GATEOENTEROLOGY 1.2 (AB)

Question 1

What is the gold standard diagnostic test for Hirschsprung Disease (Congenital Aganglionic Megacolon)?

Answer 1

Rectal suction biopsy

Question 2

What developmental disorder is characterized by absence of ganglion cells in the submucosal and myenteric plexus?

Answer 2

Hirschsprung Disease (Congenital Aganglionic Megacolon)

Question 3

What is the most common cause of lower intestinal obstruction in neonates?

Answer 3

Hirschsprung Disease

Question 4

What is the incidence of Hirschsprung Disease?

Answer 4

1 in 5,000 live births

Question 5

What is the male-to-female ratio in short-segment Hirschsprung Disease?

Answer 5

0.16736111111111107

Question 6

What is the male-to-female ratio in total colonic aganglionosis?

Answer 6

~2:1

Question 7

What is the pathophysiology of Hirschsprung Disease?

Answer 7

Arrested migration of neuroblasts causing absence of myenteric and submucosal plexus, leading to inadequate bowel relaxation and obstruction

Question 8

What are the classic neonatal clinical manifestations of Hirschsprung Disease?

Answer 8

Distended abdomen, failure to pass meconium, bilious emesis, feeding intolerance

Question 9

What neonatal conditions should Hirschsprung Disease be differentiated from?

Answer 9

Meconium plug syndrome, meconium ileus, intestinal atresia

Question 10

What is the Currarino triad associated with older patients with Hirschsprung Disease?

Answer 10

Anorectal malformations, sacral bone anomalies, presacral anomaly

Question 11

What are examples of anorectal malformations in Currarino triad?

Answer 11

Ectopic anus, anal stenosis, imperforate anus

Question 12

What are examples of sacral bone anomalies in Currarino triad?

Answer 12

Hypoplasia, poor segmentation

Question 13

What are examples of presacral anomalies in Currarino triad?

Answer 13

Anterior meningoceles, teratoma, cyst

Question 14

What is intussusception?

Answer 14

Telescoping of one part of the intestine into an adjacent segment

Question 15

What is the segment that invaginates called in intussusception?

Answer 15

Intussusceptum

Question 16

What is the receiving segment called in intussusception?

Answer 16

Intussuscipiens

Question 17

What is the most common cause of intestinal obstruction between 5 months and 3 years?

Answer 17

Intussusception

Question 18

What is the most common abdominal emergency in children younger than 2 years?

Answer 18

Intussusception

Question 19

What stool characteristic is pathognomonic for intussusception?

Answer 19

Currant jelly stool

Question 20

What physical exam finding is characteristic of intussusception?

Answer 20

Sausage-like mass

Question 21

What ultrasound finding is characteristic of intussusception?

Answer 21

Target sign

Question 22

What is the treatment for intussusception?

Answer 22

Surgery

Question 23

What is peptic ulcer disease (PUD)?

Answer 23

Inflammatory condition caused by imbalance between cytoprotective and cytotoxic factors in stomach and duodenum

Question 24

What are the key factors in peptic ulcer disease pathogenesis?

Answer 24

Acid and pepsin (damage), mucosal defense failure

Question 25

What are the two types of peptic ulcers?

Answer 25

Primary (chronic, duodenal), Secondary (acute, stress-related)

Question 26

Where are gastric ulcers usually located?

Answer 26

Lesser curvature of the stomach

Question 27

Where do 90% of duodenal ulcers occur?

Answer 27

Duodenal bulb

Question 28

What is the main causative factor for mucosal injury in PUD?

Answer 28

Acid-pepsin activity

Question 29

What are examples of mucosal defense defects in PUD?

Answer 29

Impaired mucus-bicarbonate barrier, reduced prostaglandin synthesis, decreased mucosal blood flow

Question 30

What bacterial infection is a contributing factor for peptic ulcer disease?

Answer 30

Helicobacter pylori infection

Question 31

What medication class contributes to peptic ulcer disease by inhibiting prostaglandin synthesis?

Answer 31

NSAIDs

Question 32

What symptoms are associated with peptic ulcer disease?

Answer 32

Epigastric pain, nausea, vomiting, hematemesis, melena

Question 33

What are severe complications of peptic ulcer disease?

Answer 33

Perforation, obstruction

Question 34

What is the causative agent of Helicobacter pylori gastritis?

Answer 34

Helicobacter pylori (Gram-negative, S-shaped rod)

Question 35

How is Helicobacter pylori transmitted?

Answer 35

Fecal-oral or oral-oral (e.g., kissing)

Question 36

What are key enzymes produced by Helicobacter pylori?

Answer 36

Urease, catalase, oxidase

Question 37

What gastric condition is commonly associated with H. pylori but often asymptomatic?

Answer 37

Chronic active gastritis

Question 38

What extragastric conditions can H. pylori infection cause?

Answer 38

Iron deficiency anemia, idiopathic thrombocytopenic purpura (ITP), short stature

Question 39

What malignancies are linked to H. pylori infection?

Answer 39

Gastric adenocarcinoma, MALT lymphoma

Question 40

What is the gold standard diagnostic method for H. pylori?

Answer 40

Endoscopy with biopsy

Question 41

What non-invasive test for H. pylori detects urease activity?

Answer 41

13C-Urea breath test

Question 42

What stool-based test is highly sensitive and specific for H. pylori, especially in children?

Answer 42

Stool antigen test

Question 43

What is the first-line eradication therapy for H. pylori?

Answer 43

Triple therapy: PPI + Amoxicillin + Clarithromycin for 14 days

Question 44

What is the recommended treatment for resistant H. pylori infection?

Answer 44

Quadruple therapy: PPI + Bismuth + Metronidazole + Tetracycline

Question 45

What medication should be discontinued 2 weeks before H. pylori testing to avoid false negatives?

Answer 45

PPI

Question 46

What classification does WHO assign to Helicobacter pylori?

Answer 46

Group I carcinogen

Question 47

What is the relative risk increase for gastric cancer in H. pylori-infected adults?

Answer 47

2.3 to 8.7 times higher

Question 48

How does urease contribute to H. pylori pathogenesis?

Answer 48

Converts urea to ammonia, neutralizing acid but damaging mucosa

Question 49

What are the invasive methods to diagnose H. pylori?

Answer 49

Endoscopy with biopsy, histologic exam with Giemsa stain

Question 50

What are the non-invasive methods to diagnose H. pylori?

Answer 50

13C-Urea breath test, stool antigen test