PANCE Gastrointestinal (GI) and Nutrition Practice Test

These questions are part of the practice quiz. Start practicing

• Diagnostic test of choice for lactose intolerance
• What is the most appropriate diagnostic test to evaluate a suspected Mallory-Weiss tear?
• Which biomarker is not useful for detecting recurrence after curative surgical resection for colorectal cancer?
• Which exam provides a definitive diagnosis of liver cancer?
• Which of the following is a risk factor for pancreatic carcinoma?
• The patient described with a posterior vaginal wall bulge that is reducible and requires manual reduction for defecation is most consistent with which condition?
• Which of the following is not a treatment option for anal fissure?
• In toxic megacolon, radiographic evidence of colonic dilation exceeding 6 cm is a diagnostic criterion in adults.
• Which drug cannot be used to treat chronic hepatitis B infection?
• In adults with suspected acute appendicitis, which imaging modality is most sensitive for diagnosis?
• Which statement is true about colorectal cancer biomarkers?
• Which hepatitis is not transmitted by blood?
• Which condition shows the 'bird's beak' feature on a barium swallow?
• Which patient scenario places the greatest risk for cholesterol gallstone formation?
• Which trio of features characterizes Plummer-Vinson syndrome?
• If you could order only one investigation at this time for suspected pancreatic cancer, which would you order?
• Which of the following is associated with irritable bowel syndrome?
• In variceal bleeding, which intervention reduces infection-related mortality when combined with resuscitation?
• Which hepatitis is classically transmitted by fecal-oral route and often associated with outbreaks in areas with poor sanitation?
• Which statement about CEA as a marker for colorectal cancer is true?
• Hirschsprung disease is diagnosed most definitively by which procedure?
• Which esophageal motility disorder is defined by decreased peristalsis and increased LES tone?
• Which test is least reliable for confirming active H. pylori infection after eradication therapy?
• Which test is used to detect H. pylori infection in stool samples?
• The gold standard for definitive diagnosis of Peptic Ulcer Disease (PUD) is?
• Which radiologic imaging technique is the most sensitive in the diagnosis of acute pancreatitis and pancreatic pseudocysts?
• A 55-year-old man presents with swollen gums, easy bruising, and a swollen knee; diagnosis suggests vitamin deficiency. Which vitamin deficiency is most likely?
• According to Rome III criteria for functional constipation, which is not a component?
• Steakhouse syndrome is associated with which esophageal finding?
• Which finding would be considered a red flag suggesting an alternative diagnosis rather than IBS?
• What type of hernia involves passage of intestine through the external inguinal ring at Hesselbach's triangle and rarely enters the scrotum?
• 36 year old man presents with sudden onset severe epigastric pain following an alcohol binge. Pain is referred to his back and relieved when he sits and leans forward. What is the most likely diagnosis?
• Which drug class is most effective in relieving symptoms of GERD?
• Which pattern of liver enzyme elevation is most suggestive of alcoholic liver disease?
• A 69-year-old man presents with epigastric pain radiating to the back, weight loss, jaundice, pruritus, cachexia, icterus, scratch marks, and a palpable gallbladder. The most likely diagnosis is which cancer?
• A 70-year-old man develops postoperative ileus following a right hemicolectomy; what is the most appropriate initial management?
• Most common underlying cause of portal hypertension in the United States?
• Which statement about Clostridium difficile diarrhea is correct?
• Which finding is most characteristic of Crohn's disease on colonoscopy?
• Diagnosis of Candida esophagitis is supported by demonstration of yeast or hyphae in plaques stained with which stain?
• A patient has anti-HBc IgG and anti-HBs. What is the hepatitis B infection status?
• A 70-year-old woman with constipation; recommended management?
• The most common cause of acute cholangitis is which condition?
• Where do most pancreatic carcinomas occur?
• Initial resuscitation of a patient with toxic megacolon includes all of the following except
• Which factor predisposes to Clostridium difficile colitis?
• Which is the most common type of esophagitis?
• Familial adenomatous polyposis (FAP) is clinically defined by
• Which statement regarding carcinoembryonic antigen (CEA) and colorectal cancer is true?
• 65-year-old man with watery diarrhea after antibiotics; most likely cause?
