GI Liver, Biliary, and Pancreatic Disorders 2

Question 1

Portal hypertension leads to esophageal varices primarily through which mechanism?

Accepted Answer

Development of portosystemic collateral vessels to decompress elevated portal pressure

Answer

Increased lymphatic pressure causing vessel dilation

Answer

Direct erosion of the esophageal mucosa by bile acids

Answer

Splenomegaly compressing the esophagus

Question 2

What is the recommended first-line treatment for acute esophageal variceal bleeding?

Accepted Answer

Endoscopic band ligation combined with IV octreotide

Answer

Emergency surgical portosystemic shunt

Answer

Balloon tamponade with a Sengstaken-Blakemore tube alone

Answer

TIPS procedure as primary intervention

Question 3

Courvoisier's sign — painless jaundice with a palpable, non-tender gallbladder — is classically associated with which condition?

Accepted Answer

Carcinoma of the head of the pancreas

Answer

Choledocholithiasis

Answer

Primary sclerosing cholangitis

Answer

Acute cholecystitis

Question 4

Which scoring system is used at 48 hours to predict severity and mortality in acute pancreatitis?

Accepted Answer

Ranson's criteria

Answer

APACHE II score only

Answer

Glasgow-Blatchford score

Answer

BISAP score only

Question 5

Which hepatitis virus is transmitted via the fecal-oral route and never causes chronic infection?

Accepted Answer

Hepatitis A

Answer

Hepatitis B

Answer

Hepatitis C

Answer

Hepatitis D

Question 6

What is currently the most common cause of chronic liver disease in the United States?

Accepted Answer

Non-alcoholic fatty liver disease (NAFLD)

Answer

Hepatitis B

Answer

Alcoholic liver disease

Answer

Hepatitis C

Question 7

Wilson's disease results from the toxic accumulation of which trace metal due to an ATP7B gene mutation?

Accepted Answer

Copper

Answer

Iron

Answer

Manganese

Answer

Zinc