Family Practice Exam Gastrointestinal Medicine 2

Question 1

Which hepatitis B serologic pattern indicates immunity due to vaccination (not prior infection)?

Accepted Answer

Anti-HBs positive only (HBsAg negative, anti-HBc negative)

Answer

HBsAg positive with anti-HBc IgM positive

Answer

Anti-HBc positive with anti-HBs positive

Answer

Anti-HBe positive with HBsAg positive

Question 2

Which of the following is the most common cause of acute pancreatitis in the United States?

Accepted Answer

Gallstones

Answer

Alcohol use

Answer

Hypertriglyceridemia

Answer

Medication-induced

Question 3

Which endoscopic finding is more characteristic of Crohn's disease than ulcerative colitis?

Accepted Answer

Skip lesions with areas of normal intervening mucosa

Answer

Continuous mucosal involvement from the rectum proximally

Answer

Isolated rectal disease without proximal extension

Answer

Pseudopolyp formation limited to the sigmoid colon

Question 4

A 52-year-old patient with chronic constipation has failed dietary fiber supplementation and increased fluid intake. Which pharmacological agent is the most appropriate next step?

Accepted Answer

Polyethylene glycol (osmotic laxative)

Answer

Senna (stimulant laxative)

Answer

Docusate sodium (stool softener)

Answer

Bisacodyl suppository

Question 5

A 28-year-old traveler returns from Central America with 4 days of watery, non-bloody diarrhea and mild cramping but no fever. What is the most appropriate initial management?

Accepted Answer

Oral rehydration therapy and supportive care

Answer

Empiric ciprofloxacin for 3 days

Answer

Empiric metronidazole for Giardia

Answer

Stool culture and ova and parasite exam before any treatment

Question 6

Which intervention has the strongest evidence for improving liver histology in non-alcoholic fatty liver disease (NAFLD)?

Accepted Answer

Weight loss of 7–10% of body weight through diet and exercise

Answer

Metformin therapy in non-diabetic patients

Answer

High-dose vitamin E supplementation in all patients

Answer

Ursodeoxycholic acid (UDCA) long-term therapy

Question 7

A 38-year-old woman with episodic right upper quadrant pain after fatty meals has an ultrasound confirming cholelithiasis. She has no fever, jaundice, or signs of acute cholecystitis. What is the definitive treatment?

Accepted Answer

Elective laparoscopic cholecystectomy

Answer

Urgent cholecystectomy within 24 hours

Answer

Long-term ursodeoxycholic acid to dissolve stones

Answer

Dietary fat restriction as sole management