GI & Hepatic Symptoms — General Medicine

GI & Hepatic Symptoms MCQs: practice questions

Sample GI & Hepatic Symptoms multiple-choice questions from General Medicine.

1. A patient with chronic diarrhea develops weakness and weight loss. Which nutritional consequence is particularly likely if the small intestine is extensively affected?

   • A. Increased albumin synthesis
   • B. Iron overload
   • C. Multiple micronutrient deficiencies
   • D. Hypervitaminosis from malabsorption
   • E. Increased body mass

2. A patient with chronic liver disease develops confusion and asterixis. Which complication is most likely?

   • A. Diverticulitis
   • B. Achalasia
   • C. Hepatic encephalopathy
   • D. Acute appendicitis
   • E. Cholelithiasis

3. A patient has severe abdominal pain radiating to the back with elevated pancreatic enzymes. Which pathologic process is most likely?

   • A. Diverticulosis
   • B. Chronic cholecystitis
   • C. Ulcerative colitis
   • D. Acute pancreatitis
   • E. Esophageal carcinoma

4. A patient has recurrent episodes of jaundice caused by red-cell destruction. Which bilirubin fraction is expected to predominate?

   • A. Unconjugated bilirubin
   • B. Bile acids only
   • C. Conjugated bilirubin only
   • D. Urobilinogen deficiency
   • E. Direct alkaline phosphatase

5. A patient with hepatitis develops chronic liver injury and progressive fibrosis. Which cell type is central to hepatic fibrogenesis?

   • A. Kupffer cells only
   • B. Pancreatic acinar cells
   • C. Bile duct epithelial cells only
   • D. Colon goblet cells
   • E. Hepatic stellate cells

6. A patient with chronic diarrhea has PAS-positive macrophages in the small-intestinal lamina propria. Which diagnosis is most likely?

7. A patient has long-standing ulcerative colitis and develops worsening diarrhea with blood. Which complication is particularly important to monitor over time?

8. A patient with chronic liver disease develops edema and ascites. Which plasma protein abnormality contributes to the edema?

9. A patient with pancreatic head carcinoma develops painless jaundice. Which anatomic process best explains the symptom?

10. A patient has chronic diarrhea, abdominal pain, and skip lesions involving the terminal ileum. Which diagnosis is most likely?

11. A patient with persistent vomiting develops metabolic alkalosis. Which mechanism contributes to the acid-base disturbance?

12. A patient with painless progressive jaundice and weight loss has a palpable gallbladder. Which process should be suspected?

13. A patient with chronic pancreatitis develops bulky, greasy stools and weight loss. Which mechanism best explains the diarrhea?

14. A patient with gallstones develops episodic right upper quadrant pain after fatty meals. Which condition is most likely?

15. A patient with Crohn disease has chronic diarrhea and abdominal pain. Which complication is characteristic of transmural intestinal inflammation?

16. A patient has diarrhea with blood, mucus, and urgency. Which pathologic process is most consistent with this pattern?

17. Which type of bilirubin is more likely to accumulate when hepatocytes cannot efficiently excrete conjugated bilirubin into bile?

18. A patient develops watery diarrhea after broad-spectrum antibiotic therapy. Which pathologic process is most likely?

19. A patient with long-standing constipation develops abdominal discomfort and altered bowel habits. Which structural lesion is associated with chronic constipation in older adults?

20. A patient with celiac disease has chronic diarrhea and iron-deficiency anemia. Which intestinal site is most relevant to the anemia?

21. A patient with cirrhosis develops a prolonged prothrombin time. Which mechanism best explains this finding?

22. A patient with jaundice has markedly elevated alkaline phosphatase compared with aminotransferases. Which pattern is most suggestive?

23. A patient with chronic alcohol use develops jaundice and hepatomegaly. Which histologic feature supports alcoholic hepatitis?

24. A patient has progressive jaundice, dark urine, and pale stools from extrahepatic obstruction. Which mechanism explains the pale stool?

25. A patient has severe chronic liver disease with ascites. Which mechanism contributes most directly to the fluid accumulation?

26. A patient with a history of hepatitis B develops hepatocellular carcinoma. Which risk factor strongly promotes this malignancy?

27. A patient with cirrhosis develops hematemesis from esophageal varices. What is the underlying cause?

28. A patient has chronic constipation and iron-deficiency anemia without an obvious source of bleeding. Which diagnosis must be considered?

29. A patient develops chronic watery diarrhea after extensive small-intestinal disease. Which consequence is most likely?

30. A patient with chronic inflammatory bowel disease develops toxic megacolon. Which underlying disease is most strongly associated with this complication?