Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
23 Gastroenterology MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 8 practice questions
- Inflammatory bowel disease
- Colonic disease
- Reflux disease
- Gastric disease
- Coeliac disease
- Endoscopy
- Lower GI bleeding
- Pregnancy and pancreatic disease
1. A patient has diarrhoea and abdominal pain and IBD versus IBS is being distinguished, and another with colitis has patchy inflammation, deep ulcers and rectal sparing. Which statements are correct?
- AFaecal calprotectin has high sensitivity even when CRP is normal, and the endoscopic pattern is Crohn's disease
- BFaecal elastase, and ulcerative colitis
- CESR, and microscopic colitis
- DAlbumin, and ischaemic colitis
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A. Faecal calprotectin has high sensitivity even when CRP is normal, and the endoscopic pattern is Crohn's disease Ulcerative colitis shows loss of vascular pattern, granularity and friability; Crohn's shows patchy inflammation, strictures and perianal disease.
2. A patient with colorectal cancer has a germline mismatch repair mutation, and an older patient has a pericolic abscess from diverticulitis. Which statements are correct?
- AChromosomal instability accounts for 15%, and immediate colectomy
- BEpigenetic only, and colonoscopy
- CCIMP accounts for 85%, and stimulant laxatives
- DMicrosatellite instability accounts for about 15% of sporadic cancers and most HNPCC, and antibiotics with percutaneous drainage are used because trials show no benefit from acute resection
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D. Microsatellite instability accounts for about 15% of sporadic cancers and most HNPCC, and antibiotics with percutaneous drainage are used because trials show no benefit from acute resection Chromosomal instability occurs in about 85% and CIMP 20-30%; emergency surgery is reserved for severe haemorrhage or perforation.
3. A pregnant woman with Crohn's disease takes methotrexate and tofacitinib, and a man with alcohol-related chronic pancreatitis needs assessment. Which statements are correct?
- AAll drugs are safe, and CT measures function
- BStop all drugs, and MRCP measures function
- CMethotrexate and tofacitinib must be avoided before and during pregnancy, and faecal elastase measures exocrine function while secretin juice collection is gold standard but invasive
- DOnly biologics are safe, and ultrasound measures function
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C. Methotrexate and tofacitinib must be avoided before and during pregnancy, and faecal elastase measures exocrine function while secretin juice collection is gold standard but invasive Aminosalicylates, glucocorticoids, thiopurines and biologics can continue; gallstones do not cause chronic pancreatitis.
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