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

ACG guidelines recommend bismuth quadruple therapy (PPI + bismuth + metronidazole + tetracycline) for 10-14 days as the preferred first-line regimen in areas with high clarithromycin resistance.

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

ACG guidelines recommend surveillance endoscopy every 3-5 years for Barrett's esophagus with no dysplasia, as the risk of progression to adenocarcinoma is low.

Question 3

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

Accepted Answer

Skip lesions with rectal sparing

Answer

Skip lesions with rectal sparing are characteristic of Crohn's disease, while ulcerative colitis typically shows continuous inflammation starting from the rectum.

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

IgA tTG antibody is the recommended first-line serologic test for celiac disease diagnosis due to its high sensitivity and specificity when the patient is on a gluten-containing diet.

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

ACG guidelines updated in 2021 recommend colorectal cancer screening beginning at age 45 for average-risk adults, lowering the threshold from the previously recommended age of 50.

ACG - American College of Gastroenterology Practice Test

ACG - American College of Gastroenterology Practice Test

ACG Gastrointestinal Disease Diagnosis and Management