• Which imaging modality is the gold standard for acute cholecystitis?
• A patient with a history of rectal abscesses now presents with a chronic perianal fistula. What is the most appropriate management?
• A hernia whose blood supply has been cut off is called
• For colorectal cancer, which statement about CEA as a screening test is true?
• Lactase enzyme breaks down lactose into which two monosaccharides?
• Which of the statements is false about diverticular disease?
• Kwashiorkor in infants is caused by which type of deficiency?
• Which is the most appropriate treatment for constipation-predominant irritable bowel syndrome?
• A 72-year-old man presents with abdominal distension, constipation, and vomiting. Abdominal X-ray shows dilated loops of colon with air-fluid levels. Which of the following is the most appropriate next step in the diagnosis?
• What is the most likely diagnosis given left lower quadrant pain, a palpable mass, and barium enema showing segmental spasm and muscular thickening with narrowing?
• Achalasia is characterized by decreased esophageal peristalsis and increased LES tone. Which pattern of dysphagia is most typical?
• In suspected acetaminophen overdose with signs of acute liver failure, what is the most appropriate initial management step?
• Which test helps distinguish inflammatory bowel disease from irritable bowel syndrome?
• Which may help prevent formation of new polyps in patients with polyps or colon cancer?
• Biopsy sampling sites for confirmation of celiac disease commonly include which portion of the small intestine?
• Which medication does not cause constipation?
• Which laboratory marker would be most helpful in supporting the diagnosis of acute appendicitis?
• The malabsorption in celiac disease is due to which of the following?
• Which of the following statements is not true concerning pancreatic carcinoma?
• The treatment of acute pancreatitis must include all of the following except
• Which of the following is not a complication of cholelithiasis?
• Where do most pancreatic carcinomas occur?
• Which histologic finding is most characteristic of celiac disease?
• Which medication would you give to treat someone with Candidal esophagitis?
• Diverticulitis most commonly occurs in which segment of the colon?
• A 45-year-old HIV-positive patient presents with one week of dysphagia; endoscopy shows small yellow-white plaques with surrounding erythema; PAS staining reveals yeast. What is the diagnosis?
• Which statement about proton pump inhibitors (PPIs) compared with H2 blockers is NOT an advantage?
• Acyclovir is primarily used to treat infections caused by which virus?
• Which statement about post-resection CEA is true?
• A 65-year-old man with sudden onset severe abdominal pain 10 minutes after eating and rectal bleeding; he reports noncompliance with medications. Physical examination shows pain that is out of proportion to the abdomen. What is the most likely diagnosis?
• Which condition serves as the precursor to esophageal adenocarcinoma in the setting of chronic GERD?
• Cullen's sign is a periumbilical ecchymosis associated with which condition?
• The most effective treatment for Achalasia is?
• Which precursor lesion is most commonly associated with progression to colorectal cancer?
• If red flag features are present in suspected IBS, which diagnostic procedure is commonly used to evaluate the colon?
• Which symptom is commonly used in diagnosing IBS according to the Rome criteria?
• Which treatment modality provides a potential cure for pancreatic cancer when indicated?
• Which laboratory finding supports a diagnosis of acute appendicitis?
• Postoperative ileus is most likely caused by which mechanism after major surgery?
• Which of the following is a complication of GERD?
• Quadruple therapy for H. pylori eradication typically includes which of the following?
• Which of the following is not a treatment modality for esophageal stricture?
• What percentage of the general population experiences daily GERD symptoms?
• Best next step to confirm portal hypertension in a cirrhotic patient with ascites?
• What is the standard treatment for localized stage II colon cancer?
• Adenocarcinoma of the esophagus is most likely to occur in which part of the esophagus?
• Murphy's sign is used in diagnosing which condition?
• Which of the following is the most likely diagnosis for a 26-year-old female with periumbilical pain migrating to the right lower quadrant, fever, anorexia, vomiting, and leucocytosis?
• Which of the following is not a component of Charcot's triad?
• Which of the following is NOT part of the diagnostic criteria for toxic megacolon?
• Surgical management for chronic mesenteric ischemia includes all of the following options; which is not appropriate?
