Family Practice Exam Gastrointestinal Medicine 3

Question 1

A 72-year-old man presents with painless, large-volume bright red blood per rectum. Vital signs are stable. What is the most likely cause?

Accepted Answer

Diverticular bleeding

Answer

Internal hemorrhoids

Answer

Colorectal carcinoma

Answer

Ischemic colitis

Question 2

Which diagnostic procedure is the preferred initial evaluation for a patient presenting with hematemesis and hemodynamic stability?

Accepted Answer

Esophagogastroduodenoscopy (EGD)

Answer

CT angiography of the abdomen

Answer

Tagged red blood cell nuclear scan

Answer

Upper GI barium series

Question 3

Barrett's esophagus is best defined as which of the following histological changes?

Accepted Answer

Replacement of normal squamous epithelium with intestinal-type columnar epithelium

Answer

Dysplastic change within existing squamous epithelium

Answer

Replacement of columnar epithelium with squamous epithelium

Answer

Adenocarcinoma arising in the distal esophagus

Question 4

A patient presents with jaundice, generalized pruritus, dark urine, and clay-colored stools. Lab results show markedly elevated direct bilirubin and alkaline phosphatase. What type of jaundice does this pattern represent?

Accepted Answer

Cholestatic (obstructive) jaundice

Answer

Hemolytic jaundice

Answer

Hepatocellular jaundice

Answer

Gilbert syndrome

Question 5

Which of the following is the most common cause of small bowel obstruction in adults in developed countries?

Accepted Answer

Intra-abdominal adhesions from prior surgery

Answer

External hernias

Answer

Crohn's disease strictures

Answer

Small bowel neoplasm

Question 6

A 24-year-old male presents with periumbilical pain that migrated to the right lower quadrant over 12 hours, accompanied by nausea, low-grade fever, and leukocytosis. Which physical exam finding is most classic for acute appendicitis?

Accepted Answer

Rebound tenderness at McBurney's point

Answer

Murphy's sign (inspiratory arrest with RUQ palpation)

Answer

Rovsing's sign (RLQ pain with LLQ palpation)

Answer

Psoas sign (RLQ pain with right hip extension)

Question 7

Which complication of hepatic cirrhosis is defined by spontaneous infection of ascitic fluid with >250 neutrophils/mm³ in the absence of a surgical intra-abdominal source?

Accepted Answer

Spontaneous bacterial peritonitis (SBP)

Answer

Secondary bacterial peritonitis

Answer

Hepatic encephalopathy

Answer

Hepatorenal syndrome