ITE Gastroenterology and Hepatology 2

Question 1

A 58-year-old man with alcoholic cirrhosis develops confusion and asterixis. Ammonia level is elevated. Which treatment is most appropriate?

Accepted Answer

Lactulose

Answer

Neomycin

Answer

Rifaximin

Answer

Zinc supplementation

Question 2

A 45-year-old woman presents with jaundice, pruritus, and elevated alkaline phosphatase. AMA is positive. What is the most likely diagnosis?

Accepted Answer

Primary biliary cholangitis

Answer

Primary sclerosing cholangitis

Answer

Autoimmune hepatitis

Answer

Choledocholithiasis

Question 3

A patient with long-standing Crohn's disease develops right lower quadrant pain and fever. CT shows a 4 cm fluid collection adjacent to the terminal ileum. What is the best next step?

Accepted Answer

Percutaneous drainage plus antibiotics

Answer

IV antibiotics alone

Answer

Emergent surgery

Answer

Colonoscopy

Question 4

Which of the following is the most common cause of acute pancreatitis in the United States?

Accepted Answer

Gallstones

Answer

Hypertriglyceridemia

Answer

Alcohol

Answer

Medications

Question 5

A 62-year-old man undergoes colonoscopy showing a 1.5 cm sessile serrated lesion in the ascending colon. When should surveillance colonoscopy be performed?

Accepted Answer

3 years

Answer

1 year

Answer

5 years

Answer

10 years

Question 6

A 35-year-old woman with diarrhea, bloating, and weight loss has anti-tissue transglutaminase IgA antibodies. Duodenal biopsy shows villous atrophy and crypt hyperplasia. What is the first-line treatment?

Accepted Answer

Gluten-free diet

Answer

Mesalamine

Answer

Prednisone

Answer

Azathioprine

Question 7

A patient with cirrhosis develops spontaneous bacterial peritonitis (SBP). After treatment, which prophylactic antibiotic is recommended to prevent recurrence?

Accepted Answer

Norfloxacin

Answer

Cephalexin

Answer

Metronidazole

Answer

Amoxicillin-clavulanate