Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Gastroenterology
Page: 10

Question 46#Print Question

A 52-year-old woman presents for her annual physical examination. Her past medical history is significant for hypertension and diabetes mellitus type 2. She endorses smoking two packs of cigarettes per day for the past 18 years. Her vital signs are stable and her physical examination is unremarkable. She receives a colonoscopy that demonstrates multiple diverticular outpouchings. The patient is very concerned and has plenty of questions about the conditions.

Which of the following recommendations should be offered to this patient in the setting of her newly diagnosed condition?

a. Smoking cessation
b. Prophylactic broad-spectrum antibiotics
c. Elective surgical resection
d. Increase daily fiber intake

Question 47#Print Question

A 43-year-old woman presents with jaundice, right upper quadrant pain, and bothersome pruritus for the past 6 months. Her past medical history is significant for asthma and she only takes inhaled albuterol as needed. Laboratory testing reveals positive anti-mitochondrial antibodies and the patient is diagnosed with primary biliary cirrhosis.

Which of the following is the best initial treatment for this patient?

a. Liver transplantation
b. High-dose steroids
c. Biliary stent placement
d. Ursodeoxycholic acid

Question 48#Print Question

A 37-year-old man presents with abdominal pain, mild nausea, and “dark stools.” The patient reports that over the past 6 months he has noticed abdominal pain that is only alleviated by eating. He has gained 6.8 kg (15 lb) during this time period. The patient denies alcohol or illicit drug use, but does report headaches for which he takes over-thecounter acetaminophen. Physical examination is unremarkable; however, fecal occult blood test (FOBT) is positive.

Which of the following is the most likely diagnosis?

a. Peptic ulcer disease
b. Diverticulosis
c. Colon cancer
d. Mesenteric ischemia

Question 49#Print Question

A 47-year-old man with a history of chronic viral hepatitis C infection is brought in by his partner for vomiting blood over the past 2 hours. He is unarousable on physical examination and he has a temperature of 36.8°C, blood pressure of 124/90 mmHg, heart rate of 96 beats per minute, and a respiratory rate of 18 breaths per minute. While being examined, the patient begins to vomit a large amount of blood.

In addition to normal saline administration, which of the following is the best next step in management of this patient?

a. Upper GI endoscopy
b. Abdominal CT scan
c. Endotracheal intubation
d. Octreotide

Question 50#Print Question

A 27-year-old woman presents with abdominal pain, bloody diarrhea, and nausea for the past 6 weeks. She has lost 4.5 kg (10 lb) over this time period. She has an insignificant past medical history and denies alcohol or illicit drug use. She has a temperature of 38.7°C, blood pressure of 80/48 mmHg, heart rate of 124 beats per minute, and a respiratory rate of 18 breaths per minute. Physical examination demonstrates abdominal distention and tenderness to palpation in all four quadrants. The patient has diminished bowel sounds. Rectal examination is performed and gross blood mixed with mucous is appreciated. The patient’s leukocyte count is severely elevated at 28,000/mm3 .

Which of the following is the initial test of choice in the diagnostic workup of this patient’s suspected condition?

a. Abdominal ultrasound
b. Abdominal x-ray
c. Emergent paracentesis
d. Colonoscopy

Category: Q&A Medicine--->Gastroenterology
Page: 10 of 10