FINALS: Gastrointestinal Disorders

Question 1

What is dyspepsia?

Answer 1

Upper abdominal discomfort or pain, often after eating.

Question 2

What distinguishes heartburn from dyspepsia?

Answer 2

Heartburn is a retrosternal burning sensation; suggestive of GERD.

Question 3

What are causes of dyspepsia?

Answer 3

Food/drug intolerance, H. pylori infection, GIT dysfunction, pancreatic or biliary disease.

Question 4

How is dyspepsia diagnosed?

Answer 4

Upper endoscopy if alarm symptoms; H. pylori testing.

Question 5

What is the first-line pharmacologic treatment for dyspepsia?

Answer 5

Proton Pump Inhibitors (PPI) like omeprazole, esomeprazole.

Question 6

What are common causes of nausea without abdominal pain?

Answer 6

Food poisoning, systemic illness, medications.

Question 6

What is the H. pylori triple therapy regimen?

Answer 6

PPI + clarithromycin + amoxicillin/metronidazole for 10–14 days.

Question 7

What suggests vomiting due to gastric outlet obstruction?

Answer 7

Vomiting of undigested food 1–2 hours after eating.

Question 7

What initial management is recommended for persistent vomiting?

Answer 7

Clear liquids, IV fluids with potassium, antiemetics.

Question 8

Which imaging study can help assess vomiting causes?

Answer 8

Abdominal X-rays, CT scan, upper endoscopy.

Question 8

What is singultus?

Answer 8

Repetitive involuntary myoclonic contractions of the diaphragm.

Question 9

How can hiccups be stopped?

Answer 9

Carotid massage, breath-holding, vagal stimulation.

Question 10

What medications are used for persistent hiccups?

Answer 10

Chlorpromazine, baclofen, metoclopramide.

Question 11

What causes belching (eructation)?

Answer 11

Swallowed air or esophageal gas release.

Question 12

What are two sources of intestinal gas?

Answer 12

Swallowed air and bacterial fermentation.

Question 12

What defines constipation?

Answer 12

Fewer than 3 bowel movements/week, hard stools, straining.

Question 13

What are secondary causes of constipation?

Answer 13

Medications, systemic disorders, colonic obstruction.

Question 14

What indicates inflammatory diarrhea?

Answer 14

Fever, bloody stools (dysentery).

Question 14

What defines acute diarrhea?

Answer 14

Diarrhea lasting less than 2 weeks.

Question 15

What is osmotic diarrhea?

Answer 15

Diarrhea that decreases with fasting; caused by poorly absorbed substances.

Question 15

What is secretory diarrhea?

Answer 15

Large-volume diarrhea that persists despite fasting.

Question 16

What causes esophageal varices?

Answer 16

Portal hypertension due to chronic liver disease.

Question 16

What is a major complication of esophageal varices?

Answer 16

Massive gastrointestinal bleeding (hematemesis).

Question 17

What are common causes of erosive gastritis?

Answer 17

NSAIDs, alcohol, stress from severe illness.

Question 18

What is the hallmark finding on endoscopy for erosive gastritis?

Answer 18

Subepithelial hemorrhages, petechiae, erosions.

Question 18

How is H. pylori detected non-invasively?

Answer 18

Urea breath test.

Question 19

What is peptic ulcer disease?

Answer 19

Mucosal break in the stomach or duodenum caused by acid and pepsin.

Question 19

What bacteria is most associated with PUD?

Answer 19

Helicobacter pylori.

Question 20

What are major complications of PUD?

Answer 20

Bleeding, perforation, obstruction.

Question 20

What is "coffee ground" emesis a sign of?

Answer 20

Upper GI bleeding from a peptic ulcer.

Question 21

What is the standard treatment for H. pylori-associated ulcers?

Answer 21

PPI + two antibiotics (triple therapy).

Question 22

What is the main risk factor for stomach cancer?

Answer 22

Chronic H. pylori infection.

Question 22

What is the main diagnostic tool for stomach cancer?

Answer 22

Upper endoscopy with biopsy.

Question 22

What are risk factors for colon cancer?

Answer 22

Family history, inflammatory bowel disease, diet high in red/processed meat.

Question 23

What are common symptoms of stomach cancer?

Answer 23

Weight loss, early satiety, abdominal pain, vomiting blood (hematemesis).

Question 24

What symptoms suggest colon cancer?

Answer 24

Rectal bleeding, weight loss, change in bowel habits.

Question 25

What quadrant is most affected in diverticulitis?

Answer 25

Inflammation of diverticula causing pain, fever, nausea.

Question 25

What quadrant is most affected in diverticulitis?

Answer 25

Left lower quadrant.

Question 25

What is the screening method for colon cancer?

Answer 25

Colonoscopy

Question 25

What is diverticulitis?