• Which of the following is a common side effect associated with PPIs?
• Biopsy findings in celiac disease most consistent with villous atrophy would be which option?
• A 35-year-old man presents with rectal bleeding, mucoid discharge from the rectum, and protrusion of structures through the anal canal. Proctoscopic examination reveals large internal hemorrhoids. What is the best next step in management?
• Which sign is most commonly associated with acute cholecystitis?
• Which following is not a component of the TRIPLE THERAPY for H. pylori eradication?
• On MRCP, which finding is characteristic of Primary Sclerosing Cholangitis?
• A Schatzki ring typically causes dysphagia to which type of food?
• Which of the following is the most appropriate treatment for the patient described above?
• Which medication is considered the mainstay of therapy for mild to moderate inflammatory bowel disease?
• Which of the following is not a component of Reynolds pentad?
• The classic triad of pellagra includes all of the following except
• Which of the following statements is false about GERD?
• An elderly man with 3 months of progressive dysphagia from solids to liquids and weight loss most likely has esophageal cancer. What is the first-line diagnostic test?
• Rickets mechanism in a vegan infant with sun-limited exposure?
• Which physical finding is commonly associated with portal hypertension?
• Choledocholithiasis refers to which of the following?
• What type of hernia involves passage of intestine through the internal inguinal ring down the inguinal canal, may pass into the scrotum. Often congenital and will present before age one?
• Radiation therapy to the chest can cause which type of esophagitis?
• Which proton pump inhibitor requires caution in hepatic impairment?
• Which option is not commonly used to treat bleeding esophageal varices?
• A 56-year-old woman presents with a lump protruding from the anal opening. It was initially reducible, but is now irreducible. There is associated pain and itching, and bright-red blood on defecation. She has a history of chronic constipation. Perianal examination shows skin tags and a tender perianal mass covered with mucosa; there is no fissure. What is the most likely diagnosis?
• Which statement correctly describes an indirect inguinal hernia?
• Which imaging modality is best during an acute episode of diverticulitis?
• The gold standard test to confirm celiac disease is
• A patient with reflux reports regurgitation of small amounts of food back into the mouth and very foul-smelling breath. What do you suspect?
• 3-day history nonbloody watery stool with mild abdominal pain; most appropriate management?
• After identification and excision of an adenomatous polyp via routine colonoscopy, a follow-up colonoscopy should be scheduled in
• H. pylori infection is associated with which of the following conditions?
• A 35-year-old man presents with anal pain and bright red blood on toilet paper; posterior midline ulcer; diagnosis?
• Most common cause of acute liver failure in the United States?
• Which of the following is typically considered the first sign of iodine deficiency?
• The test with the highest sensitivity in diagnosis of appendicitis is
• Which laboratory finding is part of the diagnostic criteria for toxic megacolon?
• Palpable, non-tender gallbladder in a patient with jaundice is most strongly suggestive of pancreatic head cancer (Courvoisier sign). Which condition corresponds to this presentation?
• What lifestyle factor is most effective for MASLD management through weight loss?
• Which statement about irritable bowel syndrome is incorrect?
• Which drug is used to treat Cytomegalovirus (CMV) esophagitis?
• Eosinophilic esophagitis is often triggered by which type of antigens?
• Which tumor marker is elevated in liver cancer?
• Which endoscopic finding is characteristic of Candida esophagitis?
• Incarcerated hernia is defined as
• A patient presents with hematemesis after repeated retching during an alcohol binge. The most likely diagnosis is?
• Which of the following is not a pharmacological agent used in treating constipation?
• Which esophageal motility disorder presents with regurgitation of undigested food hours after meals?
• For moderate to severe gastroesophageal reflux disease, what is considered first-line pharmacologic therapy?
• Which lifestyle modification is recommended for GERD management?
• Which medication class should not be given to patients with toxic megacolon due to potential to worsen colonic motility?
• MASLD primary risk factor?
• In acute cholangitis with biliary obstruction, the definitive therapy to relieve obstruction is which procedure?
• A 60-year-old man with four weeks of dysphagia to solids and a history of GERD for over 20 years. What is the most likely diagnosis?
