FREE Physician Assistant Gastrointestinal and Nutrition Questions and Answers

Question 1

A 48-year-old male with a long history of heavy alcohol consumption presents with jaundice, ascites, and fever. His laboratory results show an AST of 300 U/L, an ALT of 120 U/L, and an elevated GGT. Which of the following features is most characteristic of alcoholic liver disease?

Accepted Answer

AST:ALT ratio > 2:1

Answer

An AST to ALT ratio greater than 2:1 is a classic laboratory finding highly suggestive of alcoholic liver disease. [6, 8, 11] In most other forms of liver injury, the ALT is typically higher than or equal to the AST. The absolute levels of aminotransferases in alcoholic hepatitis are usually only moderately elevated (<500 U/L). [2, 14, 26]

Question 2

A 68-year-old female with a history of autoimmune gastritis presents with progressive fatigue, paresthesias in her lower extremities, and glossitis. A complete blood count reveals a macrocytic anemia. Which of the following is the most likely underlying deficiency?

Accepted Answer

Cobalamin (Vitamin B12)

Answer

The patient's presentation of macrocytic anemia combined with neurological symptoms (paresthesias) is a classic manifestation of cobalamin (Vitamin B12) deficiency. [32, 34, 36] Her history of autoimmune gastritis is a major risk factor for pernicious anemia, which is the leading cause of B12 deficiency due to a lack of intrinsic factor needed for absorption. [3, 5, 7]

Question 3

According to the most recent United States Preventive Services Task Force (USPSTF) recommendations, at what age should average-risk adults begin screening for colorectal cancer?

Accepted Answer

45

Answer

In May 2021, the United States Preventive Services Task Force (USPSTF) updated its guidelines, lowering the recommended age for average-risk adults to begin screening for colorectal cancer from 50 to 45. [9, 12, 16] This change was based on data showing an increasing incidence of colorectal cancer in younger adults. [12]

Question 4

A 4-week-old male infant presents with a 1-week history of non-bilious, projectile vomiting immediately after feeding. The mother reports he seems hungry all the time. On physical examination, an olive-sized mass is palpated in the epigastric region. What is the most appropriate next step to confirm the diagnosis?

Accepted Answer

Abdominal ultrasound

Answer

The history and physical exam findings are classic for hypertrophic pyloric stenosis. Abdominal ultrasound is the preferred, most sensitive, and specific imaging modality to confirm the diagnosis. [13, 23, 24] It is non-invasive, avoids radiation exposure, and allows for direct measurement of the pyloric muscle thickness and channel length. [25, 28]

Question 5

A 25-year-old male is diagnosed with moderate-to-severe ileocolonic Crohn's disease. Which of the following biologic agents is often considered a first-line therapy for inducing and maintaining remission in this patient?

Accepted Answer

Infliximab (an anti-TNF agent)

Answer

For moderate-to-severe Crohn's disease, biologic therapies such as anti-TNF agents (e.g., infliximab, adalimumab) are recommended as a first-line treatment to both induce and maintain clinical remission. [15, 29, 45] Corticosteroids like prednisone are used for short-term induction but not maintenance, while mesalamine has limited efficacy in moderate-to-severe disease. [4, 10]

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FREE Physician Assistant Gastrointestinal and Nutrition Questions and Answers