Physician Assistant Gastrointestinal and Nutrition 4

Question 1

A 55-year-old obese man with a history of Barrett's esophagus undergoes surveillance endoscopy showing high-grade dysplasia. What is the most appropriate management?

Accepted Answer

Endoscopic eradication therapy or esophagectomy

Answer

High-grade dysplasia in Barrett's esophagus carries significant risk of progression to adenocarcinoma and requires endoscopic eradication or surgical resection.

Question 2

Which finding is most consistent with acute mesenteric ischemia?

Accepted Answer

Pain out of proportion to physical examination findings

Answer

Acute mesenteric ischemia classically presents with severe abdominal pain that is disproportionately worse than the relatively benign physical exam findings early in the course.

Question 3

A 40-year-old woman presents with episodic right upper quadrant pain after fatty meals, lasting 30–60 minutes. Ultrasound shows gallstones but no bile duct dilation. What is this condition called?

Accepted Answer

Biliary colic

Answer

Biliary colic is transient RUQ pain caused by temporary gallstone obstruction of the cystic duct, without sustained inflammation or infection.

Question 4

Which test is the gold standard for diagnosing H. pylori infection in a patient who has not recently taken PPIs or antibiotics?

Accepted Answer

Upper endoscopy with biopsy

Answer

Upper endoscopy with biopsy allows direct visualization and multiple testing methods (urease test, culture, histology), making it the gold standard for H. pylori diagnosis.

Question 5

A patient with short bowel syndrome following extensive small intestine resection is at highest risk for which type of kidney stones?

Accepted Answer

Calcium oxalate stones

Answer

Fat malabsorption in short bowel syndrome increases free oxalate absorption (enteric hyperoxaluria), predisposing to calcium oxalate nephrolithiasis.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Gastrointestinal and Nutrition 4