PATHOLOGY: GIT QUIZ

1. A 25-year-old man presents with low-grade fever, weight loss, fatigue, crampy abdominal pain, episodic
diarrhea, and postprandial bloating. Right lower quadrant tenderness is felt on palpation of the abdomen. A
capsule endoscopy reveals thickening of the terminal ileum, edema, marked luminal narrowing, and a
cobblestone appearance of the mucosa. Which of the following is a characteristic of this condition?

 Answer: e. it can cause fistula formation between loops of affected bowel.

o Explanation: The patient's presentation is consistent with Crohn's disease, which can cause
fistula formation between loops of affected bowel.

2. A 34-year-old man comes to the office due to upper abdominal pain. The patient has vague discomfort that
happens mostly in the afternoon and at night and is partially relieved by food. He sometimes feels nauseated.
He has had no vomiting, black or bloody stools, or weight loss. The patient takes no prescription or over-the-
counter medications. Family history is negative for cancer. Upper gastrointestinal endoscopy reveals a small
ulcer with a clean base in the duodenal bulb. Biopsy of which of the following sites is most likely to
demonstrate the infectious agent responsible for this patient's current condition?

 Answer: b. Gastric antrum

o Explanation: Biopsy of the gastric antrum is most likely to demonstrate the presence of
Helicobacter pylori, the most common cause of duodenal ulcers.

3. A 30-year-old woman sees her physician because she has had diarrhea and fatigue and has noticed a 3-kg
weight loss over the past 6 months. On physical examination, she is afebrile and has mild muscle wasting,
but her motor strength is normal. Laboratory studies show no occult blood, ova, or parasites in the stool. A
biopsy specimen from the duodenum is obtained, and microscopic findings are reviewed. The patient is placed
on a special diet with no wheat or rye grain products. The change in diet produces dramatic improvement.
Which of the following microscopic features is most likely to be seen in the biopsy specimen?

 Answer: b. Villous blunting and flattening.

o Explanation: The patient's presentation is consistent with celiac disease, which is
characterized by villous blunting and flattening in the small intestine.

4. A 60-year-old man presents with hematemesis, melena, guaiac-positive stools, and signs of circulatory
collapse. He has a 20-year history of burning midepigastric pain and tenderness relieved by food, milk, or
antacids. In addition, he has been taking high doses of NSAIDs to relieve the pain of long-standing arthritis.
Esophagogastroduodenoscopy reveals a peptic ulcer in the upper duodenum. Which of the following is an
important association of duodenal peptic ulcer disease?

 Answer: e. H. pylori infection

o Explanation: The patient's presentation is consistent with duodenal peptic ulcer disease,
which is commonly associated with H. pylori infection.

5. A 45-year-old woman with long-standing rheumatoid arthritis complains of dry eyes and dry mouth. Bilateral
enlargement of the parotids is noted on physical examination. The syndrome described here is best described
as:

 Answer: d. Primary Sjogren syndrome.

o Explanation: The patient's presentation is consistent with primary Sjogren syndrome,
which is characterized by dry eyes, dry mouth, and enlargement of the parotid glands .
6. A 57-year-old woman has had burning epigastric pain after meals for more than 1 year. Physical examination
shows no abnormal findings. Upper gastrointestinal endoscopy shows an erythematous patch in the lower
esophageal mucosa. A biopsy specimen shows basal squamous epithelial hyperplasia, elongation of lamina
propria papillae, and scattered intraepithelial neutrophils with eosinophils. Which of the following is the most
likely diagnosis?

 Answer: b. Reflux esophagitis.

o Explanation: Reflux esophagitis is the likely diagnosis due to an erythematous patch in

the lower esophageal mucosa seen on endoscopy and basal squamous epithelial hyperplasia
with scattered intraepithelial neutrophils and eosinophils seen on biopsy, caused by
stomach acid irritation.

PATHOLOGY: GIT QUIZ FRIDAY 03/03/2023