ABPath Gastrointestinal Pathology

Question 1

Barrett esophagus is defined histologically by the presence of which type of metaplasia?

Accepted Answer

Intestinal metaplasia with goblet cells

Answer

Barrett esophagus requires intestinal metaplasia with goblet cells in the distal esophagus, confirmed by Alcian blue stain at pH 2.5.

Question 2

Helicobacter pylori preferentially colonizes which region of the stomach?

Accepted Answer

Antrum

Answer

H. pylori colonizes the gastric antrum preferentially, where it is detected by Giemsa, Warthin-Starry silver stain, or CLO (rapid urease) test.

Question 3

Which histologic feature BEST distinguishes Crohn disease from ulcerative colitis?

Accepted Answer

Transmural inflammation with granulomas

Answer

Transmural inflammation with non-caseating granulomas is the hallmark of Crohn disease, whereas ulcerative colitis is limited to the mucosa and submucosa.

Question 4

Hirschsprung disease results from absence of ganglion cells in which layer of the bowel wall?

Accepted Answer

Submucosal (Meissner) and myenteric (Auerbach) plexuses

Answer

Hirschsprung disease results from failed neural crest cell migration, causing absence of ganglion cells in the submucosal and myenteric plexuses of the rectosigmoid.

Question 5

A villous adenoma of the rectum is associated with highest risk for malignant transformation compared to other polyp types because it has:

Accepted Answer

Largest surface area with maximal dysplasia exposure

Answer

Villous adenomas have the greatest malignant potential (up to 40%) due to their larger size, greater surface area, and higher degree of dysplasia at diagnosis.

American Board of Pathology (ABPath) Practice Test

American Board of Pathology (ABPath) Practice Test

ABPath Gastrointestinal Pathology