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Which of the following is most likely in a 21-year-old man who has had continuous nasogastric suction for 4 days?
A 63-year-old man has ascites and peripheral edema due to advanced cirrhosis with portal hypertension. In addition to furosemide, addition of which of the following is most effective in promoting diuresis?
A 69 year-old female presents with tenesmus. Digital rectal exam reveals a firm fixed mass. What is your initial diagnosis?
The presence of which of the following serum antibodies is most likely to be noted in a patient who has primary biliary cirrhosis?
A 59-year-old man who takes no medication has ecchymoses on his body. The prothrombin time is abnormally prolonged. Which of the following is the most likely underlying disorder?
A patient presents to the office with difficulty swallowing solids and liquids. Which of the following disease processes would be in your differential diagnosis?
Six months after a surgical splenectomy, a 32-year-old man has the acute onset of generalized abdominal pain and fever. Peritonitis with bacteremia is diagnosed. Which of the following is the most likely infecting organism?
Peptic ulceration in Zollinger-Ellison syndrome is mainly due to excessive production of which of the following?
A 2-year-old girl ingested a calculator battery. A chest X-ray shows that the battery is in the esophagus at the level of the lower esophageal sphincter. What would be the most appropriate course of action to take at this time?
A 43-year-old woman has a 3 week history of worsening generalized pruritus. Examination shows only scratch marks scattered on the trunk and extremities. Serum alkaline phosphatase is elevated, but serum aminotransferases are normal. Which of the following is the most likely diagnosis?
A 75-year-old man complains of upper abdominal discomfort, anorexia, and a 15-lb unintentional weight loss over the past 4 months. Which of the following diagnostic studies is most appropriate in the management of this patient?
Which of the following hernias is best described as protrusion of intraperitoneal contents through the internal ring?
A 53-year-old man is brought to the office with complaints of constant right upper quadrant pain, weight loss, and “swelling” of his abdomen for 4 weeks. A CT scan of the abdomen demonstrates a right hepatic tumor. Which of the following is the correct tumor marker for this suspected cancer?
A 40-year-old man complains of painful defecation for 2 weeks. The patient has not defecated for 2 days due to the pain. He denies bleeding, pruritus, mass, or trauma. Physical examination discloses an afebrile patient with an anal skin tag without erythema, edema, bleeding, or palpable mass. However, rectal examination is incomplete due to the patient’s painful discomfort. Which of the following is the most likely diagnosis based on these findings?
A 22-year-old man presents to your office with complaints of increased stool frequency, sometimes bloody diarrhea, abdominal cramping, and weight loss. You refer him for further evaluation, and colonoscopy findings are consistent with normal mucosa, focal areas of ulcerations, and acute and chronic inflammation especially in the cecum and terminal ileum. Which of the following is the most likely diagnosis?
A 28-year-old man has complaints of intermittent, colicky, periumbilical, and lower quadrant pain for 24 hours. The patient admits to nausea and decreased appetite. He is afebrile. Which of the following is the most likely diagnosis?
Which of the following statements is true regarding acute appendicitis?
Which of the following is a clinical feature of gastrointestinal vascular ectasia?
The most effective drug for peptic ulcers induced by nonsteroidal anti-inflammatory drugs is:
Which of the following structures produces intrinsic factor?
A 44-year-old male with a history of alcoholism presents with forceful vomiting and hematemesis. Endoscopy reveals an esophageal tear at the gastroesophageal junction. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?
A 49-year-old patient presents with abdominal pain, distention, fever, and tachycardia. Physical exam reveals abdominal tympany. Abdominal X-ray reveals colonic distention, confirming a diagnosis of volvulus. Which of the following clinical procedures would you use to treat this disorder?
A 26-year-old female with history of diarrhea, steatorrhea, weight loss, and weakness has a positive small bowel biopsy for celiac disease. Which of the following treatments must this patient adhere to in order to avoid flare-ups from this disorder?
Which of the following gastrointestinal disorders is characterized by the twisting of any part of the bowel on itself, and normally involves the sigmoid or cecal area of the bowel?
Which of the following gastrointestinal disorders involves the invagination of a proximal segment of the bowel into the portion just distal to it?
A 29-year-old male presents with abdominal pain, diarrhea, low-grade fever, and fatigue. Colonoscopy and biopsy confirm the diagnosis of Crohn’s disease. Which of the following medications are indicated for maintenance of Crohn’s disease?
A 68-year-old male presents with abdominal pain, bloating, belching, weight loss, and intermittent gastrointestinal bleeding. Blood work reveals elevated serum chromogranin A, iron-deficiency anemia and elevated liver enzymes. Endoscopy reveals a neoplasm near the pylorus. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?
Which of the following treatment options is recommended for treatment of carcinoid tumor?
A 26-year-old female presents with diarrhea, weight loss, weakness, and abdominal distention. You suspect Celiac disease. Which of the following clinical procedures would you perform to confirm the diagnosis?
A 22-year-old male presents with left lower-quadrant pain, weight loss, fever, and pus-filled diarrhea. Abdominal X-ray reveals colonic dilatation. Colonoscopy confirms the diagnosis of ulcerative colitis. Which of the following medications are indicated for the maintenance of ulcerative colitis?