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

Vaccination generates anti-HBs without anti-HBc, because vaccines contain only surface antigen; natural infection also produces anti-HBc.

Question 2

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

Accepted Answer

Gallstones

Answer

Gallstones account for approximately 40–70% of acute pancreatitis cases, as a stone obstructing the common bile duct can impair pancreatic enzyme drainage.

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

Crohn's disease characteristically produces patchy, discontinuous 'skip lesions,' whereas ulcerative colitis shows continuous mucosal inflammation extending proximally from the rectum.

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

Polyethylene glycol is the preferred first-line pharmacological agent for chronic constipation, with strong evidence for efficacy and long-term safety.

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

Mild traveler's diarrhea without fever, bloody stools, or systemic symptoms is self-limiting; oral rehydration and supportive care are sufficient management.

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Family Practice Exam Gastrointestinal Medicine 2