer
  • Patients will have guaiac positive stool
  • Upper endoscopy with biopsy is the most accurate test
  • Abdominal CT is the most accurate test
  • It is common in Japan

Question 49

Question
Which of the following is NOT a cause of fecal impaction?
Answer
  • Psychiatric problems
  • Neuro diseases of the colon
  • Spinal cord diseases
  • All of the above

Question 50

Question
Which of the following conditions can be treated with gancyclovir?
Answer
  • CMV esophagitis
  • Candida esophagitis
  • Herpes simplex esophagitis
  • AIDS esophagitis

Question 51

Question
Patient presents with dysphagia, odynophagia, and substernal chest pain. You also notice some oral thrush on physical exam. Which of the following studies will you order in order to obtain your diagnosis?
Answer
  • Endoscopy with biopsy and brushings
  • Colonoscopy with biopsy
  • FOBT
  • Stool sample

Question 52

Question
Which of the following endoscopic findings would you expect to see in someone who has candidal esophagitis?
Answer
  • Diffuse, linear, yellow white plaques adhering to mucosa
  • One to several large shallow superficial ulcers
  • Multiple small deep ulcers
  • Single or multiple ulcers at the squamocolumnar junction

Question 53

Question
Which of the following endoscopic findings would you expect to see in someone who has CMV esophagitis?
Answer
  • Diffuse, linear, yellow white plaques adhering to mucosa
  • One to several large, shallow, superficial ulcers
  • Multiple small deep ulcers
  • Single or multiple erosions or ulcers at the squamocolumnar junction

Question 54

Question
Pill induced esophagitis will show one to a few discrete ulcers that can be shallow or deep on endoscopy
Answer
  • True
  • False

Question 55

Question
Which of the following is strong predisposing factor to Mallory-Weiss tears?
Answer
  • Alcoholism
  • Smoking
  • Obesity
  • Hypercholesteronemia

Question 56

Question
Where are Mallory-Weiss tears located?
Answer
  • At the gastroesophageal junction
  • At the pharyngeal-esophageal junction
  • In the upper 1/3 of the esophagus
  • None of the above

Question 57

Question
Which of the following is NOT a treatment of choice for Mallory-Weiss tears?
Answer
  • Cautery with probe
  • Injection with epinephrine
  • Injection with botox
  • Endoclip placement

Question 58

Question
What is the study of choice for diagnosing Mallory-Weiss tears?
Answer
  • Barium x-ray
  • Upper endoscopy
  • CBC with diff
  • Abdominal CT

Question 59

Question
Which of the following endoscopic findings is consistent with eosinophilic esophagitis?
Answer
  • White exudates or papules, red furrows, corrugated concentric rings, strictures
  • Multiple small deep ulcers
  • Single or multiple erosions or ulcers in distal esophagus
  • Diffuse plaques on mucosa

Question 60

Question
Which of the following can NOT cause persistent hiccups?
Answer
  • Infections
  • Uremia
  • Hypercapnia
  • Neoplasms

Question 61

Question
Which of the following studies is best to visualize esophageal webs and rings?
Answer
  • Upper endoscopy
  • Barium esophagogram
  • Transesophageal ultrasound
  • CT scan

Question 62

Question
Which of the following does not characterize Esophageal webs?
Answer
  • Thin, diaphragm-like membrane
  • Typically occurs in the mid or upper esophagus
  • Usually located in the distal esophagus
  • Can occur with eosinophilic esophagitis

Question 63

Question
Which of the following does not characterize Esophageal rings?
Answer
  • Smooth, circumferential, thin mucosal structures less than 4mm in thickness
  • They are associated in nearly all cases with hiatal hernias
  • Can occur with graft-versus-host disease
  • Located in the distal esophagus

Question 64

Question
How are patients with esophageal webs treated?
Answer
  • Bougie dilators
  • Endoscopic electrosurgical incision of the ring
  • Treat with long-term PPIs in pts with heartburn
  • All of the above

Question 65

Question
45 year old Caucasian male with a h/o of GERD and 60 pack year history of smoking presents to your office for multiple complaints including worsening dysphagia, unintentional weight loss, odynophagia, hematemesis, hoarseness of his voice, and some generalized, nonradiating chest pain. Which of the following tests will help you make a definitive diagnosis?
Answer
  • Barium swallow
  • Upper endoscopy with biopsy
  • Transesophageal ultrasound
  • CT scan

