GI GI Disorders and Diseases 2 — Questions and Answers
Question 1: Which laboratory finding is most consistent with acute pancreatitis?
- Elevated serum lipase > 3× upper limit of normal (Correct answer)
- Elevated serum alkaline phosphatase
- Decreased serum bilirubin
- Elevated serum albumin
Correct answer: Elevated serum lipase > 3× upper limit of normal
Serum lipase elevated more than three times the upper limit of normal is the most sensitive and specific marker for acute pancreatitis.
Question 2: Primary sclerosing cholangitis (PSC) is most strongly associated with which inflammatory bowel disease?
- Crohn's disease
- Ulcerative colitis (Correct answer)
- Microscopic colitis
- Ischemic colitis
Correct answer: Ulcerative colitis
PSC occurs in approximately 5% of patients with ulcerative colitis and is characterized by fibro-inflammatory strictures of bile ducts.
Question 3: Barrett's esophagus is defined as replacement of normal squamous epithelium in the distal esophagus with which type of epithelium?
- Transitional epithelium
- Stratified squamous epithelium
- Intestinal metaplastic (columnar) epithelium (Correct answer)
- Ciliated pseudostratified epithelium
Correct answer: Intestinal metaplastic (columnar) epithelium
Barrett's esophagus is the presence of intestinal metaplasia (goblet cells) in the distal esophageal mucosa, a precursor to adenocarcinoma.
Question 4: Diverticulosis most commonly affects which segment of the colon in Western populations?
- Cecum
- Ascending colon
- Transverse colon
- Sigmoid colon (Correct answer)
Correct answer: Sigmoid colon
In Western populations, diverticulosis predominantly affects the sigmoid colon due to high intraluminal pressures in this narrow-caliber segment.
Question 5: Toxic megacolon is a life-threatening complication most commonly associated with which condition?
- Irritable bowel syndrome
- Celiac disease
- Severe ulcerative colitis or Clostridioides difficile colitis (Correct answer)
- Diverticulosis
Correct answer: Severe ulcerative colitis or Clostridioides difficile colitis
Toxic megacolon is defined as non-obstructive colonic dilation >6 cm with systemic toxicity, most often complicating severe UC or C. diff colitis.
Question 6: Which condition is characterized by iron-deficiency anemia, glossitis, koilonychia, and dysphagia due to an esophageal web in the postcricoid region?
- Zenker's diverticulum
- Plummer-Vinson (Paterson-Kelly) syndrome (Correct answer)
- Achalasia
- Diffuse esophageal spasm
Correct answer: Plummer-Vinson (Paterson-Kelly) syndrome
Plummer-Vinson syndrome features a cervical esophageal web, iron-deficiency anemia, and glossitis, predominantly in middle-aged women.
GI GI Disorders and Diseases 2
Which laboratory finding is most consistent with acute pancreatitis?