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

Rome IV criteria define IBS as recurrent abdominal pain at least 1 day per week in the last 3 months, associated with ≥2 of the following: relation to defecation, change in stool frequency, or change in stool form.

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

Pan-genotypic DAA combinations such as sofosbuvir/velpatasvir or glecaprevir/pibrentasvir for 8-12 weeks are the current standard of care, achieving sustained virologic response in over 95% of patients.

Question 3

Which test is considered the gold standard for diagnosing gastroparesis?

Accepted Answer

Gastric emptying scintigraphy with a standardized solid meal

Answer

Gastric emptying scintigraphy using a technetium-99m labeled standardized solid meal measured at 1, 2, and 4 hours is the gold standard for diagnosing gastroparesis.

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

ACG guidelines support outpatient management with oral antibiotics or even observation alone for mild uncomplicated acute diverticulitis in immunocompetent, low-risk patients.

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

The FIB-4 score, calculated from age, AST, ALT, and platelet count, has been validated as an accurate non-invasive test for significant liver fibrosis in NAFLD and is ACG's recommended first-line assessment.

ACG - American College of Gastroenterology Practice Test

ACG - American College of Gastroenterology Practice Test

ACG Gastrointestinal Disease Diagnosis and Management 2