Gastroenterology Medicine 15 Single Best Answer (SBA)
1. A 45-year-old man presents with burning epigastric pain that worsens with meals. He has a history of using NSAIDs regularly for chronic back pain. What is the most likely diagnosis?
Answer:
Explanation: Peptic Ulcer Disease typically presents with burning epigastric pain that is worse with meals, especially in patients using NSAIDs.
2. A 35-year-old woman presents with a history of frequent heartburn and regurgitation, especially after meals and when lying down. What is the most likely diagnosis?
Answer:
Explanation: Gastro-Oesophageal Reflux Disease (GORD) typically presents with heartburn and regurgitation, often worse after meals and when lying down.
3. A 60-year-old woman presents with a history of chronic constipation, abdominal bloating, and straining during bowel movements. What is the most likely diagnosis?
Answer:
Explanation: Chronic constipation typically presents with a history of infrequent bowel movements, straining, and bloating.
4. A 30-year-old man presents with severe abdominal pain that began around his umbilicus but has now moved to the right lower quadrant. He also has nausea, vomiting, and fever. What is the most likely diagnosis?
Answer:
Explanation: Appendicitis typically presents with pain that starts periumbilical and then localises to the right lower quadrant, along with nausea, vomiting, and fever.
5. A 55-year-old man presents with painless rectal bleeding and a change in bowel habits, including alternating constipation and diarrhoea. He has been treated for gastro-oesophageal reflux disease (GORD) in the past. What is the most likely diagnosis?
Answer:
Explanation: Rectal neoplasms typically present with painless rectal bleeding, a change in bowel habits, and possibly a feeling of incomplete evacuation.
6. A 25-year-old woman presents with crampy abdominal pain, bloating, and alternating diarrhoea and constipation. She has no weight loss or rectal bleeding. What is the most likely diagnosis?
Answer:
Explanation: Irritable Bowel Syndrome (IBS) typically presents with crampy abdominal pain, bloating, and alternating diarrhoea and constipation, without weight loss or rectal bleeding.
7. A 70-year-old man presents with severe abdominal pain, vomiting, and inability to pass gas or stool. He has a history of multiple abdominal surgeries. What is the most likely diagnosis?
Answer:
Explanation: Intestinal obstruction typically presents with severe abdominal pain, vomiting, and inability to pass gas or stool, especially in patients with a history of abdominal surgeries.
8. A 40-year-old man presents with severe right upper quadrant pain, fever, and jaundice. He has a history of gallstones. What is the most likely diagnosis?
Answer:
Explanation: Acute cholecystitis typically presents with severe right upper quadrant pain, fever, and a history of gallstones.
9. A 50-year-old woman presents with a long history of chronic hepatitis B infection and now has ascites, jaundice, and variceal bleeding. What is the most likely diagnosis?
Answer:
Explanation: Cirrhosis typically presents with complications like ascites, jaundice, and variceal bleeding in patients with chronic liver disease such as hepatitis B.
10. A 4-week-old infant presents with projectile vomiting after feeding, poor weight gain, and dehydration. What is the most likely diagnosis?
Answer:
Explanation: Pyloric stenosis typically presents in infants with projectile vomiting after feeding, poor weight gain, and signs of dehydration.
11. A 40-year-old man presents with severe right upper quadrant pain, fever, and jaundice. He has a history of gallstones. What is the most likely diagnosis?
Answer:
Explanation: Acute cholecystitis typically presents with severe right upper quadrant pain, fever, and a history of gallstones.
12. A 65-year-old woman presents with a long history of chronic hepatitis B infection and now has ascites, jaundice, and variceal bleeding. What is the most likely diagnosis?
Answer:
Explanation: Cirrhosis typically presents with complications like ascites, jaundice, and variceal bleeding in patients with chronic liver disease such as hepatitis B.
13. A 75-year-old man presents with severe abdominal pain, vomiting, and inability to pass gas or stool. He has a history of multiple abdominal surgeries. What is the most likely diagnosis?
Answer:
Explanation: Intestinal obstruction typically presents with severe abdominal pain, vomiting, and inability to pass gas or stool, especially in patients with a history of abdominal surgeries.
14. A 50-year-old woman presents with chronic heartburn, dysphagia, and unintentional weight loss. She has been treated for gastro-oesophageal reflux disease (GORD) in the past. What is the most likely diagnosis?
Answer:
Explanation: Oesophagus Neoplasms typically present with dysphagia, weight loss, and a history of chronic GORD.
15. A 45-year-old man presents with chronic hepatitis C infection and now has abdominal pain, weight loss, and an abdominal mass. What is the most likely diagnosis?
Answer:
Explanation: Hepatic neoplasms, such as hepatocellular carcinoma, often present with abdominal pain, weight loss, and an abdominal mass in patients with chronic liver disease.
Total Score: 0/15