Gastroenterology 1

A newborn infant has meconium ileus. Which of the following is the most likely underlying cause?

A 39-year-old white male presents to your office complaining of difficulty swallowing. He said that he first noticed the problem several years ago, but it has slowly worsened so that now he has problems swallowing both liquid and solid foods. He also complains of occasional regurgitation of undigested food, some chest burning and a nocturnal cough. He has not lost any weight. A barium swallow shows a bird’s beak tapering of the distal esophagus. Which of the following is the most likely diagnosis?

A 67-year-old obese man has a 1 month history of chronic hoarseness. In the past week he has awakened twice with acute wheezing. He has no dysphagia and has not regurgitated undigested food. Vital signs are normal. Examination of the lungs and heart is normal. Which of the following is the most likely diagnosis?

A 34-year-old male presents with a three-day history of worsening colicky right upper quadrant abdominal pain, which radiates to his right scapula. The patient’s history is positive for Crohn’s disease, but he has no other pertinent medical history. Physical exam reveals a positive Murphy’s sign. Which of the following is the preferred initial diagnostic imaging procedure for this patient?

A 21-year-old male complains of non-bloody diarrhea, abdominal pain and weight loss. The patient undergoes a barium enema which shows colonic areas with ulcerations alternating with normal colonic mucosa. There is no rectal pathology found. Which of the following is the most likely diagnosis?

A mother presents with her 10 day old daughter and states that the child has been vomiting after feeding for the past three days. The mother is concerned as the vomiting has become progressively worse and more forceful. She states that the baby is always hungry and wishes to eat. Which of the following is the most likely diagnosis?

A 27-year-old female presents complaining of anorexia, persistent nausea over the last month with epigastric pain exacerbated by food. She is presently most concerned by an episode of vomiting yesterday in which she vomited what she describes as ”coffee grounds”. The patient is a busy executive who denies any medical history, however states she has taken ibuprofen daily to help with stress headaches for the last 5 months. Which of the following is the most likely diagnosis?

A 32-year-old male presents the emergency room after four days of diarrhea. The patient reports persistent high fever, nausea, vomiting, abdominal discomfort and loose stools. The patient reports that he’s noted blood and mucus in his stool. His physical exam is grossly unremarkable other than diffuse abdominal pain which is mild on palpation. A complete blood count is obtained and reveals a mild leukocytosis. Which of the following is the most likely organism?

Which of the following is the most likely disorder in a child who is suffering diarrhea, weight loss, nutritional deficiency and abdominal bloating after eating bread and pasta?

A 17-year-old female with no previous medical history, presents complaining of right lower quadrant abdominal pain for the last six hours. She has been unable to eat, feels nauseous and vomited once. Exam finds right lower quadrant tenderness with guarding and positive bowel sounds. Her last period was 3 weeks ago and her pregnancy testing is negative. Complete blood count shows a white blood cell count of 18,000. She is noted to have a temperature of 102°F and a positive iliopsoas sign. Which of the following is the most likely diagnosis?

Pathology results on your patient revealed that numerous colon polyps were removed during a recent screening colonoscopy. For which of the following histologic types of polyps would a surveillance colonoscopy be recommended?

All of the following could be a likely gastrointestinal cause of iron deficiency anemia except?

A 42-year-old obese man arrives at the office complaining of an 8-month history of burning substernal pain that is worse 1 hour after meals and frequently wakens him from sleep. The pain is typically relieved by sitting up and taking over-the-counter ranitidine. Over the past 2 weeks, the pain has persisted despite over-the-counter treatment, and he now complains of regurgitation. Which of the following is a reasonable clinical intervention at this time?

A 37-year-old man recently diagnosed with acquired immunodeficiency syndrome is brought to the emergency department complaining of odynophagia, dysphagia, and severe retrosternal pain for 1 week. Endoscopic evaluation shows multiple large, superficial ulcers. Which of the following is the most likely diagnosis?

Which of the following factors is implicated in the pathogenesis of peptic ulcer disease?

A 48-year-old woman arrives at the office complaining of progressive dysphagia, substernal discomfort with eating, regurgitation of undigested food, and halitosis for 6 months. Barium esophagography shows esophageal dilation with a classic “bird’s beak” narrowing of the distal esophagus. Which of the following is the most likely diagnosis?

Which of the following is the pathologic agent responsible for causing antibiotic-associated colitis?

A 32-year-old woman, who is a nonsmoker, arrives at the office complaining of intermittent diarrhea, fecal urgency, and tenesmus during the past month. The patient states she has up to five bowel movements daily and describes the stool as loose with occasional red blood and mucus. She denies weight loss, abdominal pain, rectal intercourse, change in diet, or recent travel. On physical examination, a low-grade fever and pale mucus membranes are noted. The abdomen is soft and nontender, with red blood present on digital rectal examination. Which of the following is the most likely diagnosis?

Which of the following diagnostic studies is most useful in the evaluation of a patient in the acute stages of diverticulitis?

A 19-year-old man with a history of cystic fibrosis is brought to the emergency department complaining of a sudden onset of severe, boring epigastric pain that radiates to his back. The pain is aggravated by lying supine or walking and feels slightly better when he leans forward. He admits to vomiting four times in the past 2 hours. On physical examination, a low-grade fever, epigastric tenderness, bluish discoloration of the skin around the umbilicus, and decreased bowel sounds are noted. Which of the following is the most likely diagnosis?

A 10-year-old girl is brought into the clinic by her parents. She has been suffering from diarrhea and excessive flatulence after certain meals that include foods like breads, pastas, cereals, Her parents also report that she has begun to show signs of weight loss and her abdomen is slightly distended. Her stool is free of blood, she does not report any abdominal pain, and does not have a fever. Which diagnosis is the most likely to be correct given her symptoms?

A 58-year-old male patient with a history of cirrhosis arrives in the emergency room after he starts vomiting blood. The patient also reports lightheadedness, excessive thirst, and reduced urination. You diagnose him with esophageal varices. Which of the following would be the most likely form of treatment for this condition?

A 59-year-old male patient arrives at the clinic complaining of abdominal pain. Physical examination shows a herniation of the stomach through the diaphragm. He had no previous abdominal surgeries. Based on these findings, from which type of hernia is the patient suffering?

A 57-year-old female patient who recently quit smoking presents at the clinic with bloody, pus-filled diarrhea, abdominal cramping, and tenesmus. Examination reveals continuous inflammation of the colon. Based on this information, which of the following diagnoses is most likely to be correct?

Which of the following is the most common cause of appendicitis?

A 30-year-old male patient who smokes is suffering from abdominal cramping, bloody diarrhea, and a slight fever. Examination reveals areas of bowel inflammation, particularly around the terminal ileum and right colon. Based on this information, which of the following diagnoses is most likely to be correct?

Which of the following toxidromes would most likely be treated with gastric lavage?

A 38-year-old male patient is complaining of mild chest pain. He has recently experienced severe vomiting due to excessive alcohol consumption. Examination reveals a Mallory-Weiss tear in his esophagus. Which of the following treatments would likely be the most appropriate?

A 40-year-old female patient arrives at the clinic complaining of fatigue, malaise, and sudden weight loss. She presents with jaundice and pruritis. Examination shows hepatomegaly and splenomegaly. Based on the patient’s condition, which of the following diagnoses is most likely to be correct?

A 40-year-old male is suffering from an anorectal abscess causing anal swelling, erythema, and difficulty with defecation. Which of the following treatments would be most appropriate in this case?