GI Emergency Procedures & Response 2

Question 1

A patient presents with sudden severe abdominal pain, rigid abdomen, and absent bowel sounds. Which condition should be suspected first?

Accepted Answer

Perforated peptic ulcer

Answer

A rigid (board-like) abdomen with absent bowel sounds and sudden severe pain are classic signs of peritonitis from a perforated peptic ulcer.

Question 2

Which intervention is the highest priority for a patient presenting with hematemesis and hemodynamic instability?

Accepted Answer

Establish large-bore IV access and initiate fluid resuscitation

Answer

Hemodynamic stabilization via IV access and fluid resuscitation takes precedence before any diagnostic or pharmacologic intervention in an unstable patient.

Question 3

A patient with known cirrhosis develops confusion and asterixis after a GI bleed. What is the most likely complication?

Accepted Answer

Hepatic encephalopathy

Answer

GI bleeding increases nitrogenous load in the gut, triggering hepatic encephalopathy in cirrhotic patients due to impaired ammonia metabolism.

Question 4

What is the recommended first-line pharmacologic treatment to reduce rebleeding risk in variceal hemorrhage before endoscopy?

Accepted Answer

Octreotide (somatostatin analogue)

Answer

Octreotide reduces splanchnic blood flow and portal pressure, decreasing variceal bleeding and is given as soon as variceal hemorrhage is suspected.

Question 5

During endoscopy for acute lower GI bleeding, the source cannot be found. What is the next best diagnostic step?

Accepted Answer

CT angiography of the abdomen and pelvis

Answer

CT angiography can identify the bleeding source if it is active (≥0.3–0.5 mL/min) and guide subsequent embolization.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Emergency Procedures & Response 2