MD - Doctor of Medicine Gastrointestinal Tract Disorders Questions and Answers

Question 1

Which of the following histopathological findings is most characteristic of Crohn's disease and helps differentiate it from ulcerative colitis?

Accepted Answer

Non-caseating granulomas

Answer

Crypt abscesses

Answer

Continuous inflammation limited to the mucosa

Answer

Pseudopolyps

Question 2

A 34-year-old woman presents with chronic diarrhea, bloating, and significant weight loss. Serological testing is positive for IgA anti-tissue transglutaminase (tTG) antibodies. An upper endoscopy with duodenal biopsy is performed. Which of the following biopsy findings would confirm the diagnosis of celiac disease?

Accepted Answer

Villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes

Answer

Glandular atrophy and intestinal metaplasia

Answer

Foamy macrophages within the lamina propria

Answer

Transmural inflammation with skip lesions

Question 3

A 52-year-old male is diagnosed with a duodenal ulcer, and a urease breath test is positive for Helicobacter pylori. He has no known drug allergies. According to the most recent ACG (American College of Gastroenterology) guidelines, which of the following is a recommended first-line treatment regimen?

Accepted Answer

Bismuth subsalicylate, metronidazole, tetracycline, and a PPI for 14 days.

Answer

A proton pump inhibitor (PPI) and amoxicillin for 10 days.

Answer

Esomeprazole and ranitidine for 8 weeks.

Answer

Omeprazole, clarithromycin, and metronidazole for 7 days.

Question 4

A 48-year-old man with a history of alcohol abuse presents with severe epigastric pain radiating to the back. His serum lipase is markedly elevated. On day two of admission, he develops a respiratory rate of 24/min, a heart rate of 110 bpm, and his BUN increases from 18 to 30 mg/dL. Which of the following is the best indicator of a severe disease course in this patient?

Accepted Answer

The development of Systemic Inflammatory Response Syndrome (SIRS).

Answer

The degree of lipase elevation.

Answer

The etiology being alcohol-related.

Answer

The presence of epigastric tenderness on exam.

Question 5

A 45-year-old asymptomatic woman with no family history of colorectal cancer (CRC) presents for a routine physical. According to the current guidelines from the U.S. Preventive Services Task Force (USPSTF), what is the recommended age to begin average-risk CRC screening?

Accepted Answer

45 years

Answer

55 years

Answer

50 years

Answer

40 years

Question 6

Which of the following best describes the key histopathological change seen in Barrett's esophagus and the primary long-term risk associated with this condition?

Accepted Answer

Intestinal metaplasia; increased risk of esophageal adenocarcinoma.

Answer

Squamous metaplasia; increased risk of esophageal stricture.

Answer

Glandular hyperplasia; increased risk of esophageal squamous cell carcinoma.

Answer

Muscular hypertrophy; increased risk of achalasia.