Physician Assistant Gastrointestinal and Nutrition 5

Question 1

A 62-year-old man with alcoholic cirrhosis develops sudden onset, large-volume hematemesis. Endoscopy reveals actively bleeding esophageal varices. Which pharmacologic agent should be initiated immediately?

Accepted Answer

Octreotide

Answer

Octreotide (somatostatin analogue) reduces splanchnic blood flow and portal pressure and is the preferred pharmacologic agent for acute variceal bleeding.

Question 2

A 50-year-old woman presents with chronic watery diarrhea, episodic flushing, and wheezing. Urine 5-HIAA levels are elevated. Where is this tumor most likely located?

Accepted Answer

Appendix or terminal ileum

Answer

Carcinoid syndrome (flushing, diarrhea, wheezing) with elevated 5-HIAA is most commonly caused by carcinoid tumors of the appendix or terminal ileum with hepatic metastases.

Question 3

A 45-year-old woman presents with iron deficiency anemia and a positive fecal occult blood test. Which is the most appropriate next diagnostic step?

Accepted Answer

Both upper endoscopy and colonoscopy

Answer

In a patient with FOBT-positive iron deficiency anemia, bidirectional endoscopy (both upper and lower) is recommended to identify the source of occult GI bleeding.

Question 4

Which dietary modification is the first-line treatment for non-alcoholic fatty liver disease (NAFLD)?

Accepted Answer

Low-fat, low-calorie diet with weight loss of 7–10%

Answer

A sustained weight loss of 7–10% through caloric restriction improves hepatic steatosis, inflammation, and fibrosis in NAFLD.

Question 5

A 30-year-old woman is diagnosed with irritable bowel syndrome (IBS) with predominant constipation. Which dietary intervention has the strongest evidence for improving her symptoms?

Accepted Answer

Low FODMAP diet

Answer

The low FODMAP diet reduces fermentable carbohydrates that cause osmotic diarrhea and gas production, and has the strongest evidence for symptom relief in IBS.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Gastrointestinal and Nutrition 5