Answer 25

Inflammation of diverticula causing pain, fever, nausea.

Question 26

What imaging is needed in severe diverticulitis?

Answer 26

CT scan.

Question 26

What antibiotics are used for diverticulitis?

Answer 26

Metronidazole plus ciprofloxacin or amoxicillin-clavulanate.

Question 27

What is the classic presentation of appendicitis?

Answer 27

Early periumbilical pain shifting to right lower quadrant.

Question 27

What are hallmark findings of pseudomembranous colitis?

Answer 27

Yellow plaques seen on sigmoidoscopy.

Question 27

What organism is most associated with antibiotic-associated colitis?

Answer 27

Clostridium difficile.

Question 28

What causes Zollinger-Ellison Syndrome?

Answer 28

Gastrin-secreting tumors (gastrinomas) in pancreas/duodenum.

Question 28

What are signs of appendicitis?

Answer 28

Psoas sign, obturator sign, rebound tenderness at McBurney’s point.

Question 29

What is the treatment for appendicitis?

Answer 29

Antibiotics followed by appendectomy.

Question 30

What is the hallmark finding in Zollinger-Ellison Syndrome?

Answer 30

Elevated gastrin levels and recurrent peptic ulcers.

Question 31

What is first-line treatment for C. difficile colitis?

Answer 31

Metronidazole or vancomycin.

Question 31

What are the two types of IBD?

Answer 31

Crohn’s disease and ulcerative colitis.

Question 32

What is the hallmark symptom of ulcerative colitis?

Answer 32

Bloody diarrhea.

Question 32

What is the key diagnostic tool for ulcerative colitis?

Answer 32

Sigmoidoscopy.

Question 33

What is Whipple’s disease?

Answer 33

Infection by Tropheryma whipplei, causing malabsorption.

Question 34

How is Whipple’s disease treated?

Answer 34

Long-term antibiotics.

Question 34

What symptoms are seen in Whipple’s disease?

Answer 34

Fever, lymphadenopathy, diarrhea, weight loss.

Question 34

What are hemorrhoids?

Answer 34

Venous congestion of the hemorrhoidal plexus.

Question 34

When is hemorrhoidectomy indicated?

Answer 34

For bothersome or complicated hemorrhoids.

Question 34

What is an anal fissure?

Answer 34

Tear in the anal mucosa, often painful.

Question 34

What is first-line treatment for anal fissures?

Answer 34

Topical treatments, antibiotics, debridement if needed.

Question 35

What is choledocholithiasis?

Answer 35

Gallstones in the common bile duct.

Question 35

What is the classic sign of acute cholecystitis?

Answer 35

Positive Murphy’s sign.

Question 35

What is Charcot’s triad in cholangitis?

Answer 35

Fever, jaundice, RUQ pain.

Question 36

What is biliary colic?

Answer 36

Sharp RUQ pain without fever; gallstone obstructing cystic duct.

Question 36

What is the gold standard for diagnosing bile duct stones?

Answer 36

ERCP (Endoscopic Retrograde Cholangiopancreatography).

Question 36

What causes a Mallory-Weiss tear?

Answer 36

Severe vomiting or retching leading to mucosal tear at GE junction.

Question 37

What is the treatment for Mallory-Weiss tear?

Answer 37

Supportive care, endoscopic hemostasis if needed.

Question 37

What causes jaundice?

Answer 37

Accumulation of bilirubin in blood.

Question 38

What differentiates conjugated from unconjugated jaundice?

Answer 38

Conjugated: cholestasis. Unconjugated: hemolysis or impaired uptake.

Question 38

How is Hepatitis A transmitted?

Answer 38

Fecal-oral route.

Question 39

What is the major risk of Hepatitis B transmission?

Answer 39

Blood, sexual contact, mother-to-child.

Question 40

Which hepatitis has the highest risk in pregnancy?

Answer 40

Hepatitis E.

Question 41

What are major causes of cirrhosis?

Answer 41

Chronic hepatitis, alcohol, metabolic diseases.

Question 42

What is cirrhosis?

Answer 42

End-stage liver fibrosis with nodular regeneration.

Question 43

What are the main causes of acute pancreatitis?

Answer 43

Gallstones and alcohol.

Question 44

What labs are elevated in acute pancreatitis?

Answer 44

Serum amylase and lipase.

Question 45

What is the imaging of choice for pancreatitis complications?

Answer 45

CT scan with contrast.

Question 46

What are symptoms of chronic pancreatitis?

Answer 46

Chronic epigastric pain, steatorrhea, weight loss.

Question 47

What is the most common cause of chronic pancreatitis?

Answer 47

Chronic alcohol use.

Question 48

What is the main diagnostic enzyme for pancreatitis?

Answer 48

Lipase (more specific than amylase).