Medicine
Gastroenterology & Hepatology
Which two causes account for a large proportion of acute pancreatitis cases?
A. Asthma and eczema
B. Migraine and epilepsy
C. Gallstones and alcohol
D. Iron deficiency and folate deficiency
Correct Answer: C
Gallstones and alcohol are among the most common causes of acute pancreatitis.
Medicine
Gastroenterology & Hepatology
Which complication or major adverse outcome is particularly associated with Acute pancreatitis?
A. Hemorrhagic shock
B. Pancreatic necrosis
C. Perforated peptic ulcer
D. Septic shock
Correct Answer: B
Severe pancreatitis can cause necrosis, infection and multiorgan failure.
Medicine
Gastroenterology & Hepatology
A patient is diagnosed with Acute pancreatitis. Which is the most appropriate management principle?
A. Provide early supportive care with appropriate IV fluids, analgesia and early enteral nutrition as tolerated
B. Provide supportive care for uncomplicated disease and urgently evaluate any evidence of acute liver failure
C. Stabilize airway and circulation, establish IV access, resuscitate appropriately and arrange urgent endoscopic therapy
D. Use an evidence-based H. pylori eradication regimen and confirm eradication after treatment
Correct Answer: A
Most acute pancreatitis is treated supportively; the precipitating cause and complications must also be addressed.
Medicine
Gastroenterology & Hepatology
In a patient with suspected Acute pancreatitis, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical assessment plus a search for precipitating factors such as infection, bleeding, electrolyte disturbance or constipation
B. Liver profile, coagulation status and targeted viral serology
C. Urgent upper endoscopy after initial stabilization
D. Serum lipase plus targeted imaging when diagnosis, severity or biliary cause requires clarification
Correct Answer: D
Lipase is useful diagnostically; ultrasound is important when gallstones are suspected, and CT is reserved for selected situations.
Medicine
Gastroenterology & Hepatology
A patient has severe epigastric pain radiating to the back with vomiting and a markedly elevated pancreatic enzyme level. What is the most likely diagnosis?
A. Decompensated cirrhosis with ascites
B. Hepatic encephalopathy
C. Acute pancreatitis
D. Acute viral hepatitis
Correct Answer: C
Typical pain with a significant lipase or amylase elevation strongly supports acute pancreatitis.
Medicine
Gastroenterology & Hepatology
Which medication group commonly contributes to peptic ulcer formation and bleeding?
A. Inhaled beta-agonists
B. Nonsteroidal anti-inflammatory drugs
C. Topical antifungals
D. Oral rehydration salts
Correct Answer: B
NSAIDs impair mucosal protection and are a major cause of peptic ulcer disease and bleeding.
Medicine
Gastroenterology & Hepatology
Which complication or major adverse outcome is particularly associated with Helicobacter pylori-associated peptic ulcer disease?
A. Perforated peptic ulcer
B. Septic shock
C. Toxic megacolon
D. Spontaneous bacterial peritonitis
Correct Answer: A
Deep ulceration can perforate the stomach or duodenum and cause peritonitis.
Medicine
Gastroenterology & Hepatology
A patient is diagnosed with Helicobacter pylori-associated peptic ulcer disease. Which is the most appropriate management principle?
A. Provide early supportive care with appropriate IV fluids, analgesia and early enteral nutrition as tolerated
B. Give IV antibiotics and arrange urgent biliary decompression when obstruction with significant cholangitis is present
C. Use severity-appropriate anti-inflammatory therapy; severe acute colitis requires hospital-based management
D. Use an evidence-based H. pylori eradication regimen and confirm eradication after treatment
Correct Answer: D
Successful eradication reduces ulcer recurrence and related complications.
Medicine
Gastroenterology & Hepatology
In a patient with suspected Helicobacter pylori-associated peptic ulcer disease, which investigation or diagnostic approach is most appropriate at this stage?
A. Urgent upper endoscopy after initial stabilization
B. Serum lipase plus targeted imaging when diagnosis, severity or biliary cause requires clarification
C. Test for active H. pylori infection using an appropriate noninvasive or biopsy-based method
D. Liver tests and biliary imaging, usually starting with ultrasound
Correct Answer: C
Active-infection testing guides eradication therapy; test selection depends on clinical context and endoscopy status.
Medicine
Gastroenterology & Hepatology
A patient has recurrent epigastric pain and endoscopy demonstrates a peptic ulcer without regular NSAID use. What is the most likely diagnosis?
A. Acute viral hepatitis
B. Helicobacter pylori-associated peptic ulcer disease
C. Acute upper gastrointestinal bleeding
D. Acute pancreatitis
Correct Answer: B
H. pylori is a common cause of peptic ulcer disease and should be considered when an ulcer is found.
Medicine
Gastroenterology & Hepatology
In a cirrhotic patient with suspected variceal bleeding, which additional therapy should be started early alongside resuscitation?
A. Vasoactive variceal therapy and prophylactic antibiotics
B. Routine thrombolysis
C. Immediate oral iron only
D. High-dose NSAID therapy
Correct Answer: A
Suspected acute variceal hemorrhage requires specific vasoactive therapy and infection prophylaxis in addition to urgent endoscopic management.
Medicine
Gastroenterology & Hepatology
Which complication or major adverse outcome is particularly associated with Acute upper gastrointestinal bleeding?
A. Spontaneous bacterial peritonitis
B. Coma with loss of airway protection
C. Acute liver failure
D. Hemorrhagic shock
Correct Answer: D
Ongoing GI blood loss can cause severe hypovolemia and shock.
Medicine
Gastroenterology & Hepatology
A patient is diagnosed with Acute upper gastrointestinal bleeding. Which is the most appropriate management principle?
A. Use severity-appropriate anti-inflammatory therapy; severe acute colitis requires hospital-based management
B. Use sodium restriction and appropriate diuretic therapy; perform therapeutic paracentesis for tense ascites
C. Stabilize airway and circulation, establish IV access, resuscitate appropriately and arrange urgent endoscopic therapy
D. Treat the precipitant and use lactulose, adding other ammonia-lowering therapy when indicated
Correct Answer: C
Resuscitation comes first; definitive management depends on the endoscopic source and severity.
Medicine
Gastroenterology & Hepatology
In a patient with suspected Acute upper gastrointestinal bleeding, which investigation or diagnostic approach is most appropriate at this stage?
A. Liver tests and biliary imaging, usually starting with ultrasound
B. Urgent upper endoscopy after initial stabilization
C. Colonoscopy with biopsies when safe and appropriate
D. Diagnostic paracentesis for new or clinically significant ascites
Correct Answer: B
Endoscopy identifies the bleeding source and often provides definitive endoscopic treatment after resuscitation.
Medicine
Gastroenterology & Hepatology
A patient presents with hematemesis, melena, tachycardia and postural hypotension. What is the most likely diagnosis?
A. Acute upper gastrointestinal bleeding
B. Acute pancreatitis
C. Acute ascending cholangitis
D. Ulcerative colitis
Correct Answer: A
Hematemesis and melena with hemodynamic compromise indicate significant upper GI bleeding.