GI Diagnostics & Treatment 2

Question 1

Which test is considered the gold standard for diagnosing Helicobacter pylori infection in a patient who recently stopped taking proton pump inhibitors?

Accepted Answer

Stool antigen test

Answer

Stool antigen test is preferred when PPI use within 2 weeks may confound the urea breath test, though both are accurate non-invasive options.

Question 2

A patient with suspected celiac disease has negative serology but continues to have symptoms. What is the next best diagnostic step?

Accepted Answer

Upper endoscopy with duodenal biopsies

Answer

Upper endoscopy with multiple duodenal biopsies remains the gold standard for celiac diagnosis, even when serology is negative, particularly in IgA-deficient patients.

Question 3

Which of the following is the first-line treatment for acute severe ulcerative colitis in a hospitalized patient?

Accepted Answer

IV corticosteroids

Answer

IV corticosteroids (methylprednisolone or hydrocortisone) are the initial treatment of choice for acute severe ulcerative colitis.

Question 4

A 55-year-old male presents with dysphagia to solids progressing to liquids over 6 months and unintentional weight loss. What is the most appropriate next step?

Accepted Answer

Upper endoscopy with biopsy

Answer

Progressive dysphagia with weight loss is an alarm symptom requiring urgent upper endoscopy with biopsy to rule out esophageal malignancy.

Question 5

What is the mechanism of action of lactulose when used to treat hepatic encephalopathy?

Accepted Answer

Acidifies colonic contents, trapping NH4+ and accelerating transit

Answer

Lactulose is metabolized by colonic bacteria to organic acids, lowering pH and trapping ammonia as ammonium (NH4+), which is then expelled with accelerated bowel transit.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Diagnostics & Treatment 2