ACG Gastrointestinal Disease Diagnosis and Management 2

Question 1

According to the Rome IV criteria, which symptom pattern is required for the diagnosis of irritable bowel syndrome (IBS)?

Accepted Answer

Recurrent abdominal pain at least 1 day/week for the last 3 months associated with defecation or stool changes

Answer

Daily abdominal cramping with alternating diarrhea and constipation for at least 6 months

Answer

Bloating and flatulence occurring more than 3 days/week without structural disease

Answer

Loose stools after every meal for at least 1 month with no organic cause identified

Question 2

What is the current standard of care for treatment-naive chronic hepatitis C with genotype 1 in the United States?

Accepted Answer

Pan-genotypic direct-acting antiviral (DAA) combination therapy for 8-12 weeks

Answer

Pegylated interferon plus ribavirin for 48 weeks

Answer

Sofosbuvir monotherapy for 12 weeks

Answer

Ribavirin monotherapy with close virologic monitoring

Question 3

Which test is considered the gold standard for diagnosing gastroparesis?

Accepted Answer

Gastric emptying scintigraphy with a standardized solid meal

Answer

Upper endoscopy with retained food assessment

Answer

Abdominal CT scan with oral contrast

Answer

Wireless motility capsule pH measurement

Question 4

A hemodynamically stable patient with mild uncomplicated acute diverticulitis (Hinchey Stage Ia) is managed as an outpatient. Which initial approach is supported by ACG guidelines?

Accepted Answer

Oral antibiotics or observation without antibiotics

Answer

Emergency laparoscopic sigmoid resection

Answer

Intravenous antibiotics with hospital admission for 72 hours

Answer

Urgent colonoscopy within 24 hours to assess severity

Question 5

Which non-invasive index is recommended by ACG as the preferred first-line tool for assessing liver fibrosis stage in patients with NAFLD?

Accepted Answer

FIB-4 score

Answer

AST/ALT ratio

Answer

NAFLD Fibrosis Score (NFS)

Answer

APRI score

Question 6

A 70-year-old patient with overt GI bleeding undergoes capsule endoscopy revealing an actively bleeding arteriovenous malformation (AVM) in the mid-jejunum. What is the preferred therapeutic approach?

Accepted Answer

Device-assisted enteroscopy with endoscopic hemostasis

Answer

Surgical resection of the affected small bowel segment

Answer

Repeat capsule endoscopy in 4 weeks

Answer

Transcatheter angiographic embolization as first-line therapy

Question 7

Which annual stool-based test is recommended by ACG as a non-invasive colorectal cancer screening option for average-risk patients?

Accepted Answer

Fecal immunochemical test (FIT) annually

Answer

Guaiac fecal occult blood test (gFOBT) every 3 years

Answer

Stool DNA test (Cologuard) every 1 year

Answer

Fecal calprotectin test annually