GI Treatment Planning & Management 2

Question 1

A patient with Crohn's disease has failed mesalamine therapy. What is the most appropriate next step in management?

Accepted Answer

Initiate corticosteroid therapy

Answer

When 5-ASA agents like mesalamine fail in Crohn's disease, corticosteroids are the standard next step to induce remission.

Question 2

Which antibiotic combination is the first-line treatment for Helicobacter pylori eradication in the US?

Accepted Answer

Clarithromycin + amoxicillin + a PPI

Answer

Triple therapy with clarithromycin, amoxicillin, and a PPI remains standard first-line H. pylori eradication in low-resistance areas.

Question 3

A cirrhotic patient develops ascites for the first time. What is the initial management strategy?

Accepted Answer

Sodium restriction and spironolactone

Answer

First-line management of new ascites in cirrhosis is sodium restriction combined with spironolactone as the preferred diuretic.

Question 4

What is the recommended surveillance interval for colonoscopy after removal of a single tubular adenoma < 10 mm with low-grade dysplasia?

Accepted Answer

5–10 years

Answer

Current guidelines recommend repeat colonoscopy in 5–10 years after removal of a low-risk adenoma (single, small, low-grade dysplasia).

Question 5

A patient with ulcerative colitis in remission is maintained on 6-mercaptopurine. She wants to become pregnant. What is the recommended approach?

Accepted Answer

Continue 6-MP as it is considered relatively safe in pregnancy

Answer

6-mercaptopurine is considered relatively safe during pregnancy and maintaining disease remission is prioritized to avoid flares.

(GI) Gastrointestinal Practice Test