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Gastrointestinal Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 45-year-old obese woman presents with episodic RUQ pain after eating, with ultrasound showing gallstones but no wall thickening or pericholecystic fluid. What is the diagnosis?

    Answer: Biliary colic

    Biliary colic presents with episodic RUQ pain triggered by fatty meals, but unlike acute cholecystitis, there is no fever, prolonged pain, or sonographic signs of inflammation.

  2. A patient with chronic alcohol use presents with hematemesis. Upper endoscopy reveals tortuous, dilated veins at the gastroesophageal junction. What is the mechanism of this finding?

    Answer: Increased portal venous pressure causing portosystemic shunting

    Esophageal varices develop when portal hypertension causes blood to shunt through portosystemic collaterals including the submucosal esophageal veins.

  3. Which of the following best distinguishes Crohn disease from ulcerative colitis on endoscopy?

    Answer: Skip lesions with cobblestone appearance

    Crohn disease classically shows discontinuous skip lesions, transmural inflammation, and cobblestone mucosa due to deep fissuring ulcers, unlike UC's continuous mucosal disease.

  4. A 70-year-old presents with sudden onset severe abdominal pain out of proportion to exam, with a history of atrial fibrillation. Lactate is elevated. What is the most likely diagnosis?

    Answer: Acute mesenteric ischemia

    Acute mesenteric ischemia from embolism (commonly from atrial fibrillation) causes severe pain disproportionate to exam findings with elevated lactate from bowel ischemia.

  5. Which of the following is the recommended screening interval for colonoscopy in an average-risk patient with no findings on initial screening at age 50?

    Answer: 10 years

    Current guidelines recommend repeat colonoscopy in 10 years for average-risk patients with a normal (no polyps) initial screening colonoscopy.

  6. A 25-year-old presents with recurrent abdominal pain, diarrhea, and mouth sores. Labs show elevated ESR and CRP. Colonoscopy shows ileitis with skip lesions. What extraintestinal manifestation is most commonly associated with this condition?

    Answer: Erythema nodosum

    Erythema nodosum (tender red nodules on the shins) is the most common extraintestinal skin manifestation of both Crohn disease and ulcerative colitis.

  7. Which test is most appropriate for diagnosing Clostridioides difficile infection?

    Answer: PCR for C. difficile toxin genes

    Nucleic acid amplification tests (NAAT/PCR) for C. difficile toxin genes are the most sensitive and specific initial diagnostic test for C. diff infection.