• A 40-year-old male with fatigue, pruritus, and jaundice. He has a history of ulcerative colitis. MRCP shows irregular narrowing and dilation of intrahepatic and extrahepatic bile ducts (beading). Which is the most likely diagnosis?
• In a patient with strong clinical suspicion of acetaminophen toxicity, should NAC be started before obtaining an acetaminophen level?
• For suspected esophageal cancer, which is listed as the first-line investigative modality in the provided material?
• Which IV meds combination is typically used to stop acute variceal bleeding?
• In a patient with signs of significant upper gastrointestinal bleeding, what is the most immediate management step?
• Which of the following is not a cause of upper gastrointestinal bleeding?
• The most common cause of esophageal stricture is?
• In the setting of toxic megacolon due to ulcerative colitis, which is the definitive management option?
• Which of the following is a risk factor for peptic ulcer disease?
• Which is the most common cause of gastritis?
• Anal fissures most commonly occur in which location?
• Which organism is the most common cause of acute cholangitis?
• Which vitamin deficiency is classically associated with pernicious anemia due to autoimmune intrinsic factor deficiency?
• Family members of those with familial polyposis syndrome should be evaluated
• Which feature is characteristic of Crohn disease?
• Which is the most common organic cause of constipation in children?
• Fullness in the epigastric region and a palpable mass in a patient with acute pancreatitis are most likely due to
• Which statement about GERD management is true?
• Which statement is accurate regarding vitamin A deficiency?
• Cystine stones are most commonly associated with which organ system?
• What is the hallmark sign of a strangulated hernia?
• In an otherwise healthy infant with a reducible umbilical hernia, what is the recommended management?
• A 25-year-old woman with 8 months of intermittent crampy lower abdominal pain, loose stools four times daily, pain worse during her menstrual period and relieved by defecation, bloating, and ongoing work-related stress, with no alarm features. What is the most likely diagnosis?
• A traveler who recently returned from abroad develops fever, RUQ pain, and jaundice; most likely cause?
• Plummer-Vinson syndrome is diagnosed by finding of which endoscopic feature?
• Which is the most clearly established risk factor for pancreatic cancer?
• Which condition is most closely associated with metabolic syndrome and hepatic steatosis in the absence of significant alcohol intake?
• A 26-year old lady presents with 11 months of recurrent epigastric pain worse when hungry, relieved by food and antacids. Most likely diagnosis?
• In familial polyposis syndrome, what is the recommended strategy to reduce colorectal cancer risk?
• Which of the following is NOT among the classic 6 F's risk factors for gallstones?
• Crohn's disease is associated with which finding?
• A 58-year-old woman presents after cesarean section with distension; what is the best next diagnostic step?
• In acetaminophen overdose, NAC is most effective when given within how many hours of ingestion?
• Concerning the patient described above, what is the grade of the hemorrhoidal condition?
• Which drug class is a common noninfectious cause of peptic ulcer disease?
• A 45-year-old woman with ulcerative colitis develops abdominal pain, vomiting, diarrhea with blood and mucus, fever. She is pale, febrile, dehydrated, tachycardic. Exam shows abdominal distension with hypoactive bowel sounds; Hb 9 g/dL, WBC 14 x 109/L, CRP elevated. Stool negative for C. difficile. Abdominal radiograph shows a dilated transverse colon of about 11 cm. What is the most likely diagnosis?
• A 60-year-old man with a history of rectal bleeding and change in bowel habits undergoes a colonoscopy, which reveals a mass in the ascending colon. What is the most appropriate next step in management?
• Deficiency of which vitamin leads to night blindness and conjunctival xerosis?
• Which statement best reflects the Rome IV criteria for irritable bowel syndrome diagnosis?
• Presence of antibodies to hepatitis B surface antigen and antibodies to hepatitis B core antigen indicates:
• Which statement about inflammatory bowel disease is not true?
• Which study is not mandatory before initiating treatment for HCV infection?
• PPI use has been associated with an increased risk of which infection due to reduced gastric acidity?
• Dunphy's sign is associated with which condition?
• Next recommended lifestyle modification for MASLD after dietary changes?
• Which medication is effective for constipation-predominant irritable bowel syndrome?
• Which of the following is not an extraintestinal manifestation of inflammatory bowel disease?
