GI Treatment Planning & Management 3

Question 1

Which medication is used for primary prophylaxis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with low-protein ascites?

Accepted Answer

Norfloxacin or ciprofloxacin

Answer

Norfloxacin (or ciprofloxacin) is recommended for primary SBP prophylaxis in high-risk cirrhotic patients with ascites protein < 1.5 g/dL.

Question 2

A patient with Barrett's esophagus without dysplasia is found on endoscopy. What is the appropriate management?

Accepted Answer

Surveillance endoscopy every 3–5 years with PPI therapy

Answer

Non-dysplastic Barrett's esophagus is managed with PPI therapy and surveillance endoscopy every 3–5 years per ACG guidelines.

Question 3

What is the treatment of choice for acute variceal hemorrhage in a cirrhotic patient?

Accepted Answer

Endoscopic band ligation plus vasoactive drugs (e.g., octreotide)

Answer

Combination of endoscopic variceal band ligation and vasoactive drugs like octreotide is the standard of care for acute variceal bleeding.

Question 4

A 55-year-old patient with chronic liver disease develops hepatic encephalopathy. Which medication reduces ammonia-producing colonic bacteria?

Accepted Answer

Both lactulose and rifaximin are used

Answer

Both lactulose (reduces colonic pH and traps ammonia) and rifaximin (suppresses urease-producing bacteria) are used in hepatic encephalopathy management.

Question 5

Which therapy is appropriate for a patient with refractory gastroesophageal reflux disease (GERD) not responsive to twice-daily PPI?

Accepted Answer

Perform esophageal manometry and pH testing, then consider surgical fundoplication

Answer

Refractory GERD requires objective evaluation with pH monitoring/manometry before considering surgical options like laparoscopic Nissen fundoplication.

(GI) Gastrointestinal Practice Test

(GI) Gastrointestinal Practice Test

GI Treatment Planning & Management 3