Question 66

Question
Which of the following best describes the cause of zenker diverticulum?
Answer
  • Loss of elasticity of upper esophageal sphincter causing restricted opening during swallowing
  • Portal hypertension
  • Increase pressures in the esophagus
  • Idiopathic cause

Question 67

Question
Patient presents c/o vague oropharyngeal dysphagia with some throat discomfort. She also states she has been waking up at night with choking episodes and notices she has been regurging undigested food. You perform a barium x-ray and notice protrusion of the phayngeal mucosa. Which of the following is the best treatment for this patient?
Answer
  • Upper esophageal myotomy
  • Surgical diverticuloectomy
  • Incising the septum between the esophagus and the diverticulum
  • These are all treatment options

Question 68

Question
Which is the most common cause of GI bleed d/t portal HTN?
Answer
  • Esophageal varices
  • Mallory-Weiss tears
  • Boerhaave syndrome
  • Cirrhosis

Question 69

Question
Which of the following causes increase risk of bleed if present in esophageal varices?
Answer
  • Pressure gradient between the protal vein and inferior vena cava is greater than 6 mmHg
  • Presence of red wale markings
  • Presence of dysphagia
  • When bleeding spontaneously stops

Question 70

Question
Which of the following drugs can be given to patients with medium to large varices, small variceal red wale marks or advanced cirrhosis in order to prevent a bleed from ever occurring?
Answer
  • Non-selective beta blockers
  • B1 selective beta blockers
  • Corticosteroids
  • ASA

Question 71

Question
IBS is usually present with nocturnal symptoms.
Answer
  • True
  • False

Question 72

Question
What should be given to patients who have variceal bleading with an INR>1.8-2 or platelet count <50,000?
Answer
  • Fresh frozen plasma
  • Vitamin K
  • Platelets
  • Thrombin

Question 73

Question
Cirrhotic patients admitted with upper GI bleeds have more than 50% chance of ____________, and that is why they need prophylaxis with ____________.
Answer
  • Severe bacterial infection; IV fluoroquinolones or IV 3rd generation cephalosporins
  • Bleed; vitamin K
  • increased portal hypertension; selective beta blockers
  • Liver cancer; 5-ASA

Question 74

Question
Prolonged use of ASA and NSAIDs is known to decrease risk of cancer and carcinomas
Answer
  • True
  • False

Question 75

Question
What is the most important determinant of long-term survival:
Answer
  • Stage of the disease at initial presentation
  • Screening
  • The severity of patient's symptoms
  • The carcinoembryonic antigen (CEA) measurement

Question 76

Question
Rectal cancer has a worse prognosis than colon cancer
Answer
  • True
  • False

Question 77

Question
Which of the following is standard for detecting cancer and large adenomas in patients with chronic blood loss?
Answer
  • Hemoccult II
  • Sensitive FOBT
  • Rectal exam
  • Colonoscopy as first test

Question 78

Question
If polyps are found with flexible sigmoidoscopy, what would be the next best step?
Answer
  • Scope the entire colon with colonoscopy
  • Start patients on chemotherapy
  • Obtain routine studies for staging
  • Obtain a double contrast barium enema

Question 79

Question
A good colonoscopy study does not depend on the patient's prep before the procedure
Answer
  • True
  • False

Question 80

Question
Which of the following does require bowel prep?
Answer
  • Upper GI obstruction
  • Suspected acute diverticulitis
  • Recent bowel surgery
  • When used for screening

Question 81

Question
When using laser or coagulator on colonoscopy, you must remove air and use CO2 to avoid explosion
Answer
  • True
  • False

Question 82

Question
The majority of the appendices are present in the ____________
Answer
  • Retrocecal fossa
  • Anterocecal fossa
  • Lateralocecal fossa
  • Inferocecal fossa

Question 83

Question
What is the diagnostic standard for appendicitis?
Answer
  • Abdominal US
  • Abdominal CT
  • Abdominal X-ray
  • none of the above

Question 84

Question
Patient presents with fever and chills, jaundice, RUQ pain. Patient's wife states he has not been acting himself, stating pt had difficulty remembering her name today. Patient's blood pressure is 90/50, HR was 100, RR 14. Which of the following conditions are you likely concerned about?
Answer
  • Cholangitis
  • Supperative cholangitis
  • Choledocolithiasis
  • Cholescystisis
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