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

When portal pressure rises, blood is shunted through portosystemic collaterals, including submucosal esophageal veins, forming varices.

Question 2

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

Accepted Answer

Endoscopic band ligation combined with IV octreotide

Answer

Endoscopic band ligation with concurrent IV octreotide (to reduce splanchnic blood flow) is the standard first-line treatment for acute variceal hemorrhage.

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

Pancreatic head carcinoma obstructs the common bile duct gradually, allowing the gallbladder to distend painlessly; stones cause chronic fibrosis and a non-distensible gallbladder.

Question 4

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

Accepted Answer

Ranson's criteria

Answer

Ranson's criteria evaluate 11 parameters (5 at admission, 6 at 48 hours); a score ≥3 indicates severe disease with significantly increased morbidity and mortality.

Question 5

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

Accepted Answer

Hepatitis A

Answer

Hepatitis A is transmitted fecal-orally, causes self-limited acute illness, and does not establish chronic infection or a carrier state.

Gastrointestinal GI Practice Practice Test

Gastrointestinal GI Practice Practice Test

GI Liver, Biliary, and Pancreatic Disorders 2