FREE Internal Medicine Gastrointestinal and Liver Diseases Questions and Answers

Question 1

A 55-year-old male presents with a 3-month history of progressive dysphagia to solids, followed by liquids, and significant weight loss.
He also reports occasional regurgitation of undigested food.
Barium swallow shows a 'bird's beak' appearance.
Esophageal manometry reveals absent peristalsis in the distal esophagus and incomplete relaxation of the lower esophageal sphincter (LES).
What is the most likely diagnosis?

Accepted Answer

Achalasia

Answer

Esophageal adenocarcinoma

Answer

Diffuse esophageal spasm

Answer

Scleroderma esophagus

Question 2

Which of the following is the most appropriate initial management for a 35-year-old female diagnosed with acute, uncomplicated diverticulitis?

Accepted Answer

Outpatient management with oral antibiotics and a clear liquid diet

Answer

Inpatient admission for intravenous antibiotics and bowel rest

Answer

Urgent surgical resection of the affected segment of colon

Answer

Colonoscopy to assess the extent of diverticular disease

Question 3

A 48-year-old male with a history of intravenous drug use presents with jaundice, dark urine, and right upper quadrant pain. Laboratory tests show elevated aminotransferases (ALT > AST), elevated total and direct bilirubin, and a positive HBsAg and anti-HBc IgM. Which of the following is the most likely diagnosis?

Accepted Answer

Acute Hepatitis B infection

Answer

Acute Hepatitis C infection

Answer

Autoimmune hepatitis

Answer

Alcoholic hepatitis

Question 4

A 60-year-old female with a 20-year history of ulcerative colitis, currently managed with mesalamine, presents for routine follow-up. Her last colonoscopy was 3 years ago and showed pancolitis with mild dysplasia. She is asymptomatic. What is the most appropriate recommendation for her surveillance colonoscopy schedule?

Accepted Answer

Annual colonoscopy with biopsies for dysplasia

Answer

Colonoscopy every 1-2 years

Answer

Colonoscopy every 5 years

Answer

Colonoscopy only if symptoms recur

Question 5

Which of the following conditions is most commonly associated with the development of primary sclerosing cholangitis (PSC)?

Accepted Answer

Ulcerative colitis

Answer

Crohn's disease

Answer

Celiac disease

Answer

Type 1 diabetes mellitus

Question 6

A 45-year-old male presents with sudden onset severe epigastric pain radiating to the back, nausea, and vomiting. On examination, he is febrile (100.8°F), tachycardic, and has diffuse abdominal tenderness with guarding. His lipase level is significantly elevated at 1500 U/L (normal < 160 U/L). What is the most common etiology for acute pancreatitis in this patient population?

Accepted Answer

Alcohol abuse

Answer

Hypertriglyceridemia

Answer

Gallstones

Answer

Medication-induced pancreatitis