GI Disorders & Diseases 4

Question 1

Which condition presents with chronic watery diarrhea, normal colonoscopy appearance, but abnormal colonic biopsy showing increased subepithelial collagen or lymphocytes?

Accepted Answer

Microscopic colitis

Answer

Microscopic colitis includes collagenous and lymphocytic colitis, both presenting with chronic watery diarrhea and a grossly normal colon on endoscopy but diagnostic histologic changes.

Question 2

A patient with chronic alcohol use presents with confusion, ataxia, and ophthalmoplegia. Which GI-related nutritional deficiency is responsible?

Accepted Answer

Thiamine (B1) deficiency

Answer

Wernicke's encephalopathy is caused by thiamine (vitamin B1) deficiency, commonly seen in alcoholics due to poor nutrition and impaired absorption, presenting with the classic triad of confusion, ataxia, and ophthalmoplegia.

Question 3

What is the most common cause of lower GI bleeding in patients over 60 years old?

Accepted Answer

Diverticulosis

Answer

Diverticulosis is the most common cause of significant lower GI bleeding in older adults, typically presenting as painless, large-volume hematochezia that often stops spontaneously.

Question 4

Which finding on liver biopsy is pathognomonic for alcoholic hepatitis?

Accepted Answer

Mallory-Denk bodies (alcoholic hyaline)

Answer

Mallory-Denk bodies are eosinophilic intracytoplasmic inclusions of damaged cytokeratin filaments found in hepatocytes and are a hallmark of alcoholic hepatitis, though not exclusively diagnostic.

Question 5

A patient with PSC (primary sclerosing cholangitis) has an increased risk of developing which malignancy?

Accepted Answer

Cholangiocarcinoma

Answer

Primary sclerosing cholangitis is a major risk factor for cholangiocarcinoma (bile duct cancer), with a lifetime risk of approximately 10-15% in affected patients.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Disorders & Diseases 4