• Gallstones are classified into which type not included?
• Which laboratory test is described as the criterion standard for diagnosing vitamin A deficiency?
• Which treatment modality offers a cure for an esophageal tumor when indicated?
• PH monitoring with an intra-esophageal electrode is the gold standard for diagnosing GERD. True or False?
• MASLD statin therapy is primarily indicated to address which risk?
• Which statement best describes risk factors for colorectal cancer?
• A 60-year-old man with progressive dysphagia to solids only and a long history of GERD most likely has which type of esophageal cancer?
• A patient has negative celiac screening but dramatic symptom improvement after eliminating gluten. What is the best recommendation?
• Which of the following is not a risk factor for abdominal hernias?
• Which serologic pattern indicates acute hepatitis B infection?
• Which type of hepatitis is associated with a high infant mortality rate in pregnant women?
• Which noninvasive test is most appropriate to confirm Helicobacter pylori infection in a patient with dyspepsia and no prior eradication therapy?
• What is the most common cause of cirrhosis in the United States?
• Which of the following is not recognized as a symptom that supports the diagnosis of IBS according to the Rome criteria?
• Which statement best describes the pattern of pain in a duodenal ulcer?
• Deep palpation of the left iliac fossa causing pain in the right iliac fossa is which sign?
• In the immediate management of a patient with suspected acute cholangitis in the emergency department, which is inappropriate?
• Night blindness is a classic early symptom of deficiency in which vitamin?
• Which of the following is a treatment option after failure of conservative treatment for anal fissure?
• Charcot's triad includes which three findings?
• Which of the following is most sensitive and specific for detection of Helicobacter infections?
• Carcinoma of the colon most commonly originates in which of the following?
• Murphy's sign is classically positive in which condition?
• Which physical examination finding is most suggestive of acute cholecystitis?
• Which of the following cannot be the cause of chronic hepatitis infection in an otherwise healthy adult?
• A 72-year-old man with constipation and rectal bleeding has not had a colonoscopy for 10 years. What is the most appropriate next step in management?
• A 65-year-old man with months of dysphagia to solids and then to liquids and a history of tobacco and alcohol use most likely has which diagnosis?
• Chronic alcoholism is typically associated with deficiency of which vitamin?
• On day 7 of amoxicillin-clavulanate therapy, fulminant diarrhea; which is the treatment of choice?
• A 35-year-old female with fever and a tender, fluctuant mass near the anal verge; most appropriate next step?
• A 26-year-old mildly obese woman presents with a 2-month history of heartburn and a 2-week history of regurgitation. She uses alcohol and smokes occasionally. Which would you not advise her to do?
• In a patient with long-standing GERD and progressive dysphagia over about a year, the most likely diagnosis is?
• Which test is not a serologic test and is used to diagnose celiac disease rather than screen?
• Which of the following is not a risk factor for cholesterol gallstones?
• Which of the following best describes H. pylori?
• Esophageal varices are most likely due to portal hypertension from which condition?
• Which type of esophagitis is associated with atopy?
• Which of the following is a comprehensive non-surgical management for anal fissure?
• Which is the correct combination for triple therapy?
• Which enzyme is most specific for diagnosing acute pancreatitis?
• Which statement best describes the mechanism of Clostridium difficile colitis?
• Which feature best distinguishes Crohn disease from ulcerative colitis?
• Which procedure is best for diagnosing esophageal varices?
• In ascitic fluid analysis, which statement about SAAG is true?
• Which is most likely diagnosis for lactose intolerance after milk ingestion in a child?
• Which statement concerning femoral hernias is not true?
• Diverticulosis is a cause of which type of GI bleeding?
• Which of the following is the most appropriate next step in management for severe acetaminophen-induced liver failure with renal dysfunction and encephalopathy?
• Which sign is not associated with acute appendicitis?
• Which hepatitis can only occur alongside hepatitis B infection?
• In fat malabsorption, which vitamin will not be affected?
• Which serologic marker indicates vaccination-induced immunity to hepatitis B?
• Most appropriate initial treatment to control bleeding in esophageal varices with hypotension?
• Surgical treatment for complicated umbilical hernia is typically considered before which age?