PANRE Gastroenterology 3

Question 1

A 45-year-old woman presents with right upper quadrant pain after fatty meals, nausea, and a positive Murphy's sign. Ultrasound shows gallstones. What is the definitive treatment?

Accepted Answer

Laparoscopic cholecystectomy

Answer

Symptomatic cholelithiasis is best treated with laparoscopic cholecystectomy, which is the definitive and most commonly recommended intervention.

Question 2

Which of the following is the most sensitive and specific test for diagnosing H. pylori infection in a patient who cannot undergo endoscopy?

Accepted Answer

Urea breath test

Answer

The urea breath test has the highest sensitivity and specificity among non-invasive tests for active H. pylori infection.

Question 3

A 58-year-old man presents with new-onset ascites. Paracentesis shows SAAG of 1.5 g/dL. Which condition is most consistent with this result?

Accepted Answer

Portal hypertension

Answer

A SAAG ≥1.1 g/dL indicates portal hypertension as the cause of ascites, including cirrhosis, heart failure, or Budd-Chiari syndrome.

Question 4

A 32-year-old woman presents with alternating constipation and diarrhea, bloating, and abdominal cramping relieved by defecation. No alarm features are present. What is the most likely diagnosis?

Accepted Answer

Irritable bowel syndrome

Answer

The pattern of alternating bowel habits, bloating, and pain relieved by defecation without alarm features fits the Rome IV criteria for irritable bowel syndrome.

Question 5

A 66-year-old man is found to have a 1.2 cm sessile polyp removed during colonoscopy. Pathology shows a tubular adenoma with low-grade dysplasia. When should the next colonoscopy be performed?

Accepted Answer

3 years

Answer

Current guidelines recommend repeat colonoscopy in 3 years for patients with 1-2 tubular adenomas <10 mm with low-grade dysplasia.

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PANRE Gastroenterology 3