GIT MCQs (Gastrointestinal Tract)

A 65-year-old man presents with bright red rectal bleeding but is hemodynamically stable.

What is the most appropriate next step?

A 60-year-old man presents with progressive difficulty swallowing solids, then liquids. He has a 40-pack-year smoking history.

What is the most appropriate next step?

A 40-year-old man presents with acute upper GI bleeding. He has a history of liver cirrhosis. What is the first-line management?

A 45-year-old man presents with severe epigastric pain that radiates to his back. He has a history of chronic alcohol use. His serum amylase is markedly elevated.

What is the most likely diagnosis?

A 60-year-old man with long-term NSAID use presents with melena and epigastric pain.

What is the most likely diagnosis?

A 55-year-old man presents with progressive dysphagia to solids and weight loss over 3 months. A barium swallow shows a ‘bird’s beak’ appearance.

What is the most likely diagnosis?

A 65-year-old man presents with painless rectal bleeding and a change in bowel habits.

What is the most appropriate initial investigation?

A 50-year-old man with cirrhosis presents with confusion, asterixis, and elevated ammonia levels.

What is the most appropriate treatment?

A 40-year-old man presents with severe epigastric pain after a large meal. He has tachycardia, hypotension, and abdominal rigidity.

What is the next best step in management?

A 65-year-old man presents with painless jaundice, weight loss, and dark urine. His bilirubin and ALP are elevated.

What is the most likely diagnosis?

A 52-year-old woman presents with pruritus, fatigue, and hepatomegaly. Her ALP is significantly elevated, and anti-mitochondrial antibodies (AMA) are positive.

What is the most likely diagnosis?

A 35-year-old woman presents with right upper quadrant pain, fever, and jaundice. Her blood tests show leukocytosis and raised alkaline phosphatase. What is the most likely diagnosis?

A 70-year-old man with a history of chronic constipation presents with acute severe left lower quadrant pain, fever, and leukocytosis.

What is the most likely diagnosis?

A 50-year-old man presents with severe vomiting followed by hematemesis. An endoscopy reveals a linear tear at the gastroesophageal junction.

What is the diagnosis?

A 50-year-old woman presents with jaundice, pruritus, and fatigue. Her ALP is significantly elevated, and anti-mitochondrial antibodies (AMA) are positive. What is the most likely diagnosis?

A 45-year-old man presents with progressive dysphagia to solids and liquids, weight loss, and iron deficiency anemia.

What is the most likely diagnosis?

A 28-year-old woman with Crohn’s disease presents with severe abdominal pain, fever, and tachycardia. CT scan shows dilated loops of the small bowel with air-fluid levels.

What is the most likely complication?

A 35-year-old woman presents with chronic watery diarrhea that persists even when fasting.

What is the most likely cause?

A 70-year-old woman presents with postprandial abdominal pain and weight loss. A Doppler ultrasound shows mesenteric artery stenosis.

What is the most likely diagnosis?

A 30-year-old man presents with abdominal pain, diarrhea, and perianal fistulas.

What is the most likely diagnosis?

A 55-year-old man with a history of chronic alcohol use presents with severe epigastric pain radiating to the back. His serum lipase is elevated.

What is the best initial management?

A 60-year-old man presents with progressive jaundice, weight loss, and a palpable, non-tender gallbladder.

What is the most likely diagnosis?

A 45-year-old woman presents with severe epigastric pain that worsens after fatty meals. An ultrasound shows gallstones but no bile duct dilation.

What is the most likely diagnosis?

A 24-year-old man presents with severe periumbilical pain that later shifts to the right lower quadrant. He has nausea and fever.

What is the most likely diagnosis?

A 28-year-old woman presents with bloody diarrhea, abdominal pain, and urgency for the past 4 weeks. She has no travel history.

What is the most likely diagnosis?

A 30-year-old man with ulcerative colitis presents with abdominal distension, fever, tachycardia, and hypotension. An abdominal X-ray shows colonic dilation >6 cm.

What is the most likely diagnosis?

A patient presents with jaundice, abdominal pain, and an enlarged gallbladder. What is the most likely cause?

A 28-year-old man presents with dysphagia, weight loss, and multiple esophageal ulcers on endoscopy. He has a history of HIV.

What is the most likely cause?

A 70-year-old man with chronic constipation presents with sudden onset left lower quadrant pain and fever.

What is the most likely diagnosis?

A 60-year-old man with a history of Barrett’s esophagus presents with progressive dysphagia to solids. He has lost 5 kg in the past month.

What is the most likely diagnosis?

A 35-year-old woman presents with intermittent diarrhea, bloating, and weight loss. Her symptoms worsen after eating bread or pasta.

What is the most likely diagnosis?

A patient with cirrhosis is diagnosed with spontaneous bacterial peritonitis (SBP). What is the first-line treatment?

A patient with suspected acute pancreatitis has a serum amylase level of 120 U/L (normal: 25-125).

What is the best next step?

A 30-year-old woman with long-standing GERD presents with new-onset dysphagia and weight loss.

What is the most appropriate next step?