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GI Pathology Exam 2024 | QUESTIONS with 100% Solutions
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GI Pathology Exam 2024 | QUESTIONS with 100%Solutions
A 56-year-old male with a remote history of intravenous drug use presents to an initial
visit complaining of increased abdominal girth but denies jaundice. He drinks about 2 to
4 glasses of wine with dinner and recalls having had abnormal liver enzymes in the past.
Physical exam reveals telangiectasias, a palpable firm liver, mild splenomegaly, and
shifting dullness consistent with the presence of ascites. Liver function is found to be
deranged with elevated aminotransferases (AST: 90 U/L, ALT: 87 U/L), and the patient is
positive for anti-hepatitis C antibody. - Ans Cirrhosis
A 60-year-old woman with a past medical history of obesity, diabetes, and
dyslipidemia is noted to have abnormal liver enzymes with elevated aminotransferases
(ALT: 68 U/L, AST: 82 U/L), and normal alkaline phosphatase and bilirubin. She denies
significant alcohol consumption, and tests for viral hepatitis and autoimmune markers
are negative. An abdominal ultrasound reveals evidence of fatty infiltration of the liver
and slight enlargement of the spleen. - Ans Cirrhosis
A 46-year-old obese woman presents with a 6-hour history of moderate steady pain in
the RUQ that began after eating dinner and radiates through to her back. This pain
gradually increased before becoming constant over the last few hours. She has had
previous episodes of similar pain for which she has not sought medical advice. Her vital
signs are normal. The pertinent findings on physical exam are tenderness to palpation in
the right upper quadrant without guarding or rebound. - Ans Cholelithiasis
, A 20-year-old obese woman with a 2-year history of gallstones presents to the
emergency department with severe, constant RUQ pain, nausea, and vomiting after
eating fried chicken for dinner. She denies any chest pain or diarrhea. Three months
ago she developed intermittent, sharp RUQ pains. On physical exam she has a
temperature of 100.4°F (38ºC), moderate RUQ tenderness on palpation, but no
evidence of jaundice. - Ans Cholecystitis
A 53-year-old man presents to the emergency room complaining of severe mid-
epigastric abdominal pain that radiates to the back. The pain improves when the
patient leans forward or assumes the fetal position and worsens with deep inspiration
and movement. He also complains of nausea, vomiting, and anorexia, and gives a
history of heavy alcoholic intake this past week. He is tachycardic, tachypneic, and
febrile with hypotension. He is slightly agitated and confused. He is diaphoretic with
decreased breath sounds over the base of the left lung. - Ans Acute Pancreatitis
A 47-year-old overweight woman is admitted with generalized abdominal pain. She has
been unable to eat or drink due to nausea and vomiting. She states the pain started in
the right upper quadrant, similar to previous episodes that she had been to the
emergency room with over the past few months. An ultrasound obtained on her last
visit to the emergency room revealed gallstones with no inflammation of the
gallbladder, and she was told that she should see a surgeon. She looks jaundiced and in
distress. She has point tenderness under her ribs on the right, which is worsened with
deep palpation. No mass is palpable. - Ans Acute Pancreatitis
A 41-year-old alcoholic man has a 6-year history of recurrent attacks of pancreatitis
characterized by epigastric pain radiating to the back. The initial attack required
hospitalization for severe pain, and clinical chemistry showed a >15-fold elevation in
serum amylase and lipase. Subsequent attacks were less severe, managed primarily as
an outpatient, and lasted less than 10 days, with long symptom-free intervals. After
detoxification 6 months ago he had no further attacks, but has recently developed
evidence of diabetes and steatorrhea. CT imaging shows pancreatic calcifications but
no cystic or mass lesions. - Ans Chronic Pancreatitis
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