Gastroenterology Practice Questions
Gastroenterology tests inflammatory bowel disease workup, ulcerative colitis treatment escalation, and colorectal cancer surveillance, which is high-yield on the MCCQE, USMLE Step 2 CK, and PLAB. These four sample questions come from MediLingo's bank of 3,900+ questions across 23 specialties.
Sample questions
Question 1
What is the role of fecal calprotectin in IBD?
a) It definitively diagnoses IBD without the need for endoscopic evaluation
b) It is a non-invasive marker of intestinal inflammation ✓ Correct
c) It distinguishes Crohn's disease from UC based on specific antibody patterns
d) It is a stool pathogen detection test for identifying bacterial causes
Key teaching point: Fecal calprotectin: non-invasive marker of gut inflammation. Elevated in IBD, normal in IBS. Useful for monitoring activity and relapse prediction.
Question 2
What is first-line therapy for mild-to-moderate ulcerative proctitis?
a) Oral corticosteroids for induction of remission
b) Rectal 5-ASA suppositories or enemas ✓ Correct
c) Infliximab for induction of remission
d) Proctocolectomy with ileal pouch-anal anastomosis for definitive treatment
Key teaching point: Mild UC: topical 5-ASA for proctitis. Oral 5-ASA for extensive disease. Add steroids if inadequate. Step up to biologics if refractory.
Question 3
A patient with severe UC is on IV hydrocortisone for 5 days with no improvement. What is the next step?
a) Continue IV steroids at the same dose for an additional 2 weeks
b) IV cyclosporine or infliximab → colectomy if no response ✓ Correct
c) Transition to oral 5-ASA therapy for outpatient management
d) Add high-dose probiotics for gut flora restoration and mucosal healing
Key teaching point: Severe UC rescue: IV cyclosporine or infliximab after 3-5 days of IV steroid failure. If no response → colectomy. Oxford criteria predict steroid failure.
Question 4
When should colonoscopy surveillance for colorectal cancer begin in a patient with UC pancolitis?
a) At the time of pancolitis diagnosis during the initial colonoscopy
b) 8 years after symptom onset ✓ Correct
c) 20 years after initial diagnosis of pancolitis
d) When the patient develops symptoms suggestive of colorectal cancer
Key teaching point: CRC surveillance: colitis proximal to rectum → start 8 years after symptom onset. PSC → annually from diagnosis. Multiple biopsies with chromoendoscopy.
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