Gastroenterology Disorders Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastroenterology Disorders flashcards as text
A 25-year-old presents with fatigue, iron-deficiency anemia, bloating, and diarrhea. Tissue transglutaminase IgA antibody is markedly elevated. Small bowel biopsy shows villous atrophy and crypt hyperplasia. What dietary modification is curative?
Answer: Strict gluten-free diet
Celiac disease is an immune-mediated enteropathy triggered by gluten; strict lifelong gluten avoidance leads to mucosal healing.
A 68-year-old develops profuse, watery, non-bloody diarrhea after a 10-day course of clindamycin for a skin infection. Stool PCR is positive for C. difficile toxin. This is his first episode. What is the first-line treatment?
Answer: Oral vancomycin or fidaxomicin
Updated guidelines (IDSA 2021) recommend oral vancomycin or fidaxomicin over metronidazole for initial C. difficile infection due to superior cure rates.
A 60-year-old with alcoholic cirrhosis develops increasing abdominal girth. Ultrasound confirms ascites. Serum-ascites albumin gradient (SAAG) is 1.5 g/dL. What does this SAAG indicate?
Answer: Portal hypertension-related ascites
SAAG ≥ 1.1 g/dL indicates portal hypertension as the cause of ascites with 97% accuracy.
A 45-year-old with autoimmune hepatitis presents with elevated ALT/AST (10x normal) and positive anti-smooth muscle antibodies. What is the standard induction therapy?
Answer: Prednisone with or without azathioprine
Autoimmune hepatitis is treated with prednisone alone or combined with azathioprine to induce remission.
A 50-year-old with known esophageal varices presents with acute hematemesis. After resuscitation, what pharmacologic therapy should be started immediately before endoscopy?
Answer: IV octreotide (somatostatin analogue)
Octreotide reduces portal pressure by inhibiting splanchnic vasodilation and should be initiated immediately in suspected variceal bleeding.
A patient presents with 8 weeks of dyspepsia unresponsive to antacids. Urea breath test is positive. What is the most appropriate treatment regimen?
Answer: Clarithromycin-based triple therapy (PPI + clarithromycin + amoxicillin) for 14 days
Clarithromycin-based triple therapy for 14 days is a standard first-line H. pylori eradication regimen in areas with low clarithromycin resistance.
A 70-year-old man is found to have a 2 cm hepatic mass on ultrasound. He has a history of hepatitis C cirrhosis and AFP of 450 ng/mL. Dynamic CT shows arterial enhancement with venous washout. What is the most likely diagnosis?
Answer: Hepatocellular carcinoma
Arterial enhancement with venous-phase washout on CT in a cirrhotic patient with elevated AFP is diagnostic of hepatocellular carcinoma per AASLD criteria.