GI Tract

Question 1

A 40-year old man had retro-sternal pain that was most pronounced when lying down after meals. This was associated with regurgitation of gastric acid into his mouth. What is the most likely cause of this condition?

Answer 1

Gastro esophageal reflux

Question 2

A 60-year old man with a history of heavy smoking and alcohol consumption could not swallow meat. What could account for dysphagia in this patient?

Answer 2

Barrett esophagus

Question 3

A 40-year old man complained of epigastric pain 3 to 4 hours after meals. He could pinpoint the most painful site on the anterior abdominal wall. What is the most likely diagnosis?

Answer 3

Peptic ulcer

Question 4

A 20-year old woman complained of frequent bowel movements and bloody stools. Biopsy of the colon revealed ulceration of the superficial bowel mucosa. What is the most likely diagnosis?

Answer 4

Pseudomembranous colitis caused by C. diff or ulcerative colitis

Question 5

The absence of peristalsis in the body of the esophagus and failure of the lower esophageal sphincter to relax in response to swallowing. Associated with the lack of ganglion cells in the myenteric plexus:

Answer 5

Achalasia

Question 6

Dilated veins immediately beneath the mucosa, which are prone to rupture and hemorrhage. They arise in the lower third of the esophagus, virtually always in patients with portal hypertension, secondary to liver cirrhosis:

Answer 6

Esophageal varices

Question 7

Most cancers of the esophagus are histologically identified as:

Answer 7

Squamous cell carcinomas

Question 8

A narrowing of the pyloric canal that obstructs the outlet of the stomach. It is the most common cause of abdominal surgery in the first 6 months of life. It is four times more common in males than in females.

Answer 8

Congenital pyloric stenosis

Question 9

Chronic inflammation of the stomach mucosa that ranges from mild superficial involvement to severe atrophy. A common infectious cause is Helicobacter pylori:

Answer 9

Gastritis/ infectious gastritis

Question 10

Breaks in the mucosa of the stomach and proximal duodenum that are produced by the action of gastric secretions. Risk factors include cigarette smoking, increased gastric secretion of pepsin and hydrochloric acid, aspirin ingestion, chronic infection with Helicobacter pylori and genetic factors.

Answer 10

Peptic ulcer disease

Question 11

An acquired herniation of the mucosa and submucosa through the muscular layers of the colon. Present in nearly one half of persons in the US older than the age of 60 years.

Answer 11

Divericulosis

Question 12

Inflammation of a diverticulum caused by retention of fecal material. It is generally asymptomatic, but may present with episodic abdominal pain.

Answer 12

Diverticulitis

Question 13

A chronic, granulatomatus inflammatory disease of the bowel of unknown etiology. The disease usually appears in adolescents or young adults. The inflammation involves all layers of the bowel wall - transmural inflammation. The most frequent symptoms are abdominal pain, diarrhea and recurrent fever.

Answer 13

Crohn disease

Question 14

A disease of the large intestine characterized by chronic diarrhea and rectal bleeding, with a pattern of exacerbations and remissions. Usually extends from the most distal part of the rectum for a variable distance proximally. Persons with this disease have a higher risk of developing colon cancer.

Answer 14

Ulcerative colitis

Question 15

A 60-year old man reported having thinned stools that were tinged with blood. What is a likely diagnosis?

Answer 15

Colorectal cancer or polyps

Question 16

Columnar metaplasia of esophageal squamous epithelium in response to injury produced by chronic gastroesophageal reflux. High risk for adenocarcinoma:

Answer 16

Barrett esophagus

Question 17

Communication between the trachea and esophagus:

Answer 17

Tracheoesophageal fistula

Question 18

Most carcinomas of the colon are believed to arise from these preexisting lesions:

Answer 18

Adenomatous polyps

Question 19

Name an autosomal dominant trait which inevitably leads to carcinoma of the colon by age 40 unless a total colectomy is performed:

Answer 19

Familial adenomatous polyposis