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Gastroenterology Flashcards

7 cards from real PANRE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 55-year-old woman presents with fatigue, arthralgias, and elevated transaminases (AST/ALT 3× ULN). ANA titer is 1:320 and anti-smooth muscle antibody is positive. Liver biopsy shows interface hepatitis. What is the diagnosis?

    Answer: Autoimmune hepatitis

    Autoimmune hepatitis is characterized by elevated transaminases, positive ANA and anti-smooth muscle antibodies, and interface hepatitis on biopsy.

  2. A 38-year-old man presents with severe epigastric pain radiating to the back, nausea, and vomiting. He denies alcohol use. Lipase is 4× normal and triglycerides are 1,800 mg/dL. What is the cause of his pancreatitis?

    Answer: Hypertriglyceridemia-induced pancreatitis

    Triglyceride levels above 1,000 mg/dL can cause acute pancreatitis, and this patient's markedly elevated triglycerides with no other identified cause confirms hypertriglyceridemia-induced pancreatitis.

  3. A 25-year-old woman presents with watery diarrhea (8-10 stools/day) and mild cramping. She recently completed a course of clindamycin. Stool testing is positive for C. difficile toxin. What is the first-line treatment?

    Answer: Vancomycin (oral)

    Current IDSA/ACG guidelines recommend oral vancomycin as the first-line treatment for initial C. difficile infection, having replaced metronidazole as first-line therapy.

  4. Which of the following features distinguishes Crohn's disease from ulcerative colitis?

    Answer: Transmural inflammation with skip lesions

    Crohn's disease is characterized by transmural inflammation that can affect any part of the GI tract in a discontinuous (skip lesion) pattern, unlike the continuous mucosal inflammation of UC.

  5. A 68-year-old man undergoes colonoscopy and is found to have a 25 mm pedunculated polyp in the transverse colon. Pathology shows invasive adenocarcinoma confined to the stalk with clear margins. What is the most appropriate next step?

    Answer: No additional surgery if resection margins are clear and no high-risk features

    Pedunculated polyps with invasive cancer at clear margins, no lymphovascular invasion, and well-differentiated histology can be managed endoscopically without surgery.

  6. A 50-year-old man with long-standing GERD undergoes surveillance endoscopy revealing Barrett's esophagus with high-grade dysplasia. What is the recommended management?

    Answer: Endoscopic eradication therapy (radiofrequency ablation)

    Endoscopic eradication therapy, particularly radiofrequency ablation, is the recommended treatment for Barrett's esophagus with high-grade dysplasia as it effectively eliminates dysplastic epithelium.

  7. A 45-year-old man presents with diarrhea, flushing, and wheezing. Urine 5-HIAA levels are elevated. CT abdomen shows a liver mass. What is the most likely primary tumor location?

    Answer: Small intestine

    Carcinoid syndrome (diarrhea, flushing, wheezing) with elevated 5-HIAA and liver metastases most commonly originates from a small intestinal carcinoid tumor.