ACG Gastrointestinal Disease Diagnosis and Management

Question 1

According to ACG guidelines, what is the preferred first-line regimen for Helicobacter pylori eradication in regions with high clarithromycin resistance?

Accepted Answer

Bismuth quadruple therapy for 10-14 days

Answer

Clarithromycin-based triple therapy for 7 days

Answer

Amoxicillin monotherapy for 14 days

Answer

Levofloxacin dual therapy for 5 days

Question 2

A 55-year-old with long-standing GERD undergoes endoscopy revealing Barrett's esophagus without dysplasia. Per ACG guidelines, what is the recommended surveillance interval?

Accepted Answer

Every 3-5 years

Answer

Every 6 months

Answer

Every 1 year

Answer

No further surveillance needed

Question 3

Which endoscopic finding best distinguishes Crohn's disease from ulcerative colitis on colonoscopy?

Accepted Answer

Skip lesions with rectal sparing

Answer

Continuous mucosal inflammation from the rectum

Answer

Pseudopolyps in the sigmoid colon

Answer

Mucosal friability and bleeding

Question 4

What is the recommended first-line serologic test for diagnosing celiac disease in a patient actively consuming gluten?

Accepted Answer

IgA tissue transglutaminase antibody (tTG-IgA)

Answer

Anti-endomysial antibody (EMA-IgA)

Answer

Anti-gliadin antibody (AGA-IgG)

Answer

Deamidated gliadin peptide IgG (DGP-IgG)

Question 5

According to updated ACG guidelines, at what age should colorectal cancer screening with colonoscopy begin for average-risk adults in the US?

Accepted Answer

Age 45

Answer

Age 40

Answer

Age 50

Answer

Age 55

Question 6

Which scoring system uses clinical and laboratory parameters assessed at admission and at 48 hours to stratify severity of acute pancreatitis?

Accepted Answer

Ranson criteria

Answer

Child-Pugh score

Answer

APACHE II score

Answer

Glasgow-Blatchford score

Question 7

A patient presents with dysphagia, food impaction, and peripheral eosinophilia. Endoscopy shows esophageal rings and furrows with 20 eosinophils/HPF on biopsy. What is the most likely diagnosis?

Accepted Answer

Eosinophilic esophagitis (EoE)

Answer

Gastroesophageal reflux disease (GERD)

Answer

Achalasia

Answer

Esophageal candidiasis