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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 28-year-old woman presents with bloody diarrhea, tenesmus, and urgency. Colonoscopy shows continuous mucosal inflammation starting from the rectum. Biopsy shows crypt abscesses. What is the diagnosis?

    Answer: Ulcerative colitis

    Continuous inflammation starting from the rectum with crypt abscesses on biopsy is the hallmark presentation of ulcerative colitis.

  2. Which finding on endoscopy is most indicative of Barrett's esophagus?

    Answer: Salmon-colored tongues of mucosa extending above the GEJ

    Barrett's esophagus is characterized by salmon-colored columnar metaplasia extending proximal to the gastroesophageal junction, confirmed by intestinal metaplasia on biopsy.

  3. A 72-year-old woman on warfarin presents with painless bright red blood per rectum. Colonoscopy shows bleeding diverticula in the sigmoid colon. What is the most appropriate initial management?

    Answer: Endoscopic hemostasis (clips or coagulation)

    Endoscopic hemostasis with clips or coagulation is the first-line treatment for actively bleeding diverticula identified at colonoscopy.

  4. A patient with chronic liver disease develops sudden onset abdominal pain, fever, and ascitic fluid PMN count >250 cells/mm³. What is the empiric antibiotic of choice?

    Answer: Cefotaxime or ceftriaxone

    Third-generation cephalosporins (cefotaxime or ceftriaxone) are the empiric treatment of choice for spontaneous bacterial peritonitis.

  5. A 44-year-old man presents with jaundice, pruritus, and an elevated alkaline phosphatase. MRCP shows multifocal strictures of both intrahepatic and extrahepatic bile ducts with a 'beaded' appearance. What is the most likely diagnosis?

    Answer: Primary sclerosing cholangitis

    The beaded appearance of multifocal bile duct strictures on MRCP is pathognomonic of primary sclerosing cholangitis.

  6. Which of the following best describes the mechanism of action of lactulose in hepatic encephalopathy?

    Answer: Acidifies colonic content, converting NH3 to NH4+ and reducing absorption

    Lactulose is metabolized to lactic and acetic acid, acidifying the colon and trapping ammonia as ammonium ion (NH4+), which is then excreted in stool.

  7. A 60-year-old man with a history of alcohol use presents with acute pancreatitis. His lipase is 1,200 U/L and CT shows peripancreatic fat stranding but no necrosis. What is the Revised Atlanta Classification severity?

    Answer: Mild acute pancreatitis

    Mild acute pancreatitis has no organ failure and no local or systemic complications, resolving within the first week.