PANRE Gastroenterology 4

Question 1

A 28-year-old woman presents with bloody diarrhea, tenesmus, and urgency. Colonoscopy shows continuous mucosal inflammation starting from the rectum. Biopsy shows crypt abscesses. What is the diagnosis?

Accepted Answer

Ulcerative colitis

Answer

Continuous inflammation starting from the rectum with crypt abscesses on biopsy is the hallmark presentation of ulcerative colitis.

Question 2

Which finding on endoscopy is most indicative of Barrett's esophagus?

Accepted Answer

Salmon-colored tongues of mucosa extending above the GEJ

Answer

Barrett's esophagus is characterized by salmon-colored columnar metaplasia extending proximal to the gastroesophageal junction, confirmed by intestinal metaplasia on biopsy.

Question 3

A 72-year-old woman on warfarin presents with painless bright red blood per rectum. Colonoscopy shows bleeding diverticula in the sigmoid colon. What is the most appropriate initial management?

Accepted Answer

Endoscopic hemostasis (clips or coagulation)

Answer

Endoscopic hemostasis with clips or coagulation is the first-line treatment for actively bleeding diverticula identified at colonoscopy.

Question 4

A patient with chronic liver disease develops sudden onset abdominal pain, fever, and ascitic fluid PMN count >250 cells/mm³. What is the empiric antibiotic of choice?

Accepted Answer

Cefotaxime or ceftriaxone

Answer

Third-generation cephalosporins (cefotaxime or ceftriaxone) are the empiric treatment of choice for spontaneous bacterial peritonitis.

Question 5

A 44-year-old man presents with jaundice, pruritus, and an elevated alkaline phosphatase. MRCP shows multifocal strictures of both intrahepatic and extrahepatic bile ducts with a 'beaded' appearance. What is the most likely diagnosis?

Accepted Answer

Primary sclerosing cholangitis

Answer

The beaded appearance of multifocal bile duct strictures on MRCP is pathognomonic of primary sclerosing cholangitis.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Gastroenterology 4