Multiple Choice Questions (MCQ)

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Category: Medicine--->Gastroenterology
Page: 4

Question 16# Print Question

A 40-year-old white man complains of slowly progressive generalized weakness, weight loss, abdominal pain, and wrist and knee pain over the past several months. He was told at an urgent care visit that his blood sugar was a little higher than normal. There is a family history of liver disease on his father’s side. On examination, the patient has diffuse hyperpigmentation and a palpable liver edge. Mild polyarthritis of the wrists is also noted.

What is the best test or combination of tests to help you diagnose this patient’s problem? 

A. Complete blood count with differential and a comprehensive metabolic pane
B. Hemoglobin A1C
C. Iron, total iron-binding capacity, and ferritin
D. Alpha-1-antitrypsin level
E. Liver-spleen scan

Question 17# Print Question

A 32-year-old white woman complains of abdominal pain off and on since the age of 17. She notices abdominal bloating relieved by defecation as well as alternating diarrhea and constipation. She has no weight loss, GI bleeding, or nocturnal diarrhea. On examination, she has slight LLQ tenderness and gaseous abdominal distension. Laboratory studies, including CBC, are normal.

Which of the following is the most appropriate initial approach?

A. Recommend increased dietary fiber, antispasmodics as needed, and follow-up examination in 2 months
B. Refer to gastroenterologist for colonoscopy
C. Obtain antiendomysial antibodies
D. Order UGI series with small bowel follow-through
E. Order small bowel biopsy

Question 18# Print Question

A 55-year-old white woman has had recurrent episodes of alcohol-induced pancreatitis. Despite abstinence, the patient develops postprandial abdominal pain, bloating, weight loss despite good appetite, and bulky, foul-smelling stools. KUB shows pancreatic calcifications.

In this patient, you should expect to find which of the following?

A. Diabetes mellitus
B. Malabsorption of fat-soluble vitamins D and K
C. Guaiac-positive stool
D. Courvoisier sign
E. Markedly elevated amylase

Question 19# Print Question

A 34-year-old white woman is treated for a UTI with amoxicillin. Initially she improves, but 5 days after beginning treatment she develops recurrent fever, abdominal bloating, and diarrhea with six to eight loose stools per day.

What is the best diagnostic test to confirm your diagnosis?

A. Identification of Clostridium difficile toxin in the stool
B. Isolation of C difficile in stool culture
C. Stool for white blood cells (fecal leukocytes)
D. Detection of IgG antibodies against C difficile in the serum
E. Visualization of gram-positive rods on microscopic examination of stool

Question 20# Print Question

A 27-year-old woman is found to have a positive hepatitis C antibody at the time of plasma donation. Physical examination is normal. Liver enzymes reveal ALT of 62 U/L (normal < 40), AST 65 U/L (normal < 40), bilirubin 1.2 mg/dL (normal), and alkaline phosphatase normal. Hepatitis C viral RNA is 100,000 copies/mL. Hepatitis B surface antigen and HIV antibody are negative.

Which of the following statements is true?

A. Liver biopsy is necessary to confirm the diagnosis of hepatitis C
B. Most patients with hepatitis C eventually resolve their infection without permanent sequelae
C. This patient should not receive vaccinations against other viral forms of hepatitis
D. Serum ALT levels are a good predictor of prognosis
E. Patients with hepatitis C genotype 2 or 3 are more likely to have a favorable response to treatment with interferon and ribavirin

Category: Medicine--->Gastroenterology
Page: 4 of 5