Q.1 Which of the following is the most common cause of peptic ulcer disease?
Stress
Helicobacter pylori infection
NSAID use
Smoking
Explanation - Helicobacter pylori infection is the most common cause of peptic ulcer disease, followed by NSAID use. Stress and smoking are risk factors but less direct causes.
Correct answer is: Helicobacter pylori infection
Q.2 A 45-year-old man presents with jaundice, pruritus, and dark urine. Which laboratory test is most useful initially?
Serum amylase
Liver function tests
Urine ketones
Serum creatinine
Explanation - Liver function tests help evaluate bilirubin levels and liver enzyme abnormalities, which are key in assessing jaundice.
Correct answer is: Liver function tests
Q.3 Which part of the gastrointestinal tract is most commonly affected by Crohn’s disease?
Stomach
Duodenum
Terminal ileum
Rectum
Explanation - Crohn’s disease can affect any part of the GI tract, but the terminal ileum is most commonly involved.
Correct answer is: Terminal ileum
Q.4 What is the most common cause of acute pancreatitis?
Gallstones
Alcohol
Trauma
Hyperlipidemia
Explanation - Gallstones are the most common cause of acute pancreatitis, followed by chronic alcohol use.
Correct answer is: Gallstones
Q.5 A patient presents with difficulty swallowing both solids and liquids from the onset. Which condition is most likely?
Achalasia
Esophageal cancer
Esophageal stricture
GERD
Explanation - Achalasia causes difficulty swallowing both solids and liquids due to failure of the lower esophageal sphincter to relax.
Correct answer is: Achalasia
Q.6 Which of the following is the gold standard for diagnosing celiac disease?
Barium swallow
Duodenal biopsy
Serum amylase
Colonoscopy
Explanation - Duodenal biopsy showing villous atrophy confirms celiac disease after positive serology.
Correct answer is: Duodenal biopsy
Q.7 Which hepatitis virus is transmitted mainly through contaminated water?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Explanation - Hepatitis A spreads through the fecal-oral route, often via contaminated food or water.
Correct answer is: Hepatitis A
Q.8 What is the first-line treatment for mild ulcerative colitis?
Corticosteroids
Azathioprine
Mesalamine
Infliximab
Explanation - Mesalamine (5-ASA) is the first-line treatment for mild to moderate ulcerative colitis.
Correct answer is: Mesalamine
Q.9 Which vitamin deficiency is common in chronic alcoholics leading to Wernicke’s encephalopathy?
Vitamin B1 (Thiamine)
Vitamin B12
Vitamin D
Vitamin K
Explanation - Chronic alcoholics often have thiamine deficiency, leading to Wernicke’s encephalopathy.
Correct answer is: Vitamin B1 (Thiamine)
Q.10 A 60-year-old man with a history of chronic GERD is at risk for which premalignant condition?
Barrett’s esophagus
Peptic stricture
Esophageal varices
Hiatal hernia
Explanation - Chronic GERD can cause Barrett’s esophagus, a premalignant condition predisposing to adenocarcinoma.
Correct answer is: Barrett’s esophagus
Q.11 Which test is most sensitive for detecting small amounts of upper GI bleeding?
Endoscopy
CT scan
Fecal occult blood test
Ultrasound
Explanation - The fecal occult blood test can detect small, non-visible amounts of GI bleeding.
Correct answer is: Fecal occult blood test
Q.12 Which bacteria is most associated with gastric cancer?
E. coli
H. pylori
Shigella
Salmonella
Explanation - H. pylori infection increases the risk of gastric adenocarcinoma and MALT lymphoma.
Correct answer is: H. pylori
Q.13 A 22-year-old woman with chronic constipation and bloating is most likely suffering from:
Ulcerative colitis
Irritable bowel syndrome
Crohn’s disease
Colon cancer
Explanation - IBS often presents in young women with constipation, bloating, and abdominal pain without structural abnormalities.
Correct answer is: Irritable bowel syndrome
Q.14 What is the most common complication of liver cirrhosis?
Hepatocellular carcinoma
Esophageal varices
Splenic rupture
Gallstones
Explanation - Portal hypertension in cirrhosis leads to esophageal varices, a major complication with life-threatening bleeding.
Correct answer is: Esophageal varices
Q.15 Which of the following is a feature of irritable bowel syndrome (IBS)?
Bloody stools
Weight loss
Chronic abdominal pain relieved by defecation
Nocturnal diarrhea
Explanation - IBS typically presents with abdominal pain relieved after defecation and altered bowel habits without alarm features like bleeding or weight loss.
Correct answer is: Chronic abdominal pain relieved by defecation
Q.16 What is the most common site of diverticulosis?
Cecum
Ascending colon
Sigmoid colon
Transverse colon
Explanation - Diverticulosis most commonly affects the sigmoid colon due to high intraluminal pressure.
Correct answer is: Sigmoid colon
Q.17 Which of the following is a known risk factor for hepatocellular carcinoma?
Hepatitis B infection
GERD
Celiac disease
Gallstones
Explanation - Chronic hepatitis B and C infections, along with cirrhosis, are strong risk factors for hepatocellular carcinoma.
Correct answer is: Hepatitis B infection
Q.18 Which enzyme is most specific for diagnosing acute pancreatitis?
Amylase
Lipase
AST
LDH
Explanation - Serum lipase is more specific than amylase for diagnosing acute pancreatitis.
Correct answer is: Lipase
Q.19 Which inflammatory bowel disease is associated with continuous colonic involvement?
Crohn’s disease
Ulcerative colitis
Celiac disease
Irritable bowel syndrome
Explanation - Ulcerative colitis typically shows continuous mucosal inflammation starting from the rectum and extending proximally.
Correct answer is: Ulcerative colitis
Q.20 Which is the most common cause of lower gastrointestinal bleeding in the elderly?
Diverticulosis
Hemorrhoids
Polyps
Colon cancer
Explanation - Diverticulosis is the leading cause of painless lower GI bleeding in older adults.
Correct answer is: Diverticulosis
Q.21 Which drug is most likely to cause drug-induced hepatitis?
Acetaminophen
Ibuprofen
Aspirin
Omeprazole
Explanation - Acetaminophen overdose is a well-known cause of acute liver failure and drug-induced hepatitis.
Correct answer is: Acetaminophen
Q.22 A patient with cirrhosis develops confusion, asterixis, and disorientation. What is the most likely diagnosis?
Hepatic encephalopathy
Stroke
Meningitis
Epilepsy
Explanation - These neurological symptoms in cirrhosis are due to hepatic encephalopathy caused by ammonia accumulation.
Correct answer is: Hepatic encephalopathy
Q.23 Which of the following is the most effective treatment for acute variceal bleeding?
Propranolol
Octreotide
Endoscopic band ligation
Lactulose
Explanation - Endoscopic band ligation is the preferred treatment for controlling acute variceal bleeding.
Correct answer is: Endoscopic band ligation
Q.24 Which condition presents with “skip lesions” on colonoscopy?
Ulcerative colitis
Crohn’s disease
Celiac disease
Ischemic colitis
Explanation - Crohn’s disease shows patchy inflammation with skip lesions, unlike the continuous involvement of ulcerative colitis.
Correct answer is: Crohn’s disease
Q.25 What is the first-line eradication therapy for H. pylori infection?
Dual therapy
Triple therapy with PPI + clarithromycin + amoxicillin
Steroids
Antacids
Explanation - The standard first-line treatment is triple therapy including a proton pump inhibitor, clarithromycin, and amoxicillin (or metronidazole if allergic).
Correct answer is: Triple therapy with PPI + clarithromycin + amoxicillin